Hi,

When I drew up issues to watch out for in global health in 2025, I somewhat naively said it would be the year when multilateralism would come under pressure. I massively underestimated what came after. These things don’t age well.

In any case, I will still stick my neck out and humbly submit to you what in my limited assessment are, some of the key trends to watch out for in 2026 for global health. As before, in this edition, we also look at stuff beyond global health. It is pointless to put blinkers on, and focus only on the field per se.

Starting this year, we will on occasion present the GHF View: our opinion on issues. As we begin our seventh year in operations, we have earned our stripes to do this.

Also, sharing a recent piece I wrote for Geneva Solutions, on what global health needs this year. (I may lose powerful readers on this account, but our experience in 2025 tells me that our readers like it when we tell them as we see it.)

At some point last year, after facing a particularly ugly bout of “push-back” to our work, I fell deep into reflection on the limited role of journalism in changing anything. However, my conclusion was that, we should do what we can while we can – as with most things in life. Naysayers are tiresome.

Thank you for reading.

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More soon!

Best,

Priti

Feel free to write to us: patnaik.reporting@gmail.com or Follow us on Twitter: @filesgeneva

I. THE GHF VIEW

What To Watch Out For In Global Health In 2026

By Priti Patnaik

This year we will witness the fuller impact of what was unleashed in 2025.

1. Geopolitics Will Circumscribe Global Health

It is becoming difficult to speak about global health without referring to geopolitics. This year will be no different.

Barely had global health professionals in the Northern hemisphere fired up their computers, in the afterglow of the annual holiday season at the beginning of 2026, that the U.S. administration cast a new reality upon Caracas, Venezuela, followed by a swift abduction of the country’s President, Nicolas Maduro.

You may ask how this concerns global health. To understand this, simply look at the public statements issued by authorities in the UK, the EU and others, (exceptions including Norway), in response to the nature of this action. Therein lies the storyline that will form the arc of this year – a continuation of years past.

So broken is this defense of the breaking of the international order, it will take a real optimist to believe that in the realm of global health, countries will come together to forge solidarity and embrace rules-based approach in anything.

From the lack of moral courage on Palestine, to negotiations on tariffs, taxes, and other matters including reigning in Big Tech, the lack of leadership and coordination among the biggest countries in the world has been breathtaking.

(And while we are at it, you may want to read this fascinating piece that describes Trump’s Venezuela action as being driven by securing petrodollars, and to protect the legitimacy of the American dollar as the reserve currency for the world, in light of the rising importance of the Chinese currency. Watchers will also not miss the painful justifications, a doctoring of the nuance, and the convenience of arguments, among international law commentators on the unfolding Venezuelan saga. Thank god for alternatives to the mainstream western narrative.)

Days into the new year, the world is already on tenterhooks.

The rise in conflicts is tied intrinsically to outcomes for global health. Peace is foundational for health, The Lancet said in an editorial earlier this week, and we could not agree more.

Years past also showed us the pussyfootedness and a widespread lack of unequivocal acknowledgment of the devastation and the genocide in Gaza. Not linking peace to health, is deception.

This brings me to leadership in global health.

2. The Test Of Leadership In Global Health

While 2025 was bad, and 2026 could be worse. Things will continue to get worse before they will begin to get better, unless there is a change in the fundamentals.

Will we see more innovation to deal with funding crisis, for example? Are we past the hand-wringing, and worse, cajoling-the-powers phase? I don’t think so.

The evidence that this year may be different, has not presented itself yet.

While one recognizes the tough diplomatic choices between a rock and a hard place, real leadership is forged during crisis. This is different from opportunists capitalizing on every public sector failure as a space to exploit a market.

Global health will have to confront changed realities and put in place processes to guide this forced transition to make it more humane in the long term. (See what experts have to say: “Debates on reform need to begin from the perspective of what countries and regional bodies require, rather than from the needs of existing institutions.” See Think Global Health: Transforming the Global Health Ecosystem for a Healthier World in 2026)

Although weakened, WHO remains a key central coordinating authority for global health. The forthcoming change of guard at the institution in 2027, will be important for the field. So, the year 2026 will see the most committed candidates throw in their hats in the ring, vying to lead WHO in order to hopefully secure the place of the institution, and prevent further weakening of its financial and normative powers. It will be the collective effort of member states and other actors, to define the path ahead for the institution in the coming months.

But global health is much more than WHO. The year will see active participation from a range of stakeholders as strategic conversations gather steam to redraw the map of the field.

3. Global Health’s Reckoning with Unbridled Superpower Behavior?

To make progress, one sometimes needs a break from the past. Some of the enlightened experts in this community tell me, that the time has come for global health to call out superpower behaviour. But I am not too positive this will happen.

Aggression and bullying are antithesis to health for all. (See by Andrew Harmer: The global health community needs to wake up and fight back against the Trump administration.)

It is not just that countries do not care for multilateralism as much as they should, many are focused on an array of unique challenges they face at home. And some, merely play to constituencies back home, without any real engagement or commitment to multilateralism. (We are beginning to hear that even rich countries are cutting down on resources for global health work in Geneva.)

The problem is effective governance of global health and optimal outcomes for people’s health, will depend on greater coordination and solidarity. So, while there is still power in the numbers, a demonstration of this power in opposition to the powerful will be important for global health.

Not calling out “might is right” will simply not work in global health given the sheer interconnectedness of a host of determinants, from the access to information to depth of networks. (Let’s call it the geopolitical determinants of global health?)

Take one example: the failing effort to ensure digital security and rights for kids. This is a global health matter, and will need leadership on the part of WHO member states, and will necessarily need a confrontation with super powers and the machines that oil them. We know there are consequences, but there is no other choice.

(Also relevant from Foreign Policy: The World-Minus-One Moment)

4. The Hobson’s Choice Facing Some African Countries:

After the shock and awe of U.S. bilateral deals on trade and health, this year will see how African countries make choices for themselves. It is a difficult and an unenvious predicament. When aid cuts where announced in early 2025, it was worse than the ground beneath shifting, across communities in developing countries notably in Africa. It fuelled a determination of resilience and sovereignty across the continent. But the test for this commitment came too soon for some of the countries, by way of American bilateral deals that promise aid in exchange for biological information. This year would reveal the weight of such choices. (On the implications on multilateral negotiations at WHO see more below.)

Also see: The America First Global Health Strategy and the Dilemma of Pan-Africanism

5. The Financial Crunch

Last year, UN organizations and other global health agencies, shed hundreds of jobs, institutions lost expertise. It is difficult to estimate how much 2025 setback global health from a governance perspective. The worry is that the cutting back may not have been strategic. Crucial areas of global health would have lost direction, with such moves impacting the most vulnerable communities including refugees, for example.

What comes after is hard to say. It appears the lack of adequate financing is a new normal that organizations have to simply contend with.

With uncertainty comes opportunity, for some. This year will also reveal how desperate organizations will make friends in places you rather not, in lieu of hard cash that they so badly need to run their operations.

Some amount of pragmatism will hurt credibility and worse, health outcomes depending on the motivations of “new friends” of global health.

We will soon know whether the withdrawal of the U.S. from WHO will become effective. The U.S. continues to owe WHO membership dues (assessed contributions). WHO told us on January 6, 2026: “When it joined WHO, the United States of America reserved its right to withdraw from the Organization on a one-year notice, provided however that the financial obligations of the United States to the Organization shall be met in full for the Organization’s current fiscal year. The USA gave notice of withdrawal on 22 January 2025. As of today, the USA has not paid the invoiced amounts for its assessed contributions for the biennium 2024-2025.”

Also, it seems some rich countries are not fighting hard enough to raise revenues to fund their public services. (See Tax Justice Network: OECD collapse will lock in countries’ tax losses to US firms).

6. Global Health Negotiations at WHO: PABS

The Pathogen Access Benefit Sharing System – which is an annex to the Pandemic Agreement that was adopted last year – could be a silver lining in the darkening sky of multilateralism. That is if countries get there before May 2026.

With every new country signing away the sharing of health information for aid, the prospect and commitment to a rules-based multilateral system governing these areas, becomes dimmer. But WHO member states have surprised themselves before by adopting the Pandemic Agreement despite the turbulent winds of conflicts and geopolitics. At this point, reaching consensus on PABS is very much in the realm of possibility and optimism, as is the risk that the whole edifice of PPPR may just be a shadow of what was initially envisioned during the dark days of COVID-19. (PPPR: Pandemic Prevention, Preparedness and Response)

For the success of PABS, countries will have to square complex circles. And for now, there are few overlaps in the Venn diagrams of these negotiations. Negotiators will do what they can backed by capitals. What will eventually come to pass, may be determined by the distance of those capitals from Washington D.C. (We will continue to report on these discussions.)

Also do not forget that the negotiations will also be shaped by the hand of the industry. And pharma companies and the countries that host originator companies, weigh costs and benefits of operating in a volatile trade environment of unilateral tariffs measures. Uncertainty means risk, risk means premium. Expect all relevant actors to be dictated by their bottom lines and not the “greater public good” - some understand this as health security, and others as equity.

7. The Pressure On the Agenda for Diversity, Inclusion, Equity (DEI)

The challenges to protect the policy space for the sensitive and vital matters on sexual and reproductive health, became most acute in 2025. Unless actors with agency step up to cushion the attacks on women’s health, and the rights of LGBTQ communities, much of this fight will be fought on the street by communities, activists and islands of professionals working under pressure at their institutions. When the U.S., announced a series of measures to delegitimize this space, many countries around the world were buffeted by the winds of such short-sighted harmful policies. Institutions in Geneva were not left behind, some dropped DEI like a hot potato at the first instance.

There is some desperate, ridiculous reframing of the DEI agenda, efforts by such apologists are appalling to say the least. This fight will get deeper and more contentious even as people pay with their lives.

8. Disinformation and Vaccines

While there has been impressive progress made on immunization, rampant, institutional misinformation threatens to reverse the gains made over decades. Vaccine-preventable diseases are on the rise. A deadly cocktail of sovereign powers in setting vaccination policies (notably in the U.S.), and commercial incentives for disinformation, are impinging on evidence-based global health measures such as vaccination. Precious resources are being invested in debunking myths. This challenge will not let up easily and is one of the biggest crises in global health in recent years.

A top WHO official said in December 2025: “The spread of false and misleading information about vaccines continues to undermine public trust, distort perceptions of risk, and hinder uptake. Countering misinformation must remain an integral part of immunization programmes — through transparent communication, community engagement and partnerships that amplify evidence-based messages.”

The risk of the export of American vaccine politics to the rest of the world are compounding with every passing day. How will countries and international institutions cope with this onslaught?

9. AI and Global Health – Who is Regulating This Stuff?

We will leave the possibility of the fragility of the AI bubble to financial pundits. What concerns global health is who is regulating the interface of global health and AI, and what are the implications for already entrenched health inequities? Already, the healthcare sector is one of the more fervent adopters of AI in a bid to cut costs and gain efficiency.

While I don’t expect any big country to regulate Big Tech effectively enough, but global health institutions have the responsibility to review their relationships, and examine what the embrace of AI means for public health.

The lack of effective regulation of Big Tech is a global risk. Will the Davos Club qualify this as a risk?

(Also see, Ilona Kickbusch in the BMJ: Managing the impact of AI on both human health and planetary health requires new forms of governance)

10. Weight-Loss Pills

Fighting non-communicable diseases (NCDs) has traditionally not been prioritized enough by donors. But the buzz around obesity drugs is changing how NCDs will be addressed this year and in the future (global sales of these drugs is tipped to be more than US $100 billion by 2030).

Obesity affects more than a billion people globally and the global economic cost of obesity could touch US$ 3 trillion a year by 2030, the WHO has said. The FT reported that obesity drugs “will remain the pharma sector’s main growth engine”.

In December 2025, WHO issued its first global guidelines on the use of Glucagon-Like Peptide-1 (GLP-1) therapies to treat obesity. These are conditional recommendations by the WHO, and several authorities are still reviewing the long-term impacts of the drugs. Also, patents on semaglutides (the active ingredient in Ozempic) will expire soon, with implications for many countries on not only increasing access to these drugs but also in ensuring quality, efficacy and safety for their populations. In China alone, two dozen companies are reportedly preparing to launch weight-loss drugs.

TAIL PIECE:

All this feels like we are headed towards another mixed if not grim year. We did not even come to discussing the crisis in governing the climate crisis, the U.S. presidency of the G20, the EU’s security concerns, and potentially unforeseen events in 2026.

There is no doubt that some countries and actors are resisting the anti-globalism junta. We must savor the efforts at the Brazilian climate COP last year, for example. But can the world reach a critical mass of such efforts? Lets hope so!

Also see:

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