Is the global health system a house of cards?

Our world is facing a global health crisis unlike anything we’ve ever seen before. Pandemics, climate change, and the rise of non-communicable diseases are overwhelming fragile health systems, leaving millions vulnerable. Yet, the very architecture designed to protect us (the global health system) is crumbling under the weight of its own complexity.

 “We must also address the root causes of health inequities, tackling issues like poverty, inequality, and climate change. Finally, we need to foster innovation, supporting research and development of new tools and technologies to improve health outcomes for all.”

This is the current state of global health. Countless organisations, each with its own agenda and funding streams, operate in silos. Aid flows in unpredictable bursts, often bypassing national systems and undermining local ownership.

This piecemeal approach is wasteful and can’t last in the long run. As budgets tighten and global challenges intensify, the system is teetering on the brink of collapse.

A time for change

It’s encouraging to see so many voices calling for change, and there’s a growing momentum for reform. This resonates deeply with my own belief that we need a different approach. Some organisations, like the Centre for Global Development (CGD), are doing critical work, analysing the system’s weaknesses and charting a path towards a more effective and equitable future for global health.

Read also: Mathematical Biologist addresses global health challenges with innovative research

Three pillars of reform

A healthier future rests on three core principles:

• Quality over quantity—simply throwing money at global health challenges won’t solve the problem. We need to prioritise ‘strategic investments’—those that deliver the biggest impact for every dollar spent. This means focusing on efficiency, ensuring minimal waste, and maximising the return on our investments. It also means ensuring equity, reaching the most vulnerable populations, and leaving no one behind. We must also build sustainable health systems that can withstand future shocks, ensuring long-term resilience and preventing future crises.
• Country ownership is key—The current system often dictates terms from the outside, leaving countries with little control over their own health agendas. This must change. We need to shift the power dynamic, empowering countries to lead. This means prioritizing national priorities, aligning aid with the specific needs identified by each country, not donor agendas. We must also strengthen local institutions, investing in the capacity of national governments to effectively plan, implement, and manage their own health programs. True progress requires fostering genuine partnerships between donors and countries, built on mutual respect and shared responsibility.
• A long-term vision—We must move beyond short-term fixes and focus on building a sustainable future for global health. This requires a long-term vision. We need to invest in long-term solutions, strengthening health systems at their core, from accessible primary care to robust disease surveillance. We must also address the root causes of health inequities, tackling issues like poverty, inequality, and climate change. Finally, we need to foster innovation, supporting research and development of new tools and technologies to improve health outcomes for all.

Taking action:

Business leaders must be actively working to translate these principles into concrete action. This includes:

• Diagnosing the problem—analysing the current system to identify its weaknesses and predict future challenges. This involves understanding the impact of globalisation, climate change, and technological advancements on global health.
• Driving incremental change—Advocating for practical reforms within existing institutions, such as Gavi and the Global Fund, to improve efficiency, equity, and impact. This could involve leveraging their expertise in areas like data analytics, supply chain management, and technology to optimise resource allocation and improve service delivery.
• Envisioning a new future—Business leaders have a critical role to play in envisioning and shaping a radically improved global health architecture. This involves exploring bold yet achievable reforms that can fundamentally transform the system.

One key area for action is investing in innovation. Business leaders can significantly contribute by supporting research and development of cutting-edge technologies and healthcare solutions. This could include supporting the development of AI-powered diagnostics, advancing telemedicine platforms, and driving the growth of personalised medicine.

Furthermore, fostering strong public-private partnerships is essential. Working hand in hand with governments, non-profits, and researchers, business leaders can put their resources and know-how to work to find innovative solutions to the urgent health crises facing our world.

Championing sustainable business practices is another critical aspect. Integrating social and environmental responsibility into their business models ensures that their operations do not negatively impact human health or the environment. This can involve minimising their environmental footprint, promoting ethical sourcing, and prioritising the well-being of their employees and the communities they operate in.

Lastly, business leaders must actively advocate for policies that support global health. This includes using their influence to advocate for policies that promote equitable access to healthcare for all, invest in robust public health infrastructure, and address the social determinants of health, such as poverty, inequality, and environmental degradation.

The future of global health hangs in the balance. We cannot afford to stand idly by while the current system crumbles. It’s time for bold action, a time for innovation, a time for a global health system that truly delivers for all.

Ota Akhigbe is a renowned leader with a diverse background in healthcare, finance, and telecommunications. She is passionate about driving positive change and creating a more equitable and sustainable world.