By Precious Matsoso
A Defining Moment for Global Health
The first decades of the 21st century have tested public health systems in unprecedented ways. Pandemics, climate-related disasters, conflict, economic shocks, forced migration, and widening inequalities have exposed deep vulnerabilities in the systems that shape health and well-being.
COVID-19 did not create these fault lines. It revealed them.
It exposed overwhelmed hospitals, fragile supply chains, and health inequities that left millions without access to essential care. Misinformation spread faster than the virus itself, while countless families were pushed deeper into poverty because illness meant lost income, unaffordable treatment, or both.
Yet this period also demonstrated what humanity can achieve when faced with a common threat. Vaccines were developed in record time. Digital technologies expanded access to care. Communities mobilized to support one another. Above all, the pandemic renewed a fundamental understanding: health is not a privilege for the few. It is public good that benefits everyone.
As we look toward 2030 and beyond, the question is no longer whether change is necessary. The real question is whether we have the courage to build a new global compact for health, one grounded in equity, solidarity, and sustainability.
As Nelson Mandela reminded us:
"It is health that is real wealth and not pieces of gold and silver."
The future of public health depends on moving beyond fragmented responses toward a shared vision that protects both people and planet. If we fail, we risk repeating the same cycles of crisis and neglect. If we succeed, we can create systems that are resilient, fair, and capable of protecting everyone, everywhere.
Health as a Global Common Good
The COVID-19 pandemic underscored a simple truth: health security is only as strong as the most vulnerable among us. Diseases do not respect borders. An outbreak that begins in a remote community can become a global emergency within weeks. At the same time, the benefits of prevention, preparedness, and universal access benefit all societies. When children are vaccinated, communities have clean water, and primary healthcare is accessible, entire populations become healthier, safer, and more productive.
A new global compact must therefore treat health not as a commodity, but as a common good. This requires renewed commitment to universal health coverage, equitable access to medicines and technologies, and stronger public health institutions. It also requires a new understanding of health financing.
For too long, health budgets have been viewed as expenses to be reduced during economic downturns. Yet health is not a cost center. It is the foundation of education, productivity, social cohesion, and economic growth. Strong health systems are not simply instruments of care; they are engines of development and stability.
Investing in health is investing in people, communities, and future prosperity.
A New Social Contract for Health
Health outcomes are shaped far beyond clinics and hospitals. They are influenced by where people live, learn, work, and age.
A new social contract for health must recognize that health is co-produced by societies and that responsibility extends across all sectors.
Governments must create enabling environments through responsive laws, policies, and investments in education, housing, clean air, water, and social protection.
Communities must be empowered to participate in decisions affecting their well-being because health solutions are most effective when designed with those they serve.
The private sector must align innovation and business practices with public interest. From food systems to pharmaceutical production to digital platforms, profit cannot come at the expense of health.
Civil society must continue to champion accountability and equity, while international institutions must foster cooperation rather than competition.
A healthier future depends on collective responsibility. Public health has always been about more than preventing disease. It is about tackling social determinants of health. It is about creating conditions that allow people to live with dignity, opportunity, and hope.
The Pandemic Agreement: From Lesson to Legacy
If COVID-19 was the warning, the Pandemic Agreement must be our answer.
The pandemic exposed critical weaknesses in global cooperation, from inequitable access to vaccines and medical supplies to fragmented responses and inconsistent information sharing. These failures came at enormous human and economic cost.
The Pandemic Agreement represents an opportunity to ensure that the lessons of COVID-19 become the foundation of future preparedness rather than a missed opportunity.
This agreement is not about surrendering sovereignty. It is about strengthening collective security through agreed principles and shared responsibilities before the next crisis emerges. It is about building trust, improving cooperation, and ensuring that future responses are faster, fairer, and more effective.
To succeed, the Agreement must deliver on four core priorities.
1. Equity in Access
Equity must move from rhetoric to reality.
The world cannot repeat a situation in which life-saving vaccines, diagnostics, and treatments are concentrated in a handful of countries while others wait. The Agreement must support equitable access to pandemic-related health products, technology transfer, and regional manufacturing capacity.
Preparedness without equity is preparedness for only a few.
2. Prevention and Preparedness
Preparedness cannot begin when an emergency is declared.
Countries need sustained investment in surveillance systems, laboratories, workforce capacity, and primary healthcare. Early warning systems must trigger timely action, while greater attention must be given to preventing spillover events and addressing the environmental and social drivers of disease emergence.
3. Whole-of-Government and Whole-of-Society Action
Health emergencies affect every sector.
Successful responses require coordination across health, finance, education, trade, transport, and social services. Communities must be active participants, not passive recipients of directives.
Trust and engagement are as important as technology and infrastructure.
4. Accountability and Science
Misinformation cost lives during COVID-19.
Future preparedness must be built on transparency, evidence, and accountability. Information sharing, independent review mechanisms, and respect for human rights are essential to maintaining public trust and ensuring effective action.
The Pandemic Agreement, together with universal health coverage and strong primary healthcare systems, can form the backbone of a more resilient global health architecture for 2030.
Putting Equity at the Center
Health inequities remain among the world's most persistent challenges.
Millions of people continue to experience poorer health outcomes because of where they live, their income, gender, disability status, race, or migration status. The pandemic widened many of these disparities.
Children lost educational opportunities. Women carried greater unpaid care burdens. Informal workers lost livelihoods. Migrants, refugees, and marginalized communities often face barriers to essential services.
The success of any new global compact will depend on whether it reaches those who have historically been left behind. This means investing in primary healthcare, strengthening community health systems, supporting community health workers, protecting frontline workers and removing barriers to access such as cost, distance, discrimination, and lack of information.
The true measure of progress is not how well systems serve the average person, but how effectively they protect those facing the greatest vulnerability.
A system that works for the most vulnerable works for everyone.
Harnessing Technology for the Public Good
Technological innovation has enormous potential to improve health outcomes, but its benefits are not automatic.
Without deliberate action, digital technologies can deepen inequalities, reinforce bias, and exclude those without access, connectivity, or digital literacy.
To ensure technology serves the public good, digital transformation must be accompanied by ethical governance, privacy protections, equitable access, and investments in digital public infrastructure.
Innovation should expand opportunities, not widen divides.
Rebuilding Trust
Perhaps the most important lesson from recent crises is the value of trust.
Public trust in institutions, science, leadership, and health systems is essential for effective public health action. Without trust, even the most sophisticated interventions can fail.
Building trust requires transparency, accountability, and humility. It means acknowledging uncertainty, correcting mistakes, and ensuring that communities have a meaningful voice in decision-making.
People must not simply be beneficiaries of policy. They must be partners in shaping it.
At the international level, solidarity must replace narrow self-interest. Viruses do not respect borders. Climate change does not stop at national boundaries. Inequality anywhere creates risks everywhere.
Cooperation remains humanity's most powerful public health tool.
A Call to Action
Imagine a world where every person can access quality healthcare without financial hardship.
A world where health policy is developed alongside climate, education, agriculture, finance, and social protection policy.
A world where governments work across sectors, communities shape the decisions that affect them, and technological innovation serves humanity rather than narrow interests.
A world where environmental stewardship is recognized as a prerequisite for health and where solidarity guides global action.
The year 2030 should not be seen as a destination, but as a milestone on the journey toward a healthier, fairer, safer world and more sustainable future.
The new global compact for health must rest on three enduring principles: equity, solidarity, and sustainability.
The Pandemic Agreement offers a historic opportunity to turn those principles into action. It can help build a future where preparedness is stronger, access is fairer, and no country is left to face global threats alone.
The moment is ours to seize.
Let us choose cooperation over division, prevention over reaction, and solidarity over self-interest.
Let us build the world that 2030 demands.