From stalled Pathogen Access and Benefit Sharing (PABS) negotiations to failing consensus in global climate policies, United Nations structures face a profound crisis. Diplomats are currently being forced to explore alternative governance models to bridge the disconnect between sluggish, power-driven diplomacy and the rapid, equitable action required in health and climate crises.

This institutional rupture and the resulting emergence of two-speed multilateralism took centre stage during a critical panel hosted by the Global Health Centre in Geneva on 30 March.

“The world order and the postwar institutions that were created to address global problems are at a unique moment of rupture, possibly collapse or transformation, depending on where we go from here,” said Professor Suerie Moon, co-director of the Global Health Centre at the Geneva Graduate Institute, during her opening remarks of the expert panel discussion.

The event was co-hosted by the Centre’s International Geneva Global Health Platform, alongside the World Health Organization (WHO), the International Institute for Sustainable Development (IISD) and the Geneva Environment Network.

There was clear unity among the expert panellists – ranging from global health researchers and climate adaptation advisors to international diplomats – that when traditional, consensus-based multilateralism stagnates, the international community must pragmatically turn to alternative, faster diplomatic channels.

This “two-speed multilateralism” combines the universal legitimacy of consensus-based UN negotiations with the rapid implementation capabilities of smaller, highly ambitious “coalitions of the willing”, aiming at preventing single nations from vetoing desperately needed progress on environmental and public health protections.

“Consensus has been, in essence, weaponised by a few countries to obstruct progress,” said Miguel Ruiz Botero, second secretary at the Permanent Mission of Colombia to the UN in Geneva, during the panel discussion.

For example, as global temperatures reach record levels, experts argue that traditional structures are simply not mobilising political action fast enough to protect vulnerable populations affected by climate change.

To bypass this gridlock, Colombia is hosting the Santa Marta Conference on 28-29 April , which will serve as a prime example of this accelerated diplomatic speed.

Co-hosted by the Netherlands, the summit aims to establish a clear pathway for transitioning away from fossil fuels outside the traditional UN architecture.

This parallel track aims to establish a strict division of diplomatic labour, as COP30 President André Aranha Corrêa do Lago recently outlined.

While the “first tier” ensures universal legitimacy and sets the collective legal direction, the “second tier,” or fast track tier, focusses exclusively on rapid implementation by mobilising finance and deploying solutions at scale without reopening debates already settled by consensus.

WHO support for two-speed approach

Notably, the WHO voiced clear support for this parallel approach. “If a certain subset of parties or countries can take a part of the agenda that moves things in a positive way, then you know that has to be supported,” said Dr Diarmid Campbell-Lendrum, WHO head of the climate change, energy and air quality.

He noted that the health gains from reducing air pollution would effectively cover the costs of transitioning away from fossil fuels, making a compelling, evidence-based case for this accelerated track.

Key Moments for Climate and Health Diplomacy in 2026

This decisive backing for initiatives outside the formal UN architecture is unusual for an agency traditionally restrained by universal consensus.

However, in private discussions following the event, experts observed that the WHO is navigating new political dynamics. Following the US exit, the institution may be experiencing reduced diplomatic pressure, inadvertently allowing it to embrace more pragmatic, parallel agreements without its usual hesitation.

This momentum will continue at the upcoming 79th World Health Assembly in May. While the WHO will not formally report on its “Global Action Plan on Climate Change and Health” during the main agenda, Türkiye and Brazil are set to co-host a high-level side event to fill the gap and strengthen the integration of the health and climate dossiers ahead of the COP31 summit in November 2026.

Bypassing slow paced consensus is not new

The strategy of utilizing alternative diplomatic pathways to bypass institutional gridlock is not a novel invention.

“Two-speed multilateralism is certainly not a new phenomenon,” said Moon. “Ever since the UN was founded 80 years ago, there have been parallel bilateral and minilateral processes that work alongside global multilateral processes.”

In recent decades, parallel negotiations and smaller alliances have historically operated alongside universal frameworks to influence broader international arenas. When traditional consensus rules made a UN-based landmine convention impossible in the late 1990s, Canada and a group of progressive nations moved negotiations outside the formal architecture to create the Ottawa Process.

This historical success, alongside the eventual adoption of the Arms Trade Treaty by the UN General Assembly, demonstrates how coalitions of the willing can effectively force meaningful international agreements when broad consensus fails, explained Colombia’s representative Botero.

The upcoming Santa Marta conference will act as the first major testing ground for establishing this diplomatic strategy in climate policies. Unlike exclusive diplomatic clubs where powerful nations make decisions behind closed doors, this approach remains open to states ready to act.

Integrating health into climate action

Ultimately, these efforts aim to create a push-pull dynamic that elevates the baseline ambition of the entire international community.

“We see value in both tracks, the inclusiveness and legitimacy of the UN system alongside the dynamism of the coalition of voluntary initiatives that can accelerate progress,” said Dr Gül Mersinlioğlu Serin, a health expert at the Turkish Ministry of Health.

However, securing these baseline commitments – and breaking down two decades of silos between climate and health negotiations – remains challenging.

Despite these hurdles, the recent COP30 summit in Belém, Brazil, delivered clear progress by finalising the Baku Adaptation Roadmap and establishing 59 voluntary indicators for the Global Goal on Adaptation.

This allows the international community to measure climate impacts through human health metrics, such as heat-related mortality and local health system resilience, explained Ömer Öztürk, head of adaptation to climate change and local policies at the Turkish Ministry of Environment, Urbanization and Climate Change.

Expanding action through local health

The Belém Health Action Plan established a critical framework for building low-carbon, climate-resilient health systems, effectively translating slow-moving global agreements into on-the-ground implementation. By targeting surveillance, capacity-building, and digital innovation, the plan ensures adaptation measures actively address severe health inequities.

To successfully execute these measures at an accelerated pace, experts argue that broad climate goals must be communicated in terms that specific sectoral ministries understand.

“This is a translation, this is different language and this happens with all the sectors,” said Margarita Gutierrez, policy advisor for Friends of Climate and Health at the International Institute for Sustainable Development, emphasising that mainstreaming climate considerations into everyday sectoral policies provides a crucial opportunity to coordinate joint actions.

However, Gutierrez warned that unless countries actively integrate these health metrics into their formal UN commitments – such as Nationally Determined Contributions (NDCs) – securing health’s relevance and funding on future global agendas will remain incredibly difficult.

But as amending these universal UN agreements is a years-long bureaucratic process, experts argue that fast-track, parallel coalitions are urgently needed to bypass the gridlock and deploy health solutions immediately.

Rebuilding trust through equitable cooperation

However, building on two-speed multilateralism and operating outside universal frameworks carries significant risks, prompting debates about fragmentation and the potential exclusion of smaller developing nations.

“Considering, for example, that small island developing states are some of the most vulnerable to climate change, it’s really important that they have the equal weight to be able to stop the process,” said WHO’s Campbell-Lendrum, arguing that universal forums allow vulnerable nations to demand the same attention as major powers.

To ensure these frontline voices are not lost, diplomats are actively elevating regional priorities.

Highlighting this effort, Australia, presiding over the negotiations at the COP31 summit, announced that it is cooperating with Pacific islands to support a pre-COP31 gathering.

“We are working hand in hand with Pacific Island Forum members and regional organisations to shine a global spotlight on our region,” said Margot Morris, counsellor at the Permanent Mission of Australia to the UN.

As the Geneva event concluded with characteristic sober pragmatism, the underlying message was clear: by ensuring rapid progress does not come at the expense of equity, two-speed multilateralism could help counter the climate crisis and stabilise the deeply fractured international order.

Image Credits: Felix Sassmannshausen/HPW, WHO/PAHO/Karina Zambrana , Unsplash/Ernests Vaga.