Insights on global health reform discussions, trends and perspectives: April 2026
The fourth in our ongoing series of Insights papers on global health reform discussions, trends and perspectives is now available.
Discussions on global health reform remain highly active and continue to garner high-level political attention. The intent behind reform initiatives is starting to shift from inspiring thinking to seeking action. The Accra Reset and the WHO-hosted process stand out in this regard, both promising to deliver on a much-needed roadmap. Nonetheless, as these two distinct initiatives develop, it is crucial to ensure complementarity.
The WHO-hosted process is a time-bound, multilateral effort, aspiring for broad geographical and institutional engagement. Yet it may struggle to achieve this in practice given the asymmetries in Member States’ capacities and interests to engage. By contrast, the Accra Reset reflects a stronger Global South anchoring with Head of State leadership and diverse representation in its high-level panel. Progress updates from the Accra Reset are anticipated during major global governance moments. The upcoming 79th World Health Assembly will be a key chance to assess whether processes intend to converge.
The US continues to reaffirm that its interest is not to retreat from global health, but to engage on its own terms. The ‘America First’ approach should not be treated as an unspoken or negligible factor in reform discussions. Its tensions with multilateral cooperation for health have been apparent, not least through the bilateral health compacts. Clarifying and navigating the US’ red lines could help manage the volatility in the current landscape.
The international system for health must sustain the gains it has helped to achieve, as well as deliver new health improvements. Reform will be incremental, driven by cumulative decisions taken across institutions and levels, rather than one decisive moment. These efforts must be aligned around a shared direction, shaped by voices across regions.
We will continue to share regular updates and analyses around key issues and decisions in what will be a critical 12 months for shaping the future of global health.