The Global Health ecosystem in transition: challenges and opportunities

Morning: Communities of Practice sessions

The morning programme was dedicated to sessions of the Communities of Practice (CoPs): the three working groups that form the heart of the Global Health Hub.

After a plenary opening by the Ministry of Health, Welfare and Sport and Ministry of Foreign Affairs, the members of the three CoPs gathered in groups to reflect on the achievements of the last year, identified challenges and set priorities for 2026. Participants acknowledged the GHH’s growing sense of community and its value as a neutral platform for dialogue between government, academia, civil society and the private sector. Furthermore, the participants discussed successes, like how we informed each other in preparation of some key global policy events, for example, in preparation of the UN general assembly on non-communicable diseases. Or, with different stakeholders, we dove into what the Netherlands can best prioritize and contribute to implementing the commitments made in the United Nations Political Declaration on antimicrobial resistance (AMR).  

Several challenges were discussed as well: There is a need for a more strategic direction, better feedback loops between the GHH and ministries and the wish for more engagement from private sector partners. The groups agreed that in 2026, they should focus on tangible outcomes and the strengthening of global health systems.

Afternoon: Plenary session ‘The Global Health Ecosystem in Transition: Challenges and Opportunities’

The event continued in the afternoon at a familiar external location in The Hague, de Glazen Zaal, where additional partners, international guests and other invitees joined us for the afternoon programme, which revolved around the theme of this year’s event: ‘The Global Health Ecosystem in Transition: Challenges and Opportunities’. The session was opened with words of welcome from the moderators, emphasizing that since the GHH is now entering its third year, this is the moment to consolidate achievements and reaffirm commitment to shared priorities.

The session continued with the formal address by Ms Judith Tielen, State Secretary for Youth, Prevention and Sport, in which she reflected on the need for global cooperation in times of health crises and the urgency to remain alert, informed and connected. She underlined the Netherlands’ commitment to multilateralism, to strengthening collaboration with the WHO and partners worldwide and to putting women’s health at the forefront of the global health agenda. As she stated, “Health equity is a cornerstone of global health and women’s health is central to achieving it. So, it is a global responsibility to close this gap. And a national one.”

In addition, Ms Pascalle Grotenhuis, Director-General for International Cooperation at the Ministry of Foreign Affairs, highlighted the importance of collaboration and strong networks in an evolving global health ecosystem. She reflected on the impact of shifting funding landscapes and the pressure on the multilateral system, emphasising that “no single actor can address these issues alone.” Ms Grotenhuis called for a country-led and partnership-driven approach to ensure resilient health systems and sustainable solutions, stressing that investing in gender equality and women’s health is both a moral and a strategic imperative.

The session continued with the formal address by Ms Judith Tielen, State Secretary for Youth, Prevention and Sport, in which she reflected on the need for global cooperation in times of health crises and the urgency to remain alert, informed and connected. She underlined the Netherlands’ commitment to multilateralism, to strengthening collaboration with the WHO and partners worldwide and to putting women’s health at the forefront of the global health agenda. As she stated, “Health equity is a cornerstone of global health and women’s health is central to achieving it. So, it is a global responsibility to close this gap. And a national one.”

In addition, Ms Pascalle Grotenhuis, Director-General for International Cooperation at the Ministry of Foreign Affairs, highlighted the importance of collaboration and strong networks in an evolving global health ecosystem. She reflected on the impact of shifting funding landscapes and the pressure on the multilateral system, emphasising that “no single actor can address these issues alone.” Ms Grotenhuis called for a country-led and partnership-driven approach to ensure resilient health systems and sustainable solutions, stressing that investing in gender equality and women’s health is both a moral and a strategic imperative.

The session was followed by the speech from this year’s keynote speaker, Sir Jeremy Farrar, Assistant Director-General of Health Promotion, Disease Prevention and Care at the World Health Organization, in which he described a world at a historic turning point for global health, in which the established order of global health is under pressure and emphasised that leadership is especially crucial in these difficult times.

He spoke of a professional and collective ‘grieving process’ within the global health community, as old certainties and models of cooperation disappear, urging participants to accept this loss and look ahead because the world will not return to how it was. Farrar highlighted that the ‘global North’ must recognise this shift and no longer approach countries as it did decades ago. This also forces countries to rely more on their own resources, leading to more equal partnerships. “Don’t look back to the past because it’s gone. Black and white movies are not coming back.” He added that while we are living in a time of enormous scientific advancement, it carries risks, including the potential to increase inequality as knowledge and technology remain concentrated in a few wealthy countries and private companies, but the shift of scientific influence to other regions should be embraced, not slowed down.

Farrar also outlined that the internal reforms at WHO, in response to external pressures, are aimed at strengthening the organisation and breaking down silos, including the reduction of executive leadership and the integration of disease-specific programmes with underlying drivers of health such as climate and nutrition, with the goal of making WHO more accessible, with a single central point of contact for external partners. He concluded with a call to action: to recognise this historic moment that requires leadership from everyone, focus on concrete improvements instead of abstract goals as the best preparation for a pandemic is a strong health system that meets daily needs, and, at last, to take responsibility for tangible results, summarising his approach with the motto: “under promise and over deliver.” With this message he combined realism about the challenges ahead with optimism about the opportunities for transformation, provided the global health community demonstrates the courage to let go of the past and embrace a more equitable future.

After a short break, we were pleased to invite Tim Roosen, International Health Policy Expert, Belgian Ministry of Foreign Affairs and Sarah Splettstößer, Head of Political Dialogue, Global Health Hub Germany, on stage for a short interview. As a continuation of our European collaboration and following last year’s exchange with our French colleagues on global health, they shared insights on their respective efforts and explored opportunities to learn from each other’s experiences. A dialogue followed between the speakers, reflecting on the value of bottom-up, multi-sectoral networks in shaping national and European global health agendas. Sarah Splettstößer explained how their network, with over 2,000 members, is organised to contribute to global health in an impactful way in which their network demonstrates the power of collective dialogue: “We see increasing engagement in global health, even amid budget cuts and uncertainty. The Hub provides a safe space for exchange, evidence and advocacy.”

Tim Roosen explained the set-up of the Belgian Global Health Network and how it differs from the German and Dutch networks. He also reflected on youth participation and shared a success story from Belgium. In response to questions about the current transition in the global health ecosystem, Tim discussed the importance of bilateral and multilateral relationships, emphasising the continued value of multilateral efforts as well as a focus on health sovereignty, human rights and science. Sarah, in turn, reflected on how the transition has affected collaboration within Global Health Hub Germany and among its members, highlighting the resilience of a bottom-up, member-oriented network that operates through intrinsic motivation and voluntary contributions.’

The event continued with a panel discussion featuring representatives from the GHH-NL Communities of Practice, who shared their perspectives on the challenges and opportunities of the ongoing transition of the global health ecosystem. The panel included:

Mariska Meurs, Team Lead Health Financing at Wemos;

Guido Geerts, President and CEO of Delft Imaging;

Margo Warren, Director of Government Engagement and Policy at the Access to Medicine Foundation;

Gidado Mustapha, Executive Director of the KNCV TB Foundation;

Yvette Fleming, Senior Business Developer at TNO; and

Odette Hekster, Managing Director of PSI Europe.

The discussion highlighted how these transitions are affecting core strategies within organisations, including the challenges of maintaining essential services amid shifting funding landscapes and the need to strengthen domestic health budgets, with international aid playing a complementary role. The panel also emphasised the importance of countries taking an active role in driving financial reforms to increase resources for achieving the SDGs, including through mechanisms such as tax justice and debt restructuring. Partnerships and collaboration were another central focus, with attention on engaging local and national stakeholders to build resilient and mutually beneficial networks. Panellists explored the interconnected nature of global health challenges, from pandemic preparedness and antimicrobial resistance to climate-related health risks and equitable access, stressing that coordinated action across sectors is essential.

Overall, the panel agreed that the strength of the Global Health Hub lies in its diversity and multi-sectoral approach, enabling knowledge and experience to be translated into actionable recommendations. There was broad consensus that maintaining momentum, facilitating cross-community collaboration and linking Dutch efforts to international initiatives are key to addressing current and future global health challenges while ensuring shared accountability and long-term sustainability. This community was recognised as a unique mechanism to channel collective expertise into practical and impactful outcomes.

For example, Margo Warren would emphasise that bringing a variety of partners to the table, including the private sector, to have constructive, solutions-oriented discussions, is key for encouraging further action. She adds: “the Access to Medicine Foundation specialises in this type of work and has been using its successful catalytic change-making model to resolve access barriers and guide companies in the right direction for nearly 2 decades. New partnerships forged through these convenings will be essential for improving access to medicine and building sustainable health systems. ”

Furthermore, Mariska Meurs reflected on the discussion and hopes to have brought across three crucial messages to the Dutch global health community: “Firstly, two of the largest drains on low-income countries’ budgets—debt servicing and tax losses—are beyond their control. Without addressing these, domestic resources for health systems will remain insufficient. Secondly, global processes can help: a UN Framework Convention on International Tax Cooperation to curb tax abuse, and a similar UN approach to address the debt crisis. Lastly, the global health community should speak out on these issues. Policy coherence, a core element of the Dutch Global Health Strategy, requires not taking with one hand what is given with the other. Through our participation in the boards of global health initiatives we can call upon them to use their leverage, become vocal and support these UN processes.”

The event concluded with closing reflections from Ms. Marjolijn Sonnema, Director-General for Public Health at the Ministry of Health, Welfare and Sport, and Sir Jeremy Farrar, Assistant Director-General of Health Promotion, Disease Prevention and Care at the World Health Organization. In their remarks, they emphasised the growing pressures on global health and the importance of coming together across sectors and disciplines. Ms. Sonnema highlighted insights shared by partners of the Global Health Hub’s Communities of Practice during the panel discussions, which reflected on key challenges such as coordination gaps, structural barriers, and resource limitations. These reflections underscored both the urgency of joint action and the value of collaboration across governments, civil society, academia, and the private sector. She encouraged participants to “stay connected to ensure that the WHO has the capacity and the authority to play its normative and coordinating role,” reaffirming that the Netherlands will remain a critical friend of WHO. Sir Jeremy Farrar emphasised that critical friends are essential, urging the audience to “use your ‘Dutchness’, and to use your directness.” To conclude, both underlined the strength of the Global Health Hub as an intersectoral community in connecting diverse actors, aligning strategies, and facilitating horizontal collaboration to address the complex global health challenges effectively.