3 key global health leadership changes to watch

Changes are afoot in global health. The leaders of some of the biggest global health institutions are stepping down by the end of 2026 or spending their last full year in their current positions. They include officials from The Global Fund to Fight AIDS, Tuberculosis and Malaria; Unitaid; and the World Health Organization. At some of these institutions, the process for recruiting or selecting the next leader is already underway. These changes come amid a pivotal time for the sector as it navigates foreign aid cuts and growing calls for fundamental change in how global health operates. The Accra Reset — launched in 2025 — calls for a retooling of global governance for health and development, one that is rooted in national ownership and equitable cooperation. The U.S. “America First” global health strategy also presents a key shift in the way U.S. global health assistance works. This means the next leaders of these institutions will be operating in a significantly different landscape than their predecessors, and must expertly navigate these shifts while responding to new challenges and opportunities. 1. The Global Fund to Fight AIDS, Tuberculosis and Malaria Peter Sands has led the Global Fund since 2018. He was reappointed for a second four-year term that started in 2022. He was supposed to leave in March 2026, but the Global Fund board decided to extend his term until the end of the year to provide “continuity of leadership” during the fund’s eighth replenishment. Sands oversaw three replenishment conferences for the Global Fund, helping raise over $40 billion in pledges for the fund’s work since 2019. In 2025, amid funding uncertainties, he was able to secure $11.34 billion in pledges for the fund’s work until 2029, including $4.6 billion from the U.S. government. He also led the fund during the COVID-19 pandemic, one of the deadliest disease outbreaks in history. Under his leadership, the fund created the COVID-19 Response Mechanism, or C19RM, helping countries respond to COVID-19 while protecting HIV, TB, and malaria programs. C19RM became the largest external funding vehicle for COVID-19 diagnostics and therapeutics. The U.S. government contributed $3.5 billion to the mechanism. “I’ve witnessed Peter quickly win and maintain the trust of members of [the U.S.] Congress and two presidential administrations. Why is he so successful? I think it’s because policymakers and their staff can sense he is not doing a sales job,” Chris Collins, president and CEO of Friends of the Global Fight, told Devex. The Global Fund’s next leader, however, will be operating in a different setting, where partner countries are expected to be leading the management and financing of health programs. “Like any institution, the Global Fund will need to adapt. Fortunately, it is already at the leading edge of country leadership, aid transition, and systems building,” Collins said. “The next Global Fund ED will need to provide leadership through the transition period while also staying true to the values that make the Global Fund so successful, including a commitment to multistakeholder engagement, reaching the most vulnerable and marginalized, and putting communities in the center of the response,” he added. The selection process for Sands’ successor has already begun, and the new executive director is expected to be identified in mid-2026. 2. Unitaid Dr. Philippe Duneton took over Unitaid in March 2020, in the midst of COVID-19. He’s retiring toward the end of 2026. Under his leadership, Unitaid invested in COVID-19 tests and treatment programs, and in the past two years, launched programs supporting regional and local production of medicines and diagnostics for HIV, malaria, and maternal health in Africa, as well as investments in the expansion of medical oxygen production in East Africa. “Under his leadership … we really drove important investments and changes for access to oxygen in response to COVID, but then we carried on from a sustainability standpoint to sustain the momentum and investments in access to oxygen,” Robert Matiru, Unitaid’s director of program management, told Devex. Duneton has also pivoted the agency to responding to emerging crises and opportunities. In 2023, Unitaid launched its climate and health strategy aimed at turning health products into “climate-smart health products.” And last September — as part of its work to make new health products available and affordable in low- and middle-income countries — it announced a deal that would make generic versions of the HIV prevention injectable lenacapavir available and more affordable to 120 LMICs at $40 a year by as early as 2027. In his last year on the job, however, Duneton is faced with anticipated cuts in foreign aid from some of Unitaid’s biggest donors, such as France and the United Kingdom. France is Unitaid’s largest donor, accounting for nearly 60% of its funding, while the Gates Foundation and the U.K. serve as the organization’s second and third-largest donors, according to Matiru. Both countries have announced cuts to their official development assistance, or ODA, budgets in 2026 amid efforts to increase defense spending. While it’s not yet clear how that impacts Unitaid, the organization already underwent a reprioritization exercise in 2025 to determine which investments to prioritize in case it receives less funding, and which ones to pause or stop. Among those it had to put on hold are investments in monoclonal antibodies. The changes over the past year have also prompted Unitaid to look at its role in a changing global health landscape, where there are calls for more efficiency and consolidation — something that the next leader of Unitaid will have to navigate. Matiru said the next Unitaid chief will have to contend with how to make Unitaid more efficient and aligned with the evolving global health landscape. “Unitaid is based in Geneva. We have 100 or so staff based in Geneva. How do we do that in a way that is meaningful and intentional, and positions us more closely to governments and their strategic priorities? Because that's the direction of travel with the Lusaka Agenda, the ‘Accra Reset’ and so on,” he said. Its next leader will also be leading Unitaid’s next strategy. The current one ends in 2027. “The HIV, TB, malaria response is not over. We have to continue to prioritize those things alongside maternal health, regional and local production, climate and health. But then what are other new things we have to consider … without spreading ourselves too thin? These are opportunities, but they're also challenges for the new leader to contend with,” he added. The recruitment of the next executive director will follow WHO rules and process, as Unitaid is a WHO-hosted partnership. According to a Unitaid spokesperson, the application notice is expected to be posted on the WHO website around mid-January, and a selection panel will conduct the initial screening process and identify a limited number of candidates who will be interviewed by Unitaid’s entire executive board. 3. WHO Tedros Adhanom Ghebreyesus took over WHO in 2017, in a landslide victory seen as unprecedented in WHO history. He is the first African to lead WHO, and the first to be elected in a voting process that included all of its member states. He ran uncontested for a second five-year term in 2022. WHO underwent several reorganizations and transformations under Tedros, the most recent one in 2025, after the new Trump administration announced its intention to withdraw from the United Nations agency. Tedros has made it his mission to change WHO’s financing, to make it more predictable and less donor-dependent. During his term, member states agreed to gradually increase their dues, and in 2024 WHO launched an investment round to help raise more flexible and predictable funding for the agency. But the U.S. decision to withdraw and other donor funding cuts revealed the agency remains vulnerable to donor pullouts. It left a gaping hole in the agency’s budget, forcing the organization to cut its global staff numbers and senior management and relocate some of its workforce outside Geneva. Tedros’ time in office has also been marred by controversies, from WHO's response to COVID-19 to Gaza. U.S. President Donald Trump accused WHO of being a “puppet of China,” and experts said the agency was slow in recognizing COVID-19 as airborne. Israeli officials have also accused the agency of bias. The next WHO director-general election is slated for 2027, but there’s been quite a buzz already over potential candidates — from WHO insiders to health ministers. The World Health Assembly in May 2026 serves as a fertile campaigning ground for interested candidates. Peter Singer, who served as Tedros’ special adviser until 2023, wrote in a recent Substack that the next WHO director-general should “revive the results agenda, make WHO neutral on Israel, and bring back the US.” He wrote that WHO’s focus on Israel’s attacks against health facilities in Gaza “has likely contributed, even unintentionally, to anti-Israel and anti-Jewish sentiment.” And while the candidate doesn’t necessarily have to advocate for bringing back the U.S., he hopes the criteria he mentioned and “some humility about the handling of COVID-19 might be enough.” In an opinion piece for The New York Times, Singer wrote about how WHO can “do more to assuage concerns about its pandemic response” by calling for a moratorium on “risky virus research” and doing more to recognize “potential missteps” in the COVID-19 response to regain trust.