Building new bridges to overcome contradictions in global health

From coffee breaks to side events and sessions, the conversations at this year’s World Health Summit (WHS) reflected the turbulence and profound transformations shattering official development aid and reshaping international and national activities to improve health globally. Long-held beliefs and approaches are changing rapidly, and it is becoming increasingly clear that the most vulnerable communities and regions of the world will bear the heaviest and immediate burden. It is also clear that this development poses risks to all countries worldwide and requires a fundamentally new way to interact, cooperate and address health challenges.  

Yet at the very moment when cooperation and greater commitments to health are required due to climate change and other global threats, more and more states are retreating from those responsibilities. This situation is a great challenge to high-level international gatherings such as COP30 and the G20 summit, which should serve as critical spaces for collective action for humanity’s most urgent challenges.

In the current global environment, policymakers must address the fact that common principles that once underpinned major global health advances are increasingly being challenged.

• International cooperation as a strategy has become less popular, often regarded as a threat to national
  sovereignty. 
• International solidarity is increasingly perceived to drain public funds and to compete with national
  development and interests.
• Protecting the climate and investing in health on a global scale are portrayed as threatening or even hindering national prosperity and economic development.  

These are false contradictions. They stem from a narrow analysis of an increasingly complex situation – omitting the fact that our habitat, the planet and the biosphere, but also our economies and societies are highly connected. False contradictions are used and promoted by critical actors in the political and industrial domains to protect and develop their business models. Nationalistic movements promise their people a bigger share of the ‘cake’ by neglecting the need to cooperate in a meaningful way at the global level. Ironically, in doing so, they cause the entire ‘cake’ to shrink and in the long run their people and the global community will lose in absolute terms. 

Let’s compare the situation for health with international flight control: No country leaves the International Civil Aviation Organization (ICAO) as its benefits are well recognized. All states found effective solutions to align international aspects of air travel with their national authorities and sovereignty. They all acknowledge the necessity for the safety of their own citizens and prosperity. This applies in a similar way to health issues and climate change. As we all know well enough – they are international in nature, to the same degree as air travel.   

Prosperity and multilateralism are not mutually exclusive; in fact, they reinforce each other. If we want international cooperation to be successful – and that means securing a healthy life for current and future generations – we need to clearly refute these false contradictions and show that transparent and fair international cooperation is in the best interest of all countries and their populations.  

We cannot waste time and effort on international gatherings such as G20 if they are only used to reiterate and corroborate the opposing viewpoints at both sides of the river. What is missing are bridges – compromises or even the infamous ‘deals’. This is not only about emphasizing the interconnectedness of our world, which should naturally call for stronger multilateral action. It is also about recognizing that these seemingly overwhelming challenges, such as climate change, present significant opportunities if we move together. 

Take pandemic preparedness, for example: a pandemic only ends when it ends everywhere. Addressing it collectively benefits us all. In funding and implementing scientific knowledge and resilient health systems, we protect lives and spark innovation that creates new technologies, industries, and jobs. 

To overcome false contradictions people must be involved and informed from the beginning, to see for themselves that national prosperity depends on international cooperation, international solidarity can ultimately strengthen national interests, and
climate protection as well as health investments are key drivers of long-term prosperity.

The question remains: What can the G20 achieve and where are its limitations? The G20 summit, in contrast to other international fora, does not offer participation mechanisms, a standing secretariat or a rules-based system. What matters is not only who sits at the table, but also who has never been invited to participate. The G20 will always remain an exclusive format. Democratic participation needs to take place through other channels. 

Yet even within these boundaries, this year’s G20 summit still offers an opening: an opportunity to build new bridges to overcome contradictions and find new consensus to push global health efforts forward. We need to consider the foundations the G20 can lay, and how we carry this forward into sustainable, long-term international cooperation.

Importantly, this work does not end with the G20 summit. For global health, the upcoming WHS Regional Meeting 2026 in Kenya under the theme ‘Reimagining Africa’s Health Systems: Innovation, Integration, and Interdependence’, offers an important opportunity to put these ideas into action. The Nairobi meeting also stands as a reminder that global health transformation must emerge from inclusive dialogue and genuine partnership with those on the frontlines of change.