Insights on global health reform discussions, trends and perspectives: January 2026

We observe that in conversations around the future of global health, attention continues to be directed at diagnosing the problems in the existing ecosystem, despite most of these being well-known and extensively described. The unprecedented momentum for change has not yet translated into a coherent path forward, though more concrete proposals are surfacing. 

The primacy of health sovereignty is a common principle across reform initiatives and debates; what differs is the way sovereignty is conceptualized and the extent to which it is deemed feasible. The emerging bilateral deals and the continued strain on multilateralism are threatening further dissonance between global, regional and national health governance. 

Amid the ongoing uncertainty, discussions have been converging on the view that 2026 must focus on developing broad consensus and coalitions of the willing on reform priorities, and most importantly, a roadmap for how to deliver such change. This would enable reform-related decisions to be implemented in the next 2 years, capitalizing on the political and institutional commitment for meaningful reform before it wanes.

Overall, one of the major questions for this year is whether the ideas and outputs coming out of the various reform initiatives will translate into political processes and actions. 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.

The full paper, summarising our understanding and analysis of the latest reform discourse, is available here: https://www.globalhealthdiplomacy.se/media/229/download