For years, several experts have argued that the global health architecture is in dire need of reform and criticized the sector for its fragmentation and reliance on donor-driven agendas. Now, with donor funding cuts exposing cracks in the system, those calls have taken on new urgency.
The abrupt withdrawal of funds — notably from the United States, global health’s biggest funder — led to the closure of numerous vital programs and organizations, curtailing access to essential health services for many individuals. Major global health entities were also forced to downsize and reevaluate their priorities.
As a result, what has long been a simmering conversation about reform is now a pressing question: Can global health build a system that is less fragmented, less donor-driven, and more resilient to political shifts?