Meeting in Geneva for its 79th session, the World Health Assembly agreed this week that the international health system requires fundamental restructuring to meet the demands of a changed world — including conflicts, funding cuts, AI, and evolving disease patterns.
Representatives from WHO’s member states gathered in Geneva this week for the 79th World Health Assembly with an agenda reflecting the convergence of multiple pressures on global public health. By the time the Assembly agreed on Thursday to establish a formal process to reform the global health architecture, the breadth of the challenge facing international health governance had been laid out plainly.
Funding is contracting. Geopolitical conflicts — including the ongoing Middle East war — are generating fresh health emergencies. Noncommunicable diseases and mental health conditions are the leading causes of illness and premature death worldwide. And the institutions designed to coordinate the global health response have, in the assessment of member states themselves, failed to keep pace with a rapidly changing world.
The Assembly’s theme for this year — “Stand with science” — was framed as a year-long campaign to highlight science as the foundation for protecting health and well-being globally. The message carried additional weight in a period when health funding from major donor nations has faced political pressure.
What the Assembly Decided
The most significant institutional decision of the week came on Thursday, when the World Health Assembly voted to establish a joint process — led by member states, hosted by WHO, and open to global health partners — to develop options and recommendations for reforming the global health architecture.
The decision acknowledged, in formal language, that while the existing framework had produced genuine gains over recent decades — in disease control, normative standards, and collective response capacity — it “had not kept pace with the new and evolving global environment.”
Member states identified several dimensions of that gap:
- The expansion of national health sovereignty and growing regional health capacities that sit alongside, and sometimes in tension with, centralised WHO frameworks
- Rapidly changing disease burdens, including the growing weight of noncommunicable diseases such as cardiovascular disease, cancer, and mental health conditions
- The rapid evolution of science, artificial intelligence, and digital health technologies that have not been adequately integrated into international health governance
- Contractions in health financing from major donor countries that have created structural funding gaps in WHO and partner organisations
The reform process will draw on existing reform initiatives and relevant elements of the UN80 Initiative, a broader effort to adapt the United Nations system to contemporary realities. Civil society and youth organisations are to have meaningful engagement in the process.
The Funding Crisis
Perhaps the most urgent thread running through the Assembly’s deliberations was the state of global health financing.
WHO Director-General Dr Tedros Adhanom Ghebreyesus, presenting his report on the work of the organisation, delivered a warning that has grown more pointed in recent years: the progress the world has made in reducing preventable deaths, extending life expectancy, and controlling communicable diseases is not locked in. It is contingent on continued investment.
A WHO report published in the lead-up to the Assembly, titled “Global health gains face threat of reversal,” made the institutional concern explicit. The gains of the past several decades — in maternal health, child survival, infectious disease control, and access to essential medicines — could be eroded if funding trends continue in their current direction.
The causes of the funding pressure are multiple. Several major donor governments have cut or frozen contributions to international health organisations in 2025 and 2026 as domestic fiscal pressures have mounted. The United States — historically the largest single contributor to global health initiatives — has reduced its profile in multilateral health funding under the current administration.
Noncommunicable diseases (NCDs) and mental health conditions, the Assembly noted, remain the leading causes of illness and premature death globally, “driven by shared social, commercial and environmental factors.” These conditions, which require sustained long-term investment in health systems rather than emergency response, are particularly vulnerable to funding contractions.
Conflict and Health: The Middle East Dimension
The Assembly also addressed directly the health consequences of the ongoing conflict in the Middle East, dedicating formal discussion time to the protection of healthcare and health workers in conflict settings.
The committee adopted a draft decision on the health emergency in Lebanon, which has faced both direct conflict impacts and the broader regional disruption caused by the US-Iran war. Iran’s retaliatory strikes — which targeted US military installations, regional civilian infrastructure, and commercial hubs — have generated humanitarian health consequences that are still being assessed.
Delegates emphasised the principle — long established in international humanitarian law — that health workers and health facilities must be protected even in active conflict zones. The practical reality, as documented in multiple recent conflicts, is that this principle is frequently violated.
A strategic roundtable held on the margins of the Assembly reflected on lessons from COVID-19 and other crises, coinciding with the tenth anniversary of the WHO Health Emergencies Programme. Ten years after the programme was established in the aftermath of the 2014-2016 Ebola epidemic, participants assessed how far the international community had come in building preparedness capacity — and how far it still had to go.
Antimicrobial Resistance: A Crisis Moving in the Background
Among the technical agenda items discussed at the Assembly were ongoing concerns about antimicrobial resistance (AMR) — the process by which bacteria, viruses, and other pathogens develop resistance to the medicines used to treat them.
AMR has been described by public health officials as a “slow pandemic” — a crisis developing in the background of more immediately visible emergencies, but one with the potential to undermine the foundations of modern medicine. The Assembly discussed AMR alongside stroke, liver disease, tuberculosis, diagnostic imaging, emergency care, haemophilia, precision medicine, and radiation safety — a list that illustrates the sheer breadth of challenges the global health system is navigating simultaneously.
The WHO’s new Global Strategy for Integrated Emergency, Critical and Operative Care for 2026 to 2035 was also on the agenda, reflecting an effort to build more coherent frameworks for emergency health response at a global level.
The Economics of Health: A New Strategy Adopted
One of the week’s formal achievements was the adoption of a new Strategy on the Economics of Health for All, covering 2026 to 2030. The strategy marks a shift in how WHO is framing the relationship between health investment and economic outcomes.
The Assembly approved the strategy with delegates emphasising that “health and economic prosperity are deeply interconnected and must be advanced through coordinated government approaches.” The strategy sets out a vision in which economies serve health as well as benefit from it — placing equity at the centre of policy and financing decisions.
The framing is significant. It represents an effort to move global health arguments away from a purely humanitarian register — where they are vulnerable to political cutting in times of fiscal pressure — and into the language of economic productivity and long-term growth. A healthier global workforce, the argument runs, is not just morally desirable; it is economically necessary.
Expert Insight
Global health observers noted that this year’s Assembly convened at a moment when the institutional framework for international health faces pressure from multiple directions simultaneously. Funding gaps, geopolitical fragmentation, the legacy of COVID-19, and the emergence of AI as a potentially transformative tool in health systems are all demanding responses that the current system was not designed to deliver at scale.
The decision to launch a formal reform process was broadly welcomed as a necessary step. The more cautious assessment is that member state consensus on the need for reform does not automatically translate into the sustained political will and financial commitment that reform will require.
What Happens Next
The reform process agreed by the Assembly will now begin the work of developing concrete recommendations. WHO member states will resume negotiations on a separate but related matter — the Pandemic Accord annex covering pathogen access and benefit sharing — at a seventh meeting scheduled for July 2026.
The 79th World Health Assembly closed having acknowledged what the evidence has long suggested: the world’s capacity to protect public health globally is not keeping pace with the threats it faces. Whether this session’s commitments translate into structural change will become clearer in the months and years ahead.
LoudFact.com is an independent global news and explainer platform. This report is based on official WHO daily updates from the 79th World Health Assembly in Geneva, May 18-23, 2026.
