Sania Nishtar The paradox at the heart of the 79th World Health Assembly

June 09, 2026

As the dust settles after the 79th World Health Assembly (WHA), it is clear that there is a paradox at the heart of global health. On the one hand, we saw an encouraging degree of consensus, collaboration and compromise over several key issues, including reforms of the global health architecture and negotiations on the operational aspects of the pandemic agreement. Yet we also saw something altogether different: a politicisation of the proceedings that is as regrettable as it is indicative of the spread and entrenchment of geopolitics today.  

Growing appetite for greater health sovereignty 

First let us dwell on the positives.  

I and others have made repeated calls over the past 2 years for a formal, country-led process to reform the global health architecture. It has been clear for some time that the convergence of several key trends had made the case for a wide-ranging and comprehensive reform irresistible. Within this context and contrary to the public narrative which overly focuses on the retreat of official development assistance (ODA), I believe that foremost among these trends has been the growing appetite for greater health sovereignty amongst countries from the Global South. This is an appetite that has been crystallised and articulated through several landmark initiatives and movements, including the Lusaka Agenda, the Accra Reset Initiative and Africa CDC’s African High-Level Ministerial Committee on Global Health Architecture Reform. It has also been practically demonstrated at an organisational level through the Gavi Leap reform.  

Those calls for a meaningful process of reform have now been acknowledged, with the endorsement by WHO Member States of a joint process, led by a joint task force, that will ultimately make recommendations to “transform the GHA [Global Health Architecture] into a truly country-led, coherent and inclusive ecosystem that responds more effectively and efficiently to the specific and collective needs of countries and communities to maximize access, impact and equity.” 

Needless to say, Gavi, the Vaccine Alliance I lead, fully supports these aims. Indeed, for the past 12 months we have been engaged in the planning and implementation of our own reform programme – the Gavi Leap – that is predicated on the same goals of maximizing impact and access to vaccines by strengthening national health sovereignty.  

Under the proposals adopted, Gavi will be one of five Global Health Initiatives represented on the 25-member Joint Task Force alongside representatives from 14 WHO Member States, including two who will serve as co-chairs of the Task Force. We look forward to engaging with the work of the Task Force over the coming months.  

This is progress. However, we must be mindful that consensus and collaboration are not always defining features of multilateral processes, and we must guard against disunity permeating the work of the Joint Task Force.  

Growing factionalism 

The work of the Joint Task Force will dovetail with the UN80 reform initiative currently underway. And while the UN General Assembly is no stranger to conflict and factionalism, the WHA has historically largely been spared the tabling of overtly politicised resolutions. This, though, has recently started to change. It is an unfortunate reflection of the state of growing conflict around the world, but the 79th WHA was notable for the extraordinary number of rival resolutions that Member States were forced to vote on due to a lack of consensus.  

The increasing use of votes to resolve contentious issues forces countries into binary alignments. If it becomes increasingly ingrained, it will be to the detriment of WHO’s unifying role in promoting multilateral health cooperation. Politics will always be part and parcel of WHA, but we must leave conflict, ego and competition at the threshold.   

The same rule must apply to the continued negotiations around the operational aspects of the Pandemic Agreement. Member States have now adopted a recommendation to extend negotiations on the Pathogen Access and Benefit Sharing (PABS) Annex. This must be seized without further delay. Stakeholders must demonstrate their commitment to the equity, complementarity, and cohesion which can deliver on the right outcomes both for the Pandemic Agreement as well as a reformed Global Health Architecture. 

There is an urgency to forge synergy. We are all aware that the eve of the WHA saw reports of a new outbreak of Ebola disease in the Democratic Republic of the Congo (DRC) caused by the rare Bundibugyo virus. The outbreak, for which Gavi has released US$50 million from our First Response Fund, must give a practical impetus to the need to find solutions to persistent disagreements regarding the sharing of pathogen data and the benefits that arise from the use of those data. Any agreement should apply both in the event of a pandemic and in the event of a non-pandemic public health emergency of international concern, which the DRC’s latest Ebola outbreak was designated as on 17 May.  

Pandemic response is a collective responsibility 

More broadly, Gavi and other stakeholders will continue to contribute to discussions on strengthening the Pandemic Prevention, Preparedness and Response architecture, including by feeding into the formulation of the political declaration to be adopted at the forthcoming UN General Assembly in September. I will continue to advocate that existing outbreak and pandemic response mechanisms, including Gavi’s First Response Fund, are fully incorporated and strengthened as part of a broader effort to increase the financing available for outbreak and pandemic response. Pandemic response is a collective responsibility, and a practical example of how the global health architecture should come into play as a well-oiled ecosystem rather than a disparate set of institutions vying for control and visibility. At Gavi, we are very conscious of our responsibility as the global vaccine steward, and are working closely with our sister agency, the Coalition for Epidemic Preparedness Innovations (CEPI), to do whatever is necessary, speedily and seamlessly, to pave the way for future vaccines against the Bundibugyo virus. But vaccines are just one link in the chain, and it is critical that all of us work equally seamlessly and in a coordinated ecosystem, leaving our egos at the door. 

The views expressed in this commentary are those of the author and do not necessarily reflect the views of the World Health Summit (WHS). This commentary is part of the WHS Perspectives series on global health architecture. Additional perspectives from other contributors will be published in the coming weeks.