Our world is going through major crises. With this, the world is going through a churn in global, multilateral, and bilateral relations. Global institutions are increasingly struggling to fulfill their objectives of promoting global harmony and a unified outlook. Traditional leadership in global health is gradually receding, leading to uncertainties in the international support landscape. Countries that rely heavily on global development assistance are facing significant challenges as this support diminishes unexpectedly.
International trade is experiencing unexpected shifts due to the introduction of reciprocal tariffs. Countries are likely to encounter sudden disruptions in the supply of essential drugs, diagnostics, devices, and disposables, with adverse consequences on people’s health. An increasing number of countries are re-evaluating aspects of globalization, as reflected in the growing support for nationalistic movements across various regions. The movement of people, goods, information and services is getting curtailed with its own consequences on health.
The Paris Agreement on climate change is facing significant challenges, with some countries slowing down or reconsidering their climate commitments. The World Health Organization is at a crossroads following the unexpected withdrawal notice from its largest funder. Similarly, global collaborative initiatives such as GAVI, the Global Fund, and the Pandemic Fund may encounter uncertainty as nations reassess or reduce their support.
For the world amid polycrises, these recent developments heighten the threats to population health across countries. There is a real risk of epidemics and pandemics going out of control as countries do not honor their obligations to international health regulations. The anti-vaccine movement appears to be gaining traction, which could have concerning implications for public health.
Faced with these emerging challenges, what can countries do to protect the health of their people?
India has been pursuing a policy of self-reliance (Atma Nirbhar Bharat) while also emphasizing a global outlook (Vasudhaiva Kutumbakam, as highlighted during its G20 presidency). This approach to self-reliance does not imply isolation but rather aims to enhance resilience against various known and emerging challenges. A foreign policy grounded in non-alignment, with an emphasis on national well-being and adaptability to a multipolar world, is emerging as a pragmatic response to evolving geopolitical dynamics.
Countries are increasingly focusing on improving the efficiency of their public health and healthcare delivery systems. They are learning to channel limited resources toward promotive and preventive care. An enabling regulatory environment is fostering adaptive local process and technology innovations. Thailand has emerged as a role model in efficiency, achieving health indicators comparable to many developed countries while spending significantly less as a percentage of GDP. India and Indonesia have made substantial investments in comprehensive primary healthcare services. Telemedicine and community health workers have become well-established strategies for enhancing both cost efficiency and health outcomes.
African nations are steadily enhancing collaboration at both bilateral and continental levels to address common challenges and support one another. The Africa CDC exemplifies this growing cooperation, with efforts underway to harmonize regulatory systems to facilitate the smoother cross-border movement of health goods. Countries such as Egypt, India, Vietnam, and China are contributing to improved access to affordable essential vaccines and medicines. Development assistance from several GCC nations to more fragile and economically challenged states in the region is also on the rise. Meanwhile, countries across Asia are expanding the training and supply of health workers to meet both domestic and international needs. India, for instance, has doubled its annual intake of medical and nursing students over the past decade and is planning a further 50% increase over the next five years.
India and China, which together account for nearly 2.8 billion people, have already set out on the path toward green energy. This transition has been steadily accelerating and appears irreversible despite recent setbacks to the Paris Agreement. Additionally, many countries that have invested in natural disaster management systems are now able to develop adaptive strategies in response to climate change. Efforts are also underway to redesign healthcare infrastructure to withstand flash flooding, which is increasingly being witnessed across regions. Countries are showing a willingness to learn from one another and to collaborate where possible in addressing the shared challenges posed by climate change.
Countries like India and Indonesia, which have invested heavily in digital technologies, are offering their digital health solutions to other countries as digital public goods. Many low- and middle-income countries are leveraging the power of digital technologies to address gaps in their health systems. As many of these countries rely on small and medium-sized enterprises for access to health and care services, governments are making these public goods accessible to such enterprises to ensure an equitable digital transformation of health systems.
Egypt is taking the lead in the MENA region in developing a resilient regional supply chain system. India is positioning itself within the emerging global strategies, where countries are reducing dependence on a single source for APIs— as reflected in its Production Linked Incentive (PLI) policy. Countries in the Southeast Asian region, such as Vietnam, are also positioning themselves as alternative suppliers. Several GCC countries are investing in building local capacities to become more self-reliant in medical technologies.
While the multitude of global challenges may appear daunting, history has shown that the world has the capacity to adapt. Countries are likely to strengthen their independence while continuing to support and collaborate with one another for shared progress. The idea of the world as a global family remains relevant and inspiring. As we navigate these times, fostering a spirit of collaboration will be key. The cycles of creation and disruption are part of nature’s course—and our strength lies in responding to them with balance and resilience.