After months of speculation, prospective candidates in the race to become the next Director-General of the World Health Organization (WHO) are now emerging.

At the same time, member states have launched a process to review the global health architecture, with the aim of clarifying roles, strengthening coordination, and aligning financing more closely with national, regional, and global priorities. 

The next WHO Director-General will inherit not only a changing organization, but a broader debate about how the international health system should be organized, financed, and governed.

These discussions come at a time when governments are trying to do more with less. Health systems are managing growing burdens from chronic disease, public finances are under pressure, and geopolitical tensions are reshaping international cooperation. But science is not standing still.

As governments consider the future of the global health architecture, three principles should guide reform.

Foster an environment where innovation can thrive

Investment in the research and development (R&D) of innovative medicines and vaccines has helped drive remarkable progress in health, economic growth, and societal well-being. 

New medicines are estimated to account for around 70% of gains in life expectancy in high-income countries. Global immunization efforts have saved an estimated 154 million lives over the past 50 years, while emerging evidence suggests that adult immunization programs can generate 19 times the return to society.

This progress is continuing. Today, more than 9,600 potential medicines for noncommunicable diseases (NCDs) are currently in development, while hundreds of new medicines are expected to launch globally in the coming years. At the same time, artificial intelligence and data-driven research are opening new pathways for discovery and development.

Yet innovation is accelerating at exactly the moment when support for the innovation ecosystem is becoming less certain.

Today’s R&D pipeline reflects decades of investment in science, research infrastructure, regulatory capacity, and intellectual property frameworks. These conditions cannot be assumed to persist. The world needs more innovation, not less, as it confronts rising rates of NCDs, antimicrobial resistance, and future pandemic threats.

That is why reform efforts should protect and strengthen the conditions for innovation. Predictable regulatory frameworks, strong intellectual property protections, resilient supply chains, open trade, and respect for science are not abstract policy concepts. They are the foundations upon which future medical breakthroughs depend.

Strengthen health systems so innovations reach those who need them

Scientific progress alone does not improve health outcomes. Medicines, vaccines, and diagnostics only deliver impact when health systems can effectively finance, regulate, procure, and ensure access to the people who need them.

Many barriers to better health outcomes are well understood. Regulatory processes can be slow or duplicative. Health systems often face workforce shortages, infrastructure constraints, financing challenges, and fragile supply chains. 

As misinformation, political polarization, and rapid advances in AI, genomics, and other emerging technologies reshape public discourse, strengthening trust in science and health institutions is critical.

Countries may still struggle to move efficiently from policy recommendation to procurement, introduction, and uptake. The result is that innovations can take years to reach the people who need them most.

However, when governments prioritize investments in prevention, earlier diagnosis, and effective treatment, millions of lives can be saved, while supporting more sustainable health systems and economies. 

The most successful reforms will be those that connect innovation and access and reinforce national ownership, ensuring that product development, financing, regulation, procurement, and delivery are viewed as part of a single continuum rather than separate challenges.

This is not only a health imperative. It is increasingly an economic one. As populations age and the global burden of chronic disease grows, resilient and efficient health systems will become even more important to economic growth, workforce participation, and societal resilience.

Forge partnerships to advance health globally

The current global health architecture does not suffer from a lack of institutions. It suffers when institutions duplicate efforts, compete for resources, or drift beyond their comparative strengths.

WHO, development banks, global health institutions, civil society, governments, and industry each bring different capabilities. Effective reform should build on those comparative strengths rather than create additional layers of duplication.

Meaningful reform will require confronting difficult questions about mandates, accountability, and where organizations can contribute to better health outcomes.

This principle should also apply to engagement with industry.

The innovative pharmaceutical sector contributes scientific expertise, clinical research, manufacturing capacity, regulatory experience, and global supply networks that are essential to both health innovation and delivery.

Reforms should create predictable and transparent opportunities for industry to contribute where that expertise can help accelerate progress. This engagement should happen early enough to identify technical, manufacturing, supply, and implementation constraints before they become barriers to access.

As discussions continue about reforming the global health architecture, they should not only ask how to distribute today’s innovations, but how to sustain the ecosystem that delivers tomorrow’s breakthroughs. 

Done well, reform can help unlock a future of better health, stronger health systems, greater societal resilience, and economic growth. If we get it wrong, we risk slowing progress at precisely the moment when science is expanding what is possible.

David Reddy is the Director-General of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). 

Image Credits: Pfizer, Alamy, (Photo: Adobe Stock).