Health and multilateralism: Brazil’s political choice in a fractured world
In a world fractured by climate emergencies, pandemics, disinformation and multiple conflicts, humanity finds itself in a global emergency room. Our planet is a patient in critical condition: fractured, vulnerable and in urgent need of collective care. Health, in this context, has become both a front-line casualty and the medicine we must administer to rebuild trust and cooperation.
From my first years as a physician in Brazil’s public health system to my current role, serving my country for the second time as minister of health, I have learned a simple truth: health is never only a technical matter. It is a political choice – one that reflects the values we uphold, the alliances we forge and the future we want to build.
Brazil’s choice is clear: to defend multilateralism, to support the World Health Organization’s leadership in directing and coordinating international responses to global health issues, to strengthen global health governance, and to put equity at the heart of every policy. Our recent G20 and BRICS presidencies, our current Mercosur presidency, our active role in negotiating the Pandemic Agreement and the amendments to the International Health Regulations, and our preparations to host the UN climate conference in Belém and to make health a priority on the climate agenda have allowed us to translate that choice into concrete actions.
Innovation anchored in equity
At the 78th World Health Assembly, we advanced a milestone of Brazil’s G20 presidency: the launch of the Global Coalition for Local and Regional Production, Innovation and Equitable Access. This coalition has a clear objective: to strengthen health production capacity, share technology, and expand access to medicines, vaccines and diagnostics. While its mandate focuses on neglected diseases and populations in vulnerable situations, these capacities could also be repurposed to address other diseases and health emergencies when needed.
In July, at the BRICS summit in Rio de Janeiro, we launched the Partnership for the Elimination of Socially Determined Diseases. This initiative reflects Brazil’s conviction that the root causes of health inequities – poverty, exclusion and discrimination – must be addressed directly through cooperation, resource mobilisation and innovation. As President Lula da Silva reminded us in his speech at the summit: “In Brazil and around the world, income, education, gender, race, and place of birth determine who gets sick and who dies. Many of the diseases that kill thousands in our countries … would have already been eradicated if they affected the Global North.” This partnership, the Tuberculosis Research Network and the Vaccine R&D Center, among other initiatives, mobilise BRICS countries to act together, not only to treat these diseases, but also to dismantle the social and economic fractures that sustain them.
All these initiatives reflect a conviction that cooperation among countries can deliver tangible improvements to people’s lives. Innovation must walk together with equity. Production must be anchored in solidarity. No child and no family should be left behind because of where they were born.
A shared agenda for people and planet
As the current holder of the presidency of Mercosur, Brazil’s health priorities encompass strengthening immunisation coverage, promoting local and regional production, combating misinformation, advancing gender equality, and reinforcing health surveillance. In this regard, we have developed a robust agenda to advance these priorities.
That belief has also guided Brazil’s active engagement in the negotiation of the Pandemic Agreement and the amendments to the IHR, where we have consistently defended equitable access to health technologies, the strengthening of local production and technology transfer mechanisms, as well as the protection of the health workforce. Brazil also remains committed to advancing the ongoing negotiations of the Pathogen Access and Benefit Sharing System, which aims to facilitate rapid access, equitable sharing and benefit sharing related to pathogens with pandemic potential.
Yet, our political choice for multilateral-
ism goes further. In November, Brazil will host the 30th Conference of the Parties of the United Nations Framework Convention on Climate Change in Belém. Recognising the profound impacts of the climate emergency on people’s health, Brazil – together with partners from governments, civil society, international organisations and other stakeholders – is bringing forward the Belém Health Action Plan. Our ambition is to build together and share with the world a global reference document for strengthening climate-resilient health systems, rooted in the principles of climate justice and health equity. Hosting COP30 in the Amazon sends a powerful message: protecting the planet and protecting people’s health are inseparable goals.
From BRICS to G20, from the Pandemic Agreement to COP30, the rationale is the same: in a fragmented world, health can be a bridge. It can connect countries that disagree on many issues but still recognise that the well-being of their people depends on shared solutions. It can turn geopolitical competition into practical cooperation. Moreover, it can remind us that, despite our differences, we are bound by the same vulnerabilities and the same hopes.
As minister of health, I have learned that the success of global health is measured not only by the agreements we sign, but also by the lives we improve and the trust we build. The initiatives we launch must be designed to deliver concrete benefits for populations and to reinforce the multilateral system that makes such benefits possible.
A future with healthier people, animals and the environment will not be shaped by chance, but by political choices. Brazil has chosen to act with solidarity, to lead with equity and to invest in alliances that make a difference. This is the political choice that inspires our support for the WHO and that we have brought to the BRICS, G20, Mercosur and COP30. It is the choice we hope will inspire others, because only through inclusive, cooperative, and sustained multilateralism can we turn today’s fractured world into tomorrow’s cohesion, ensuring health as a right for all, not a privilege for the few. ▪
