Adapting the Global Health Architecture in a Fragmenting World

The past few decades saw impressive progress in child mortality and infectious disease epidemic control, with the global under-five mortality rate falling by 52 per cent since 2000. As the global health architecture expanded, people’s health in lower income countries saw a significant improvement and health equity gaps were reduced. Vaccine-preventable child deaths have decreased by more than 70% in Lower-Income Countries (LICs).

As the global health architecture expanded, people’s health in LICs saw a significant improvement and health equity gaps were reduced. The expansion and specialization of the global health institutions led to impressive positive trends, from chasing polio into a few corners of the world to massively reducing cases of measles, HIV/AIDS and malaria. However, it also led to fragmentation, unintended inefficiency, and even a barrier to progress in certain instances. Mission creep has led to duplication and at times competition amongst health actors, with infinite organizational lifespans leading to a lack of focus and urgency. These flaws in the global health architecture are inches closer to becoming fatal in the current global context of funding scarcity and declining confidence in multilateralism.

To protect the gains of the past and to secure further progress in the future, transformative change is required. Global health must leap to a new architecture in which institutions work seamlessly together and find new ways to do more with less, with a clear understanding of their mandate and their lifetimes. To address this reality, this WHS session will convene high-level representatives of countries and partners to discuss what is needed for the global health architecture to embrace a radical transformation focused on maximizing simplicity, transparency, and synergies. The discussion will focus on four mutually supportive principles for revitalizing the global health landscape: country-centricity, self-reliance, focused mandates, and finite lifespans.