A Coherent Roadmap is Needed to Accelerate Global Health Reform
New research from Seed Global Health and the Harvard T.H. Chan School of Public Health finds the unprecedented disruption to global health financing has opened an historic window to build a more country-led, coordinated, and resilient global health system.
The research, which examines 11 major initiatives including the Accra Reset, Lusaka Agenda, WHO reform process, Gavi Leap, and emerging bilateral health agreements, assessed where reforms are converging, where tensions remain, and discusses what should happen next for the reform process.
Our analysis found growing convergence across major reform initiatives – but warned that without clearer coordination and implementation pathways, the system risks reproducing fragmentation rather than resolving it.
The key findings include:
- Consensus exists on the direction of reform: reform efforts are increasingly aligned around country leadership, stronger national systems, financing alignment, and more sustainable health architectures.
- The opportunity now is implementation: while consensus on goals are growing, clearer coordination, governance, and delivery pathways are still needed to translate ambition into practice.
- Capacity gaps are the biggest bottleneck: institutional capacity, workforce investment, and delivery systems are under-addressed across most reform initiatives.
- Financing transitions are accelerating: countries are under growing pressure to expand domestic financing while navigating shrinking aid flows, debt burdens, and evolving external financing models.
- Country leadership and multilateral cooperation must advance together: countries should lead priority-setting and implementation, while coordinated international cooperation remains essential to address shared challenges including pandemics, climate change, and health security.
Senior author of the analysis, our CEO Dr. Vanessa Kerry, will share the findings during the World Health Assembly, including at an event with the Accra Reset event alongside President John Mahama of Ghana on Monday May 18, where she is expected to say:
“There is now remarkable agreement on the need for and direction of reform. Across initiatives, we found growing alignment around the principles of country ownership, stronger national systems, sustainable financing, and the need to move beyond fragmented, project-based approaches.
But while the sector is increasingly aligned on where global health needs to go, there is little agreement on how reforms are to be carried out. The next phase of reform must be a coherent implementation roadmap.”
Dr. Kerry added: “Across reform discussions, there is still far too little focus on the systems, institutions, and workforce that deliver care.
These are not “nice to haves.” They are the foundation on which the reform agenda – and ultimately health systems – will succeed or fail.”
These preliminary findings come, as WHO Member States prepare to launch a new WHO-facilitated process on global health architecture reform at the 79th World Health Assembly, aimed at improving coordination, alignment, and country-led implementation across the global health system.
The pre-print of the preliminary findings is available here: http://dx.doi.org/10.2139/ssrn.6753079
The 11 initiatives included are: Accra Reset; Africa CDC Health Security and Sovereignty Initiative; European Donor Alignment; Gavi Leap; Health Works Leaders Coalition; HEAR CSO Consortium; Lusaka Agenda; Sevilla Platform of Action; US Bilateral Health Agreements; WHO Global Health Architecture Reform Process; Wellcome Trust Convening Dialogues.
Media opportunities
Dr. Vanessa Kerry is available for interviews during WHA79 on:
- Global health architecture reform
- The 2025 aid shock and implications for health systems
- Country ownership and financing transition
- Pandemic preparedness and health system resilience
- Climate change and health systems
A check against delivery version of Dr. Vanessa Kerry’s full remarks is available on request.
Media contact
For media questions please contact Tom Fairchild, Director of Advocacy and Media, Seed Global Health:
tfairchild@seedglobalhealth.org
+447772238359
