Ahead of the 79th World Health Assembly in Geneva, NCD Alliance, City Cancer Challenge, and the Partnership for International Politics and Diplomacy for Health convened a webinar calling for noncommunicable diseases (NCDs), including mental health and neurological conditions, to be placed at the centre of global health architecture reform.
The event, The Pulse of Tomorrow: Shifting the Paradigm for NCDs in Global Health Architecture, took place at a critical moment. Drastic cuts to global health financing, shifting geopolitics and growing pressure for reform have created a window of opportunity to rethink an international health system largely shaped around communicable diseases, maternal and child health, and vertical financing models.
Speakers stressed that NCDs, civil society and people with lived experience must be meaningfully included in reform discussions if the future architecture is to reflect today’s realities. In particular, Katie Dain* raised concern that the proposed WHO task force for the joint process on global health architecture reform does not include a dedicated seat for civil society.
“The role of civil society and impacted communities in both the reform process itself, as well as having a seat at the table in the governing bodies of what comes next, is absolutely critical.” - Katie Dain
Opening the session, Anders Nordström framed the conversation around the need for global health architecture to respond to future health realities, not preserve structures built for the past.
“How can we have an international response that is responding more to the future, and not just to the past?” - Anders Nordström
Speakers highlighted what Katie Dain described as a “fundamental structural mismatch” between global health architecture and financing, and today’s greatest disease burden. NCDs cause around three-quarters of deaths globally, yet receive less than 3% of development assistance for health.
From vertical models to integrated care
The first panel, moderated by Isabel Mestres, focused on what reform should look like in practice. Nelson Otieno Ochieng described the current moment as an opportunity for countries to lead more integrated, community- and facility-led health systems, drawing on Healthy Heart Africa as an example of strengthening links from communities to primary and tertiary care.
Noella Bigirimana said NCDs will be a defining test of whether global health reform works, calling for country-owned NCD roadmaps, predictable financing and integrated care pathways that start close to communities, with primary health care as “the spine” of the system.
“If reform delivers only a leaner version of the same MDG-era architecture, it will fail.” Noella Bigirimana
Sandro Demaio highlighted the links between NCDs, climate change, air pollution, food systems and urban design, calling for stronger alignment between climate and health action.
“Prevention-focused healthcare is green, and green is good for NCDs.” Sandro Demaio
From commitments to accountability
The second discussion, moderated by Anders Nordström, focused on the political and institutional decisions needed to turn reform language into action. José Luis Castro called for health systems to be redesigned around continuity of care, prevention and the long-term needs of people living with NCDs.
"We need a system of collaboration that focuses on people, not on the preservation of institutions". - José Luis Castro
Ren Minghui stressed that global commitments must be followed by stronger accountability and implementation at country and community level, and highlighted the critical role of the private sector in NCD prevention and control.
"Whether it is reducing sugar in food products or advancing tobacco control, meaningful progress is impossible without effective private sector engagement." - Ren Minghui.
Chikhu Ng’ombe, speaking from lived experience and civil society leadership, warned that people living with NCDs must not be included only symbolically, but must have a meaningful role in shaping decisions.
“We need involvement that is not just ticking the boxes.” - Chikhu Ng’ombe
Civil society must have a seat at the table
Closing the session, Isabel Mestres called on civil society, donors, WHO, governments and partners to ensure that reform reflects today’s disease burden, supports country-led implementation, and includes people living with NCDs in governance, accountability and decision-making.
"Donors and philanthropies should prioritise long-term, locally-driven investment -responding to local needs rather than chasing quick wins that lead to fragmented interventions instead of real systems transformation." - Isabel Mestres
As WHA approaches, NCDA and partners are calling for the WHO joint process on global health architecture reform to include civil society and people living with NCDs from the outset.
Without meaningful engagement of civil society and affected communities, reform risks changing the language of global health without changing the systems, priorities and accountability mechanisms that people rely on.