The global health architecture has contributed significantly to progress towards the Millennium Development Goals over the past decade. As the target date approaches for adoption of the new Sustainable Development Goals, this paper suggests that reconfiguration of the architecture is necessary if it is to be fit to address the challenges of the post-2015 period.
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.