World Health Summit: reimagining global health

Resilience, pushback, and opportunities for civil society organisations working to adapt to the new normal: John Plastow, Frontline AIDS Executive Director, reflects on the World Health Summit.
2025 has been a bleak year for the HIV response and global health more broadly. Not so long ago the aspirational sustainable development goal (SDG) to eradicate AIDS by 2030 was a meaningful global rallying call. The unprecedented downturn in overseas development aid (ODA) has hit the global HIV response incredibly hard and effectively killed off any semblance of its usefulness as an achievable global target.
For many Frontline AIDS partners it has been a year of unprecedented collapse in their capacities and the services they offer communities.
Speaking with leaders of civil society partner organisations from Uganda, Ukraine and Morocco at the summit, there was acute concern about their remaining a driving force in their national HIV responses. However, there is also a shared commitment to responding to the situation and being part of new solutions.
As a civil society organisation, we need to take up our position and be the bridge so that commitments made at the summit become a reality, especially for very marginalised peopleDr Pasquine Ogunsanya, Executive Director, Alive Medical Services, Uganda
Encouraging news for the Global Fund
The theme for the 2025 World Health Summit’s was: “Taking Responsibility for Global Health in a Fragmented World’. This conveys the sense of uncertainty that has been the experience of actors working on global health this year. It was held in Berlin, and the German government made the headlines thanks to an announcement of a $1 billion pledge to the Global Fund. Sceptics may point out that the German government has in fact scaled down their contribution to the Global Fund by a couple of €100m and that it provides cover for other big donors to scale back on their contributions.
In a year characterised by conversations about alternatives to traditional overseas development aid, the German government’s pledge includes €100m of ‘Health for Debt’ swap. Peter Sands, the Executive Director of the Global Fund, welcomed this announcement and he was noticeably buoyant about the prospects for the 8th round of Replenishment. He even expressed confidence that the US would still be coming on board, noting the administration’s recognition of the Global Fund’s cost effectiveness when compared to many of the multilaterals from which the US is fast disinvesting.
Challenging proposed UN reform
Much attention has focused on the UN Secretary General’s intention as part of the UN80 Initiative to ‘sunset’ UNAIDS by 2026. This apparent demonstration of reforming intent was subject to push-back from a range of actors. African governments and donor countries are amongst those who have thrown their weight behind UNAIDS’ plan to wind down at a slower pace than the Secretary General’s paper proposes, in line with the approach agreed at the UNAIDS board meeting in June of this year.
Perhaps most vocal were the Netherlands, who have pledged €74 million to UNAIDS over the next four years. They were joined by voices from Ukraine and the Middle East, and by Frontline AIDS along with many of our partners and wider civil society.
Alongside our concern about the proposal to close UNAIDS at such a critical time for the HIV response, we brought a strong call to the World Health Summit for good governance within the wider UN reform process. In a letter to the UN Secretary General, (which you can read and endorse) we call for the meaningful engagement of civil society and communities in the UN80 Initiative, noting that they have so far been excluded from the reform discussions and decision-making.
For agencies working on HIV, the summit provided a window into other important discussions. While Global Fund pledges to the continued fight against HIV, TB, and malaria were prominent, there was a notable focus on the need to increase attention and resources to non-communicable diseases.
Integrating health responses
Cardiovascular disease, cancer, diabetes and obesity are placing increasing burden on constrained health budgets. They have already surpassed communicable diseases as the biggest killer in the world, according to the World Health Organisation.
In sub-Saharan Africa, currently only 1-2% of overseas development aid goes to tackling non communicable diseases. For stakeholders who work in the communicable disease space, the importance of moving away from vertical programmes that focus on single health concerns such as HIV, and towards integrated health system approaches, becomes ever more essential.
The key challenge now is to ensure that health systems integrate the full range of interventions needed for a comprehensive HIV response, including services that meet the needs of marginalised populations, along with action to remove the human rights barriers that people living with HIV, as well as key and vulnerable populations, often face.
As ever, in these large gatherings of global expertise there was much, much more going on that I would have liked to have been more closely engaged in, including the considerable attention on the role of AI in global health and the importance of paying more attention to health needs in crisis contexts.
The likelihood of hundreds of thousands of additional HIV deaths and millions of additional infections remain shockingly real. I left Berlin no less concerned by the multiple threats to progress facing communities living with and vulnerable to HIV and associated health challenges. But the mood has shifted somewhat from the deep despondency earlier this year towards action, and critically, transformation.
What next?
The World Health Summit showed that the global health sector is regrouping and following a variety of pathways. As civil society actors, we must be part of this regrouping, pushing for approaches that preserve the best of the old and shaping the new with vision. But we too need to adjust to these new realities and seize the opportunities where they exist.
We must continue to play our part by working with purpose to be more collaborative, both within the Frontline AIDS partnership, and with other allies: in governments across the world, parliaments, multilaterals, and the private sector. Frontline AIDS’ Transition Initiative is already doing this by supporting national coalitions in five countries in sub-Saharan Africa to advocate for sustainable HIV care. As we work towards multi-disease integration in health systems, we must advocate for the inclusion of community-led models in service delivery and the most marginalised people in decision-making processes. I invite all partners in health to get involved in this important work.
Dr Pasquine Ogunsanya, Executive Director of Alive Medical Services, a Frontline AIDS partner organisation in Uganda, puts it perfectly: “As a civil society organisation, we need to take up our position and be the bridge so that commitments made at the summit become a reality, especially for very marginalised people.”
The 2025 World Health Summit was held on 12 – 14 October. For more details, including session recordings, please click here.