6.F. Round table: Geopolitical Shifts and Global Health Equity: Reclaiming Governance in Turbulent Times

Abstract Global health governance is under mounting pressure. New geopolitical tensions, donor re-alignments and a shrinking civic space in health are reflective of wider interlocking trends that challenge institutional trust, multilateral collaboration and accountability. From increasingly publicised tensions between health and political spheres, eg national withdrawals from WHO, changing aid paradigms, and scholars being targeted for speaking out on humanitarian crises, we are witnessing an erosion of public health values and institutions. A recent BMJ editorial warned that “science is under siege.” Around the world, research institutions are being dismantled, evidence is sidelined in favour of ideology, and public health expertise is being undermined. In this re-defined space, disinformation thrives while critical voices are excluded. The European public health community now face the dual challenge of defending scientific integrity at home while responding to the global consequences of its erosion. Reclaiming space for equity, accountability and evidence-informed civic engagement is now both urgent and necessary. Objectives Explore how shifting geopolitical dynamics are transforming global health governance and what this means for health outcomes and civic participation: • Political disengagement (eg, US & Argentina distancing from WHO) signalling a growing retreat from multilateral cooperation, undermining legitimacy, funding and effectiveness while emboldening narrow national self-interests; • Foreign aid cuts (eg PEPFAR & DREAMS) or shifting dynamics in multi-stakeholder partnerships (eg Gavi) reflecting rising political expediencies and changing financing priorities; • Academic and activist suppression (eg risks of speaking out on Gaza), in part reflective of a more generally reduced civic space for challenging emerging norms and political priorities; Following this, the roundtable session will focus on opportunities created by these shifting geopolitical dynamics, including for addressing already existing issues, eg the WHO funding model and to identify strategies to be pursued by the public health community and wider networks for addressing these and related issue. Format 1. Setting the Stage: Framing recent geopolitical shifts and potential impacts on science, and the session's goals. 2. Lightening Panel: Short presentations on political disengagement, shifting multi-stakeholder & multilateral dynamics, & shrinking civic space to challenge emerging norms. 3. Small Group Facilitated Discussion: Facilitated discussion on opportunities, strategies and ways forward. 4. Plenary Strategy Identification: Co-develop strategies to enhance equity, voice, & scientific freedom and integrity. 5. Wrap-up & Next Steps: Summary & invitation to join a follow-up initiative, eg joint commentary or advocacy initiative. Expected Outcome Yield actionable insights, spark new collaborations, explore a joint commentary & shared strategies. Key messages • Political interference and geopolitical shifts are not just symptoms of crisis, but drivers that undermine health equity, scientific integrity, and civil space. • A coordinated, cross-sector response is needed to reclaim inclusive, evidence-based global health governance Speakers/Panellists Marleen Bekker Wageningen University & Research, Wageningen, Netherlands Carlos Bruen TCD, Dublin, Ireland Greg Williams University of Manchester, Manchester, UK