When world leaders gathered in New York for the first in-person United Nations General Assembly since the COVID-19 pandemic, an underlying debate was evident: How do we move toward a healthier and more secure world?
A century ago, a global flu destroyed lives and shook economies. We believed that the scientific and technological progress would protect us from another similar event. But the inequities that persisted in our global system kept the promise of good health and prosperity out of reach for many, which we see starkly in the consequences of COVID-19.
Today, the world is off-track from achieving the Sustainable Development Goals for health and, alarmingly, life expectancy has decreased for the first time in a century. We are grappling with diseases such as polio that were once eradicated in parts of the world and increased deaths from infectious diseases, such as tuberculosis and malaria, and noncommunicable diseases, such as cancer and heart disease.
Growing urgency of these challenges has revealed an unprecedented opportunity to forge a new vision for the future of global health, one that is more inclusive, adaptive, and effective in preparing us to meet the needs of the moment and the challenges of tomorrow.
Since I joined RTI International as vice president for global health, I have spoken with many partners, communities, public health leaders, and global health students about the future of global health. I am often asked, what are the priorities for the future? How can we close health equity gaps? Are the right players engaged and investments made?
“Growing urgency of these challenges has revealed an unprecedented opportunity to forge a new vision for the future of global health, one that is more inclusive, adaptive, and effective.”
—This earnest questioning of what’s next is key. Together, our answers can shape a new future for global health — one in which health systems are responsive and resilient, communities are at the center, and expanded coalitions continuously deliver good health outcomes and prosperity.
Responsive and resilient health systems
COVID-19 affirmed that none of us is safe until everyone is safe. It highlighted deep disparities and inequities in our current health systems. These challenges will persist — and be exacerbated by future shocks and stresses — until we tailor health systems to the needs of the people they serve.
The future of global health requires resilient and responsive health systems oriented to primary health care. To do this, we must build from the ground up and invest in whole-of-government and whole-of-society approaches. We must also narrow the financial and capacity gaps between high- and lower-income countries so that any person, anywhere can access appropriate care, leaving no one behind.
Health systems strengthening is not a new concept, but to be effective it must be evidence-based, inclusive, context-specific, integrated, and locally designed and led. If achieved, these systems can deliver quality and equitable health services and outcomes, making everyone safer.
Communities at the center
The pandemic also highlighted the enormous potential of primary health care and community health as the cornerstones of equitable and resilient health systems. Empowering community health workers and making them the vanguard of renewed public health systems has meant more vaccines delivered, better health literacy among communities, stronger networks of preventative health services, and more. RTI is putting this into practice in the Philippines, where we are partnering with the U.S. Agency for International Development to respond to COVID-19. It's also integral to our work to eliminate neglected tropical diseases around the world.
A new vision for global health should reinforce this focus on primary health care and community health to build a future where anyone can get care when and where they want it.
As global leaders develop new health strategies, science should be trusted alongside the voices of vulnerable communities. Funders should prioritize supporting the local vision and goals of national policy makers. The power of a new vision for global health lies in effectively connecting, integrating, and implementing these pieces.
Expanded coalitions and integrated approaches
COVID-19 taught us that global health is a shared responsibility. We too often segment development sectors, resulting in fragmented approaches to interconnected challenges. But we are realizing that we can overcome these limits by integrating health interventions into nonhealth programs such as education, energy, agriculture, and the environment to achieve equity and sustainable, inclusive outcomes.
A brighter future for global health relies on more expansive coalitions than those of the past. Embracing the principles of “one health” and expanding the platform to include environmental players will position us to collaborate strategically across and between countries, sectors, and agencies for optimal health in an increasingly unpredictable world.
Building coalitions to define and meaningfully incorporate health equity into global health initiatives from the outset will balance the power dynamic between donor and “recipient” countries. Designing, testing, and continuously innovating new funding models will enable more effective responses to emerging threats. Incorporating greater accountability into impact measurements will help ensure investments make a real difference.
The opportunity is exciting: We can deliver on global health security, preparedness, and response while benefiting non-health sectors and economies. RTI has invested in this idea, pulling resources from across the organization and reinforcing the commitment, including building a dedicated team, to develop solutions to advance these goals.
Our coalitions must also include nontraditional groups such as research institutions, universities, and the private sector to stimulate transformational technology and innovation. We must also give space and credence to the voices of the next generation who will carry this work forward.
A better future for global health
As someone who has served as a health provider and development practitioner for 24 years, I have seen numerous health challenges around the world. I have also seen how partnerships and interventions — when done right — can work. The urgent health challenges of today can be met with meaningful solutions that prepare us for the challenges of the future.
While there will always be adversity and uncertainty, gaps to address, and emerging challenges, there will also be new generations of health leaders, and the spirit of our shared humanity. This gives me hope for a reimagined vision and future for global health.
From strengthening health systems to empowering communities to expanding our coalitions, we have an opportunity to emerge from the COVID-19 pandemic wiser and more committed to accelerating progress toward a world that is secure from public health threats.
RTI International is both a global research institute and a leading international development organization. We combine these powerful capabilities with those of our partners to co-create smart, shared solutions for a more prosperous, equitable, and resilient world. Learn more about our work in global health.
About the author
Dr. Hala Jassim AlMossawi
Dr. Hala Jassim AlMossawi is the vice president for global health at RTI International. Dr AlMossawi is an accomplished global health professional with more than 24 years’ experience as a technical expert, strategist, and leader for implementing partners, programs, and government. She is a published expert on infectious diseases and health system strengthening, and a seasoned leader in business development and in the design and management of health programs. As vice president of global health at RTI, Dr. AlMossawi provides strategic leadership and overall management for RTI’s global health programs. In 2022, Dr. AlMossawi was selected as one of the top 50 women business leaders for Maryland.
