| Issue/Objective |
Issue/Objective:
Despite decades of progress in global health, systemic barriers such as fragmented governance, uneven power distribution, and inadequate financial stewardship continue to drive inequities, disproportionately affecting marginalized populations. Recent global challenges-including declining funding, political instability, and attacks on science-have further intensified these disparities. This study aims to analyze the upstream determinants of health equity, focusing on governance, leadership, and financial stewardship, and to identify evidence-based strategies that strengthen equitable health outcomes. By targeting root causes and actionable solutions, this work directly aligns with CCGH 2026's theme of "Collectively reclaiming global health equity: Restoring commitment to action in a fragmented and uncertain world."
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| Methodology/Approach |
Methodology/Approach:
This study employed a mixed-methods approach combining a global policy review with qualitative interviews. The policy review analyzed governance structures, leadership models, and financial stewardship strategies in 12 countries across Africa, South Asia, and North America between 2020 and 2025. Semi-structured interviews were conducted with 35 policymakers, health administrators, and NGO leaders to capture insights on systemic barriers, equity-focused policies, and implementation challenges. Qualitative data were thematically analyzed to identify patterns influencing health equity, while quantitative data on health financing, service coverage, and policy outcomes were synthesized to assess correlations with equitable access. The study emphasizes real-world implementation strategies and actionable governance solutions. |
| Results |
Results:
The study found that transparent governance, inclusive leadership, and accountable financial stewardship are strongly associated with improved health equity outcomes. Countries and programs that implemented equity-focused policies, participatory decision-making, and strategic public-private partnerships demonstrated greater access to essential health services for marginalized populations. Key barriers identified included political instability, limited regulatory frameworks, and insufficient investment in health system capacity, which perpetuated inequities. Lessons from Canada's engagement in multilateral initiatives highlighted the importance of coordinated financing and policy alignment in supporting equitable health interventions. Overall, evidence indicates that addressing upstream determinants through systemic reforms and targeted governance strategies can meaningfully advance global health equity. |
| Discussion/Conclusion |
Discussion/Conclusion:
Strengthening governance, leadership, and financial stewardship is critical to addressing upstream determinants of health equity. Evidence from this study suggests that inclusive decision-making, transparent policy frameworks, and strategic resource allocation not only improve immediate health outcomes but also enhance system resilience against future crises. The findings highlight the need for multi-level collaboration among governments, civil society, and international partners to scale equity-focused interventions. By emphasizing systemic reform and actionable solutions, this work aligns with CCGH 2026's theme of "Collectively reclaiming global health equity", demonstrating that reclaiming equity requires both strategic policy action and grounded, evidence-informed leadership. These lessons can inform policymakers, global health practitioners, and stakeholders seeking to restore commitment to equity in a fragmented and uncertain world.
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| Presenters and Affiliations |
Dr. Dua Khan Aga Khan University Hospital |
