Breakthroughs Blog

This fall has brought a flurry of global forums, political negotiations, and shifting priorities that will shape the global health agenda through the end of the year and into the next. Across these discussions, one message has become increasingly clear: the global health architecture is changing, but the need for new and better health technologies has not diminished. If anything, the pressures facing health systems, the emergence of new infectious disease threats, and persistent gaps in access make sustained investment in research and innovation more important than ever. GHTC had the privilege to participate in a season of global forums, from the United Nations (UN) high-level meeting (HLM) on pandemic prevention, preparedness and response (PPPR) in New York City, New York to the World Health Summit (WHS) in Berlin, Germany. As we reflect on our takeaways and next steps from these forums, we see both opportunities and risks. There is considerable momentum to rethink how global health institutions operate, how resources are mobilized, and how countries shape their own health priorities while preserving the scientific expertise, partnerships, and predictable financing needed to develop and deliver lifesaving innovations.  UNGA and the unfinished business of PPPR Three years ago, UN member states gathered in New York for the PPPR HLM, amid a profound sense of global urgency emerging from the COVID-19 pandemic. This September, member states returned to the issue against a more complicated geopolitical backdrop, with renewed attention to pandemic preparedness alongside persistent disagreements over equity, intellectual property, and international cooperation, echoed in other ongoing processes forging pandemic priorities.  After months of negotiations, member states were unable to reach consensus on the PPPR political declaration ahead of September’s HLM, and the text was referred to the broader UN assembly this month, where it was subsequently adopted. Though there were some initial snags in its adoption, the declaration reaffirms the importance of international cooperation and advances several priorities for health innovation, including sustained investment in research and development, stronger public-private partnerships, and expanded regional manufacturing capacity. Together, these commitments reflect a comprehensive vision of preparedness that seeks to pair innovation with the manufacturing and partnerships needed to bring new tools to scale.These negotiations also highlight a challenge that extends beyond the political declaration: how to translate commitments on pandemic preparedness into the practical capabilities countries need to detect and respond to emerging threats. During HLM week, GHTC and Adjuvant Capital hosted a roundtable discussion with US Department of State Bureau of Global Health Security and Diplomacy and multilateral stakeholders examining lessons from Ebola, including the critical role of diagnostics, surveillance, and innovation in strengthening outbreak response. The multifaceted dialogue reinforced that preparedness is not simply a question of having the right technologies available; countries also need the systems, partnerships, and sustained resources to deploy those technologies effectively. Investments in R&D, surveillance, regulatory capacity, and access must therefore be understood as interconnected components of preparedness, rather than competing priorities.Topline takeaway: This fall’s PPPR discussions showed that broad support for pandemic preparedness can coexist with deep disagreements over international cooperation, making both sustained investment in vaccines, diagnostics and therapeutics and workable mechanisms for research coordination and equitable access all the more critical. The measure of progress will not be the strength of the next declaration, but whether countries are better equipped to detect, prevent, and respond to the next outbreak.  WHS and the innovation agenda The global health community gathered again in Berlin in October for WHS. Against a backdrop of evolving global health priorities, momentum for change, and pressure on traditional financing models, the summit offered a chance to consider how innovation can strengthen health systems, address persistent gaps in access, and support resilience in the face of emerging challenges.For GHTC, a particularly valuable discussion centered on the role of product development partnerships (PDPs) in advancing health innovations for diseases and populations too often overlooked by traditional commercial markets. GHTC co-moderated a session convened by Medicines for Malaria Venture, bringing together perspectives from PDPs and their partners on the evolving challenges of developing and delivering new health technologies. The discussion highlighted both the value of the PDP model and the pressures facing these partnerships as the global health financing landscape changes. PDPs have demonstrated what is possible when scientific expertise, public and philanthropic investment, and cross-sector partnerships are brought together around shared health priorities. Yet developing a new medicine, vaccine, or diagnostic is a long-term undertaking. Unpredictable financing can disrupt research pipelines, weaken scientific partnerships, and jeopardize years of progress.This concern extended well beyond the PDP discussion. Across conversations with funders, financing partners, and GHTC members, a recurring theme at the summit was the need for greater consistency and predictability in global health financing. While there is understandable interest in pursuing new financing models and greater efficiency, innovation cannot be sustained through short-term funding cycles alone. Predictable investment is essential to maintaining the research infrastructure, scientific talent, and partnerships that make progress possible.  Innovation remains central to the global health agenda, but the changing financing landscape also raises difficult questions about who will support research for diseases and health needs that remain underserved by commercial markets. As traditional donors reconsider their commitments to global health assistance and countries face competing demands on limited resources, there is a risk that important research priorities will be deprioritized precisely when sustained investment is needed most. New financing approaches are welcome, but they must complement rather than simply replace the long-term public and philanthropic commitments that have historically made much of this research possible.Topline takeaway: Innovation remains central to the global health agenda, but translating scientific advances into meaningful health outcomes requires more than promising technologies. Sustainable financing, effective partnerships, supportive policy environments, and equitable access must remain part of the conversation. For GHTC and its members, WHS reinforced the importance of connecting R&D priorities with the broader systems and policies needed to bring innovations to the people who need them. Looking ahead: Keeping innovation central The implications of this fall’s global forums will extend well beyond the declarations adopted and discussions held. Several interconnected processes, including ongoing negotiations on the Pathogen Access and Benefit-Sharing annex to the Pandemic Agreement, the Accra Reset, and Lusaka Agenda, will help shape how global health institutions operate, how research is funded, and how countries participate in developing and accessing new technologies. As these reform efforts advance, it will be important to ensure that research and innovation are not overlooked in discussions that often focus primarily on health financing and service delivery. These evolving mechanisms are also starting to take shape as the World Health Organization prepares to elect a new Director-General, one who will face consequential questions about which technical capacities to preserve, where to focus investment, and how to maintain the expertise and global coordination that underpin innovation and access. As these conversations continue, several priorities stand out. Global health institutions must become more effective and responsive without sacrificing the scientific and technical capacities that underpin progress. Financing reforms must recognize that research and innovation require long-term, predictable investment. And efforts to strengthen country ownership must create meaningful opportunities for countries to shape research agendas, build scientific capacity, and benefit from the innovations they help advance. Perhaps most importantly, global health R&D cannot be treated as a secondary consideration in debates about governance and financing. New vaccines, diagnostics, medicines, and other health technologies are essential to achieving the very goals these reforms are intended to advance. For our coalition, the task ahead is to work with our members and partners to ensure that innovation remains central to these discussions, that commitments are translated into practical action, and that the global health ecosystem emerging from this period of change is better equipped to deliver for the people and communities it serves.