Multilateral cooperation remains crucial as global health financing changes

As the United States withdraws from the World Health Organization and cuts foreign aid, regional partnerships are crucial to protecting the health of member countries in a region where climate change and chronic diseases are becoming more serious.

These are some of the reflections of WHO Regional Director for the Western Pacific, Sai Ma’u Piukali, on the health challenges facing the region and the measures needed to overcome them as he heads to the World Health Summit (October 12-14) in Berlin, Germany.

Ahead of a key regional meeting in Fiji later this month, Piukala will join other global health leaders to discuss how healthcare governance and healthcare financing models must adapt to the new reality of declining foreign aid.

In a written interview, he talks about the critical role of philanthropic partnerships, why multilateralism in health is more important than ever, and the threat that disinformation and disinformation pose to public health.

How is WHO preparing for future pandemics in the face of financial challenges and geopolitical changes?

The US withdrawal forced the WHO to rethink and restructure on a global scale. This is painful, but also an opportunity to refocus and diversify our funding. Member States in the Western Pacific have stepped up and shown strong support.

To quote the cliché, out of adversity comes opportunity – we are using this moment to recalibrate and re-strategize, focusing more than ever on what we need to do and with whom we need to work together to ensure we can deliver on our mandate.

Health multilateralism is not in crisis – it is more important than ever. The Pandemic Agreement provides countries with the tools to better prepare for and respond to emerging health threats, including pathogens with pandemic potential.

At the upcoming Fiji Regional Committee meeting [20-24 October 2025]we will discuss how to implement this framework to strengthen regional preparedness.

Why are partnerships, such as with the Asia-based Philanthropy Institute, essential for the WHO Western Pacific region?

Partnerships are the lifeblood of WHO’s work – especially in a region with many middle- and lower-income countries. Our partnership with the Institute of Philanthropy helps us connect with new philanthropic actors who may not fully understand WHO’s role.

When we show the real impact of our work – supported by solid data – interest grows and doors open.

I saw this firsthand at the recent Asian Venture Philanthropy Network conference in Hong Kong, where I shared the WHO story along with key health priorities for our region. These conversations have generated real interest and are already leading to promising new opportunities for cooperation in the field of health.

How is WHO in the Western Pacific fighting disinformation and rebuilding trust in science?

Fighting the infodemic is a key pillar of our work. WHO is investing in infodemic management, integrating it into all programs.

We have called on our member states to tackle the commercial determinants of health that contribute to the staggering global burden of non-communicable diseases such as hypertension, diabetes and cancer. [These diseases are] linked to tobacco, alcohol, processed foods and fossil fuels – products representing powerful industrial giants and conglomerates around the world, including in the Western Pacific.

The more engagement we get in our efforts, the greater the response from Big Industry – including disinformation and misinformation perpetuated through insidious and aggressive marketing tactics increasingly aimed at young people, such as advertising e-cigarettes and vaping pens, or making alcohol cheaper and more accessible.

What are the top health priorities at the Fiji Regional Committee meeting and what are the impacts of climate change and artificial intelligence?

We focus on three key areas. Firstly, non-communicable diseases – represented by renewed action on tobacco – and alcohol-related diseases, where we are adapting the WHO global framework for action for our region. We’re also shining a light on oral health in a region where more than 800 million people suffer from largely preventable oral diseases.

Secondly, climate and health. Climate change is disrupting water, food and disease patterns. In particular, we are calling for health systems across our region to be much more resilient to climate change and its impacts – from tight water supplies impacting sanitation and infection control to reducing greenhouse gas emissions.

We are implementing a regional action plan and a five-year strategy to build climate-resilient health systems through our Seoul-based Center for Environment and Health for Asia and the Pacific.

Third, health emergency preparedness – implementing changes to the International Health Regulations and the Pandemic Agreement to make our region safer.

We are also exploring the potential of artificial intelligence – from telehealth to diagnostics – while asking difficult questions about equity. Who benefits? Who’s left? Health must help fill these gaps.

What is a unique success story in the region and what can we learn from it?

Elimination of measles and rubella in 21 Pacific island countries [announced in September] it is a triumph of cooperation. Despite limited resources and vast distances, countries worked together to protect their communities. For someone from Tonga, this achievement is deeply personal.

It reminds us of the global effort to eradicate smallpox – proof that health partnerships can transcend borders and politics. In our divided world, I remain realistically optimistic: with health, a better tomorrow is possible.