Abstract
Current polycrises highlight the importance of international cooperation to protect population health. However, health system governance is fragmenting. Partial disengagement of Member States, proliferation of bilateral agreements, the rise of sub-national diplomacy, and the growing influence of public–private and philanthropic actors are reshaping power, legitimacy, and accountability in global and European public health. World Health Organization (WHO) is central to these developments. We challenge the assumption that multilateralism is still the default organising principle, ask whether parallel, potentially competing, governance structures are emerging and what this means for WHO across Europe and our public health community. Building on ASPHER/EUPHA/WHO work, the round table and interactive session reframes WHO as essential, evolving global public health infrastructure. Despite political and financial pressures, WHO Europe delivers guidance, technical support, and coordination. However, without a strong normative centre, real-life risks include: impaired transnational resilience to health security threats, regulatory divergence, inequity, weakened conflict-of-interest safeguards, and erosion of scientific legitimacy. Panellists from academia, policy, and practice will examine four fault lines: bilateral health diplomacy, public–private governance, sub-national engagement, and institutional reform, highlighting WHO Europe work. Interaction will confront difficult questions: Can WHO remain authoritative without financial and political backing from key actors? Should it adapt to a more contractual, multi-actor system? Does this signal a deeper crisis of multilateralism? Could WHO find itself in competition with alternative global health structures? We will surface tensions and competing proposals, identify practical solutions and pathways forward. Audience engagement will gather issues, test alternatives, and help shape a future-oriented position paper. At stake is the future of WHO, and whether global health governance can remain coherent, equitable, and grounded in scientific integrity.
Key messages
• Global health governance is increasingly fragmented, weakening coordination, equity and resilience; WHO is essential as the normative and coordinating centre of public health in Europe and globally.
• Strengthening collaboration across actors, while reinforcing WHO as infrastructure is critical to address current governance gaps and build a coherent, resilient, and equitable global health system
Speakers/Panellists
Natasha Azzopardi Muscat
WHO/Europe, Copenhagen, Denmark, Copenhagen, Denmark
Ariane Bauernfeind
Public Health, Environmental and Community, The Andalusian School of Public Health, Granada, Spain
Alena Petráková
Faculty of Health Sciences / Palacký University Olomouc, Olomouc, Czech Republic
Meri Koivusalo
Health sciences, University of Tampere, Tampere, Finland