Ministers of health and other high-level representatives of governments across the world, Non-state actors in official relations with the World Health Organization (WHO) and several other international organisations and civil society organisations in the international health space gathered in Geneva, Switzerland for the Seventy-eight session of the World Health Assembly (WHA78) on 19-27 May 2025.

This year’s WHA, with the theme “One World for Health” was a critical moment for the WHO and global health governance. It took place amid a tumultuous world where the WHO is facing massive cuts in its funding, in the wake of Donald Trump pulling the United States out of the body. But it was not simply a WHA of despair. It was also a gathering of hope. After three long and gruelling years of negotiations, WHO Member States finally passed the Pandemic Treaty.

Public Services International, the global voice of health and care workers and the representative body of organised labour in official relations with the WHO participated actively in discussions at the Health Assembly, putting forward working-class perspectives. In our submissions on several agenda items as well as in numerous side events, including some which we co-organised, we also underscored the need for governments to fund quality public healthcare delivery, reverse austerity measures, and take concrete steps towards ensuring a just socio-ecological transition.

The world now has a global pandemic accord!

A major highlight of WHA78 was the adoption of the Global Pandemic Treaty, which is an agreement to prevent, prepare for, and respond to pandemics. 124 countries voted in favour of the accord, with 11 abstentions and no opposition. The call for a pandemic treaty arose during the COVID-19 pandemic, leading to the summoning of a Special Session of the World Health Assembly at the end of 2021, which established an International Negotiating Body (INB) for drafting and negotiating such an international agreement.

PSI and its affiliates were at the heart of this process from the beginning to the end. We participated as a Non-state actor in the Working group on strengthening WHO preparedness and response to health emergencies (WGPR) on whose recommendation the 29 November to 1 December 2021 Special Session of the World Health Assembly was summoned and the INB constituted. And since the first meeting of the INB in February 2022 to the historic adoption of the Accord on 20 May 2025, we engaged in the INB processes at the global level and at the country-level where PSI affiliates held a series of discussions with the governments of their countries on key issues in the negotiations.

Delivering our statement at the WHA78, Pedro Villardi, Coordinator of the PSI Health Equity Team, commended Member States for conclusion of the negotiations despite all odds. However, despite welcoming this historic milestone, we also highlighted the agreement’s shortcomings in several areas. Most mechanisms for achieving pandemic prevention, preparedness and response (PPR) in the accord are ad hoc and voluntary. Such voluntarism, as we pointed out, “enabled avoidable deaths during the COVID-19” pandemic.  

He also pointed out the need for PPR mechanisms that “enable countries’ fiscal policy space”. This would entail debt relief and removal of conditionalities that limit public funding for health care and health emergency spending and staffing.

In a related agenda item which dwelt on strengthening the global architecture for health emergencies, PSI also called out the tacit support for private healthcare providers. We must stop corporations from profiting from health emergencies.

Primary Health Care and Universal Health Coverage

The WHO Executive Board had expressed concern at the limited and inequitable progress towards universal health coverage at its 156th meeting earlier in the year. Health systems reforms through a primary healthcare approach was one of the key steps put forward to take, towards accelerating progress. The WHO Secretariat presented this position of the Executive Board to the Health Assembly.

In PSI’s intervention on this agenda item, Baba Aye, the PSI Sectoral Officer responsible for the health and social care sector, called on governments to walk the talk of adequate public funding, to make universal health care realisable. He also called for the de-commodification of health and care, pointing out that commercialisation and “financialisation of health in any form undermines the essence of UHC”.

Health, he stressed, “is a political choice, and UHC requires global solidarity.” Thus, PSI called on “richer countries and international financial institutions…to cancel the debts of developing countries, who on their part should invest such resources that would have been used to service debts in primary health.”

The health and care workforce is at the heart of healthcare delivery. He thus called for the scaling up of investments in health and care workforce education and training, employment and decent work, protection and retention, pointing out that this is crucial for strengthening Primary Health Care (PHC) and achieving UHC.

Baba Aye also emphasised the central place of community health workers (CHW) in Primary Health Care. Despite provisions of the 2018 WHO guideline on health policy and system support to optimise community health worker programmes which PSI contributed to drafting, CHWs in many countries remain grossly underpaid, being considered as “volunteers” in several of these, despite their working time being upwards of 40 hours a week.

We thus demanded that CHWs “must be recognised as health workers, in line with WHO guidelines and not simply as cheap ‘volunteer’ labour.” Further, as Baba Aye added, “this recognition means their entitlement to fair wages and benefits, such as maternity leave, sick leave, overtime payment, pensions, must be respected.”

Health and care workforce

The Health Assembly addressed three interconnected health and care workforce agenda items. These were on the WHO Global Code of Practice on the International Recruitment of Health Personnel; implementing the Global strategy on Human Resources for Health: workforce 2030, and accelerating action on the global health and care workforce by 2030.

Dr Davji Atellah, Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) and Chair of the African Health Sector Unions Council (AHSUC) spoke for the PSI delegation on these important agenda items.  

He expressed PSI’s support for the reflection of current implementation challenges in the review of the Code of Practice. However, as he noted, “we have serious concerns about the practices of private recruitment and placement agencies. Private businesses should not profit by exploiting migrant health and care workers.” Governments, he added, “need to ensure strict regulation of these for-profit-bodies and keep health and care services in public hands.”

This is a particularly important year for the governance of health and care labour mobility, with the review of the Code of Practice, which was adopted in 2010. Reporting is made by countries every three years. But reviews are every five years. Genevieve Gencianos, PSI’s migration programme coordinator, was a member of the Experts Advisory Group (EAG) which drafted an interim report for the review. Regional consultations of Member States of the interim report will take place over the next six months. We urged governments to include health and care workers’ trade unions in this consultation process.

Dr Atellah also expressed PSI’s support for the Director General’s call for accelerated action to protect, support and invest in the global health and care workforce. But this, as he added, was not enough. Member States of the WHO “need to take all steps necessary for adequate employment and provision of decent work for health and care workers in line with the Workforce 2030 strategy.”

Health conditions in the occupied Palestinian territory

A very sobering item on the agenda was that of the health conditions in the occupied Palestinian territory, including east Jerusalem. Some of the key recommendations of the WHO Secretariat to the WHA were: implementation of a permanent ceasefire and securing the unconditional release of all hostages; ensuring unrestricted access across the occupied Palestinian territory (OPT) to enable restoration of essential services and emergency care; safeguarding patients, healthcare workers, hospitals and medical transport in the OPT; sustaining international support for the response activities in the OPT through increased financial and logistic resources.

As PSI, we thanked the DG for the report of the Secretariat, including its recommendations. Further to the positions he highlighted, which we support, we stressed the harrowing experiences that health and care workers in Palestine are going through at the moment. Over 500 health workers have been detained by Israel, “in flagrant violation of the Geneva Convention”. This, we insisted, “must stop now”. Public Services International and its affiliates, we said, “stand in solidarity with our sisters, brothers, and comrades in Gaza. An injury to one is an injury to all. Attacks on health and care workers anywhere are attacks on health and care workers everywhere.” We cannot accept the continued killing of our colleagues.

Climate change and health

The agenda item on climate change and health generated conflict. Some Member States attempted to make the WHA to postpone approval of the new WHO Climate Change and Health Action Plan for at least another year. Saudi Arabia, with the support of several other oil-producing countries, spearheaded this initiative. This led to the call for a vote. 86 countries opposed it; 23 supported it; 11 abstained. Following several hours of negotiations, including behind-the-scenes talks, the Health Assembly adopted the Global Action Plan on its last day; 109 countries endorsed it, while 19 abstained.

PSI had welcomed the draft of the Global Action Plan. We emphasised the critical urgency of the situation, since the 1.5°C global warming limit has been exceeded. We stressed the fact that “colonial, capitalist, and oppressive systems are fuelling the climate emergency, war, and ecocide.” Thus, in line with the “common but differentiated responsibilities” principle in the Plan, we called for “binding commitments to phase out fossil fuels, dismantle extractivist neoliberal systems, enforce the polluter pays principle, and hold historic polluters accountable.”

The health of people and the health of the planet, we insisted, are inseparable. We called for a shift from high-carbon hospital models to community-based public health systems that build resilience and reduce emissions. Two interrelated elements of the Action Plan, which we also emphasised, were its call on Member States to reverse health funding cuts, and boost health workforce investment to build climate resilience.

With the adoption of the Plan, PSI and its affiliates will hold governments accountable to walk this talk. As frontline workers, we struggle for both health and justice, centring human rights and health justice in all climate action. PSI and its affiliates will not only urge governments to act, and decisively so. We will continue to work closely with communities and civil society organisations to fight for climate and health justice. Our very lives depend on it.

Other issues at the WHA and side events

PSI intervened on several other agenda items. These included the following:

•  Antimicrobial resistance: we called for investment in public pharmaceutical research and development, pointing out that profit-driven R&D cannot address the problem. We also called for an end to industrial factory farming as the overuse of antibiotics to boost livestock growth contributes significantly to Antimicrobial Resistance (AMR).

• Global traditional medicine strategy: we highlighted the deep roots of traditional medicine in culture, community, nature and spirituality, bringing health across generations. We called for respect for indigenous land rights and traditions which link health to climate justice and anti-extractivist practice considering both historic and ongoing colonial extractivism.

• Resolution on the effects of nuclear weapons and nuclear war on health and health services: we noted that any nuclear conflict would have cataclysmic effects, with the potential of species-ending for humankind. And we urged Member States with nuclear weapons to not only back the Treaty on Prohibition of Nuclear Weapons, but to commit to full nuclear disarmament.

PSI took part in several side events, making interventions in defence of universal access to quality public services, calling for adequate funding for quality health and care for all, and demanding respect, and decent work for health and care workers across the world. Some of the side events we were invited to as speakers were: “Delivering on UHC in an era of pushback against gender equality and human right to health” organised by Global Centre for Health Diplomacy and Inclusion (CeHDI) and Citizen News Service (CNS) and “Strengthening Bilateral Agreements on Health Worker Migration: Towards Mutual Benefit and Health Systems Strengthening” organised by Global Health Partnerships.

Apart from these, we co-organised the following:

Global public health needs economic justice -now!

The Geneva Global Health Hub (G2H2), Wemos, Society for International Development (SID) and PSI co-organised this side-event on the first day of the WHA78 to present realistic and sustainable political pathways for public health investments. We stressed the need for governments and the global health community as a whole to support calls for reforms to global tax rules and debt resolution, to allow increased domestic public funding, instead of so-called innovative forms of finance that leverage private for-profit capital.

Public Pharma: Democratising R&D, Ownership, and Access to Medicines in the Global South & North

PSI and the People’s Health Movement co-organised this side-event at the MSF headquarters on the evening of the second day of the WHA78. Together and with a panel of experts drawn from both organisations and the academia, we explored how Public Pharma can challenge the status quo of monopolies and bring fair access to medicines for all. This entails strong public services and is a crucial conversation for anyone fighting for health justice today.

Time for a cure of global health

For the critical civil society movement in global health, reflections on WHA78 and considerations of what is to be done at this crucial point in history took place at the tail end of the WHA78. This was at the workshop organised by the Geneva Global Health Hub (G2H2) on 26 May, with the theme: “Time for a cure of global health: the chilling consequences of having to re-imagine healthier commons.”

This was a moment for sober reflections on key issues of the day, such as how to restore a multilateralism that works for the many and not the few, and our reimagining solidarity. At the heart of this would be struggle; for health for all, for fundamental reforms of the global financial architecture and overhauling the underlying social and economic structures that underpin it. Participants in the discussions also stressed the need to mobilise around this agenda, given the upcoming 50th anniversary of the Alma Ata Declaration in three years.

After the workshop, the G2H2 Annual General Meeting was held. A new Steering Committee was elected, with Baba Aye of the PSI and Nicoletta Dentico, health programme lead of the Society for International Development re-elected as Co-presidents.