The 78th World Health Assembly (WHA78) offered a realistic reflection of the state of the global health system: on the one hand, member states’ ever-increasing expectations of the WHO; on the other, structural and financial constraints that threaten to severely limit its capacity for action. The Assembly itself took place against a backdrop of persistent geopolitical tensions and challenges—evident, for instance, in the conspicuous absence of the United States and the ongoing dispute over Taiwan’s status within the organisation. Despite unfavourable circumstances, key health policy initiatives with the potential to benefit future generations were adopted or reaffirmed. These include a multilateral pandemic agreement, the next steps in reforming the International Health Regulations (IHR), and—recognizing the signs of the times—a global climate action plan. Further, new health priorities were incorporated into the WHO agenda, signalling that while global cooperation remains arduous, it can, under pressure, yield essential results.
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