The Global Antibiotic Research and Development Partnership (GARDP) is a product development partnership that accelerates the development and access of treatments for drug-resistant infections. GARDP welcomes discussions on global health architecture reform underway at the World Health Organization (WHO). This process presents an opportunity to strengthen the effectiveness, relevance, and coherence of the global health system. This brief recommends a set of strategic considerations to help ensure that the reform process delivers a more coherent, effective and country-responsive global health architecture. Without sufficient attention to global health system functions, global public goods and implementation realities, there is a risk that reform may fall short of its intended objectives and limit the ability of the global health system to respond to shared threats and unmet need. 

Strategic Priorities for Member States 

1. Support a function-driven reform approach that prioritises system outcomes prior to institutional realignment.  
2. Recognise AMR as a critical priority within a reformed global health architecture, highlighting the need for integrated, cross-sectoral approaches and system-wide alignment. 
3. Enable and facilitate the development of global public goods as a key pillar of a reformed global health architecture.     
4. Strengthen country-level implementation and regional coordination through improved alignment of external support, enhanced coordination and sustained investment in systems and capacity.  
5. Promote more coherent and strategic use of financing to reduce duplication and better align resources with system needs.   
6. Encourage meaningful engagement of Product Development Partnerships to ensure reform is grounded in operational realities. 
7. Support strengthened multilateral cooperation, recognising that shared health threats such as AMR require coordinated global responses. 

Key Considerations for GHA Reform  

1. Reform should be driven by system functions and country needs

Member States should steer reform toward a clear assessment of what outcomes the global health architecture must deliver, at which level and with what financing and implementation support, before redefining institutional roles. Current challenges stem less from missing functions than from a system overload, their fragmentation across mandates, insufficient financing to cover all functions and inadequate governance. Without clarity on desired outcomes, reform risks reproducing existing inefficiencies. Reform should help distinguish what should be led nationally, coordinated regionally or addressed through sustained global action. 

2. AMR highlights the need for an integrated, cross-sectoral approach within a reformed architecture

AMR illustrates the interconnected nature of global health challenges and the importance of integrated, system-level approaches within the global health architecture. As a cross-cutting issue spanning multiple functions and sectors, it highlights the need for greater alignment across system functions, financing and implementation to support effective and sustainable responses. 

3. A reformed architecture must prioritise and facilitate global public goods 

A reformed global health architecture must explicitly prioritise, finance, and operationalise the delivery of global public goods.  Global public goods require sustained, coordinated action across countries and institutions, and cannot be delivered as effectively or comprehensively through fragmented or national approaches.  

4. Country ownership must be linked to implementation capacity and financing realities

Country ownership is critical to an effective global health architecture, extending beyond plans and budgets to include implementation capacity, institutions, technical systems, and reliable financing to translate global guidance into measurable outcomes. In the context of constrained resources, stronger coordination is essential to reduce duplication, align support with national priorities, and strengthen sustainable systems. This underscores the importance of treating financing as a system-wide issue while reinforcing the role of regional and implementation platforms in delivering results. 

5. Meaningful engagement of Product Development Partnerships is essential to effective reform 

PDPs play a critical role in addressing market failures and advancing innovation where traditional incentives are insufficient, including antimicrobial resistance. Their operational experience across the full product lifecycle, from research and development to regulation, manufacturing, and access, brings essential, practice-based insight into implementation and scalability.   

6. Multilateral cooperation is critical to address fragmentation and sustain global public goods

Multilateral mechanisms enable alignment of financing with national plans, pooling of resources and risks and sustain investment in global public goods and functions that cannot be delivered through national or bilateral approaches alone, including product innovation, surveillance and access. Strengthened multilateral coordination supports greater efficiency, equity and effective collective responses to cross-border health threats such as antimicrobial resistance.