Global Health

Why health diplomacy is central to easing many of today’s health crises

A health care worker treats a tuberculosis patient at a rural hospital at Tugela Ferry in South Africa's impoverished KwaZulu Natal province, October 28, 2006. A new strain of the disease, called extreme drug resistant tuberculosis (XDR-TB), has killed at least 79 people in the area since January 2005, prompting concern from the World Health Organisation who fear XDR-TB could become a major killer in AIDS-hit parts of Africa where governments have been slow to roll out TB control programs. REUTERS\Mike Hutchings  (SOUTH AFRICA)

Health systems' capacity to handle challenges such as outbreaks depends greatly on the quality of their governance. Image: Reuters/Mike Hutchings

Emanuele Capobianco
Deputy Executive Director, Partnership for Maternal, Newborn & Child Health, World Health Organization (WHO)
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Global Health

This article is part of: World Economic Forum Annual Meeting
  • Trust in governments, corporations and other institutions is low and rebuilding it is key to achieving the best outcomes for all, including in health.
  • Health systems globally face numerous challenges and their capacity to handle them depends greatly on the quality of their governance.
  • Health diplomacy and policy reforms can help to rebuild trust and create health systems that are better placed to withstand these wider challenges.

Across much of the world, levels of trust in governments, corporations and other institutions are low and need to be rebuilt. Indeed, the theme of this Davos 2024, the World Economic Forum's Annual Meeting in Davos, Switzerland, is "rebuilding trust".

Re-establishing trust will help those concerned unite and work collaboratively to navigate the changing and challenging world in which we live – to achieve the best outcomes for all, in all areas of society, including health.

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Health is influenced by complex social, economic and political factors. Health systems globally face numerous challenges, such as the rise of non-communicable diseases and climate change.

Against this backdrop, economic and political instability, conflict and existing and emerging infectious disease outbreaks, including Disease X, can ratchet up pressure on already stretched health systems, pushing them towards breaking point.

Why health system governance is so important

Ensuring equitable healthcare delivery and meeting health needs should always be a priority – regardless of the magnitude of the challenges faced. The capacity of a health system to meet these needs is largely determined by the quality of its governance.


Health systems governance is complex, involving policy-making and coordination at multiple levels and between various sectors. High levels of transparency, accountability and inclusivity are needed, as well as effective leadership that is both visionary and responsive to change.

But complex crises require more than competent governance, and call for skilful health diplomacy – coordinated collaboration and action at all levels of governance, and policy coherence and coordination between countries and among other key stakeholders including civil society, intergovernmental and non-governmental organizations.

Building and nurturing public-private partnerships can also mobilize resources, expertise, and innovation to address complex health system challenges.

Creating an enabling system of governance.
Creating an enabling system of governance in health. Image: World Health Organization

Declining transparency and accountability

The Partnership for Health System Sustainability and Resilience (PHSSR) seeks to facilitate cross-border and cross-sectoral collaboration to strengthen health systems – making them more sustainable and resilient in the face of these challenges. It commissions research that informs evidence-based policy recommendations in order to guide action.

The PHSSR’s global research findings, published in its 2023 Summary Report, identified widespread deficits in transparency, public engagement, and accountability, leading to an erosion in trust which can weaken health systems and their ability to respond to crises.

Examples of this include:

  • Lack of transparency in health system funding allocation decisions, with a lack of explicit decision-making criteria.
  • Underdeveloped mechanisms for public involvement in decision-making.
  • Deficits in accountability – stemming from a range of factors.

What is the World Economic Forum doing to improve healthcare systems?

Building back trust in health systems

So how do we reverse this and build back trust? The PHSSR 2023 Summary Report provides several recommendations:

  • Promote transparency to improve accountability and ensure that health policies and programmes are responsive to the needs and preferences of the population.
  • Encourage social participation and incorporate patients' voices in health policy development and implementation to enhance the legitimacy and effectiveness of health policies and programmes.
  • Establish formal channels for public and patient feedback at the provider level, to ensure that healthcare decisions are informed by the experiences and perspectives of those directly affected.

Promoting accountability, transparency and inclusivity has proven valuable in several countries. For example:

  • Switzerland: The Swiss system provides a platform for citizens and interest groups to intervene in decision-making at all state levels, fostering trust and cooperation between citizens and government institutions.
  • India: While India demonstrated shortcomings in formal accountability mechanisms, it has made progress by involving local communities and institutions in democratic decision-making in several states.
  • Greece: Greece has taken positive steps towards incorporating patient voices in healthcare decisions through new legislation.

A policy-making approach that engages a diverse group of stakeholders – including patients, healthcare providers, policy-makers and the private sector – in structured dialogue to develop policies that reflect their values and preferences can help to build trust.

And once policies are made and implemented, ongoing transparency is needed to enable accountability and maintain this trust. The diverse challenges faced by health systems around the world will require equally diverse policy solutions – but trust will form the foundation of success, regardless of the challenge.

Policy reforms can help to rebuild this trust to create health systems that deliver equitable care for all, and that are better placed to withstand the wider challenges.

On 17 January 2024, representatives from PHSSR member organizations AstraZeneca and Philips will take part in a Stakeholder Dialogue session during Davos 2024, the Annual Meeting of the World Economic Forum, focused on how health systems can prepare for Disease X. Follow the PHSSR on LinkedIn to receive regular updates on its activities.

The WHO Foundation is an independent Swiss foundation affiliated with, and independent of, the World Health Organization. It marshals resources, brokers partnerships and drives new initiatives to help achieve the goal of health for all. Emanuele Capobianco, Chief Strategy and Impact Officer of the WHO Foundation and PHSSR Steering Committee Member will also be in attendance at Davos 2024.

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Global HealthHealth and HealthcareDavos Agenda
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