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Initiatives on Reimagining Global Health Architecture: State of Play, An Updated Primer

One year after our primer on reforming global health architecture, this update reviews what has happened since fall 2025 to help global health leaders make sense of the state of play. It covers the major actors and processes and covers what's new and what's next, including the Accra Reset, the Wellcome Trust, the Gavi Leap, Africa CDC's AHSS Agenda, the Lusaka Agenda, WHO's reform process, the EU and like-minded donors' reflection process, and HEAR CSO. It also summarizes two widely discussed analyses from MOPAN and Think Global Health. A year on, the field looks much the same: many consultations and convenings, but no concrete plan for who will lead or finance reform.

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