- Global Health and One Health 2026
- Chapter 6
Readings from the other desks
The health baseline is read through each steward’s lens, then once as a whole. Each lens is a projection of reviewed findings, not a separate argument. The other desks’ own editions of this subject are listed first, as cross-references, not copies.
Contents
- ·Edition home
- ·Executive summary
- 1Health is where the systems meet
- 2Key findings
- 3Systems and sectors at baseline
- 4Risks and capability
- 5Outbreak, funding gap and heat season in fragile health systems
- 6Readings from the other desks
- 6.1 The other desks’ editions of this subject
- 6.2 Three lenses
- 6.3 Standards, Academy and steward contributions
- 6.4 GCRI reading: the model card
- 6.5 Global Risks Forum reading: editorial essays
- 6.6 Global Risks Alliance reading: 2027 health readiness pack
- 6.7 Nexus Standards reading: standards and regulatory watch
- 6.8 Risk Academy reading: literature and evidence review, science and assessments
- 7The 2027 agenda
- 8Systems in depth
- AMethodology
- BData appendix
- CReferences and record
- ·Complete edition, for print
6.1The other desks’ editions of this subject
Federation: each desk writes its own edition for the subjects in its remit. Until a desk releases, its edition shows its frame and the reading this edition printed for it.
| Desk | Edition | State | Identifier |
|---|---|---|---|
| GCRI Systems Evidence | No edition of this subject at this desk in the 2026 Baseline cycle | Not in this cycle | |
| GRF Public Deliberation | Outside this desk’s remit | Not in remit | |
| GRA Capital Readiness | No edition of this subject at this desk in the 2026 Baseline cycle | Not in this cycle | |
| Standards Progress | No edition of this subject at this desk in the 2026 Baseline cycle | Not in this cycle | |
| Academy Capability | No edition of this subject at this desk in the 2026 Baseline cycle | Not in this cycle | |
| Index Measurement | Outside this desk’s remit | Not in remit |
6.2Three lenses
One edition, read by each steward. The lens of this site comes first.
GCRI · KEY T
Technical Truth
The evidence supports reading health as the outcome layer of the WEFH+B system. Coverage and survival have improved, financing and people are the binding constraints, and biological risk is rising on several fronts. Evidence is strongest for burden and coverage, and weakest for facility services and animal-side drivers.
HLT-001 · FIN-010 · GOV-008 · SYS-012
GRF · KEY M
Public Meaning
For most people health risk arrives as a missed vaccine, a bill they cannot pay or a clinic without staff. The baseline asks that public debate keep the 13.5 million children with no vaccine and the 2.1 billion with financial hardship in view alongside the outbreak story.
HLT-002 · HLT-004 · GOV-008
GRA · KEY F
Capital Meaning
Readiness implications only. Aid for health has halved since 2021 and out-of-pocket spending is 17.3% of health spending4042. These show where finance-readiness evidence will matter. Nothing here is advice, a rating or an approval.
FIN-010 · HLT-001
NEXUS
Synthesis
Health is well measured at the level of deaths and coverage and thinly measured at the level of facilities, animal-side drivers and deaths without a recorded cause. The 2027 programme should bind regional outbreak evidence, test the compound pathway and map One Health surveillance gaps before they become delays.
SYS-012 · H-01 · H-02
6.3Standards, Academy and steward contributions
How the Nexus Standards drafts, the Risk Academy and the three stewards feed each quarterly edition for health. The standards are a preparatory working draft (2026) and are cited as drafts, never as adopted standards.
| Quarter | Edition | Question | Boundary |
|---|---|---|---|
| Q1 | State and Agenda | What matters this year, and what is the starting position? | observed baseline stays distinct from planned work |
| Q2 | Evidence and Build | What new evidence and capability exist? | a configured capability is not a validated result |
| Q3 | Stress Test and Readiness | What do scenarios and tests show? | simulated loss or performance is not observed impact |
| Q4 | Annual Synthesis and Renewal | What changed in the year, and what renews? | release follows review, not event publicity deadlines |
| Steward or body | Role | Contribution route |
|---|---|---|
| The Global Centre for Risk and Innovation (GCRI Canada) | Lead Institution and Consortium Secretariat; publisher of record; technical truth (key T) | science and practice communities · GCRI gateway |
| The Global Risks Forum (GRF) | leadership, dialogue and the Universe programme; public meaning (key M) | policy, Universe and national adoption · GRF gateway |
| The Global Risks Alliance (GRA) | finance, insurance and development readiness; capital meaning (key F) | finance and insurance · GRA gateway |
| Nexus Standards | preparatory drafts on vocabulary, hazards, indicators and methods | Standards site · working groups HAZ, IND, MTH, FIN, AI |
| Risk Academy | learning pathways tied to the agenda questions | Academy gateway · learning by review |
| Reports sector desks | health chapter inputs: GCRI evidence, GRA readiness, NXS standards, RA capability | sector editorial board |
Standards drafts used in this edition
- Risk vocabulary NRS-C1 (424 terms) for terms in the glossary
- Hazard atlas NHS-1 1.1.0 (905 hazards in 120 families) for risk objects
- Seven risk classes: global, catastrophic, existential, emerging, planetary, exponential, frontier-tech
Standards calendar to watch
- Founding calls from 20 October 2026; working groups meet from 5 November 2026
- Inaugural Global Standards Council session, 12 January 2027
- Quarterly reviews in March, June, September and December, aligned with each edition
6.4GCRI reading: the model card
GCRI’s reading of this edition is its model card: what the national model is, what it computes and where it stops. It is printed in full in Annex A, with the methods it belongs to. Annex A, methodology
6.5Global Risks Forum reading: editorial essays
Four signed essays by the Reports editorial team set out the positions this edition takes. They are interpretation, labelled as such; the evidence they draw on is in the findings register.
Every shock this decade has been a health event as well as something else. Cholera follows unsafe water and heat deaths follow a warming climate. Treating health as a service market understates how it collects the damage from other systems. This edition asks where a shock goes next.
EDITORIAL ESSAY · 01
Health is an outcome, not a sector
Aid for health has fallen by about half since 2021 and country offices already report disruption. Gains in HIV, tuberculosis and immunisation depend on programmes that rely on external money. Measuring the gap before it becomes a loss is the first adaptation.
EDITORIAL ESSAY · 02
The funding gap is the first constraint
More than 60% of emerging infections come from animals, and resistance moves between people, animals and the environment. The evidence on animal-side use and drivers is thin. The Quadripartite plan sets the frame; the data still have to be joined.
EDITORIAL ESSAY · 03
One Health is a measurement problem
The Bundibugyo outbreak shows detection delay, community deaths and cross-border travel at once, while the rules have just been strengthened. Preparedness is tested by concurrency, not by single events.
EDITORIAL ESSAY · 04
Security is wider than the next pathogen
6.6Global Risks Alliance reading: 2027 health readiness pack
The registers that open the 2027 global cycle. At baseline each is initialised from this edition.
| Item | Register | State at baseline | First 2027 entry |
|---|---|---|---|
| E1 | Health risk state delta | baseline set by this edition | changes against the baseline |
| E2 | WEFH+B state delta | five global system readings set | indicator updates and freshness |
| E3 | Agenda and Portfolio movement | eight agenda items · 6 proposed objects | admission decisions |
| E4 | Federation delivery register | national chapters in preparation | national chapters |
| E5 | Consortium capability register | national consortia forming | first contributions |
| E6 | Leadership questions and challenges | none yet | first challenge log |
| E7 | Foundry technical state | national environments prepared | first federation cut |
| E8 | Publication candidates | twelve findings carried forward | PUBLISH · HOLD dispositions |
| E9 | Universe readiness | one candidate mission | admission and role spine |
| E10 | Correction register | none | first federation-wide cycle |
Publication dispositions
- Publish
- Hold
- Needs evidence
- Restricted
- Superseded
6.7Nexus Standards reading: standards and regulatory watch
Instruments and published guidance that shape the systems in this edition, by status on the retrieval date. The edition assesses no one’s compliance.
- IN FORCE
- ADOPTED
- PUBLISHED · GUIDANCE
- PUBLISHED · VOLUNTARY
| Instrument | Body | Scope | Status | Relevance |
|---|---|---|---|---|
| International Health Regulations (2005), as amended in 202423 | WHO States Parties | 196 States Parties | IN FORCE FROM 19 SEPTEMBER 2025 | health security |
| WHO Pandemic Agreement21 | World Health Assembly | global | ADOPTED 2025 · NOT YET OPEN FOR SIGNATURE | pandemic response |
| Political declaration on pandemic prevention, preparedness and response22 | UN General Assembly | global | ADOPTED 2026 | post-close, context only |
| Political declaration on antimicrobial resistance51 | UN General Assembly | global | ADOPTED 2024 | resistance targets |
| One Health Joint Plan of Action 2022 to 202619 | Quadripartite | global | PUBLISHED · GUIDANCE | One Health |
| ISO 35001 biorisk management for laboratories52 | ISO | global | PUBLISHED · VOLUNTARY | laboratory biosafety |
| ISO 15189 medical laboratories53 | ISO | global | PUBLISHED · VOLUNTARY | laboratory quality |
Changed since 2024
- The IHR amendments entered into force on 19 September 2025 for most States Parties23
- Post-close, context only: the UN General Assembly adopted a political declaration on pandemic prevention, preparedness and response on 12 October 202622
- WHO updated temporary recommendations for the Bundibugyo outbreak on 24 August 202625
To watch in 2027
- Entry into force of the amended IHR for the four States Parties that rejected the 2022 amendments, due 19 September 202623
- Conclusion of the access and benefit-sharing annex, due at the Health Assembly in May 2027 or at a special session21
- Targets under the 2024 political declaration on resistance5110
6.8Risk Academy reading: literature and evidence review, science and assessments
The review behind this edition covers health assessments, peer-reviewed science and the institutional reports that bind its findings. Systematic reviews for each agenda item begin in 2027.
Review protocol
- Question
- What does the published evidence establish about the world’s health and One Health system and its couplings?
- Sources searched
- agency flagships; peer-reviewed health and One Health literature; statistics; WHO notices
- Window
- releases available at evidence close, 30 September 2026
- Selection
- sources that bind or contextualise a finding in this edition
- Next step
- systematic reviews for agenda items 01 to 05 in 2027
| Reference | Type | Year | Role | Used for |
|---|---|---|---|---|
| Naghavi et al.12 | journal article | 2024 | supports | resistance burden and forecast |
| Apeagyei et al.40 | journal article | 2025 | supports | aid for health |
| Projected health workforce requirements, WHO Africa Region41 | journal article | 2024 | supports | workforce need |
| Lancet Countdown 2025 report45 | assessment | 2025 | context | heat and health indicators |
| IPBES nexus assessment50 | assessment | 2024 | context | biodiversity and health |
| Preventing the next pandemic49 | assessment | 2020 | context | zoonotic share |
| Reference | Issuer | Year | Role | Used for |
|---|---|---|---|---|
| World Health Statistics 20261 | WHO | 2026 | supports | mortality, data gaps |
| Universal health coverage fact sheet2 | WHO | 2025 | supports | coverage |
| Global antibiotic resistance surveillance report 202511 | WHO | 2025 | supports | resistance |
| One Health fact sheet17 | WHO | 2026 | supports | zoonotic share |
| Global TB Report 202546 | WHO | 2025 | context | TB tables |
| World Malaria Report 202547 | WHO | 2025 | context | malaria tables |
| State of the world’s nursing 202544 | WHO | 2025 | context | workforce |
| Reference | Issuer | Year | Role | Used for |
|---|---|---|---|---|
| SDG Report 2026, Goal 33 | UN DESA | 2026 | supports | goal progress, aid |
| Global HIV statistics7 | UNAIDS | 2026 | supports | HIV estimates |
| State of Food Security and Nutrition 202633 | FAO | 2026 | context | hunger |
| World Development Indicators42 | World Bank | 2026 | context | spending, physicians |
| Health workforce levels and trends 202639 | WHO | 2026 | supports | workforce |
| Animal use of antimicrobials report48 | WOAH | 2025 | context | animal-side use |
| Reference | Issuer | Year | Role | Used for |
|---|---|---|---|---|
| Disease Outbreak News, September 202656 | WHO | 2026 | supports | outbreak position |
| Disease Outbreak News, August 202625 | WHO | 2026 | supports | emergency status |
| IHR amendments questions and answers23 | WHO | 2024 | supports | entry into force |
| Pandemic Agreement adoption21 | WHO | 2025 | supports | agreement status |
| Political declaration on pandemic preparedness22 | WHO | 2026 | context | post-close, context only |
| One Health Joint Plan of Action19 | Quadripartite | 2022 | context | One Health actions |
| One Health definition statement20 | Quadripartite | 2021 | context | definition |
| Surveillance system for attacks on health care43 | WHO | 2026 | context | method note |
| Political declaration on antimicrobial resistance51 | UN General Assembly | 2024 | context | resistance targets |
| Terrestrial Animal Health Code54 | WOAH | 2025 | context | animal-health standards |
Where the evidence agrees
Where it is unsettled
- How many people die from heat: WHO gives about 489 000 a year in 2000 to 2019, the 2025 Lancet Countdown gives about 546 000 a year; the periods and methods differ2855
- How many children had no vaccine: 14.3 million in 2024 in the UN DESA report and 13.5 million in 2025 in the WHO fact sheet; they are different years38
- How far aid has fallen: IHME shows USD 49.6 billion in 2024 and USD 38.4 billion estimated for 2025, while UN DESA shows net aid for medical research and basic health of USD 11.4 billion in 2024; the scopes differ403
Notes
Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references
- 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
- 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
- 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
- 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
- 22POST-CLOSE, context only: WHO (ed.), WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response, news release (12 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva and New York. Observation year 2026. Accessed 2026-11-03.back
- 51UNVERIFIED, not opened: United Nations General Assembly, Political declaration of the high-level meeting on antimicrobial resistance, September 2024; the target of a 10% cut in resistance deaths by 2030 is taken from the opened fact sheet [10]. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
- 19FAO, UNEP, WOAH and WHO (eds.), One Health Joint Plan of Action (2022 to 2026): working together for the health of humans, animals, plants and the environment, publication page (14 October 2022). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
- 52UNVERIFIED, not opened: ISO 35001:2019, Biorisk management for laboratories and other related organisations, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2019. Accessed 2026-11-03.back
- 53UNVERIFIED, not opened: ISO 15189:2022, Medical laboratories: requirements for quality and competence, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2022. Accessed 2026-11-03.back
- 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
- 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
- 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
- 41Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022 to 2030: a needs-based modelling study, BMJ Global Health, 2024; abstract read through Europe PMC. BMJ Publishing Group, London. Observation year 2022. Accessed 2026-11-03.back
- 45UNVERIFIED, not opened: Romanello, M. et al., The 2025 report of the Lancet Countdown on health and climate change, The Lancet 406 (10521), December 2025; the bibliographic record was read, the full text was blocked and no figure from it is used. Lancet Countdown, London. Observation year 2024. Accessed 2026-11-03.back
- 50UNVERIFIED, not opened: IPBES (ed.), Thematic Assessment Report on the Interlinkages among Biodiversity, Water, Food and Health (Nexus Assessment), 2024; the page returned no readable text and no figure is used. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, Bonn. Observation year 2024. Accessed 2026-11-03.back
- 49UNVERIFIED, not opened: UNEP and ILRI (eds.), Preventing the next pandemic: zoonotic diseases and how to break the chain of transmission, 2020; the page returned an access error and no figure is used. United Nations Environment Programme, Nairobi. Observation year 2020. Accessed 2026-11-03.back
- 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
- 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
- 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
- 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
- 46UNVERIFIED, not opened: WHO (ed.), Global Tuberculosis Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [4], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
- 47UNVERIFIED, not opened: WHO (ed.), World Malaria Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [5], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
- 44WHO (ed.), State of the world’s nursing report 2025, publication page (12 May 2025; no figure used). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
- 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
- 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
- 33FAO (ed.), The State of Food Security and Nutrition in the World 2026, publication page with headline figures (hunger in 2025; cost of a healthy diet). Food and Agriculture Organization of the United Nations, Rome. Observation year 2025. Accessed 2026-11-03.back
- 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
- 48UNVERIFIED, not opened: WOAH (ed.), Annual report on antimicrobial agents intended for use in animals (ANIMUSE); the report page returned an access error and no figure is used. World Organisation for Animal Health, Paris. Observation year 2022. Accessed 2026-11-03.back
- 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
- 20FAO, WOAH, UNEP and WHO (eds.), Tripartite and UNEP support the One Health High Level Expert Panel’s definition of One Health, joint statement (1 December 2021). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
- 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
- 54UNVERIFIED, not opened: WOAH (ed.), Terrestrial Animal Health Code, current edition, cited from memory with no figure. World Organisation for Animal Health, Paris. Observation year 2025. Accessed 2026-11-03.back
- 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
- 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03.back
- 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
- 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back