Reclaiming momentum – delivering health in a world of risk
Until recently, HIV was a death sentence, smallpox scarred lives and bacterial infections were often fatal. Breakthroughs such as vaccines, antibiotics and HIV treatment – alongside crucial investments beyond the health sector, from sanitation to urban planning – have transformed health, paving the way for broader development gains. Now, a new wave of innovation – from mRNA platforms to artificial intelligence – offers unprecedented promise. But any advances will only matter if every country is equipped to harness them.
Yet, health progress is increasingly overshadowed by multiplying risks. Pandemic threats are rising. Diseases once in steady retreat – malaria, tuberculosis and cholera – are resurging. Antimicrobial resistance, mental health conditions and non-communicable diseases continue to grow. Climate shocks, conflict and ecosystem collapse push more people into crisis. Even hard-won gains in responding to HIV risk erosion in the face of declining funding and political will. The gravest threat is the erosion of what has made progress possible: sustained, deliberate global cooperation. To secure lasting gains and ensure health and opportunity for all, we must confront breakdowns in health systems and strengthen inclusive governance and systems to deliver for everyone, everywhere.
Innovation without accessis not progress
Health systems have always reflected power. Your chances of living a healthy life are often shaped by who you are, where you live and what you can afford. Medicines and services that have worked well for decades – such as insulin and safe childbirth – remain beyond reach for millions. Now innovation is accelerating faster than ever, from long-acting HIV prevention to malaria and diagnostics powered by AI. Digital tools hold immense potential for telemedicine, research and development supply chains, and the delivery of services to the last mile. But access lags far behind. AI in health advances rapidly in some high-income settings, while many low-income countries struggle with inadequate infrastructure and biased tools. The Covid-19 pandemic underscored this hard truth: breakthroughs alone do not change outcomes. Systems capable of delivering them equitably at scale are essential.
To build resilience, life-saving tools must become public goods: resources or services accessible to everyone, regardless of income or location, and provided equitably without exclusion. This requires investing in public health systems, local manufacturing and digital public infrastructure, and ensuring technology improves lives, not just boosts profits. The collaboration between the Global Health Innovative Technology Fund and the Access and Delivery Partnership, led by the United Nations Development Programme and supported by Japan, shows how working across the innovation-to-access value chain can help health technologies reach those most in need. For example, through the World Health Organization’s prequalification of a paediatric medicine for schistosomiasis, millions of children in Africa could potentially receive a treatment that will free them from health impacts including anaemia, stunting and impaired cognitive development, which hamper education and productivity, and perpetuate poverty.
Trust is the hidden infrastructure
Trust is the foundation of public health. Without it, even the most advanced tools and systems cannot deliver. Covid-19 fractured this trust – unequal access, politicised responses and broken promises eroded public confidence. Disinformation has worsened vaccine hesitancy, fuelling the resurgence of preventable diseases including measles and polio. Emerging risks from AI, as highlighted in UNDP’s Human Development Report 2025, raise additional concerns: automated medical advice risks diminishing trust in healthcare providers. AI holds promise for expanding access to knowledge, but also necessitates placing human knowledge at its core, alongside rigorous safeguards against misinformation.
Rebuilding trust requires more than fact checking. It demands delivery and equity. Consider the Global Fund’s partnership model, which has saved over 65 million lives since 2002 by uniting governments, the private sector and civil society to fight AIDS, tuberculosis and malaria. Pulling back threatens to dismantle the very infrastructure and trust we have spent decades building. Instead, we must demonstrate that sustained, collective action delivers tangible results and saves lives.
Pandemics, conflicts and climate shocks are interconnected crises, yet our systems to address them remain fragmented and weak. A pandemic response without inclusive governance or social protection falters. In conflict zones, health care collapses without reliable energy or communication infrastructure. In climate emergencies, unprepared systems leave communities vulnerable. Health cannot remain siloed but must be integrated across systems shaping climate, nature and biodiversity outcomes, including One Health approaches and planetary health strategies. Indeed, some of the greatest returns still come from the basics: clean water, sanitation, air quality and adequate nutrition – the critical determinants of health.
Vast global resources exist but they are poorly aligned with the Sustainable Development Goals, including those on health. Moreover, as official aid continues its downward trajectory, we must link financing better to the SDGs and the Paris Agreement and unlock more innovative financing. That includes increasing domestic financing for health through domestic resource mobilisation and taxation and exploring innovative funding models and partnerships for more effective, sustainable financing. For instance, UNDP’s Tax for SDGs Initiative has supported Armenia to raise tobacco excise taxes, expecting to generate $130 million in additional revenue, which could be invested in achieving its health and development goals.
What it will take
The past decade has radically transformed our world, intensifying the challenges in advancing the SDGs. Global health now includes new players such as technology companies and philanthropic actors, even as multilateralism remains in flux. Yet what is needed to achieve health and well-being for all remains unchanged: long-term investment, global cooperation, effective governance, and a focus on impact and those left behind. The adoption of the Pandemic Agreement by WHO members is driven by this objective: to make the world’s future pandemic response more effective and equitable. This leadership reminds us that advancing health equity requires collective, universal action.
Complexity may define our present, but it remains a diagnosis, not an incurable condition. By aligning the forces shaping health, strengthening inclusive governance and building resilient systems, we can realise a world where our collective immune system – of solidarity, innovation and action – can withstand any crisis and ensure well-being for all.
