June 6, 2025

During our team’s time at this year’s 78th World Health Assembly (WHA78) and related side events in Geneva, one message stood out: amid significant funding cuts, global health stakeholders must find ways to do more with less.

Linksbridge’s KJ Zunigha shared a few key themes from her trip to Switzerland:

• There is anxiety around the future of the global health sector. WHO recently slashed its top leadership team and announced that it will cut the number of departments from 76 to 34. Anxiety is also trickling down to mid-level staff, some of whom are worried about the security of their positions amid the possibility of additional restructuring. Adding to the uncertainty: looming questions about Gavi’s ability to hit its $9 billion replenishment target. With global health funding under pressure, stakeholders are anxious to see whether the organization will reach its goal when it hosts its replenishment summit on June 25.
• Country ownership is the way forward. The role of multilaterals—and their funds—is shifting, creating a forcing mechanism to ditch old power dynamics and empower countries. Global partners discussed the necessity of working with governments to more closely align goals and funding with country priorities. In one session, a former minister of health said, “We needed this shock [of U.S. funding withdrawal] to wake up and change. Incremental change will not get us there, so this was necessary for real, lasting change.”
  
• Formalizing the roles of community health workers (CHWs) is key. Though they’re often viewed as volunteers, CHWs are the backbone of service delivery in Africa. Africa CDC’s work to integrate 2 million CHWs across the continent into the healthcare workforce is an important step toward achieving universal health coverage, building capacity, and delivering more consistent services. Formalizing their roles could also benefit health campaign integration—the joint planning and/or delivery of more than one health intervention. Campaigns rely heavily on CHWs, but integration and CHW compensation can be at odds. Because CHWs are usually paid per diem, reducing the number of campaigns via integration can reduce CHWs’ pay. Professionalizing CHWs and offering them a salary rather than a per diem could help reduce this conflicting incentive structure.
  
• Integration is a priority, but how do we do it? At the global level, there are still major barriers to integrating routine immunization with other essential health services. In particular, donors and advocates for specific disease programs are concerned that integration could dilute the purpose and measurable impact of individual programs. As we see funding for global health efforts shrink, there is mounting pressure for every dollar to be deployed with maximum efficiency and demonstrable impact. The big question: how do we push integration efforts forward while ensuring that diminishing resources aren’t spread too thinly across broad programs? There’s consensus that integration should occur—in certain circumstances, at the very least—but there’s a clear need for guidance on how to implement integration successfully and sustainably.
• Noncommunicable diseases are getting the attention they need (and deserve). Historically overlooked in conversations around global health priorities, NCDs are now the leading cause of death and disability globally and featured prominently at WHA78. A focus was the hits and misses of a zero draft of a political declaration on NCDs released ahead of the fourth U.N. High-Level Meeting on NCDs and Mental Health in September. Also top of mind: financing. As development dollars shrink and health needs increase, how can countries sustainably finance NCD responses? Strong political leadership and early investments in prevention will be central considerations moving forward.

Looking ahead, WHA78 stakeholders identified a clear—albeit daunting—task: we need innovative approaches to ensure progress toward global health goals even as resources become scarcer.