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INTRODUCTIONS
Reclaiming momentum – delivering health in a world of risk
U ntil recently, HIV was a death sentence, smallpox scarred lives and bacterial infections were often fatal. Breakthroughs such as vaccines, antibiotics and HIV treatment – alongside crucial investments beyond the health sector, from sanitation to urban planning – have transformed health, paving the way for broader development gains. Now, a new wave of innovation – from mRNA platforms to artificial intelligence – offers unprecedented promise. But any advances will only matter if every country is equipped to harness them. Yet, health progress is increasingly overshadowed by multiplying risks. Pandemic threats are rising. Diseases once in steady retreat – malaria, tuberculosis and cholera – are resurging. Antimicrobial resistance, mental health conditions and non-communicable diseases continue to grow. Climate shocks, conflict and ecosystem collapse push more people into crisis. Even hard-won gains in responding to HIV risk erosion in the face of declining funding and political will. The gravest threat is the erosion of what has made progress possible: sustained, deliberate global cooperation. To secure lasting gains and ensure health and opportunity for all, we must confront breakdowns in health systems and strengthen inclusive governance and systems to deliver for everyone, everywhere. INNOVATION WITHOUT ACCESS IS NOT PROGRESS Health systems have always reflected power. Your chances of living a healthy life are often shaped by who you are,
To build resilience, life-saving tools must become public goods: resources or services accessible to everyone, regardless of income or location, and provided equitably without exclusion. This requires investing in public health systems, local manufacturing and digital public infrastructure, and ensuring technology improves lives, not just boosts profits. The collaboration between the Global Health Innovative Technology Fund and the Access and Delivery Partnership, led by the United Nations Development Programme and supported by Japan, shows how working across the innovation-to-access value chain can help health technologies reach those most in need. For example, through the World Health Organization’s prequalification of a paediatric medicine for schistosomiasis, millions of children in Africa could potentially receive a treatment that will free them from health impacts including anaemia, stunting and impaired cognitive development, which hamper education and productivity, and perpetuate poverty. TRUST IS THE HIDDEN INFRASTRUCTURE Trust is the foundation of public health. Without it, even the most advanced tools and systems cannot deliver. Covid-19 fractured this trust – unequal access, politicised responses and broken promises eroded public confidence. Disinformation has worsened vaccine hesitancy, fuelling the resurgence of preventable diseases including measles and polio. Emerging risks from AI, as highlighted in UNDP’s Human Development Report 2025, raise additional concerns: automated
Achieving health and well-being for all requires long-term investment, global cooperation and effective governance. From pandemics to climate shocks, only resilient and equitable systems can deliver global health in an era of compounding crises
Achim Steiner, former administrator, United Nations Development Programme
where you live and what you can afford. Medicines and services that have worked well for decades – such as insulin and safe childbirth – remain beyond reach for millions. Now innovation is accelerating faster than ever, from long-acting HIV prevention to malaria and diagnostics powered by AI. Digital tools hold immense potential for telemedicine, research and development supply chains, and the delivery of services to the last mile. But access lags far behind. AI in health advances rapidly in some high-income settings, while many low-income countries struggle with inadequate infrastructure and biased tools. The Covid-19 pandemic underscored this hard truth: breakthroughs alone do not change outcomes. Systems capable of delivering them equitably at scale are essential.
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Health: A Political Choice – The Future of Health in a Fractured World
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