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Global health reform cannot wait for a new world order. Middle powers must act now

Chatham House | 2026-05-18 | health

Topics: Europe, Indo-Pacific, United States, Health

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English Summary

The Chatham House analysis argues that global health reform cannot await a new world order, requiring immediate action from middle powers. Given the structural pressures on multilateral bodies like the WHO, the authors propose a dual strategy: middle powers must employ 'variable geometry' by building flexible, issue-specific coalitions (e.g., for pandemic preparedness) rather than waiting for slow, comprehensive global settlements. Crucially, reform must be driven by the Global South, necessitating that Western powers move beyond mere dialogue to genuine power-sharing negotiations. Failure to cede structural power and grant permanent representation to the Global South will undermine the legitimacy and effectiveness of any reformed global health architecture.

中文摘要

查塔姆館的分析指出,全球衛生改革不能等待新的世界秩序來實現,必須由中等強國立即採取行動。鑑於世界衛生組織(WHO)等多邊機構所面臨的結構性壓力,作者們提出了一種雙軌策略:中等強國必須採用「變數幾何學」(variable geometry),即建立靈活、針對特定議題的聯盟(例如,針對疫情準備),而非等待緩慢、全面的全球性和解。至關重要的是,改革必須由全球南方主導,這要求西方國家必須超越單純的對話,進入真正的權力分享談判。若未能讓渡結構性權力並賦予全球南方永久代表權,任何改革後的全球衛生架構的合法性與有效性都將受到削弱。

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