Funding cuts over the past year have thrown multilateral health organizations into crisis. The future of these institutions, especially in places like South Africa, is now uncertain. Recently, many influential voices in global health have raised concerns about necessary reforms in these institutions.
Among these voices are Philippe Duneton, Executive Director of UNITAID, and Sania Nishtar, CEO of GAVI. They highlight how the U.S.’s shift towards bilateral agreements has negatively impacted funding for key organizations like the World Health Organization (WHO) and UNAIDS. Many have warned that without significant changes, these organizations may not survive, as evidenced by drastic restructuring within the WHO.
So why does this matter? While the current multilateral systems aren’t perfect—often seen as politicized and slow—they have delivered significant healthcare benefits. For instance, the WHO has provided essential treatment guidelines for diseases like HIV and tuberculosis, which have saved countless lives. During the COVID-19 pandemic, sharing genomic data between countries was vital in combatting the virus. Furthermore, collaborative efforts among medicine regulators have helped streamline processes, speeding up the introduction of vital treatments.
This year, a new prevention injection for HIV is launching in South Africa thanks to the Global Fund’s support. The aim is to have a stable supply of this medicine available within a couple of years, aided by initiatives from UNITAID and the Gates Foundation. Such collaborations show how multilateral health frameworks can efficiently respond to urgent needs.
Despite these successes, the reality is that multilateral health efforts are currently under threat. Historical data reveals that as we moved into the 2000s, health crises became increasingly complex, moving from infectious diseases to non-communicable diseases and mental health challenges. This shift isn’t adequately reflected in the structures of current international health organizations.
Experts like Anders Nordström suggest that we need to rethink how these organizations operate. They propose four key changes: addressing the evolving disease burden, decentralizing power from traditional hubs like Geneva and New York, modernizing institutions to be more efficient, and focusing on increasing domestic health financing rather than relying solely on international aid.
As Canadian Prime Minister Mark Carney noted, the global order is shifting. Countries must reevaluate how they engage with international health systems. The recent focus on unilateral actions may have long-term effects, impacting collaborative mechanisms like the WHO. For middle powers such as South Africa, it is crucial to explore new models that enhance regional cooperation over dependency on larger nations.
To move forward, we need a commitment to human rights-driven approaches in health. This moment can serve as an opportunity to build better, stronger, and more just health systems. Historical evidence shows that when countries work together, they can address health needs more effectively. Embracing this can ensure that our health responses remain robust and accessible for all.
While challenges remain, the lesson is clear: collaborative frameworks have essential roles in shaping health outcomes worldwide. As we navigate this changing landscape, we must prioritize our shared commitment to improving health for everyone, everywhere.
*This article was co-published with Spotlight, a South African public health magazine dedicated to raising awareness on health issues.
