Devex CheckUp: Experts weigh in on the future of global health

As I dust off my laptop after a weeklong break, I’m reminded that the best thing about holidays is that you find an excuse not to read emails. And the worst is that you come back to hundreds of unread emails — and some of them arrive unsolicited in my inbox, like one on how to crush gym anxiety.

But there are a few gems, like one from Sakiko Fukuda-Parr, professor of international affairs at The New School in New York. In response to a question we posed in our global health deep dive newsletter last week, “What exactly should the future of global health look like?” Sakiko shared the 10 principles that should guide the future of global health that she, along with 16 other development and health experts, outlined in a piece back in July. The bottom line: It needs to be “more polycentric than hegemonic.”

Neil Buddy Shah, CEO of the Clinton Health Access Initiative, argued that the future of global health must be country-led, including the procurement of drugs.

“When CHAI did market shaping early on, it was a little bit easy, because you had the Global Fund, you had PEPFAR, [you had] these big procurers that can guarantee a huge volume of sales to pharma, so pharma had the confidence say, ‘OK, we’ll produce millions of this drug at a low price point,’” Shah said during a Devex Pro Briefing.

While the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR can still do that, although potentially at a smaller scale, in the future, countries should pool their budgets to give the industry that same confidence, he said.

In the wake of massive aid cuts, Africa Centres for Disease Control and Prevention chief Dr. Jean Kaseya — in a separate Devex Pro Briefing — underlined the need for African countries to devote more of their national budgets to health care and tackle bad governance, such as corruption and fraud. He said rooting out inefficiencies would also yield huge savings for countries, potentially negating the need for external assistance.

Lots of ideas are being floated about the future of global health. What are some of yours? And what is your organization doing to enact those changes? Let us know via email at checkup@devex.com.

Read: ‘Cataclysmic’ aid cuts offer chance to rethink future, not recreate past (Pro)

Read more: Africa CDC chief on health agency’s past problems and promising future (Pro)

In case you missed our deep dive: Global health’s next era is here — but it’s full of uncertainties

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A place for everyone?

Speaking of changes, there’s been a push in recent years to host global health conferences in the global south. All too often, conferences take place in high-income countries that require exorbitant fees for visas with no guarantees of approval, denying the participation of experts who are at the forefront of tackling the challenges within their communities.

But can a change in location result in better access?

Devex contributor Paul Adepoju finds that at the recent International AIDS Conference that took place in Kigali, Rwanda, there were more African scientists, activists, and students present. And the numbers back that up: nearly 50% of the roughly 4,000 participants were from Africa versus just 26% of the 5,335 attendees at the IAS conference in Australia in 2023.

However, he also finds that access is not guaranteed. Some African researchers had their own experience of visa denials within the continent, such as Ifeanyi Omah, a Nigerian virologist who missed a conference in South Africa and an Africa CDC meeting in Ethiopia because his visa was denied.

And experts say the change should not be limited to locations only, but also to meaningful participation.

Read: Can Africa host its way to inclusion? 

A taxing issue

Still, the fact remains that many health conferences or key U.N. meetings are happening in places with extensive visa requirements. For example, the fourth U.N. high-level meeting on noncommunicable diseases and mental health, taking place in New York in September.

Members of civil society who have been hoping that the meeting would lead to stronger government action to prevent and control NCDs, however, have other problems right now. They are concerned that the draft political declaration for the meeting has been weakened, including text on targets calling for strong tax measures on products such as tobacco, alcohol, and sugary beverages that can reduce people’s exposure to risk factors linked to NCDs while generating additional revenue for governments.

Here’s one example: According to an analysis by the NCD Alliance, an earlier target for 80% of countries to either implement or increase their excise taxes on tobacco, alcohol, and sugar-sweetened beverages has been replaced with a vague commitment for 80% of countries to have “policies and legislative, regulatory and fiscal measures to support health objectives.”

Earlier text that calls for the implementation and increase of taxation on tobacco, alcohol, and sugary beverages has also been replaced with more passive language, and removes mention of taxes on sugary beverages.

With the changes, “it’s really taken out a key measure that could be so important to tackling these sort of complex problems that we're facing in terms of NCDs prevention, care and financing,” Alison Cox, NCD Alliance’s policy and advocacy director, tells me. 

Read: NCDs political declaration risks watered-down ambitions

ICYMI: WHO pushes for 50% price hike on tobacco, alcohol, and sugary drinks

One big number

On its 25th anniversary, the Gates Foundation committed to spending $200 billion over the next 20 years. Now we know part of that sum will go to advancing innovations benefiting women.

The foundation announced last week that it will spend $2.5 billion over the next five years to advance more than 40 promising innovations to improve women’s health — from AI-enabled ultrasounds to diagnose heavy menstrual bleeding to a hormonal IUD that can prevent pregnancy for 6-8 years.

The foundation remains committed to expanding contraceptive options for women so they have “more control, fewer side effects, and options that match their lives and preferences as their needs change,” Dr. Anita Zaidi, president of the foundation’s gender equality division, tells me.

It’s the foundation’s largest investment in women’s health research and development, and shows a one-third increase from its investments over the past five years.

The announcement comes against a backdrop of aid cuts that are threatening to impact women’s health, including their sexual and reproductive health and rights. The United Kingdom, for example, is reducing spending on women’s health in several countries, although details are scant on specific programs that will be cut or discontinued.

Read: Gates Foundation will spend $2.5B to boost women’s health innovations

Read more: How UK aid cuts will impact women’s health

The presidents have spoken …

Gavi, the Vaccine Alliance has some powerful backers. There’s Bill Gates, who has repeatedly cited he multilateral’s lifesaving work. And then there’s former Tanzanian President Dr. Jakaya Mrisho Kikwete, who, in a recent Devex opinion piece, called on donors to close Gavi’s funding gap.

A little background: Gavi launched its fundraising campaign last year, hoping to raise $12 billion to expand vaccine coverage and introduce new ones. But at its pledging summit in June, it fell short of that goal.

Kikwete wrote, “I fail to see the rationale for scaling back support for Gavi,” and argued that “Choosing to invest in Gavi, in vaccines, should not be a difficult choice.”

“Without full funding for Gavi, the transformation of health in Africa over the past 25 years is at risk. Rollouts of new, lifesaving vaccines are likely to be delayed. Millions of children who have yet to be vaccinated may miss out on lifesaving protection,” he wrote.

Meanwhile, in an open letter, Sierra Leone President Julius Maada Bio wrote that access to vaccines in his country means “Fewer parents have had to mourn a child lost to measles or pneumonia … fewer hospital visits and more school graduations.”

He said his government plans to finance nearly half the cost of Sierra Leone’s vaccines over the next five years, although they are “not there yet.”

“But by continuing our partnership with Gavi, we can maintain and even accelerate our progress toward national immunization programs fully financed through domestic resources,” he wrote.

Opinion: I fail to see the rationale for not supporting Gavi

Open letter: We must stand together for immunization in Africa

Background reading: Gavi pledges fall short about $2.9B as US pulls out

What we’re reading

Scientists are worried about the implications of U.S. health secretary Robert Kennedy Jr.’s decision to stop funding messenger RNA vaccine research. [Axios]

Fiji is dealing with a 550% surge in HIV cases. Experts say the rise in cases is due to an increase in the use of methamphetamines. [Telegraph]

Pacific island countries and territories are experiencing a sharp rise in dengue cases, with 16,502 confirmed cases and 17 deaths since the start of 2025. Experts say this is driven by climate change. [The Guardian]