Deepening fragmentation and a collapse in funding have plunged the global health system into a structural crisis. The increasing fragmentation and funding breakdown of the global health system. A growing number of international organisations, health funds, and multi-stakeholder initiatives (MSIs) are operating in parallel, competing for resources and influence. This raises a central question: who sets the priorities in global health policy, and what role should the WHO play going forward?
This briefing analyses the political and structural causes behind the lack of progress in implementing the SDGs and discusses different options for an effective “Beyond 2030 Agenda”, from questions of development financing and international cooperation to a fundamental debate about the current understanding of development policy. It is the final publication by our former director Jens Martens, who passed away in May 2026. We publish it in grateful memory of his longstanding commitment to global justice and sustainable development.
Massive cuts in public funding are threatening the human right to health and placing the global system under enormous pressure. To close these funding gaps, governments increasingly rely on private actors, with far-reaching consequences for access to medicines and political influence.
Global health faces a profound structural crisis as public funding cuts and rising inequalities threaten the human right to health, leaving 4.5 billion people without basic services. Many now see an opportunity to bring in private actors to close the funding gap, with little critical scrutiny. Against this backdrop, Brot für die Welt, Global Policy Forum Europe and Misereor have outlined six theses on the role of private actors in global health, offering clear, actionable recommendations for the German government.
