With the target date rapidly approaching for the institution of a set of post-2015 Sustainable Development Goals (SDGs), assessing what will shape the new priorities in global health has presented a prime opportunity to consider questions that are fundamental to sustaining progress. Is the current global health system fit for purpose? Will it be fit to meet future challenges? What could a more effective and efficient system look like?
- Making the global health system fit for purpose requires architectural improvements in six key areas: bolstering research and development (R&D) and enabling access to new medical products and technologies; responding to global threats; intersectoral cooperation; greater focus on health systems strengthening; harmonized and less fragmented systems; and transparency and accountability.
- It is possible to sketch out the possible cornerstones of a future architecture: creation of a multisectoral, development-focused response to global health through reform of the WHO and the UN health system; consolidation of funding channels; strengthened mechanisms for R&D and improved country access to new technologies; a stronger system for responding to global threats; and improved accountability.
- The implementation of major reforms to the global health architecture will require the same intensified dialogue among decision-makers and willingness to initiate and support change that supported the Millennium Development Goals.