From crisis to resilience: five global health shifts to watch in 2026

After a year of turmoil in global health and the wider development sector, with the retreat of the United States from major institutions, the closing of USAID and significant ripple effects across humanitarian and health programmes, we are turning to the year ahead. These are the five trends to watch in 2026:

1. UN80 and the reshaping of global governance

In 2026, the United Nations (UN) will face one of its most significant rounds of restructuring in decades. Work is under way to slim down the UN system in response to cuts to development and UN member states’ contributions. Under the UN80 initiative,^[1] a task-force is identifying ways to improve the UN’s efficiency, by reducing staff, moving to cheaper duty stations, as well as reviewing agencies’ mandates, potential mergers and sunsetting UN organisations. In the end, member states will decide which organisations survive, but we can already foresee that this will impact international co-operation for health. Currently, mergers between WHO and UNAIDS, and between UNFPA and UN Women are under discussion, as is the creation of a single umbrella humanitarian-response organisation that would include WHO’s large emergency pillar. In 2026, the focus will shift to agreeing on and operationalising these plans, particularly regarding the mergers and securing member states’ agreement in the General Assembly. Importantly, the pressure to restructure is already extending beyond the UN system, with other multilateral health institutions such as the Global Fund and Gavi actively pursuing organisational and financing reforms in response to the same fiscal and political constraints.

2. Preparing for the next pandemic

The year 2026 will also be a defining one for pandemic prevention, preparedness and response (PPPR). The UN will convene the second High-Level Meeting on PPPR to scale up existing initiatives to better prepare the world for the next pandemic. The adoption of the Pandemic Agreement was a milestone achievement in 2025. The year ahead will now show if member states can effectively implement the agreement and agree on the annex concerning pathogen access and benefit sharing. The annex will be presented for a vote at the World Health Assembly in May. The question remains how effective these multilateral tools can be without the buy-in of the United States. Until recently, the United States has been a major stakeholder in PPPR, given its leadership in research, the strength of its Centres for Disease Control and Prevention (CDC) and its funding of PPPR initiatives worldwide. As implementation moves forward, the World Health Summit 2026 will provide a key forum for discussing what it will take to translate these PPPR commitments into practice.

3. Shifting power dynamics

In a changing global health landscape, actors from the global south are increasingly taking on leadership roles, and we can expect this trend to continue in 2026. This shift was also clearly reflected in discussions at the World Health Summit 2025. As an example, Africa CDC unveiled a new agenda for health security and sovereignty across the continent^[2] in the autumn of 2025. As external health aid to the continent has dropped by nearly 70% in the past four years, the new strategy calls for increased domestic resource mobilization for health, stronger local manufacturing and more decision-making power for Africa “proportional to its needs and contributions”. With traditional donors retreating from international engagement in health, 2026 is likely to bring continued opportunities for others to assume leadership and reduce long-standing dependencies.

At the same time, 2026 will also be shaped by the new “America first” global health policy. The United States has set a new precedent in global health by offering countries health funding in exchange for information and pathogen access. In December 2025, Kenya was the first to sign such a bilateral deal, and 13 other African countries have since followed suit. The year ahead will show how countries in the global south balance continued multilateral engagement, bilateral agreements and local capacity building.

4. A new era of public-private collaboration

In 2026, development assistance for health is likely to remain under pressure, making domestic resource mobilisation increasingly critical. Governments will need to treat health not as a discretionary social expense, but as a strategic investment underpinning economic resilience, social stability and long-term growth. Closing persistent financing gaps will require new approaches to combining public, private and philanthropic capital, deliberately designed to complement public financing rather than substitute for it. Such approaches must be guided by clear safeguards to ensure equitable outcomes and avoid reinforcing existing inequalities —an approach the World Health Summit (WHS) supports by convening leaders and changemakers from politics, science, the private sector and civil society to foster impactful partnerships. Rethinking cross-sector collaboration in this way is essential, not only to mobilise additional resources but to ensure that health investments deliver broad-based benefits for economies, security and societies as a whole.

5. Science integrity and innovation under pressure

The year ahead will be a defining test for scientific integrity: either it is further eroded or governments, institutions and the public move decisively to protect it. In recent months, scientific evidence has been publicly discredited on important public-health issues such as immunisation, major US universities have been put under political pressure, research budgets for understanding global challenges such as climate change have faced cuts, and scientific experts have been dismissed. The key question for 2026 is how the wider research ecosystem responds to this pressure: whether funders and institutions can safeguard academic freedom, sustain long-term investment and reinforce standards for evidence-based decision-making. It will also test how governments step up to support science, protect the conditions that allow it to thrive and sustain the innovation and progress that depend on it. In this context, the World Health Summit provides a platform for scientists, policymakers, the private sector and civil society to co-create solutions grounded in evidence.

The year ahead

One thing is certain: a busy year in global health lies ahead. The imperative to build resilience cuts across all five trends, as systems are tested by geopolitical, economic, climatic and social crises. The path forward will depend on rethinking and innovating how we finance, govern and deliver health, as well as build partnerships beyond the health sector. Under the leitmotif “From Crisis to Resilience: Innovating for Health”, our next stops in 2026 are the WHS Regional Meeting in Nairobi, Kenya, in April and the annual World Health Summit in Berlin, Germany, in October.

The decisions made in 2026 will shape health outcomes for years to come. Join us in Nairobi and Berlin to help set the agenda.