On August 2, 2025, Minamata High School once again opened its doors to celebrate the beginning of a new year of the Stanford e-Minamata Program. The familiar sense of anticipation in the auditorium was met with something new as well: the confidence of a community and a program stepping into its second year. If last year’s guiding spirit was resilience and renewal, this year carries the feeling of growth and leadership, an acknowledgment that the seeds planted in 2024 are already beginning to bear fruit.

In his opening remarks, Mayor Toshiharu Takaoka reaffirmed the city’s dedication to supporting young people through this international partnership, while Dr. Gary Mukai, Director of SPICE, offered words of encouragement that were both lighthearted and deeply meaningful to the eager students in the room. Reminding students that mistakes are not just acceptable but essential to learning, Dr. Mukai underscored the courage and curiosity at the heart of leadership development. His message, paired with the mayor’s steady vision, set a hopeful tone for the year ahead.

That spirit was quickly brought to life by Minamata High School students Asuka Umekawa and Yudai Hirata, who delivered their opening remarks in English. Their poise and determination captured the excitement of their classmates, and their eagerness to bridge local and global perspectives embodied the purpose of the program itself. Their words were not only a reflection of their own commitment, but also a reminder of the potential within this year’s entire cohort.

Photo below: Yudai Hirata, August 2, 2025; photo courtesy Minamata High School.

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As the program enters its second year, the three themes of environment, emerging technologies, and U.S.–Japan relations remain at the core. Yet, like any thriving endeavor, e-Minamata continues to evolve. This year introduces a new sustainable agriculture module in collaboration with a regenerative farmer in Saga Prefecture, offering students a direct look at innovations shaping the future of Japanese agriculture. Alongside this addition, an expanded roster of guest speakers—some familiar, others new—will broaden the perspectives brought into the classroom.

The 25 students who make up this year’s cohort include first-, second-, and third-year students, creating a dynamic mix of voices and experiences. Their curiosity mirrors that of last year’s inaugural participants, many of whom continue to apply the program’s lessons in their studies, community activities, and even their plans for higher education. The continuity between these groups makes clear that the program is more than a single-year opportunity, it is building a culture of inquiry and leadership that extends beyond the classroom.

Looking ahead, one of the most anticipated elements of this year’s program will be the introduction of a community showcase. Students will work together to identify local challenges and opportunities in Minamata City, and at the end of the year, present their proposed solutions publicly. This new feature not only empowers students to see themselves as problem-solvers, but also invites the broader community to engage with their ideas. In doing so, the showcase promises to deepen the connections between classroom learning and community vitality.

The program’s growth would not be possible without the continued support of many partners. The leadership of Mayor Takaoka and Minamata City Hall remains steadfast. The Minamata Environmental Academia has taken on an expanded role, now guiding much of the program’s coordination. Within Minamata High School, Principal Yasunori Takaki, Vice Principal Fumiko Niibu, and Planning Manager Saho Yagyu continue to provide invaluable support. And while Mr. Hiroki Hara, who was instrumental in the program’s early development, has since relocated to Tokyo, his contributions remain an important part of the program’s foundation.

This year’s opening ceremony revealed the unfolding of student journeys and the steady expansion of a program that is becoming an anchor in Minamata’s ongoing story of renewal. The courage of Asuka and Yudai, the curiosity of their peers, and the unwavering support of local leaders and partners all point to a larger truth: Minamata’s youth are stepping forward not just as students, but as leaders whose perspectives will shape their community and extend far beyond it. The Stanford e-Minamata Program is an invitation to grow, to lead, and to imagine a future rooted in resilience, innovation, and connection.

Stanford e-Minamata is one of SPICE’s local student programs in Japan.

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I am coming into the MIP program from the world of foreign and defense analysis. I’ve had the opportunity to work for various groups in and out of the government in Washington D.C. looking at the foreign policy and defense strategy of various parts of Africa, the Gulf, and how the U.S. interacts with these regions.

I am particularly interested in a range of complex policy areas focusing on peace and security. My interests include evolving dynamics of drone warfare by great powers and middle powers, use of paramilitary groups by states, and strategies for countering political violence in authoritarian regimes.  

That technology aspect is one reason that drew me here to Stanford and its proximity to the Silicon Valley ecosystem. And, of course, there’s the AI aspect as well. “AI” is the buzzword in everything right now, but I want to know how these new tools and technologies are shaping political violence, democracies, and the global governance structure as a whole. If we don’t understand where the violence is coming from, we can’t understand how to pursue strategies for peace.

Another big appeal of the MIP program was that it allows me to interact with scholars like Francis Fukuyama, Larry Diamond, James Fearon, and Joe Felter. These are names I’ve read and referenced in my analytic work, and now I have the opportunity to learn from them directly. And who knows; maybe I will come back someday as a colleague if I return to Stanford for my PhD! With the hands-on experience at MIP, the networking opportunities here, and the emphasis on both quantitative and qualitative learning, I know I’m going to be in a good position to meet my goals and make a difference.
 

If you had told me ten years ago that I would be working on artificial intelligence at Stanford, in the heart of Silicon Valley, I wouldn’t have believed you. When applying to undergrad, I had to submit my application from an internet cafe in Beirut because the internet in my village in Lebanon wasn’t fast enough to upload my application. To go from a small village in Lebanon to studying at Stanford is a dream come true.

The path that led me here isn’t straightforward, but the thread that connects my experiences is a desire to be a voice for people who aren’t in the room. When I was a foreign correspondent, I published stories about systemic inequities and disadvantages. At the World Bank, it was pointing out biases and gaps in the data sets that directly impacted the distribution of aid and personal protective equipment. Today we are told artificial intelligence is going to be a “democratizing” technology. What about people who don’t have electricity? Who don’t have $20 for a ChatGPT subscription? Who have no AI literacy?  

If AI is going to impact every single person on earth’s life, how we build it can’t be decided by 0.01% of the population. If this is a printing press, Gutenberg Bible moment in history, we can’t simply leave entire communities, entire countries, nor entire continents out of the conversation. 

Drafting better AI policy is why I came back to school to the MIP program at Stanford. I worked with engineers who were Stanford CS alumni, and they were always so collaborative and inclusive. They patiently answered all of my questions while training an LLM. Those are the kinds of people and the kinds of values I want to work with to tackle these challenges. I’ve already seen that spirit here in the few weeks I’ve been at Stanford. These values of connecting the dots between engineering, policy, law and other disciplines has given me confidence that working together, we can write better AI policy and improve outcomes well beyond Silicon Valley. 
 

I come from Haiti, which is a small country. As such, we don’t always think about our foreign policy in an integrated way. How are our population, demography, topography, and borders linked? What about our trade partners and migration patterns? How do those impact our relationships with neighboring countries, or places with diaspora communities like the U.S.? I studied some of these questions while I was an undergrad at Princeton, but there’s much more to understand. 

My dream job is to work in the Ministry of Foreign Affairs in Haiti. So while I’m here at Stanford, I’m trying to write a handbook of sorts for myself and build out the agenda I hope to have someday. That is what is giving me direction for my time here at Stanford. If I’m learning about the balance of payments, the question I’m asking myself is, “What is Haiti’s balance of payment? What does it look like? What are the policy implications of that?”

By the time I graduate, I want to have a fully drafted idea of where Haiti’s policy landscape is currently, so I know what priorities to set to work on for the future. The fact that the MIP program is so customizable is one of the big reasons I wanted to come here; I can really tailor my studies to support these bigger projects. I get to make this time what I want it to be, and what will be most helpful to my goals.

But I also want to challenge myself to think beyond my field and learn about other parts of the world that may not have anything in common with Haiti, at least on the surface. I want to have a local impact, but I also want to develop as a global thinker. There’s a lot that connects us beyond our borders, and being able to think about those connections in a systematic, global way will only become more and more important as populations continue to migrate and integrate into communities throughout the world.
 

When I was serving as an active duty Space Operations Army officer, I had the opportunity to work on electromagnetic warfare and space control operations around the globe. My background is originally in history, and I began my military career as a military police officer, but I’ve always been really passionate about being part of the future.

There’s so much incredible defense technology out there, but the most up-to-date and effective versions don’t always get down to the individuals who really need them to operate effectively. There are so many inefficiencies and gaps between what’s actually codified in policy and what the warfighters on the ground need to execute their missions.

And that’s true of large-scale policies as well. Take the Space Treaty, for example. It was written back in 1967 when there were just 24 known satellites in orbit. Now there are thousands of satellites in orbit, yet we don't have another foundational governing document around space protocols. That’s got to change.

That’s what I want to start tackling while I’m here at Stanford. Making systemic changes in big organizations like the Department of Defense isn’t going to be easy, but we’ve got to close those knowledge gaps between the policymakers, the high level leaders and stakeholders, and those who are actually pressing the buttons of our space systems. We can't avoid these issues anymore, because it’s not just about the military or defense: it’s ATMs, it’s GPS, it's traffic lights, it's everything. There are no borders in space, so we must work hand-in-hand with our partners and allies to be successful in this emerging domain. This problem set truly involves everyone.

This is why being here at Stanford is going to be so beneficial. In addition to my courses in policy, it’s so easy to take a law or a business class or sit in on an aeronautics course. And we’re right in Silicon Valley where a lot of this technology is being built and distributed. That makes it so easy to look at these issues from different perspectives and get new insights into how to tackle them. We need a well-rounded perspective in order to get the right knowledge to the right people to make the right decisions.
 

At the root of all my interests in policy and foreign affairs is a desire to help people. I’ve always been drawn to problems that involve alleviating difficulties, whether that’s humanitarian issues, conflict resolution, or any other issues where civilians are not fairly represented. When I was first considering working in government, it was the consular aspect—being able to serve people from Thailand all over the world— that really appealed to me.

When I had the opportunity to serve at the UN as a Peace and Security Intern at the Permanent Mission of Thailand, my excitement for that assignment came from the same place; I liked the spirit of people coming together to discuss problems. There’s been waning faith about the usefulness of these types of big, multilateral organizations, but I still believe these kinds of bodies are important forums for dealing with conflicts. Reforms are needed, yes, but we can’t simply sideline conversations that are difficult to have or shut out nations we don’t easily agree with.

My own country of Thailand, for example, is not the biggest or most influential nation on security issues, but we have a lot we can teach and discuss when it comes to development. How do we balance some of that influence? How do we give countries in the global south more representation on these stages? Or domestically, how can we create policies that actually make a difference to people for the better? There tends to be a lot of talk and lofty goals, but then little action or follow through. 

That’s why one of the major appeals of coming to the MIP program was the emphasis on studying policymaking frameworks. In my undergrad at Columbia, I studied a lot of political theory and philosophy through the core curriculum. Here at Stanford, I want my focus to be on framing, implementation, and learning how to do things that address issues, not just identify them. I will be entering the Thai Foreign Service when I’m finished with my schooling, and I want to be as prepared as possible to excel as a diplomat—someone capable of solving problems effectively as part of a team, and, above all, helping people. I’m excited to learn from the experiences and perspectives of my cohort. MIP may not be as big as the UN, but we’re our own multilateral, multinational group trying to make a difference.
 

Behind all of my interests and experiences in policy is a commitment to understand how we shape and are shaped by the environment. Living  in different places and engaging with many kinds of people in different cultures has shown me how our lives are deeply connected to the environments we inhabit. No matter where we come from, we all depend on the same planet. We all have a stake in sustaining this place we share.

That being said, as a former negotiator for the Ministry of Economy, Trade, and Industry (METI) in Japan, I know that the best course of action for how to protect the environment is not always easy or straightforward. Climate policies that make sense in one place may not be feasible in another. Requirements about renewables that work here may not work elsewhere. There are some things that we can do universally, but it’s also important that countries realize and respect that each nation has different circumstances that will require unique planning and policies to address.

One of the areas in which I would specifically like to develop is finding ways to incentivize trade policies that accelerate the dissemination of clean, low emission, or zero emission technologies. How can we make climate-related goods more appealing to the global market? How can we get over price barriers and lower the cost of climate-related products? I want to live in a world where products and trade that support climate goals are the norm, not a specialty, and those goods are easy for everyone to access.

I’ve been fortunate to have experiences already in international engagement and inter-government coordination on climate and trade negotiations, but I am looking forward to being able to learn much more about the science side of climate and the environment. Having the ability to combine my MIP classes with courses from the Doerr School of Sustainability was one of the big appeals for me in coming to this program. Gaining that dual background in policy and analytical skills from MIP and science and research from Doerr through my electives is going to be incredibly beneficial to bring back to my ministry.
 

My archival research at Stanford University has focused on the legal and civil rights advocacy of key Mexican American leaders and institutions, including civil rights scholar Ernesto Galarza; voting rights attorney and co-author of the California Voting Rights Act Joaquin Avila; and the organizational records of the Mexican American Legal Defense and Educational Fund (MALDEF) and California Rural Legal Assistance, Inc. (CRLA). These legal organizations have played a critical role to advance the civil and voting rights of Latino communities, utilizing litigation as a strategic tool to secure equal protection under the law and promote equitable political representation through legislation. The collections offer extensive documentation of decades-long legal struggles and grassroots advocacy, illuminating both national and transnational dimensions of Latino American civil rights movements.

My research has also included conducting oral history interviews with prominent legal and civil rights leaders, such as General Counsel Thomas A. Saenz, current MALDEF President; José Padilla, former CRLA Executive Director; Ambassador Vilma Martinez, former General Counsel of MALDEF; and the only oral history ever conducted with the late Joaquin Avila, voting rights attorney and former General Counsel of MALDEF. These interviews, which are archived and publicly available through the Stanford Department of Special Collections and the Stanford Historical Society, offer invaluable firsthand accounts of the legal strategies, institutional histories, and personal commitments that have shaped Latino civil rights advocacy over the past several decades.

During the past 15 years of conducting research at Stanford, I have been consistently inspired by the dedication of lawyers and advocacy organizations working to improve the lives of marginalized communities. One formative moment occurred when I first encountered archival photographs from the 1950s of former braceros, legally contracted guestworkers. The Bracero Program was a binational labor agreement between the United States and Mexico that brought over two million braceros to the United States from 1942 to 1964. These images offered powerful visual narratives of migration, labor, and hope—stories reminiscent of iconic photographs of immigrants arriving at Ellis Island. However, these photographs pointed to a different but equally significant point of entry: The U.S.–Mexico border. This research solidified my commitment to public scholarship and the importance of making archival materials accessible to broader audiences.

Through my research in the Stanford Department of Special Collections and ongoing collaboration with the Stanford Program on International and Cross-Cultural Education (SPICE), as well as through teaching and public engagement, I have developed initiatives aimed at bridging the gap between academic research and public history. I founded the Bracero Legacy Project to share these important histories with wider audiences and have continued this work by designing ethnic studies curricula for school districts and organizing educational events that highlight the contributions and experiences of Latino communities in the United States.

This commitment to public history culminated most recently on June 10, 2025, when I co-organized, alongside Monterey County Supervisor Luis Alejo, a public commemoration marking the 50th anniversary of the banning of the short-handled hoe—a tool that had long symbolized exploitation in agricultural labor. Used for over a century by farmworkers of multiple ethnic backgrounds, the short-handled hoe required workers to remain stooped over for long periods at a time, leading to chronic injuries and long-term disability. Labor leader César Chávez himself suffered from debilitating back pain as a result of such work. The tool was officially banned on April 7, 1975, following the tireless advocacy of local farmworkers Sebastian Carmona and Hector De La Rosa, who, with legal representation from CRLA attorneys Marty Glick and Mo Jourdane, successfully brought the case before the California Supreme Court. The Mercury News opinion piece, [May 30, 2025], “Farmworker victory ending use of ‘El Cortito’ 50 years ago,” noted that the victory provided an “empowering lesson.”

The anniversary event brought together over 200 people and distinguished guests including Glick, Jourdane, and other CRLA alumni, as well as iconic figures such as labor and civil rights leader Dolores Huerta and playwright Luis Valdez, who spoke about the “long civil and labor rights movements.” I also invited the legendary music group Los Tigres del Norte, who hold a special cultural resonance in the Latino community. Their music shaped my immigrant upbringing, reflecting the complexities of navigating bicultural identity, bilingualism, and persistent anti-immigrant sentiment. Their songs—such as “La Jaula de Oro,” “Somos Más Americanos,” “Campesino,” and their tribute to César Chávez—articulate the lived experiences of immigrant communities and assert a counternarrative of dignity, resilience, and resistance in the face of marginalization.

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Jorge Hernández, co-founder of Los Tigres del Norte, has often spoken about the group’s first U.S. performance at Soledad Prison in 1968—the same year Johnny Cash played at Folsom State Prison. Since then, they have received multiple Grammy Awards, sold out Madison Square Garden, and, this past summer, were honored with a namesake street in Brooklyn. During the Monterey County event, Supervisor Alejo and the Board of Supervisors presented Los Tigres del Norte with a lifetime achievement award recognizing not only their musical legacy but also their decades-long advocacy on behalf of immigrant and Latino communities. Photo above: Dr. Ornelas (third from the left) pictured with Los Tigres del Norte band members (left to right) Luis Hernández, Hernan Hernández, Jorge Hernández, Eduardo Hernández, and Óscar Lara | photo credit: Pep Jimenez.

As part of our continued collaboration, I have invited Los Tigres del Norte to visit the Department of Special Collections at Stanford to study Ernesto Galarza’s personal papers and bracero correspondence. In particular, we will examine Galarza’s documentation of the 1963 “Tragedy at Chualar,” in which 32 braceros were killed in a devastating collision between a makeshift bus and a train. Galarza served as the principal investigator of the accident, and the archival record he left offers profound insights into the structural neglect and human cost of exploitative labor systems. Our hope is to draw from these materials to inspire a new song that honors the 32 bracero lives lost and continue to educate the public about this overlooked chapter in U.S. history.

This kind of scholarly interdisciplinary and community-based collaboration underscores the vital role of archives and public scholarship in shaping collective memory and advancing civil rights education. As I continue my work with SPICE and within the Stanford Department of Special Collections, I remain committed to collaborating with scholars across disciplines and transnationally to deepen public understanding of Latino American history and to ensure that these stories are not only preserved but heard.

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The world’s health systems face a complex and interconnected set of challenges that threaten to outpace our capacity to respond. Geopolitical fragmentation, climatic breakdown, technological disruption, pandemic threats, and misinformation have converged to strain the foundations of global health.  Building resilient global health systems requires five urgent reforms: sharpening the mandate of the World Health Organization (WHO), operationalizing the One Health concept, modernizing procurement, addressing the climate–health nexus, and mobilizing innovative financing. Together, these shifts can move the world from fragmented, reactive crisis management to proactive, equitable, and sustainable health security.

Emerging and Escalating Threats

While the global community demonstrated remarkable resilience in weathering the COVID-19 pandemic, the crisis also exposed profound structural weaknesses in global health governance and architecture. Chronic underinvestment in health systems led to coverage gaps, workforce shortages, and inadequate surveillance systems. The pandemic also revealed a fragmented global health architecture, plagued by institutional silos among key agencies (Elnaiem et al. 2023).

Years later, the aftershocks of the pandemic still resonate worldwide, with the ongoing triple burden of disease—the unfinished agenda of maternal and child health, the rising silent pandemic of noncommunicable diseases, and the reemergence of communicable diseases. These challenges, combined with the persistent challenge of malnutrition, unmet needs in early childhood development, growing concerns around mental health, and the threat of other emerging diseases, as well as the rising toll of trauma, injury, and aging populations, have placed countries across the world under immense strain. Health systems face acute infrastructure gaps, critical workforce shortages, and persistent inequities in service delivery, making it increasingly difficult to address the complex and evolving health needs of their populations. Post-pandemic fiscal tightening has constrained health budgets with debt-to-GDP ratios exceeding 70–80% in parts of the region (UN ESCAP 2023).

 Furthermore, climate change is fundamentally redefining the risk landscape. Rising temperatures, more frequent floods, intensifying storms, and shifting vector ranges for organisms like mosquitoes and ticks are disrupting food systems, displacing populations, and driving new patterns of disease transmission. Over the next 25 years in low- and middle-income countries, climate change could cause over 15 million excess deaths, and economic losses related to health risks from climate change could surpass $20.8 trillion (World Bank 2024). The cost of inaction has never been higher.

Meanwhile, deepening political polarization is amplifying conflict and weakening the global cooperation essential for scientific progress. The number of geopolitical disturbances worldwide is at an all-time high, displacing over 122 million people and eroding access to essential health services (UNHCR 2024). In 2023, false and conspiratorial health claims amassed over 4 billion views across digital platforms, compromising vaccine uptake and fueling health-related conspiracy theories. (Kisa and Kisa 2025). Furthermore, exponential technological advances in artificial intelligence are outpacing public health governance systems, creating new ethical and equity dilemmas. Global development assistance for health has significantly declined by more than $10 billion, with sharp cuts driven by the United States. This decline is likely to continue over the next five years (Institute for Health Metrics and Evaluation 2025).

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Note: Development assistance for health is measured in 2023 real US dollars; 2025 data are preliminary estimates.

Source: Institute for Health Metrics and Evaluation 2025.
 

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Five Critical Reform Directions for Future-Proofing Global Health Systems

1.    WHO matters more than ever — but only if it sharpens its focus.

The World Health Organization remains the technical backbone of global health, with a mandate to set norms and standards, shape research agendas, monitor health trends, coordinate emergency responses and regulation, and provide technical assistance. COVID-19 underscored both its indispensability and its limitations. During the pandemic, WHO convened states, disseminated guidance, and spearheaded initiatives like the Solidarity Trial and COVAX to promote vaccine equity, illustrating why it remains vital as the only neutral platform where 194 member states can cooperate on pandemics, antimicrobial resistance, or climate-related health risks. Its work on universal health coverage, the “triple burden” of disease, and global health data continues to anchor policy across countries.

At the same time, the crisis exposed structural weaknesses: WHO lacks enforcement authority, relies heavily on voluntary donor-driven funding, and sometimes stretches beyond its comparative strengths. When it shifts from convening and technical guidance into direct fund management, logistics, or large-scale program delivery, it risks diluting its mandate and eroding trust. Critics argue this reflects a broader challenge of an expansive mandate and donor-driven mission creep, pushing WHO beyond what 7,000 staff and a modest budget can realistically deliver. The way forward lies in sharpening focus: leveraging its convening power and legitimacy, providing technical expertise and evidence-based guidance, coordinating emergencies under the International Health Regulations, and advocating for equity in access to medicines and care. Anchored in these core strengths, a more agile WHO can better lead during crises, sustain credibility, and ensure that global health standards are consistently applied across diverse national contexts.

2.    Animal Health as the Next Frontier

More than 70 percent of emerging infectious diseases are zoonotic in origin, with roughly three-quarters of newly detected pathogens in recent decades spilling over from animals into humans (WHO 2022; Jones, Patel, Levy, et al. 2008). The economic costs are staggering: the World Bank estimates that zoonotic outbreaks have cost the global economy over $120 billion between 1997 and 2009 through crises such as Nipah, SARS, H5N1, and H1N1 (World Bank 2012). The drivers of spillover are intensifying due to deforestation and land-use change, industrial livestock farming, wildlife trade, and climate change. These are further accelerating the emergence of novel pathogens. 

However, the governance of animal health remains fragmented. While WHO, the Food and Agriculture Organization (FAO), and the World Organization for Animal Health (WOAH) each hold mandates, they often operate in silos. The Quadripartite, expanded in 2021 to include the United Nations Environment Programme, launched a One Health Joint Plan of Action (2022–26), but it remains underfunded and lacks strong political commitment. 

There is an urgent need to move One Health from principle to practice. To fill this governance gap, the world should consider establishing an independent intergovernmental alliance for animal health with a clear mandate. This could strengthen global One Health response by augmenting joint surveillance, building veterinary workforce capacity, and integrating environmental data into early warning systems. Such an alliance should avoid creating new bureaucratic layers and instead leverage the Quadripartite as its operational backbone. Embedding One Health into national health strategies and cross-sectoral policies would enable animal, human, and environmental health systems to work in tandem and address risks at their source. Preventive investments are also very cost-effective; the World Bank estimates that annual One Health prevention investments of $10–11 billion could save multiple times that amount in avoided pandemic losses (World Bank 2012). Strengthening One Health is both a health and economic necessity. 

3.    Agile Procurement: The Missing Link in Global Health Security

COVID-19 revealed how vital procurement and financial management are to global health security. A system built for routine procurement was suddenly called upon to handle crisis response on a worldwide scale, and it struggled to keep up. When vaccines became available, strict procedures, fragmented supply chains, and export restrictions meant access was uneven and often delayed. Developed countries’ advance purchase agreements stockpiled most of the supply, leaving many low- and middle-income countries waiting for doses. Within the UN system and its partners, overly complex procurement rules slowed the speed to market, and the lack of harmonized regulatory recognition caused further delays. As a result, those least able to handle shocks faced the longest waits and highest costs.

Reform must begin by making procurement agile, transparent, and equitable. Emergency playbooks should be pre-cleared to ensure that indemnity clauses and quality assurance requirements can be activated immediately when the next crisis arises. Regional pooled procurement mechanisms, like the Pan American Health Organization’s Revolving Fund or the African Union’s pooled initiatives, should be expanded to diversify supply sources and anchor distributed manufacturing. End-to-end e-procurement platforms would provide real-time shipment tracking, facility-level stock visibility, and open dashboards to strengthen accountability. Financial management must be integrated with procurement so that contingency funds, countercyclical reserves, and fast-disbursing credit lines can release resources in tandem with purchase orders. Together, these reforms would ensure that in future health emergencies, these procurement systems act as lifelines rather than bottlenecks.

4.    Addressing the Health–Climate Nexus

Climate change poses severe health risks, disproportionately affecting women and vulnerable populations in developing countries through heatwaves, poor air quality, food and water insecurity, and the spread of infectious diseases. Climate-related disasters are increasing in frequency and severity worldwide, reshaping both economies and health systems. In 2022, there were 308 climate-related disasters worldwide, ranging from floods and storms to droughts and wildfires (ADRC 2022). These events generated an estimated $270 billion in overall economic losses, with only about $120 billion insured—underscoring the disproportionate burden on low- and middle-income countries where resilience and coverage remain limited (Munich Re 2023). Over the past two decades, Asia and the Pacific have consistently been the most disaster-prone regions, accounting for nearly 40% of all global events, but every continent is now affected, from prolonged droughts in Africa and mega storms in North America to record-breaking heatwaves in Europe (UNEP n.d.).

Meeting this challenge requires a dual agenda of adaptation and mitigation. Health systems must be made climate-resilient by hardening infrastructure against floods and storms, ensuring reliable, clean energy in clinics and hospitals, and building climate-informed surveillance and early-warning systems that can anticipate disease outbreaks linked to environmental change. Supply chains need redundancy and flexibility to withstand shocks, and frontline workers require training to manage climate-driven health crises. At the same time, health systems must rapidly decarbonize. This means greening procurement and supply chains, phasing out high-emission medical products like certain inhalers and anesthetic gases, upgrading buildings and transport fleets, and embedding sustainability into financing and governance. Momentum is growing. The 2023 G20 Summit in Delhi, supported by the Asian Development Bank (ADB), recognized the health–climate nexus as a global priority, and institutions such as WHO, the World Bank, and ADB have begun to advance this agenda. The next step is to translate commitments into operational change by embedding climate-health strategies into national health plans, financing frameworks, and cross-sectoral policies. Climate action, sustainability, and resilience need to be integrated into the foundation of health systems.

5.    Mobilizing Innovative Financing

Strengthening health systems and preventing future pandemics will require massive financing, but global health funding is in decline. Innovative mechanisms to mobilize new resources are essential. This requires stronger engagement with finance ministries, development financing institutions, and the private sector to design models that attract and de-risk investment while enabling rapid disbursement during emergencies. International financing institutions (IFIs) need to unlock innovative financial pathways to amplify health investments. They need to deploy blended finance initiatives, public-private partnerships, guarantees, debt swaps, and outcome-based financing tools to mobilize private capital for health. Over the past few years, IFIs have committed billions in health-related financing worldwide. This has included landmark support for vaccine access facilities, delivery of hundreds of millions of COVID-19 vaccine doses, and mobilization of large-scale response packages that combine grants, loans, and technical assistance. 

There is a need to broaden the financing mandate beyond investing in universal health coverage and mobilize capital for emerging areas, including the climate-health nexus, mental health, nutrition, rapid urbanization, demographic shifts, digitization, and non-communicable diseases. By leveraging their balance sheets, IFIs can generate a multiplier effect in fund mobilization and attract new financing actors. Innovative instruments are already demonstrating potential. For example, the International Finance Facility for Immunisation (IFFIm), which issues “vaccine bonds” backed by donor pledges, has raised over $8 billion for Gavi immunization programs (IFFIm 2022; Moody’s 2024).  Debt-for-health and debt-for-nature swaps have redirected debt service into social outcomes. For example, El Salvador’s 2019 Debt2Health agreement with Germany channeled approximately $11 million into strengthening its health system, while Seychelles’ debt-for-nature swap created SeyCCAT to finance marine conservation, yielding social and resilience co-benefits for coastal communities (Hu, Wang, Zhou, et al. 2024). Similarly, contingent financing facilities—such as the Innovative Finance Facility for Climate in Asia and the Pacific (IF-CAP) and the International Financing Facility for Education (IFFEd)—also hold significant potential for health (IFFEd n.d.; ADB n.d.).  These examples demonstrate how contingent financing and swaps can expand fiscal space without exacerbating debt distress.

This can create a virtuous cycle of facilitating investments that create regional cooperation for sustainable and scalable impact. In this vein, the G20 Pandemic Fund is a beacon of catalytic multilateralism funding in a fragmented world. Launched in 2022 with over $2 billion pooled from governments, philanthropies, and multilaterals, it strengthens pandemic preparedness in low- and middle-income countries. Every $1 awarded from the Pandemic Fund has mobilized an estimated $7 in additional financing. The fund demonstrates that nations can still unite around shared threats, offering hope and a template for collective action on global challenges.

Equally important is the ability to deploy funds rapidly in emergencies. During the COVID-19 pandemic, reserve and countercyclical funds, used by countries such as Germany, the Netherlands, and Lithuania, along with the Multilateral Development Bank’s fast-track financing facilities with streamlined approval and disbursement processes, provided urgent and timely financing support (Sagan, Webb, Azzopardi-Muscat, et al. 2021; Lee and Aboneaaj 2021). These mechanisms should be institutionalized in national financial management systems as well as IFIs to ensure rapid funding disbursement in future health emergencies

Moving Forward

Delivering on this reform agenda requires more than technical fixes—it demands political will, sustained financing, and cross-sectoral collaboration. Member states must empower WHO to lead within its comparative strengths, while reinforcing One Health through stronger mandates and funding. Governments, IFIs, and the private sector should jointly design agile procurement and financing mechanisms that can be activated at speed during crises. Embedding health into climate policies and climate resilience into health strategies will ensure that future systems are both sustainable and resilient to shocks. Above all, reform efforts must be anchored in equity, so that the most vulnerable are protected first.

The opportunity before the global community is to reimagine health as the backbone of resilience and prosperity in the 21st century. A whole-of-systems approach is necessary to clarify mandates, integrate animal and environmental health, develop agile and fair procurement systems, embed climate action into health systems, and mobilize innovative financing. The steps taken in the next few years can lead to a more connected, cooperative, and future-ready global health architecture. 

Works Cited

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Hu, Yunxuan, Zhebin Wang, Shuduo Zhou, et al. 2024. “Redefining Debt-to-Health, a Triple-Win Health Financing Instrument in Global Health.” Globalization and Health 20 (1): 39. 

Institute for Health Metrics and Evaluation. 2025. “Financing Global Health.” 

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IFFIm (International Finance Facility for Immunisation). 2022. “How the World Bank Built Trust in Vaccine Bonds.” October 21. 

Jones, Kate E., Nikkita G. Patel, Marc A. Levy, et al. 2008. “Global Trends in Emerging Infectious Diseases.” Nature 451: 990–93. 

Kisa, Adnan, and Sezer Kisa. 2025. “Health Conspiracy Theories: A Scoping Review of Drivers, Impacts, and Countermeasures.” International Journal for Equity in Health 24 (1): 93.  

Lee, Nancy, and Rakan Aboneaaj. 2021. “MDB COVID-19 Crisis Response: Where Did the Money Go?” CGD Note, Center for Global Development, November. 

Moody’s. 2024. "International Finance Facility for Immunisation—Aa1 Stable” Credit opinion. October 29. 

Munich Re. 2023. “Climate Change and La Niña Driving Losses: The Natural Disaster Figures for 2022.” January 10. 

Sagan, Anna, Erin Webb, Natasha Azzopardi-Muscat, et al. 2021. Health Systems Resilience During COVID-19: Lessons for Building Back Better. World Health Organization and the European Observatory on Health Systems and Policies. 

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UNHCR (United Nations High Commissioner for Refugees). 2024. Global Trends Report. Copenhagen, Denmark. 

WHO (World Health Organization). 2022. Zoonoses and the Environment. 

World Bank. 2012. People, Pathogens and Our Planet: The Economics of One Health.  

World Bank. 2024. The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries. Washington D.C. 

CDDRL Mosbacher Director Kathryn Stoner noted that: “This award is a powerful testament to the incredible quality of Erin and Brett’s pathbreaking research. Their work significantly advances our understanding of how modern authoritarian regimes function in the 21st century, and I am so pleased that our CDDRL community helped to support some of their scholarship. But this honor is all theirs!”

The William H. Riker Book Award adds to the growing recognition of the Carters’ research: Propaganda in Autocracies has also received the Hazel Gaudet-Erskine Best Book Award from the International Journal of Press/Politics, along with honorable mentions for both the APSA Luebbert Award for Best Book in Comparative Politics and the APSA Democracy and Autocracy Best Book Award.

With this honor, Erin Baggott Carter and Brett Carter join the distinguished ranks of scholars whose work carries forward William Riker’s legacy of combining theory and empirics to deepen our understanding of political life.