The multilateral system that underpins global health security is facing significant strain. The World Health Organization (WHO) is dealing with one of its most serious funding shortfalls in recent years. The Pandemic Agreement adopted at the World Health Assembly in May 2025 is still incomplete, as negotiations on pathogen access and benefit sharing continue and ratification is pending. At the same time, traditional donors are scaling back their commitments, which is already reshaping how health programs operate in high-burden countries across Africa and Asia.

Within this already fragile system, antimicrobial resistance (AMR) continues to grow largely unchecked. It is responsible for more than 1.3 million deaths each year and could reach ten million annually by the middle of the century if current trends continue. Unlike sudden outbreaks, this is a slow-moving pandemic. It is predictable, measurable and, in principle, preventable. The UN high-level meeting on AMR in September 2024 set a goal of reducing AMR-related deaths by 10% by 2030. The scientific knowledge to support this goal is available, but implementation remains weak. Financing is still cautious, procurement systems are not aligned with public health needs, regulatory processes differ across regions, and the communities most affected by AMR are often not represented where the decisions are made.

AMR is, in many ways, a test of whether global health governance can deliver on its core promises. It requires moving innovation from research into real world use; ensuring fair access; and coordinating action across governments, institutions and the private sector without the urgency of an acute crisis. If the system cannot meet this challenge, it raises serious doubts about its ability to respond effectively to the next pandemic.

This session starts from these pressures on global health security and explores where common ground still exists and how it can be strengthened.