Redefining global health in the 21st century: Towards a more equitable global health agenda

Global health is at a critical juncture, with significant achievements in reducing deaths from HIV and under-five mortality since 2000. However, progress in other areas, such as maternal mortality and tuberculosis, remains uneven, and cardiovascular diseases continue to rise. Compounding these challenges is the emerging threat of climate change, which is predicted to cause millions of health-related deaths by the end of the century. This commentary proposes a new global health model inspired by Kate Raworth's 'doughnut' framework, which emphasizes maintaining ecological and social boundaries to foster sustainable health. The inner boundary focuses on ensuring equitable access to essential health services, particularly for underserved populations. The outer boundary addresses the health impacts of environmental degradation and climate change, advocating for adaptive and resilient health systems. This model calls for a reorientation of global health priorities to balance human well-being with environmental sustainability, urging international collective action at platforms like COP29. By addressing both health equity and ecological stability, this framework aims to guide the global health community towards a more equitable and sustainable future.