Breakthroughs Blog: United Nations

2025 has been a whirlwind year for global health. In the United States, we've seen the integration of the US Agency for International Development (USAID) into the Department of State, transformation at the Department of Health and Human Services (HHS), and a complicated and prolonged budget process. Globally, we've seen setbacks and progress in HIV and malaria, an evolution at the World Health Organization (WHO), a multilateral win with the Pandemic Agreement adoption, and African partners stepping up to boost autonomy.As the year draws to a close, GHTC is reflecting on the innovations, policy shifts, and pivotal moments that defined 2025 and what they signal for the years to come.US global health leadership in transitionOn day one of his second term, President Donald Trump initiated an effort to realign US foreign assistance programs with the goal of making America safer, stronger, and more prosperous. This effort started with an overhaul of USAID, triggering a series of layoffs, stop-work orders that turned into award terminations, and withdrawals from multilateral partnerships, culminating in the agency’s official integration into the State Department on July 1.While this suspension and termination of USAID programs disrupted critical research projects and health services worldwide earlier this year, in September, the State Department unveiled the America First Global Health Strategy, which outlines a plan to reshape the US government’s global health programming, presenting opportunities for global health research and development (R&D).The new strategy centers multiyear bilateral agreements with countries while reducing ties with nongovernmental organizations and narrowing health focal areas. While critical questions remain on implementation—including on whether the agency still retains needed expertise and how it will coordinate with interagency technical partners like the US Centers for Disease Control and Prevention (CDC)—the strategy’s focus on integrating aid more directly into national health systems is a step forward in improving sustainability and self-reliance. The strategy also raises the exciting possibility that funds could be used to support “innovative, breakthrough technologies.”  Building on USAID’s successes and shortcomings in that space, the department has a clear opportunity to establish a centralized R&D fund—in complement to bilateral agreements—to invest in innovative tools that could leapfrog global health progress. Through collaboration with global health stakeholders and interagency partners, State could reshape US global health programs to continue to save lives; foster funding beyond US government resources, including through partner nations; and promote shared security and prosperity.Overhaul of US scientific and public health infrastructureThe United States has long been a leader in global health R&D and science more broadly, with American researchers, universities, companies, and patients benefiting. In 2025, sweeping changes at HHS reshaped America’s public health and research infrastructure. These far-reaching reforms aimed to advance administration priorities of promoting “gold standard science,” improving efficiency, transparency, and oversight and realigning investments to match administration objectives. At the National Institutes of Health (NIH) and CDC, these changes have included significant staff departures, among them seasoned leaders, and the appointment of many officials who were previously critics of these agencies. It has also included new policies to overhaul oversight of foreign awards and cap indirect costs, changes to longstanding vaccine guidance, and the terminations of numerous awards, including a wind-down of mRNA vaccine development activities. The speed and scale of these changes have raised concerns across the biomedical research and public health communities. While thoughtful reforms could yield benefits, experts warn that current actions risk driving US scientists abroad, disrupting promising clinical trials, weakening the pipeline of new tools, eroding trust in public health guidance, and weakening the structures that have sustained US scientific leadership. US budget swings and shutdowns2025 began with a race to fund the government, with President Trump signing the fiscal year 2025 budget into law in mid-March. While the budget maintained global health R&D-relevant funding lines at prior levels, it funded a government that now looked significantly different after sweeping layoffs and restructuring. Months later, the administration issued its budget request, proposing significant cuts and a restructuring of global health and research programs, reflecting far-reaching changes it had already begun to enact.In June, the administration proposed a request to rescind billions in funding for foreign aid. Though Senators stepped in to remove cuts to global programs for HIV/AIDS and several other health areas, the package ultimately became law, cancelling $500 million in previously appropriated global health funds and raising the possibility that this administration will continue to use rescissions as a tool to withdraw funding.  By late summer, Senate and House appropriators advanced interim funding bills that included higher-than-expected funding for global health and medical research, maintaining funding proposed for elimination by the administration. But then stalled negotiations triggered the longest-ever government shutdown, during which the administration implemented unprecedented furloughs and layoffs that affected critical staff at public health and health research agencies.While the shutdown ended on November 12, pushing the funding fight until January, and most associated layoffs were reversed, uncertainty about future funding for global health R&D persists, especially with a deeply divided Congress and the potential of further recissions.A year of setbacks and breakthroughs in HIV and malaria effortsGlobal HIV/AIDS and malaria efforts faced major setbacks in 2025 as declining US and international donor support has threatened decades of hard-fought progress. Funding cuts could lead to millions of additional HIV and malaria cases in the coming years and has already stalled promising research advancing new HIV and malaria tools.Amid these challenges, the June approval by the US Food and Drug Administration of lenacapavir, a twice-yearly injectable drug for HIV prevention, marked a major milestone and a reminder of the incredible progress possible through strong support for research. Developed by Gilead and supported by NIH-backed research, the drug offers an alternative to daily pills or bi-monthly injections, making prevention more accessible and easier to maintain. Global partners are stepping up to expand access, and Phase 3 trials of a once-yearly version are planned.In November, Medicines for Malaria Venture and Novartis shared Phase 3 trial results for GanLum, a new drug found to be highly effective at treating malaria, including drug-resistant cases, and capable of blocking disease transmission. Pending approval, it could help counter rising resistance to current treatments.Other notable R&D advances in 2025 also targeted the growing threat of antimicrobial resistance, including a Phase 3 trial for a novel antibiotic targeting a dangerous antibiotic-resistant pathogen, support for what could be the first-ever vaccine for Escherichia coli, and efforts to harness artificial intelligence to transform antibiotic discovery. These breakthroughs underscore the importance of sustained R&D investment and the efforts to ensure new tools reach those who need them.WHO restructures amid budget shortfallFacing a severe budget crisis and pressure from member states to reprioritize programs, WHO launched a sweeping overhaul in 2025, cutting staff, slashing its budget, and reorganizing core functions. At its February Executive Board meeting, member states approved a $1.1 billion budget reduction, leaving a remaining $1.7 billion shortfall for 2026 and 2027, despite a recent increase to membership dues and appeals for voluntary contributions.In late April, WHO announced a plan to halve its senior leadership team and consolidate departments. Infectious disease and climate and health programs remain relatively well-resourced, and merging several disease-specific initiatives into a new division could strengthen certain programs. However, neglected tropical diseases and health emergency preparedness and response programs face sharp cuts, while reductions in regional and in-house expert posts may weaken global lab and surveillance networks and delay critical guidance, raising concerns about WHO’s outbreak response capacity.One core R&D function spared from the worst cuts was WHO’s prequalification (PQ) program, which evaluates medical products to support regulatory approval and rollout in countries with less advanced regulatory authorities. The program has marked some important achievements this year, launching a new portal to improve transparency for developers, introducing a new streamlined review and guidance process for TB diagnostics, and prequalifying lenacapavir for HIV prevention through a compressed process completed in just 36 days. As WHO and the broader United Nations system grapple with financial strain and diminished donor support, questions remain about the capacity to deliver on their mandate. A major outbreak could test the limits of this leaner system.Pandemic Agreement provides hope in challenging year for multilateralismAt the World Health Assembly in May, delegates adopted the Pandemic Agreement, a milestone win for global health after three years of complex negotiations. However, consensus on a pathogen and access-benefit sharing system was not reached, requiring member states to return to the negotiating table to finalize an annex for adoption at next year’s assembly. Persistent disputes over the voluntary or legally binding nature of participation signal tough negotiations ahead.While the Pandemic Agreement is a huge win, pushback from key countries and declining pandemic preparedness investments raise concerns about global readiness. Annex negotiations and the 2026 United Nations High-Level Meeting on Pandemic Prevention, Preparedness, and Response will further test international unity on this crucial topic.Meanwhile, 2026 brought notable R&D advances to strengthen our defenses against pandemic threats. The Coalition for Epidemic Preparedness Innovations launched the first-ever adjuvant library of 25 immune-boosting substances to improve vaccine effectiveness and awarded $17.3 million for Phase 2 trials of a promising Nipah vaccine, among the first candidates targeting the priority virus to reach this critical stage. IAVI’s vaccine candidate for Lassa virus, another virus with pandemic potential, was also found to be safe and effective in a first-in-human Phase 1 trial, marking further R&D progress against concerning disease threats.Partners step up to fill gaps and boost autonomyAmid steep foreign aid funding losses, African nations are accelerating efforts to boost manufacturing and laboratory capacity on the continent and reduce reliance on external partners. At October’s Conference on Public Health in Africa in Durban, South Africa, thousands of participants endorsed The Durban Promise, a roadmap for Africa’s health sovereignty, urging action on manufacturing, financing, workforce and capacity development, and regulatory strengthening, a signal of growing continental unity.This momentum was echoed by the Accra Reset, led by Ghanaian President John Mahama, to forge further progress toward greater sovereignty and more equitable global cooperation. At the continental level, the Africa Centres for Disease Control and Prevention launched a new biomanufacturing fellowship to help meet the goal of producing 60 percent of Africa’s vaccine dose needs locally by 2040.South Africa held the G20 presidency this year, culminating in the first G20 summit held on African soil and a declaration focused on priorities for Africa and the Global South. The summit was punctuated by the absence of the United States, underscoring the imperative for greater African autonomy as international aid declines and health threats rise. With the United States assuming the G20 presidency next year, its priorities will be closely watched. Looking ahead to 2026If 2025 has taught us anything, it’s that global health is unpredictable and constantly evolving, so we won’t speculate on exactly what 2026 may bring. But a truth remains clear: global health R&D is a strong investment that pays off—saving lives, strengthening economies, and fueling scientific progress. As the United States redefines its approach and role in the broader global health ecosystem, it remains to be seen how it, and others, will step up to ensure that promising technologies in the pipeline are advanced to improve lives around the world.For other fascinating global health news delivered to your inbox weekly and to stay abreast of developments in 2026 and beyond, sign up now to receive GHTC’s R&D News Roundup newsletter.

This fall, the global health community gathered against a backdrop of change. Shifts in global funding, visible pullbacks from multilateralism, and an evolving global development architecture are reshaping how actors engage and advocate on the world stage.For the Global Health Technologies Coalition (GHTC)—and for many others—this moment has prompted reflection on how we show up in global forums and what it means to engage meaningfully amid transition. Following a busy season of high-level gatherings, we’ve taken time to reflect on what these moments revealed—both in the lead-up and in the conversations that followed—and how they are shaping our thinking about GHTC’s role and path forward in these spaces. Reconnecting at UNGA80 In the run-up to this year’s 80th United Nations General Assembly (UNGA80), there was an unusual air of hesitation across the global health community. Typically, mid-August brings a flurry of coordination calls and side event planning, but this year, the energy felt uncertain. For GHTC, our initial hesitation to participate stemmed from UNGA’s focus on noncommunicable diseases (NCDs), an area outside our traditional advocacy repertoire. However, we also had questions about which of our partners would be in New York City this year and what our role could or should be in the tumultuous year we have all had. Yet, as it goes, we and other organizations confirmed our plans to attend UNGA, and soon, the familiar rhythm of civil society’s presence in New York began to take shape.  In New York, GHTC and the Global Health Council (GHC), with STUF United Fund, cohosted an event on innovation, security, and equity in a changing global landscape, which brought together policymakers, funders, and implementers to examine how global health can stay resilient amid geopolitical uncertainty. The discussion was lively and focused on the technical aspects of innovation, security, and equity, but afterwards participants commented not on those technical matters, but on our authentic and pragmatic approach and tone with which we addressed these topics. Audience members remarked that the discussion was one of the most genuine moments of the week. For GHTC, moderating this dialogue reinforced the need for global health advocates to bridge communities and connect innovators, funders, and policymakers around a shared vision for equitable access. It also reminded us that the credibility of civil society depends on showing up authentically, especially in moments of uncertainty or disagreement.  One striking development at UNGA this year came during the High-Level Meeting on NCDs, where the United States laid out objections to the political declaration and voted against it, taking consensus for the resolution off the table. While this move was not unexpected given the US government’s posture toward multilateralism this year, it was still a sobering moment. Secretary of Health and Human Services Robert F. Kennedy has made NCD prevention a national priority under his leadership at the department, yet his sharp criticism of the declaration underscored the United States’ continued reluctance to advance these goals through global cooperation. Women’s health as a catalyst for R&D transformation  As the global health community’s focus shifted from New York to Berlin, Germany for the World Health Summit (WHS), many of the same themes carried forward—innovation, equity, and the importance of collaboration amid shifting global priorities. After UNGA80, we saw how essential it was for civil society's voices to remain present and aligned in global conversations, and we viewed WHS as an opportunity to do just that. For us, a standout moment in Berlin was our participation in the Gates Foundation’s Women’s Health Innovation Equity Forum—a convening of global leaders, innovators, and funders dedicated to advancing accountability and progress in women’s health research and development (R&D).  What stood out the most at this forum was the shared understanding that women’s health R&D can be a testing ground for how we build a more equitable and collaborative innovation system overall. Conversations at the forum went beyond individual products or technologies to look at the broader ecosystem: how research can better reflect women’s lived experiences, how artificial intelligence and digital tools can be designed to avoid bias, and how we can create inclusive pathways from discovery to delivery. The call was not just to innovate for women but to innovate with women, by centering their voices, co-designing solutions that fit their realities, and ensuring that they are represented as leaders, scientists, and decision-makers throughout the R&D process. These ideas align with GHTC’s work to strengthen the global health innovation ecosystem. Our goal is to help make equitable, inclusive, and well-resourced innovation systems the rule, rather than the exception.  Reimagining the global health architectureOver the past several months, we've participated in a number of conversations, meetings, and working sessions aimed at reimagining how the global health architecture can be rebuilt stronger and more resiliently in the years ahead. One gathering, hosted by the Wellcome Trust just after WHS, brought a new focus and sense of shared purpose to this discussion, convening partners from across North America and Europe to explore the future of global health amid ongoing change and reform. This initial session focused on North American and European partners, with additional regional discussions planned to ensure perspectives from low- and middle-income countries and other stakeholders are fully represented as the series continues. The gathering brought together an extraordinary mix of leaders—funders, policymakers, researchers, and advocates—who are committed to reimagining how the global health ecosystem advances innovation and equity. Our discussions explored how the next generation of global health architecture could deliver faster, more inclusive, and stronger regional capabilities for research and manufacturing and more sustainable financing that bridges discovery and delivery. It was both humbling and energizing to be part of such a thoughtful, solutions-oriented dialogue at a moment when the global community is being called to reexamine what collective action really looks like.  For GHTC, these reflections really brought home why our coalition’s work matters. The conversations highlighted how innovation, access, and financing are all part of the same continuum, which is exactly what GHTC has been advocating for as we work to strengthen R&D systems, regulatory pathways, and product access. What struck us the most was the shared understanding that reforming global health innovation is not only a technical or financial issue but also a matter of trust, shared power, and accountability. We left the meeting encouraged and inspired, knowing that voices like ours, grounded in evidence, partnership, and advocacy, have an important role to play in shaping a more connected, inclusive, and resilient global health ecosystem. In Berlin, we also had the chance to join our partners, including the Medicines for Malaria Venture (MMV), Impact Global Health, and others, at events highlighting innovation and equitable access on the margins of the WHS. Finally, to close out our continued engagement with the civil society arm of the G20, we supported our partners—including the South African Health Technologies Advocacy Coalition, Resilience Action Network Africa, MMV, Better Health Solutions, and others—in hosting a side event on science, research, and innovation on the sidelines of the G20 Social Summit. This event highlighted the value of meaningful partnerships and global collaboration, reinforcing the importance of civil society's voices in shaping health innovation and research agendas worldwide. Looking aheadAs this season of global convenings draws to a close, GHTC is taking stock. We are reexamining our multilateral priorities and exploring how to continue showing up—strategically, collaboratively, and boldly—in spaces that are themselves evolving. We extend deep thanks to our partners—GHC, MMV, Impact Global Health, the South African Health Technologies Advocacy Coalition, Resilience Action Network Africa, Better Health Solutions, and many others—for the coordination and collaboration that made this season so meaningful. Even during a period of change, these gatherings reaffirmed that innovation, solidarity, and shared purpose remain at the heart of progress in global health. 

For the first time, global leaders have come together to lay out a comprehensive plan for pandemic prevention, preparedness, and response. After over three years and 13 formal rounds of negotiations, member states of the World Health Organization (WHO) defied expectations and reached consensus on a Pandemic Agreement. The final draft of this legally binding instrument will lay the groundwork for stronger global cooperation and be a major catalyst for a more robust research ecosystem that ensures that the fruits of innovation are more equitably shared.  A win for multilateralism! This agreement is a major win for multilateralism. At times, there were reasons to think the negotiations might fail, including seemingly intractable disagreements between high-income and low- and middle-income countries on access and intellectual property issues. Then came the announcement in January that the United States intended to withdraw from WHO and would take no further part in the treaty talks. International cooperation has been tested, and it was important for the global health community to clear this hurdle.  While the text agreed upon in Geneva reflects compromise and not all negotiators’ ambitions were met, it represents important progress and lays the groundwork for action toward global readiness and equity in future health emergencies.  What’s in it for R&D? Efforts to accelerate the research and development (R&D) of vaccines, drugs, and other medical countermeasures were at the heart of the negotiations, and member states agreed to the following priorities: Promote technology transfer—which involves the transfer of scientific knowledge and know-how from one party to another to facilitate the broader production and availability of products—under “mutually agreed” terms. While this qualifier was disappointing to some low-income countries who had hoped for stronger commitments to help scale up local manufacturing of lifesaving medical countermeasures, it was ultimately a red line for wealthier countries, which prioritized preserving existing intellectual property frameworks.  In a historic first, the text obligates countries to attach conditions for access to publicly funded R&D contracts, a landmark step toward promoting equity. If implemented effectively, this means countries would be empowered to use contract enforcement measures to ensure public R&D spending ultimately results in products that reach patients. An agreement to promote post-clinical trial access to products for trial populations and for populations at risk in their communities, as well as commitments to support the transparent publication of clinical trials protocols and research results.  A framework for a new Pathogen Access and Benefits Sharing (PABS) system that grants companies access to scientific data, such as pathogen samples and genomic sequences, in return for more equitable sharing of drugs, vaccines, and diagnostics during a pandemic. Countries agreed that 20 percent of the vaccines, drugs, and diagnostics produced by participating manufacturers will be made available to the WHO for distribution. PABS wasn’t finalized during the negotiations and will now have to be fully developed through a new working group and added as a separate annex to the agreement. Establishment of a Global Supply Chain and Logistics Network to coordinate resource allocation, reduce access barriers, and mitigate the practice of hoarding of pandemic products through shared stockpiles. Beyond R&D, other key elements of the proposed agreement include a commitment to a “One Health” approach to pandemic prevention, efforts to strengthen national health systems, and the creation of a coordinating financial mechanism to support implementation of new obligations and capacity-strengthening measures.For a more detailed breakdown of the agreement, check out this briefer!Next steps: World Health Assembly and beyond After three years of intense negotiations and significant progress made toward aligning key provisions, critical procedural steps remain before the agreement can be formally adopted and implemented.   First, the text must be adopted by member states at the World Health Assembly later this month. There will then be an intergovernmental working group that will convene to hash out the details of the PABS system, likely over the course of the next year. Once the PABS annex has been finalized, at least 60 countries must ratify the treaty—in accordance with their own national laws and processes—in order for the Pandemic Agreement to become international law and enter into force. Finally, in order to support implementation and ensure enforcement and accountability, a “conference of parties” will be established to regularly review the agreement’s implementation.  The agreement has now reached an important milestone, but the work is not done. Leaders must carry it across the finish line later this month before committing to the task of ensuring its success through robust implementation. 

As 2025 kicks off, we are poised for a year of political uncertainty. There are questions aplenty around the future of US leadership in global health and how priorities will change as the Trump Administration takes office. Canadian Prime Minister Justin Trudeau's resignation and the upcoming elections in Germany may also lead to further policy changes in donor countries historically committed to global health and development. This reshaping of global political dynamics and the lasting impact of emerging infectious disease threats present challenges and opportunities for multilateral collaboration and innovation for global health research and development (R&D) in 2025. As we look ahead at the global health landscape in this pivotal year, here are some of the key issues we are watching. 1. Will the United States fully withdraw from WHO this time?In his very first day in office, President Donald Trump signed an executive order withdrawing the United States from the World Health Organization (WHO), a move that many global health experts agree will make the United States and other countries less safe from infectious diseases and other public health threats. President Trump had previously initiated the process to pull US support from the organization in 2020, but the clock ran out before the end of his term, and President Joe Biden later reversed the decision at the start of his presidency. In the executive order, President Trump outlined his administration’s reasoning for pulling out of the global health agency, decrying “unfairly onerous” payments from the United States compared to other member states and the organization’s “inappropriate political influence.”  The departure from WHO will have dire consequences for global public health, as well as US security, diplomacy, and influence. There are a number of US institutions that collaborate closely with WHO on important work that remains vital to US interests, including polio eradication, cancer prevention, and global health security. US agencies, pharmaceutical companies, and laboratories rely on the WHO Pandemic Influenza Preparedness Framework to gain access to new influenza virus samples for R&D. Severing ties with WHO will impede US access to crucial tools for developing biological countermeasures to influenza.   And WHO’s work extends far beyond influenza. WHO has tremendous reach, working with 150 countries and 70 research institutions in the United States alone. WHO supports the global tracking of infectious diseases, updating networks for polio, measles, and other diseases to provide real-time data for member state officials to guide public health responses. The organization helps facilitate global access to a variety of health products and provides an accelerated path for the procurement of safe, effective, and reliable health innovations. WHO’s prequalification program expands global markets for US producers, offering an accelerated path for approval and uptake of American health innovations in low- and middle-income countries. For example, in 2024, WHO prequalified a Hepatitis self-test manufactured by Pennsylvania-based OraSure Technologies. Lastly, there are concerns about how the US withdrawal will diminish its influence in such a critical global institution. While no major organization is perfect, WHO has chartered a path of reform in recent years, due in large part to US leadership pushing for more effective and efficient governance structures. US concerns will only continue to be addressed if we remain a member state, working with WHO officials and other countries on improvements to the organization. The executive order also calls for broad reassessment and reassignment of American WHO personnel, many of whom play a pivotal role in supporting and directing the organization’s essential work around the world—from responding to disease outbreaks and training local health care workers to classifying disease variants and chairing the WHO Science Council. In fact, there are more Americans in leadership positions at WHO than from any other country. Pulling out of the organization only jeopardizes the United States’ ability to continue to be the most important player in the global health space. 2. Is there enough time to successfully conclude the Pandemic Accord negotiations?A Pandemic Accord could be a game changer in strengthening R&D capacity and creating new frameworks for the development of and access to new medical countermeasures. Reaching a position of solidarity is undoubtedly challenging in an increasingly fragmented world, but if the agreement fails, it will represent a massive failure for global health.   In 2024, countries tried and failed to finalize this proposed international agreement to strengthen pandemic prevention, preparedness, and response (PPPR). Negotiations proved too contentious and the timeline too short to deliver on a new framework. In 2025, countries have one last chance to get it across the finish line. While significant progress was made on reaching consensus on several articles at the end of last year, pain points persist on technology- and knowledge-sharing mandates and the inclusion and operational details of the proposed Pathogen Access and Benefit Sharing system—a mechanism that would facilitate the sharing of pathogen samples and genetic data needed for product development in exchange for benefits like free or discounted contributions of health products.  The Pandemic Accord negotiators held five meetings in 2024, adding up to a total of twelve negotiating sessions held since 2022. And though member states are closer to reaching a finalized text, late last year, negotiators again pushed back their deadline to the 78th World Health Assembly in May 2025. The Executive Order signed by President Trump on January 21 demands that the Secretary of State cease negotiations on the Pandemic Accord and recall and reassign American staff working with WHO; these actions will further disrupt the negotiating process, leaving the United States notably absent from any further discussions.3. How will the G20 and G7 continue the momentum in 2025?  South Africa assumed the G20 presidency late last year, and the question now is how they will build on the momentum of global health progress made under previous G20 presidencies. At the end of last year, South Africa outlined its health priorities, which include accelerating Universal Health Coverage through primary care, strengthening health workforces, combating noncommunicable diseases, and advancing PPPR. South Africa also introduced a science and innovation arm to its global health agenda, committing to review, strengthen, and leverage member state science, research, and innovation sectors.  It will be worth watching whether South Africa builds upon and facilitates the implementation of Brazil’s signature initiative from their presidency last year, the Coalition for Local and Regional Production, Innovation, and Equitable Access, which seeks to strengthen local production to enable more equitable access to safe, affordable, high-quality, and effective health products for neglected diseases.  While South Africa has established an ambitious global health agenda, there is a broader concern that the G20 might succumb to the current tumultuous political climate—France is resettling after elections of its National Assembly last year, the United States has swapped party leadership across the White House and Congress, and Germany has federal elections scheduled for February. With several G20 members undergoing political shake-ups and heavy domestic issues underpinning global conversations, finding member state synergy will be critical this year. And the G7 does not appear to be in a better position after Prime Minister Trudeau’s resignation in early January, as leadership transitions and operational delays will likely sidetrack G7 responsibilities and hamper ambition.  4. Will the financing drum beat fade?This year will also be significant for global health financing. 2025 wraps the seventh three-year replenishment fundraising cycle of The Global Fund to Fight AIDS, Tuberculosis and Malaria. The new WHO Investment Round continues as well, and the World Bank Pandemic Fund announced that its third funding cycle will begin later this spring, shifting from the last two rounds of financing PPPR-related projects to now emphasize support for national and regional health institutions.  Yet, despite the continued need to increase investment in key global health institutions and priority areas, many governments find themselves in constrained resource environments, and around the globe, leaders are pulling back their commitments to provide the necessary funds to address critical challenges like emerging infectious diseases. Mobilizing new funds will be vital for delivering on the Sustainable Development Goals, and 2025 may represent a crossroads on whether countries can sustainably and adequately finance programs, research, and initiatives that boost PPPR.  It is undoubtedly a year marked by change and challenge in global health. As we move into 2025, policymakers, experts, and advocates must navigate an increasingly complex space. The road ahead will require all of us to foster collaboration, embrace creativity, and strengthen advocacy efforts within the global health community. But most of all, it may be the year for the global health community to showcase resilience and forge innovative pathways and partnerships that drive meaningful progress in global health R&D.