26 June 2026
The current global health architecture (GHA) has brought important achievements in global health. Examples include a significant increase in life expectancy globally, 60% and 40% reductions in under-5 and maternal mortality respectively; and, since 2000, an estimated 75 million, 25 million and 13 million deaths averted due to vaccine-preventable diseases, HIV and malaria respectively.
The context in which this architecture was built has however changed profoundly. New challenges include changes in the areas of demography, economics, environment, epidemiology, and geopolicy. This changing environment brings new dynamics. Countries are asserting stronger national ownership of health priorities and financing. Regional institutions are playing a more central role. Science is advancing rapidly, with new tools and technologies reshaping how health systems operate.
These developments create opportunities, but they also create risks for widening inequalities, instead of narrowing them.
The global health architecture has not kept pace. Today, it is characterized by fragmentation, duplication, misaligned priorities, competition, gaps in financing, and persistent power imbalances.
What is the global health architecture (GHA)?
Many organizations and agencies shape global health, including working to prevent disease, respond to emergencies, strengthen health systems and protect populations.
The GHA includes:
- countries and governments;
- United Nations organizations;
- global health institutions, initiatives and partnerships;
- regional and country-level health bodies; and
- civil society, academia, philanthropy and the private sector.
It is an overall system of actors that is shaped by rules, financing mechanisms, and processes that guide, coordinate, finance and implement efforts to protect and improve health worldwide.
Considering the current weaknesses of the global health architecture as described above, a number of initiatives have been launched aiming at better defining the problem, providing research and data analysis and trying to find solutions.
Related GHA reform initiatives
Accra Reset – Resetting Global Development Cooperation for a Post-Dependency World.
Reform of the Global Health Architecture – African High-level Ministerial Committee
EU and Like-Minded Donors’ Reflection Process on Reform of the Global Health Architecture.
HEAR CSO – Reimagining Global Health Architecture.
The Lusaka Agenda – Conclusions of the Future of Global Health Initiatives Process.
MOPAN Global Health Insights Study
Wellcome Trust – From Rethinking to reform: the way forward for the global health system.
Other related initiatives
The Gavi Leap: Transforming the Vaccine Alliance through simplicity, transparency and synergy
Health Works Leaders Coalition
Sevilla Platform for Action – Global Health.
The reform process
The WHO Executive Board has requested the development of a proposal for a joint, inclusive and time-bound process to support reform of the global health architecture. In a joint process together with major global health actors (UNICEF, UNFPA, UNITAID, CEPI, Gavi, the Global Fund, the Pandemic Fund and the World Bank) options and recommendations will be developed for the consideration and decision by the World Health Assembly and the respective boards of global health institutions.
The initial objectives include but may not be limited to:
- strengthening coordination across global, regional and country levels;
- clarifying roles, responsibilities and comparative advantages; and
- aligning financing and support more closely to country-led priorities.
In May 2026, the WHO Secretariat presented a proposed joint reform process to the Seventy-ninth World Health Assembly (WHA), based on which Member States established a 1 year, Member State-led, WHO-hosted, Joint Process on GHA Reform with representatives of relevant United Nations entities and global health initiatives, the World Bank and regional health organizations, and in consultation with civil society and stakeholders.
Joint Task Force on GHA Reform
In keeping with the WHA decision WHA79(20), the WHO Director-General has been asked to set up a Joint Task Force on GHA Reform (“the Task Force”) of up to 25 members, of whom 14 will be representatives of WHO Member States, two from each WHO region and, and two additional members from the regions providing the Co-chairs. There will be five representatives of global health initiatives (Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Coalition for Epidemic Preparedness Innovations; Unitaid; and the Pandemic Fund); up to four representatives of United Nations entities, including WHO; one representative of the World Bank and one of a regional health organization.
The purpose of the Task Force is to develop options, recommendations and, for its final report, a potential implementation roadmap for the consideration of the governing bodies of WHO and partner organizations. The Task Force itself is not a decision-making body. The options and recommendations would be in line with each of the 3 objectives of the Joint Process as follows:
- functions, mandates and capacities – to enhance alignment of the mandates and capacities of GHA actors with global health functions, and across global, regional and national levels;
- coordination and decision-making – to strengthen collaboration, accountability and coherence across global, regional and country levels; and
- financing – to align financing to advance national self-reliance and ensure sustainable and predictable support for essential regional functions1 and global public health goods.
The scope of work will be global and cover all essential global health functions2; national, regional and global levels; and both current and future public health priorities.
1 including, but not limited to: regional policy coordination and governance, regional disease surveillance and health security, transboundary threats, technical support and surge capacity, pooled procurement.
2 setting norms, technical guidance and standards; data, monitoring and knowledge; surveillance and health security; product innovation and access; development cooperation for health (including health systems strengthening); and humanitarian emergency response.
Based on the nominations received from WHO Member States and Global Health Initiatives respectively, the following members have been appointed to the Task Force:
| Region | Country | Name | Title |
|---|---|---|---|
| African Region | Ethiopia | Dr Cherinet Mebratu MASSEBO | Chief of Staff, Office of the Minister, Federal Ministry of Health, Ethiopia |
| African Region | Burundi | Dr Oscar NITHABOSE | Directeur Général Responsible du Programme Prévention et Sécurité Sanitaire au Ministère de la Santé Publique |
| Region of the Americas | Mexico | Amb Francisca Elizabeth MENDEZ ESCOBAR | Permanent Representative of Mexico to the United Nations Office and Other International Organizations in Geneva |
| Region of the Americas | Brazil | Prof Rômulo PAES DE SOUSA | President of the Brazilian Association of Collective Health (ABRASCO); Director of the Center for Strategic Studies (CEE-Fiocruz), Oswaldo Cruz Foundation (Fiocruz) |
| European Region | Germany | Mr Bjorn KUMMEL | Head of Unit, Multilateral/Global Health, German Federal Ministry of Health |
| European Region | France | Ms Amélie SCHMITT | Special Representative to the Minister of Health on Global Health Reforms, Head of Global Health |
| Eastern Mediterranean Region | Kuwait | Dr Abdulrahman ALQASHAAN | Health Attaché for International Health Organizations, Permanent Mission of Kuwait to the United Nations in Geneva |
| Eastern Mediterranean Region | Pakistan | Mr Tahir Hussain ANDRABI | Permanent Representative of Pakistan to the UN in Geneva |
| South-East Asia Region | Thailand | Pol. Maj. Suriwan THAIPRAYOON | Deputy Director, Global Health Division, Office of Permanent Secretary, Ministry of Public Health, Royal Thai Government |
| South-East Asia Region | Bhutan | Mr Ugyen TASHI | Chief Program Officer, Health Intervention and Technology Assessment Division, Department of Health Services, Ministry of Health, Royal Government of Bhutan |
| Western Pacific Region | China | Dr Yong FENG | Director-General, Department of International Coordination, China National Health Commission |
| Western Pacific Region | Japan | Dr Satoshi EZOE | Senior Assistant Minister for Global Health, Ministry of Health, Labour and Welfare |
| Global Health Initiative | CEPI | Ms Aurélia NGUYEN | Deputy Chief Executive Officer |
| Global Health Initiative | GAVI, the Vaccine Alliance | Dr Sania NISHTAR | Chief Executive Officer |
| Global Health Initiative | The Global Fund | Ms Françoise VANNI | Director of External Relations and Communications |
| Global Health Initiative | The Pandemic Fund | Ms Priya BASU | Executive Head, Pandemic Fund Secretariat |
| Global Health Initiative | Unitaid | Dr Vincent BRETIN | Director, Results and Climate |
| UN Entity | UNFPA | Dr Catharina BOEHME | Assistant Secretary General and Deputy Executive Director for Programme |
| UN Entity | UNICEF | Mr Ted CHAIBAN | Assistant Secretary General and Deputy Executive Director for Humanitarian Action and Supply Operations |
| World Bank | World Bank | Dr David WILSON | Senior Advisor on Health Issues |