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Systemic path to global health 2050
Joachim Sturmberg1, Maru Mormina2, Holger Pfaff3
1University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, Callaghan, NSW 2308, Australia.
Bulletin of the World Health Organization
|July 1, 2026
Summary
Global health investments must address complex social, economic, and political factors. A systems-thinking approach is crucial for sustainable, equitable health improvements by investing in social determinants of health.
Area of Science:
- Global Health
- Health Systems Research
- Complexity Science
Background:
- The Lancet Commission proposed pragmatic global health investments targeting specific conditions and interventions.
- This approach may oversimplify the complex, adaptive nature of health and its determinants.
- Existing frameworks may not adequately address social, economic, and political influences on health.
Purpose of the Study:
- To critically analyze global health investment frameworks through the lens of complexity and systems thinking.
- To identify key areas for enhancing health investment strategies.
- To propose principles for more sustainable and equitable global health investments.
Main Methods:
- Iterative, interpretive analysis of proposed global health investment frameworks.
- Mapping frameworks against complexity, systems thinking, and health epistemology.
- Identifying thematic areas for development and proposing guiding principles.
Main Results:
- Identified five key areas: health as emergent, non-biomedical determinants of inequity, adaptive health systems, epistemic injustices, and community-led implementation.
- Disruptions in international aid present an opportunity to redesign health investment.
- Proposed five guiding principles: community co-production, adaptive governance, complex systems literacy, cross-sectoral partnerships, and context-sensitive metrics.
Conclusions:
- Rethinking global health investment is essential to address the root causes of inequity, not just symptoms.
- Sustainable and equitable health improvements require investing in social determinants as direct health strategies.
- Policy-makers must adopt a systems-thinking approach, prioritizing community engagement and adaptive strategies.
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