[Comment] The Gavi Leap: radical transformation for a new global health architecture
It has long been acknowledged that the global health system needs reform. Although this system has improved public health, saved lives, and advanced health equity,1,2 it remains fragmented, uncoordinated, at times inefficient, and in some settings even a barrier to progress.3 Now, in the harsh light of geopolitical realities in 2025 and an unprecedented squeeze on funding from traditional donor countries,4 discussions about how to reform global health have taken on an existential quality.
It has long been acknowledged that the global health system needs reform. Although this system has improved public health, saved lives, and advanced health equity,1,2 it remains fragmented, uncoordinated, at times inefficient, and in some settings even a barrier to progress.3 Now, in the harsh light of geopolitical realities in 2025 and an unprecedented squeeze on funding from traditional donor countries,4 discussions about how to reform global health have taken on an existential quality.
