Health Sovereignty, Financing Reform and Protecting What Matters Most: Women’s, Children’s and Adolescents’ Health

The global health landscape is undergoing profound change. Development assistance is declining, fiscal space in many countries is tightening, and geopolitical priorities are reshaping how health systems are financed and governed. At the same time, major global reform processes, from financing sustainability discussions to broader debates on the future of multilateral cooperation, are redefining the global health architecture.

Across regions, and particularly in Africa, there is a growing political shift toward health sovereignty, reflected in African Union commitments and Africa CDC’s New Public Health Order among others. These emphasize domestic resource mobilisation, stronger national systems, and reduced dependence on external financing.

Yet within these transitions, a critical risk is emerging: sexual and reproductive health and rights (SRHR), and the broader health of women, children and adolescents (WCAH), are not being explicitly protected in financing and reform agendas.

This year’s Lives in the Balance dialogue is grounded in a simple proposition: Financing decisions are political decisions, and they determine whether women, children and adolescents are protected or left behind.

Ensuring access to comprehensive SRHR services and improving outcomes for women, children and adolescents is therefore the clearest test of whether health sovereignty agendas and global health reforms are delivering where it matters most.