Introduction
Experts in global health and development have identified several key buzzwords expected to be relevant in 2026. These terms reflect significant global changes, including reductions in foreign aid, ongoing climate and conflict crises, and emerging disease threats.
Fractured Resilience
"Resilience," the ability to withstand adversity, is increasingly vulnerable. "Fractured resilience" describes situations where a series of adverse events overwhelms the capacity to provide essential services. An example is Sri Lanka, where climate change-induced heat and pesticide exposure led to a rise in kidney disease, exacerbated by Cyclone Ditwah, which caused floods that disrupted healthcare, including critical dialysis services. This challenge is not limited to Sri Lanka, with similar kidney disease increases observed in South America, Southeast Asia, and East Africa, often in a context of reduced foreign aid.
Pragmatic Solidarity
Coined by the late Dr. Paul Farmer, "pragmatic solidarity" combines empathy with practical action to alleviate suffering. It involves actively supporting those in need, even when inconvenient, and utilizing available resources to address immediate needs and their underlying structural causes. This concept is considered crucial amid "unprecedented challenges" in global health, including funding cuts and health inequities. It also calls for aligning moral urgency with practical incentives, such as prizes for developing affordable diagnostics for conditions like neonatal sepsis. Dr. Ifeanyi Nsofor highlights the need for leaders in low- and middle-income countries (LMICs) to practice pragmatic solidarity to reduce donor dependency.
Memorandum of Understanding (MOU)
A Memorandum of Understanding (MOU) is a contract between two parties. In a new post-USAID era, the U.S. "America First Global health strategy" is championing MOUs with specific countries. These agreements detail aid provisions, U.S. business involvement, and recipient country responsibilities. So far, 14 MOUs have been signed with African nations. This marks a departure from historical foreign aid delivery, which often channeled funds through nonprofit partners. While this direct funding approach may be an overdue reform for sustainability, concerns exist regarding the rapid transition and lack of clear recourse if countries do not meet all stipulated conditions, particularly for complex health programs.
Zero-Dose Children
This term refers to children who have not received any routine vaccinations. In 2024, an estimated 14.3 million children globally were "zero-dose." These children often reside in remote, impoverished, or conflict-affected areas. For instance, in Sudan, conflict since April 2023 has led to a significant decline in vaccination coverage, doubling the number of zero-dose children to 1.8 million and resulting in measles and polio outbreaks. The WHO aims to halve the number of zero-dose children by 2030.
Disease X
"Disease X" is a placeholder scientists use for an unknown pathogen with pandemic potential. The WHO adopted the term in 2018 to encourage preparedness for such a threat. While technological advancements in pathogen sequencing have improved, some experts express concerns that overall preparedness has not significantly increased, citing mismanagement of existing threats like measles and avian influenza, along with growing public distrust in health authorities.
Decolonization and Localization
In response to disruptions in global health aid, "decolonization" and "localization" have emerged as key concepts. "Decolonization," proposed by some, suggests that the pullback of funding and involvement from Western countries, which historically influenced program implementation, could lead to greater autonomy and national ownership for LMICs. "Localization," seen as a mechanism for decolonization, focuses on rebuilding an equitable global health system. It emphasizes empowering local partners and rebalancing power dynamics, ensuring that communities most affected by health challenges lead the development of solutions.