The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030.

The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life.

From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis.

Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks.

Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates.

Primary care is the new front line

With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC.

Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken.

PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life.

Workforce shortages threaten global health

However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy.

The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation.

Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.”

The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”.

Concerns over high-tech equity divides

High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility.

Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”.

However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities.

While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned.

Ethics and trafficking fears halt global organ strategy

In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027.

The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives.

The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes.

Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen.