// TEDROS ADHANOM GHEBREYESUS Tedros Adhanom Ghebreyesus was elected director-general of the World Health Organization in 2017 and re-elected in 2022. He was the first person from the WHO African Region to serve as WHO’s chief technical and administrative officer. He served as Ethiopia’s minister of foreign affairs from 2012 to 2016 and minister of health from 2005 to 2012. He was elected chair of the Global Fund to Fight AIDS, Tuberculosis and Malaria Board in 2009, and previously chaired the Roll Back Malaria Partnership Board, and co-chaired the Partnership for Maternal, Newborn and Child Health Board.
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lance and response, supporting countries during emergencies, and translating science into policy. The Covid-19 pandemic exposed seri- ous gaps in how the world anticipates and manages shared health threats. The WHO Pandemic Agreement, adopted at last year’s World Health Assembly, was a land- mark achievement for multilateralism, establishing a more predictable, equita- ble and coordinated approach to future pandemics. Member states are continuing negotiations on the Pathogen Access and Benefit-Sharing system – an annex to the Pandemic Agreement that will facilitate the rapid sharing of data and pathogens, and timely and equitable access to the benefits that result, including vaccines, diagnostics and therapeutics. The WHO itself is also changing to meet rising expectations. In recent years, the organisation has undergone a significant transformation to sharpen its focus on its core mandate: promoting health, set- ting norms and standards, and protecting people from health emergencies. Cen- tral to this has been reform of the WHO’s financing model, which for decades relied heavily on voluntary contributions from a narrow donor base. This dependency has undermined the WHO’s independence and exposed the organisation to the risk of shocks should a major donor suddenly withdraw, as happened last year. Recognising this risk, the WHO has proposed several measures to mitigate it, including an increase in assessed con- tributions, which are the predictable and flexible dues that member states pay. In 2022, they agreed to progressively increase assessed contributions to 50% of the base budget from just 14% at the time, in five installments. The first two increases have already been approved, with the remaining three planned for 2027, 2029 and 2031. REFORMING THE ARCHITECTURE OF GLOBAL HEALTH The challenges we face in global health
do not apply only to the WHO. The global health architecture itself must evolve to meet the demands of a new era. Built incrementally over decades, the system has become increasingly complex and fragmented. While diversity brings exper- tise and innovation, it has also created overlaps, gaps and inefficiencies that undermine performance when speed, coordination and clarity are most needed. Reform is no longer optional if the system is to remain fit for purpose. Recognising this, countries have entrusted the WHO with hosting and con- vening a joint process to examine how the global health architecture can better align actors, instruments and financ- ing on shared objectives. This work is not about expanding bureaucracy, but about improving effectiveness: clarifying roles, strengthening coherence and ensur- ing the system delivers better results for countries and communities. This is where the G7, under this year’s presidency of France, can make a deci- sive difference: by supporting a stronger and more coherent global health architec- ture; by sustaining momentum towards effective pandemic cooperation; by invest- ing in preparedness that endures beyond crisis cycles; and by continuing to support a WHO that is focused, reformed and sustainably financed. The WHO welcomes the G7 framework for health sovereignty financing to support countries to transition away from aid dependency. Likewise, we welcome France’s focus on fighting cervical cancer, which the WHO has also made a priority through the Cervical Cancer Elimination Initiative, launched in 2020. We also wel- come the G7 initiative to protect minors from online risks. In a fractured world, cooperation that lasts must be built deliberately. The choices made at the Évian Summit can help ensure global health cooperation remains a source of stability in an increasingly unstable world.
S ince the turn of this century, the world has recorded remarkable gains in health. Life expectancy has risen by more than a decade, driven by declines in maternal and child mortality and real progress against HIV, tubercu- losis and malaria. New vaccines against malaria, Ebola and cervical cancer have made deadly diseases preventable. Those gains are now at risk. Progress has slowed or stalled in many areas, while non-communicable diseases place a growing burden on health systems and economies. Antimicrobial resistance threatens to undo a century of medical advance, climate change is increasingly shaping patterns of disease and vulner- ability, and epidemics and pandemics remain an ever-present threat. At the same time, misinformation and disinfor- mation are eroding public trust, aid cuts are disrupting health systems, reductions in science and research threaten hard- won gains, and geopolitical competition, conflict and institutional strain intensify. In this environment, global health coop- eration is no longer an aspiration reserved for calmer times; it is a practical necessity. Pathogens do not respect borders, markets or alliances. Health threats quickly spill into economic disruption, security shocks and social instability. Even when political relations are strained, countries remain bound by their shared vulnerability. The question is not whether cooperation matters, but whether it is resilient enough to function when politics does not. COOPERATION UNDER STRAIN This is the task the World Health Organ- ization was created to fulfil. Under increasingly difficult conditions, the WHO has continued to provide a platform for collective action: setting global norms and standards, coordinating surveil- Tedros Adhanom Ghebreyesus, director-general, World Health Organization
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