24 September 2015


A Pakistani health worker gives polio vaccines to children in the suburbs of Lahore, Pakistan, February 2015. Photo: Associated Press.
A Pakistani health worker gives polio vaccines to children in the suburbs of Lahore, Pakistan, February 2015. Photo: Associated Press.


The global health system has contributed significantly to improved health and life expectancy in recent decades. However, the existing architecture needs to be reformed in order to address future challenges and meet the health targets in the Sustainable Development Goals. Rethinking the Global Health System, a new Chatham House report, analyses how fit for purpose the current system is and identifies priority areas for reform. 

The Ebola crisis has shown that weak systems make individual countries more vulnerable and that strong, resilient and equitable systems at country level are needed to protect global health security. There is a pressing need for enhanced global disease surveillance and detection capacity, as well as improved international coordination in responding to emerging health threats.

In addition, addressing determinants of health outside the health sector requires cross-sectoral collaboration and linkages to other policy domains. Historically, the focus has rested on directly reducing illness and death, but the need to address other influences on health outcomes – safe drinking water, proper sewage treatment, good education – is now well recognized.

The report says that stronger leadership in global health is therefore required and the report lends support to calls for the creation of a new organization that would bring together United Nations agencies with health-related mandates – UN-HEALTH. Just as UNAIDS created a more coherent response for HIV, a UN-HEALTH organization could achieve a similar but more wide-reaching effect by bringing together and streamlining all UN agencies working on global health issues.

Professor David Harper, who led the Chatham House project that resulted in the report, said: 

'This report is intended to make a substantial contribution to the international debate on what the world will require of the health architecture of the future. It offers some options for political leaders to consider, but it is just a starting point. More work is urgently needed to develop the ideas introduced in this project and to help generate the high-level political traction that is so vital in any change process.'

Editor's notes

Read the report Rethinking the Global Health System from the Centre on Global Health Security at Chatham House.     

For all enquiries, including requests to speak with the authors of this paper, please contact the press office.


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