By Marisol Touraine, Chair of the Executive Board of Unitaid and Dr. Magda Robalo President of the Institute for Global Health and Development, Guinea-Bissau
This opinion piece was originally published as part of Unitaid’s report “Reimagining global health: advancing people-centered solutions.”
Low- and middle-income countries are transforming. Home to the youngest, fastest-growing populations in the world, these countries are poised to become global centers of innovation, economic dynamism, and leadership.
This progress reflects decades of health and development gains, achieved through support from Unitaid and many other partners. Infant mortality has halved since 2000. Nearly 80% of people living with HIV worldwide are on treatment. Malaria deaths have declined by two-thirds. These achievements are a testament to the resilience and leadership of countries, supported by smart global investments from governments, donors and partners.
But these hard-won gains are under threat. Many low- and middle-income countries are at the epicenter of interlinked global crises: climate change is displacing communities, worsening food insecurity and straining fragile health systems. New and re-emerging infectious diseases such as Mpox and Marburg are on the rise. And critical international aid – once the backbone of lifesaving health programs – has declined sharply.
At the same time, longstanding systemic challenges persist. The COVID-19 pandemic exposed deep inequities in access to vaccines and medical oxygen, while weak supply chains underscored the region’s need to produce the diagnostic tests and medicines it needs most.
The world is now looking to low- and middle-income countries to drive the global health response of the future. It is the time to strengthen this approach, and for countries to take the lead. The Lusaka Agenda offers a bold, unifying vision for reforming global health around country ownership, leadership and regional action. African countries and partners are working with Unitaid’s support to reinforce regional manufacturing capacity anchored in countries’ epidemiological needs, such as HIV, TB, and malaria. These efforts, more likely to be sustainable in the near term, help respond to growing challenges with non-communicable diseases while also establishing a strong foundation for pandemic preparedness. Meanwhile, our partnerships are enabling countries to access – and take ownership of – lifesaving innovations for safer childbirth, cervical cancer prevention, and medical oxygen, building sustainable systems that endure beyond donor funding.
To propel this transformation, innovative financing solutions are urgently needed. Blended finance, domestic resource mobilization, and strategic partnerships with multilateral development banks and the private sector can attract the capital needed to build resilient, locally led systems. However, these efforts won’t be enough unless resources are used effectively, and the global financial system is reformed to better support health and development goals. Our actions today will shape the global health response of the future. By investing in sustainable systems now, we are safeguarding health and prosperity for generations to come.
