Major developments at last week’s 78th World Health Assembly (WHA78) indicate next steps for industry:
- Rebuild Regionally: Redirect advocacy and programmatic partnerships to regional organisations (e.g., African Union, PAHO, APEC, ASEAN, Summit of the Americas) and away from Geneva-based engagement and UN mechanisms.
- Actively Contribute to Reform: Help shape the emerging architecture of global health institutions through expert panels, public consultations, and advisory groups.
- Track US Strategy Evolution: Closely follow the 180-day US review of multilateral engagement and submit comments through the U.S. Department of State’s Bureau of International Organisation Affairs. The Make America Healthy Again (MAHA) Report will also influence US positions on multilateral engagement for global health.
- Invest in Coalitions: Develop or join cross-sector, multi-stakeholder coalitions focused on specific health outcomes where industry investment and leadership is matched by governments, philanthropic organisations, academic and clinical institutions, and patients and civil society.
Reflections from WHA78
The 78th World Health Assembly in Geneva last week was tense. Amid cold rain and cloudy skies, global health leaders confronted a moment of structural and geopolitical reckoning in the wake of the US’ withdrawal from the World Health Organisation (WHO) and cuts to foreign development assistance. Yet most leaders also held tight to optimism. In the same breath that many eulogised the status quo and acknowledged impending budget cuts, layoffs, and institutional restructuring, they also began imagining a path forward. Many global health leaders spoke about the reshaping of global health governance and multilateral institutions as an opportunity for the private sector to reimagine how it engages, partners, and leads in global health.
Global health in flux: disintegration and realignment
The US’ absence from WHA78 was stark: no formal delegation, a controversial video address, and ambiguity about what “global health leadership” by the US looks like outside the WHO. The WHO itself, now faced with a liquidity crisis, has undergone a radical internal contraction, cutting its senior leadership team nearly in half, reducing departments from 76 to 34, and planning to shutter offices in high-income countries. The US withdrawal has also catalysed a much broader discussion about institutional realignment. Regional and country offices are ascendant, with leadership from entities like Africa CDC stepping in as new centres of gravity. Simultaneously, discussions on institutional consolidation, such as merging functions across UNAIDS, Gavi, and the Global Fund, are no longer fringe ideas. They are being openly considered by member states and former heads of state as viable paths toward greater efficiency and relevance.
Decentralisation as strategic opportunity
For private sector actors, especially firms with global operations and multi-regional footprints, this decentralisation has a strategic upside. Engagement that was once funnelled through Geneva HQs could now be redirected towards regional institutions like WHO Regional Offices (especially PAHO), African Union, the health architectures of APEC, ASEAN, and Summit of the Americas, and country-level agencies that are gaining autonomy and budgetary discretion. This evolution creates new entry points for technical assistance, market shaping, and public-private collaboration. Regional bodies are usually more flexible, faster moving, and may now be increasingly receptive to private sector participation, particularly where capacity is thin.
The new political economy of global health
This redistribution of influence coincides with a shift in geopolitical alignment. As the US retrenches, China is expanding its presence. WHA78 saw an unprecedented number of Chinese delegates and events hosted by Chinese universities, with former WHO Director-General Margaret Chan emerging as a key convener through her new role at Tsinghua University. This bifurcation of leadership models (US-aligned vs. China-aligned, or multilateral vs. mini-lateral) may prompt private firms to recalibrate their multilateral strategies. Many companies voiced frustration with the ambiguity of US policy during side-events and in private conversations, while simultaneously expressing hope for alternative channels such as APEC. Private sector actors now face a complex choice: double down on legacy partnerships, hedge with emerging regional players, or build coalitions that transcend state-centric frameworks.
WHO’s reassessment of private sector engagement
WHA78 also signalled a philosophical shift within the WHO itself. In the context of funding gaps and donor fatigue, the organisation is reportedly reevaluating its stance toward private sector engagement. Several stakeholders noted that a serious internal debate is underway about loosening barriers to private sector contributions and involvement while maintaining compliance and management of conflicts of interest. This reevaluation may open a rare window for the private sector and member states to reshape the norms of partnership toward something more constructive. Areas like pandemic preparedness, antimicrobial resistance, rare diseases, and health workforce seem particularly well-placed for joint leadership.
Adapting to the new global health order
This is a moment of reconfiguration rather than collapse. The shifts in funding, the rise of regional actors, and the geopolitical fragmentation of global health governance create volatility and opportunity. For those in the private sector willing to adapt, there is space to engage, partner, and lead in global health in new ways, and toward a new status quo of public-private cooperation that is more constructive, trusted, and built on shared value rather than zero-sum mentality.
At Access Partnership, we are deeply experienced in working with multilateral organisations and forging public-private collaborations across sectors and regions. As global health governance enters a new era, we help businesses adapt to institutional shifts, regional dynamics, and evolving regulatory frameworks.
To learn how we can support your organisation during this time of change, please contact Eric Obscherning at [email protected].
