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EDITORS’ INTRODUCTIONS
Fostering a fine future for global health in a fractured world
As global health threats intensify, the capacity to respond is faltering. Amid rising geopolitical divisions, new alliances, innovations and funding mechanisms offer a way forward
John Kirton director, Global Governance Program
erodes the capacity and effectiveness of the World Health Organization, UN Climate, the United Nations Security Council and the United Nations Human Rights Council. At the leaders’ level, this year’s UN high-level meetings on health and other major threats cover only a few of the critical health problems and their determinants. The HLMs address them in separated and sequential ways, rather than in a synergistic, simultaneous fashion, and struggle to get the heads of the world’s most important governments to attend. Nor has the gap been filled by the most powerful leaders of the world’s most powerful countries when they come together at their summits to define and deliver the solutions that they alone can produce. FALLING SHORT ON HEALTH AS CRISES CONVERGE The annual G7 summits of the world’s major democratic powers have long led in addressing conflict since their start in 1975, soon adding climate change in 1979, health in 1981 and information integrity later on. But at their most recent summit, in Kananaskis, Canada, in June 2025, G7 leaders addressed only some of these central threats. Their 149 commitments included 21 on climate-related wildfires, for second place among subjects. Those contained the summit’s only commitment related to health, as leaders promised to build on their “shared capacity to mitigate and respond to the impacts of wildfire exposure on human health and well-being”. Regional security secured eight commitments for sixth place; there were very few on mis- and disinformation, and none focused on health or pandemics. The bigger, broader, newer G20 at its most recent summit at Rio de Janeiro in November 2024, did somewhat better. Its leaders made 11 health commitments, to rank fifth among all subjects. They followed 28 on climate change in first place, 25 on development in second, 18 on international institutional reform in third and 17 on the natural environment in fourth; the five on regional security placed it eleventh. The health commitments broadly covered the WHO investment round, health systems, universal
T hroughout the world, people face exceptionally severe, persisting and rising threats to their health and well-being. Climate change, biodiversity loss and pollution breed chronic heat, drought and extreme weather events such as wildfires, floods, hurricanes and tsunamis that bring more death, disease and damage. Pandemics remain a persistent problem, as outbreaks of new Covid-19 variants, measles, avian influenza, mpox and Ebola can rapidly go global at any time. Misinformation and disinformation proliferate, making people stop protecting themselves through vaccines or long-proven basic health measures and generating fear and actions that do more harm. And increasing deadly conflicts within and between countries kill and wound innocent civilians and the healthcare workers who seek to save them. But the needed global response now comes from a world whose supply of global governance is shrinking and increasingly fractured, even among those actors with the greatest capacity and responsibility to respond. The United States, the world’s most powerful country, is withdrawing from the central multilateral organisations that counter climate change, pandemics, mis- and disinformation, and conflicts and that promote human rights, including the right to health for all. This badly
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Health: A Political Choice – The Future of Health in a Fractured World
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