Rethinking the future of global health

Sixteen countries (with more to come) in 2025 partnered with the World Bank to develop national health compacts, five-year roadmaps designed to expand access to quality, affordable health care and create millions of jobs. The compacts serve as strategic roadmaps to align resources across domestic and external sources, including the private sector, galvanize political leadership, and promote accountability for delivering results.

At the global level, several processes kicked off during 2025 – 2026 to reimagine the future of the global health architecture. They include:

WHO and UN80 Initiative

In February 2026, the Executive Board of the World Health Organization requested the Director-General, in close collaboration with, and under the direction of, Member States, in a transparent and inclusive manner, to design a proposal on a joint, WHO-hosted process that brings together and complements current global health architecture and UN80 discussions to facilitate convergence and consensus-building, in order to support the transformation of the current global health architecture, enhance coordination and leverage the comparative advantages of diverse actors, while being responsive to country needs and realities.

WHO was requested to submit the proposal for the consideration of the World Health Assembly in May 2026.

Read the full decision here: Reform of the global health architecture and the UN80 Initiative

Accra Reset

Launched by the President of Ghana, H.E. John Mahama, in the sidelines of the 80th United Nations General Assembly, the Accra Reset is an Africa-led initiative calling for a reimagined global health order that empowers nations to lead resilient and self-sustaining health responses. A Global Presidential Council – a coalition of heads of state and government from around the world – will provide political leadership to drive the Accra Reset’s agenda. The Accra Reset builds on the outcomes of the 5 August Africa Health Sovereignty Summit hosted by President Mahama in Accra that agreed that Africa must move from aid dependency to self-determination and fleshed out a process for reimagining a global health governance architecture in which Africa shares power and accountability.

European Union/Like-minded Donors Reflection Process

The European Union and Like-Minded (EU/LM) Donors’ Reflection Process on Reform of the Global Health Architecture was initiated in June 2025 by the European Commission’s Directorate General for International Partnerships (DG INTPA) to enable 11 European Union Member States (EU MS) and five aligned countries to facilitate the identification and discussion of options around how they might jointly advance global health architecture reform in the context of declining development assistance for health (DAH). The process of elaborating reform ideas and options engaged almost 500 stakeholders using several consultation methods.

Consultations identified urgent reform needs in several functional areas. As a result of these inputs, as well as through advice from an Expert Group and the donor Reference Group, reform options at the country, regional and global level are proposed within five priority areas:

Normative guidance and standard setting
Financing and resource mobilisation
Market shaping, procurement and equitable access
Data analytics, surveillance and early warning
Coordination, accountability and governance.

The donor reflection process report, published in February 2026, outlines how to move beyond content to the process for driving forward global health architecture reform through an inclusive, legitimate, global reform approach. Effective reform requires securing senior political leadership from both LMIC and donor countries, ensuring LMICs genuinely lead and co-create reform, enlisting bold reform champions at political level willing to drive radical change, streamlining parallel reform efforts, maintaining momentum through concrete action and visibility, adequately resourcing implementation and establishing robust accountability mechanisms from the start. Reform should insist on making substantial progress during 2026 through an inclusive, legitimate global process, that builds on and brings together existing reform initiatives and is able to consider concrete reform options, make decisions and ensure their timely implementation.

Read the report here.

HEAR CSO (Health Architecture Reimagined – Civil Society Organizations)

A civil society consortium led by WACI Health that includes the NCD Alliance, UHC2030 CSEM, ITPC, GNP+, StopAIDS UK and GFAN aims by July 2026 to ensure that civil society and communities are supported to develop and articulate their visions for the future of the global health ecosystem, including through existing and new processes looking at reforming the global health ecosystem to become more inclusive, equitable, and responsive to their needs. The process includes global, regional and national consultations as well as mapping and analysis of existing literature.

Check the HEAR CSO website for updates.

Sevilla Platform for Action – Global Health

A part of the Sevilla Platform for Action (SPA) launched at the IV International Conference on Financing for Development (FFD4), the initiative “Towards a Renewed Global Health Ecosystem: Navigating Challenges and Opportunities for Financing Inclusive, Resilient, and Sustainable Health Systems” aims to reform the global health architecture to be more cohesive, country-led, and aligned with sustainable financing strategies. This initiative, which builds on the Lusaka Agenda and ongoing reform dialogues, proposes a shared roadmap to strengthen health system resilience and equity without creating new mechanisms or institutions.

The initiative is structured around two key areas of action:

Inviting relevant organizations and global health initiatives to propose concrete ideas of reform aimed at improving coherence, agility, efficiency, maximizing impact, strengthening collaboration, avoiding overlapping and fragmentation and supporting partner countries leadership with a view to presenting a joint reform roadmap by early 2026 with an accountability mechanism to the Boards.
Renewing countries’ intention to support a restructured, more agile and coordinated global health ecosystem, with an emphasis on promoting universal health coverage through inclusive, resilient and sustainable national health systems.

Wellcome

Significant changes to the global health system are now inevitable. It is not a question of if the system will change. It is a question of when, in which direction and who shapes this future system.

That’s why from August to November 2025, Wellcome supported regional partners to lead five dialogues where stakeholders from over 114 countries discussed global health reform.

Dialogues involved consultations, in-person convenings and engaging governments, civil society and other actors to discuss global health priorities and how to make reform a reality.

Wellcome in March 2026 published a synthesis paper capturing insights and outcomes from these dialogues, making use of reports published by each of their regional partners. These include the key areas of global health most in need of reform, where regional priorities align or diverge, and common recommendations that emerged.

Read the paper here: The way forward for the global health system | Reports | Wellcome