Systemic path to global health 2050
Year: 2026
Type: article
Abstract: Commission on Investing in Health proposed targeting investment in 15 priority conditions through 19 modular interventions to improve global health by 2050. While pragmatic, this approach may not fully capture the complex-adaptive nature of health and health systems, nor their social, economic and political determinants. In an iterative, interpretive analysis, proposed global health investment frameworks were mapped against complexity, systems thinking and health epistemology frameworks; five thematic areas were identified for further development: (i) health as emergent from interdependent, social-biological systems; (ii) the non-biomedical determinants driving inequities; (iii) health systems' adaptive requirements; (iv) epistemic injustices that marginalize non-Western perspectives; and (v) the need for context-sensitive, community-led implementation of health measures. Recent major disruptions to international aid financing, while challenging, present a unique opportunity to redesign health investment on more sustainable and locally grounded foundations, where national governments deliberately invest in the social determinants of health as direct health improvement strategies rather than merely as adjacent social policy. To seize this opportunity, we propose five guiding principles for policy-makers: (i) community co-production of interventions; (ii) adaptive governance structures; (iii) complex systems literacy in workforce training to navigate interdependencies and uncertainty; (iv) cross-sectoral partnerships to address determinants of health; and (v) context-sensitive metrics that incorporate community engagement to support learning within health systems. These are not optional enhancements to existing approaches; they are the foundations without which any health investment strategy will continue to treat the symptoms of inequity rather than its causes.
Institutions: University of Newcastle Australia, European University Institute, University of Cologne, University Hospital Cologne, Utrecht University, McMaster University, Stellenbosch University, Inserm, Université Paris Cité, Université Sorbonne Paris Nord, Institut de Recherche pour le Développement, University of Cape Town, University of Leeds, South African Medical Research Council, University of Oslo, Case Western Reserve University, Monash University, University of Limpopo, Bertalanffy Center for the Study of Systems Science, Université Libre de Bruxelles
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7166894822