Rethinking global health governance: navigating the fault lines between neoliberalism and the universal right to health

Purpose This article interrogates the persistent contradictions in global health governance between neoliberal, market-oriented approaches and the universal right to health. It seeks to clarify how key global actors promote equity in principle while advancing market-driven frameworks that commodify healthcare. Design/methodology/approach The study adopts an interpretive and conceptual research design, relying exclusively on secondary sources, including academic literature, institutional reports and global policy documents. While adopting interpretive research design, the article's value lies in synthesising diverse strands of literature and practice into a cohesive conceptual framework, offering an agenda-setting contribution that complements ongoing empirical studies. Findings The article finds that rights-based frameworks risk fiscal overextension if detached from sustainable financing, while market mechanisms can stabilise provision but only by narrowing access and institutionalising inequity. These unresolved trade-offs, between equity and sustainability, universality and scarcity, constitute the central governance dilemma. Originality/value This article contributes a cohesive conceptual framework that integrates fragmented debates on health rights and neoliberal governance. By reinterpreting global health through the lens of governance trade-offs, it advances an agenda-setting perspective for reform.