Policy paper

Global Health Framework: working together towards a healthier world, May 2023

Published 22 May 2023

This was published under the 2022 to 2024 Sunak Conservative government

Midwives in Bangladesh. Credit: Nora Lorek-Panos

Summary

The UK government’s Global Health Framework sets out our ambition to play a leading role in improving health globally and in building resilience to future threats. It outlines the actions we will take over 2023 to 2025 in support of health and for a safer and more prosperous UK and world.

2023 is a critical moment, halfway towards the Sustainable Development Goals (SDGs) aspirations for 2030 and an opportunity to put into practice what we have learnt from COVID-19. The pandemic put unprecedented pressure on the UK’s health system and shone a spotlight on the importance of global health; it demonstrated that strong health systems can protect nations and economies. There is a need for concerted and collective action to get on track to achieve SDG 3 – to “Ensure healthy lives and promote well-being for all at all ages”, leaving no-one behind.

COVID-19 highlighted the importance of pandemic prevention, Universal Health Coverage, and improved access to vaccines, treatments, and diagnostics. Despite all the challenges it also led to innovation throughout the global health system, with safe and effective vaccines developed in record time and the rapid identification of effective therapeutics, alongside unprecedented sharing of data between countries and through the science community.

The Global Health Framework outlines shared objectives across government to strengthen global health security, reform the global health architecture, strengthen health systems in the UK and globally, and advance the UK’s position as a leader in global health science and technology. It does not try to capture all the health-related work taking place in government departments and agencies. Instead, it ensures that for our top-level objectives, we are deploying our resources as effectively as we can, in a fully joined-up way.

Baby being given medicine. iStock

The Framework ensures we are harnessing capabilities across His Majesty’s Government to deliver the global health aims of the newly refreshed Integrated Review and the International Development Strategy while aligning with the global health priorities set out in strategies across government and arm’s length bodies. Delivery of these global health outcomes will also play a critical role in strengthening the UK’s biological security, supporting the vision set out in the forthcoming Biological Security Strategy of a UK that is resilient to a spectrum of biological threats.

The UK government has a proud history of leadership in global health. We are well-placed to continue this leadership, building on our strengths, including the UK’s health system, our expertise in public health and our excellent health science and research sector. We have strong and established global research partnerships that we use to maximise our technical, scientific, and clinical knowledge and to develop more accessible and affordable technologies. We have experience and a track record of working with other countries on critical issues such as health systems strengthening, health security, infectious disease prevention and control, and sexual and reproductive health and rights (SRHR). We are strong supporters of the ‘One Health’ ^{[footnote 1]} approach and of taking a holistic approach to antimicrobial resistance. We respond promptly to incidents, such as those resulting from climate change, that affect health and involve multiple sectors.

While the Global Health Framework primarily aims to improve global health outcomes, this work also contributes to the UK’s own ability to handle health threats and strengthens our life sciences sector. A significant part of the solution to the challenges we face at home will come from overseas and having strong relationships with influential countries. The Global Health Framework therefore sits alongside the wider international engagement conducted by the government to achieve better domestic health outcomes. For example, our involvement in global health research means we can be at the forefront of technological innovation and bring those benefits to our own population, whilst being a part of global disease surveillance systems ensures we have access to early evidence of health risks that could affect the UK directly or indirectly. Now is the time to act to realise the importance of health for all by treating it as a global priority.

Introduction

The pandemic has shown that security and prosperity for the UK and globally are dependent on creating a healthier, safer and more resilient world.

The Integrated Review Refresh 2023 reaffirmed the UK’s commitment to reinvigorate progress towards the global Sustainable Development Goals (SDGs) and shape the international environment. The refresh reiterated the approach set out in the government’s 2022 International Development Strategy (IDS) which places global health as one of the UK’s top development priorities and includes commitments to leadership in science and technology, One Health, strengthening health systems and ending the preventable deaths of mothers, babies and children. It emphasises the need to catalyse international work to prevent the next global health crisis, referencing the publication of this Global Health Framework as setting out the UK’s continued commitment to global health efforts. The refresh also references the Biological Security Strategy 2023, due to be published shortly, which aims to protect the UK and UK interests from significant biological risks arising from natural disease, accidental release or deliberate misuse.

The Global Health Framework brings together our health commitments in these strategies and sets out how we will use our collective capability across government to deliver them. The Framework builds on our record of working with others to deliver an impact on global health. For example, UK funding for R&D, product development, market shaping, and programme delivery have all helped to increase life expectancy and reduce preventable deaths in childhood by tackling diseases such as malaria, TB, HIV, and polio, achieved through our product development partnerships, support to the Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi.

The Global Health Framework outlines 4 key objectives that are shared across government. It is jointly led by the Department of Health and Social Care and the Foreign, Commonwealth and Development Office. DHSC and its executive agencies, including the UK Health Security Agency, and the Office for Life Sciences (which is a joint directorate within DHSC and the Department for Science, Innovation and Technology), brings its health expertise and well-established relationships with UK and global health institutions and organisations, while FCDO draws on its diplomatic engagement and influencing, its technical and health expertise, and its portfolio of ODA investments. Significant input is also provided by the Department for Environment, Food and Rural Affairs on One Health, while the Departments for Business and Trade, and Science, Innovation and Technology help to maximise the impact of innovation, investment and engagement in support of global health. It should also be recognised that health in the UK is the responsibility of the 4 constituent nations. The nations of the UK often work in partnership and the devolved governments may support the commitments in the Global Health Framework where mutually beneficial and where there is capacity to do so.

Our approach to global health

The UK government will play a leading role in achieving Sustainable Development Goal 3 – to “Ensure healthy lives and promote well-being for all at all ages” – and supporting other SDGs.

We will work with others to maximise the combined impact of our investments, our innovation, and our influencing, shaping global policy and health outcomes through 4 strategic objectives, which will see departments working closely to:

• strengthen global health security through improved preparedness and response to future epidemics, pandemics, drug-resistant infections, and climate change

• reform global health architecture including through a strengthened World Health Organization, driving more coherent governance and collaboration across the international system (including the global health initiatives, financing institutions and the Quadripartite Collaboration for One Health) ^{[footnote 2]}

• strengthen country health systems and address key risk factors for ill health, working towards ending preventable deaths of mothers, babies and children in the world’s poorest countries and enabling women and girls to exercise their rights

• advance UK leadership in science and technology, strengthening the global health research base of UK and partner countries, while supporting trade and investment

Objective 1

Strengthen global health security through improved preparedness and response to future epidemics, pandemics, drug-resistant infections and climate change

The UK is committed to strengthening global health security and improving the way we prevent, prepare for, detect and respond to emerging diseases and drug resistant infections to protect population health in the UK and around the world. This commitment is evidenced by its inclusion in the Integrated Review ^{[footnote 3]} and by the creation of the UK Health Security Agency (UKHSA) to lead protection against these future health threats. The COVID-19 pandemic and other serious disease outbreaks, many deriving from animals,^{[footnote 4]} have resulted in severe health, social and economic impacts for households, communities, and nations. The risk of similar outbreaks will increase in the coming years, and it is important for us to take action.

Climate change, biodiversity loss, non-communicable diseases, and antimicrobial resistance are some of the greatest challenges of our century. These issues highlight the interdependence of human, animal, plant and environmental health and demand that we – both the UK and globally – work more effectively across boundaries and make One Health approaches the norm.

We will work to accelerate development, deployment and equitable access to safe and effective vaccines, treatments, and diagnostics and other technologies. This includes the UK government’s commitment to the 100 Days Mission, launched during our G7 Presidency in 2021. The mission aims to prevent millions of deaths and global economic impacts by setting a target of 100 days from a pandemic threat being identified to the availability of safe, effective and affordable vaccines, treatments and diagnostics. This builds on our earlier investments in, for example, the UK Vaccine Network. We will continue to work in international partnerships with academia and the private sector to support research and development; manufacturing innovation; and strengthening of the international clinical trials ecosystem in low and middle-income countries. This includes supporting the implementation of the World Health Assembly (WHA) Resolution on clinical trials,^{[footnote 5]} our work with the WHO, the Global Health Security Initiative, the Coalition for Epidemic Preparedness Innovations (CEPI), and with leading regional partners such as Institut Pasteur de Dakar.

We will strengthen domestic and international efforts to combat the threat of increasing antimicrobial resistance by improving global access to and stewardship of antibiotics and other priority anti-infectives; raising antibiotic manufacturing standards; reducing the risk of antimicrobial resistance being spread through the environment and farming practices; and strengthening innovation and the antibiotic development and the antimicrobial supply chain security. We will publish our 5-year national action plan for tackling antimicrobial resistance in 2024. This will outline the domestic and international actions we will take to progress the UK 20-year vision of controlling antimicrobial resistance by 2040. We will work towards progressing global efforts on AMR through the UNGA high level meeting on AMR in 2024. We will target funding through the UK’s Fleming Fund to strengthen laboratory capacity and national antimicrobial surveillance systems across Africa and Asia. The Fleming Fund’s data generation and the Global Antimicrobial Resistance Innovation Fund’s investment in innovative technology and research will support the development of crucial vaccines, treatments and diagnostics to tackle the growing threat of antimicrobial resistance. We will continue to support partnerships for product development to tackle the growing threat of antimicrobial resistance in diseases such as tuberculosis and malaria.

The UK government will continue to strengthen global and collaborative surveillance of human, animal, plant and environmental health threats through the sharing of intelligence and effective data systems at community, local, national, regional and cross-border levels. We will continue to support the implementation of global surveillance initiatives, such as the International Pathogen Surveillance Network, as well as strengthening the capacity of the WHO Hub for Pandemic and Epidemic Intelligence and the wider Quadripartite Collaboration for One Health to facilitate better data, analysis and decision-making against potential global health threats. In the G7, we will continue to support Germany’s Pact for Pandemic Readiness to improve coordination and implementation of collaborative surveillance and predictable, rapid response. The UKHSA is further collaborating with 18 countries and 6 regional partners on the New Variant Assessment Platform (NVAP) which deploys the UK’s unique sequencing and virus assessment capabilities to strengthen global health security. NVAP supports close working relations with partners to advocate rapid sharing of data relevant to priority pathogens of public health concern.

We will support partner countries, institutions, and regions to prevent, detect and respond to health threats with stronger human, animal, plant and environment health systems, response research capabilities, and enhanced compliance with the International Health Regulations (IHR) ^{[footnote 6]}. This will be achieved by providing technical expertise and building strong peer to peer partnerships with national, regional and global health institutions through the UK Public Health Rapid Support Team, the Animal Health Systems Strengthening Project, the second phase of the Tackling Deadly Diseases in Africa Programme and the IHR Strengthening Project. This also includes the UK government’s ongoing contribution to the Global Health Security Agenda whose central aims focus on IHR compliance as well as more specific action across the UK and with UK Overseas Territories to ensure the UK’s own compliance with the IHR. This support is key for protecting partner countries and the UK from the detrimental health, social, and economic impacts of disease outbreaks and other health threats.

Case study: Global health research and response to Uganda ebola outbreak

In December 2022, Oxford University’s Sudan Ebola virus vaccine candidate was shipped to Uganda, for potential use in a clinical trial just 80 days after the outbreak was declared. The research to develop the vaccine candidate was funded by DHSC’s UK Vaccine Network and with the support of FCDO, more than 40,000 doses were manufactured in partnership by the Serum Institute of India.

This rapid response delivered on our plans to develop globally affordable and accessible vaccines, treatments and diagnostics against new epidemic and pandemic threats in just 100 days. The supply of trial vaccine complemented a wider coordinated response, with the Government of Uganda, the World Health Organization (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI).

The UK also provided funding to support the response, for social sciences research with Ugandan partners, and for deploying specialists from the UK Public Health Rapid Support Team who worked with national and international response partners on infection prevention and control.

Objective 2

Reform global health architecture, including through a strengthened World Health Organization, driving more coherent governance and collaboration across the international system.

The UK government will work with others to improve governance, coordination and collaboration across the global health architecture to ensure that the world is better prepared to tackle future health threats and make progress towards Universal Health Coverage by 2030. This includes our engagement with UN agencies, the Global Health Initiatives ^{[footnote 7]}, international finance institutions and regional bodies. It also encompasses key joint initiatives, such as the Quadripartite and work on One Health.

The next 2 years are critical to capitalise on the international attention given to global health architecture through the COVID-19 pandemic. We will seek to influence international debate on the future of global health institutions and initiatives, using our strategic partnerships to secure new commitments on reform, including to promote equitable and affordable access to new technologies.

We will continue to support the WHO and strengthen it as an institution, working with the WHO and other Member States to deliver a strengthened WHO that is more efficient, accountable, effective and sustainably financed. WHO is the best placed institution to lead and coordinate the world’s response to health emergencies and to protect and promote the health of all people. We will participate actively in WHO Governing Bodies and other processes taking forward the reform agenda. The UK’s flexible funding programme will also play a key part in driving this change, in partnership with WHO.

The UK will also work closely with WHO Europe, who play a key role in our region’s health as demonstrated through recent emergencies and the war in Ukraine. WHO Europe can help strengthen health systems, set an example for other WHO regions, and be part of our work to foster stronger relationships across the European region.

We will play a leadership role in strengthening WHO-led processes around preventing, preparing for, detecting and responding to emergencies and achieving Universal Health Coverage. This includes reform of processes to deliver greater transparency and strengthen obligations on member states to enable, for example, faster data sharing. We will work with international partners to deliver this through the negotiation and agreement of a new legally binding pandemic instrument alongside targeted amendments to the International Health Regulations (2005). The UK government will also provide technical expertise, for example, through the UKHSA Centre for Pandemic Preparedness and the Centre for Climate and Health Security, working with others globally on the broader health agenda.

The Global Health Initiatives (GHIs), including the Global Fund and Gavi, the Vaccine Alliance and the Global Financing Facility, have contributed significantly to saving lives and improving the health of people globally. As a founding partner and significant funder, we will work with international partners to explore their potential evolution in the face of the changing global health landscape. This will include an emphasis on ensuring investments are sustainable, aligned behind national priorities, and are building resilient health systems, including through efforts to strengthen health workforce, on the path towards Universal Health Coverage.

We will seek to strengthen coherence of the broader architecture, particularly across the United Nations system, the World Bank, the Quadripartite Collaboration for One Health and the Global Health Initiatives. We will work with our international partners, particularly the G7 and G20, to leverage political capital, financial investments, and technical expertise to ensure the global health architecture is fit for purpose. This includes our work at the G20 to strengthen links between health and international financial institutions, to improve financing for epidemic and pandemic prevention, preparedness and response and broader health outcomes. We are a supporter of, and contributor to, the Pandemic Fund which will supplement the existing pandemic financing architecture. We will also work with the G7 on commitments made under the UK 2021 Presidency, including to influence international cooperation on global action towards achieving Universal Health Coverage.

Case study: UK funding to the WHO

The UK government provides its membership fee to the WHO (through DHSC) and flexible funding to the WHO through the Core Voluntary Contributions (CVC) programme (through FCDO).

The UK government is a leading donor to WHO. Our flexible core funding allows WHO to pursue its ‘triple billion’ targets: to ensure that 1 billion more people have Universal Health Coverage, to protect 1 billion more people from health emergencies, and to provide a further billion people with better health and wellbeing. Specific WHO activity includes:

• support to 40 countries to prioritise and implement health system reforms to achieve Universal Health Coverage
• support to countries to carry out preparedness assessments through the International Health Regulations (IHRs) to improve their readiness for future health threats. 114 assessments have been conducted since 2016
• support to 170 countries to establish national action plans to combat antimicrobial resistance. 166 countries have completed the Tripartite antimicrobial resistance country self-assessment survey and submitted information on the status of their antimicrobial resistance response by the end of 2022
• the initiative Alliance for Transformative Action on Climate and Health which works to realise the ambition set at COP26 under the UK’s Presidency to build climate resilient and sustainable health systems
• support to ensure the provision of basic health services in Afghanistan after the elected government collapsed in mid-August 2021

Objective 3

Strengthen country health systems and address key risk factors for ill health, working towards ending preventable deaths of mothers, babies and children in the world’s poorest countries and enabling women and girls to exercise their rights.

Many of the challenges faced by health systems are shared across countries. This includes keeping up with rapid advances in technology and medicine, ageing populations with greater health and social care needs, changing health and care functions and work patterns, the challenge of training, maintaining and retaining a skilled health workforce, supporting continued recovery of health systems following the COVID-19 pandemic, and ensuring preparedness for future disease outbreaks.

The majority of countries – including the UK – are still reporting disruptions to everyday health services since the COVID-19 pandemic, including routine immunisations. The pandemic has particularly affected low and middle-income countries, with some of the poorest countries seeing an estimated 2 to 3 additional deaths of mothers or children (not related to COVID-19) for each COVID-19 death recorded.

Other risks, including conflict and climate change, also affect the ability of health systems to function well. The UK government offers help to meet the most urgent needs of countries affected by humanitarian crises, coordinating across government and the wider health and care sector. Support to health in humanitarian contexts is often critical to prevent the collapse of health systems and provide a basis for recovery when the time is right.

The UK government recognises the importance of achieving Universal Health Coverage (UHC) globally and the need for strong and resilient health systems with integrated health services. We will work through our bilateral and multilateral programmes and partnerships to promote joined up approaches to health system strengthening with Primary Health Care at their heart. We aim to take a leading role in galvanising greater political commitment, financing and coordination towards UHC and will support global efforts to better respond to country priorities and needs. At the centre of our approach is a commitment to the right to health and to leaving no-one behind. We fulfil this commitment through addressing the needs of those who are disadvantaged, including the poorest; people with disabilities; and people living in remote or impoverished places. We also recognise the need for individuals to make decisions about their own health and to hold providers and policy makers to account.

As part of our health systems strengthening approach, the government supports efforts to strengthen health workforce capacity both internationally and in the UK. This is essential for achieving Universal Health Coverage. As part of our wider commitment to health systems strengthening, we will continue to work with partners across the globe to support strategic workforce planning and development as part of collective efforts to create a sustainable global healthcare workforce in the UK and globally. The UK also has a rich history of international workers in the NHS, since its inception in 1948. We will use our bilateral relationships to increase opportunities for health workers to migrate to the UK to build skills and experience, whilst fully abiding by the respective codes of practice for the international recruitment of health and social care personnel in England, Scotland, Wales and Northern Ireland, designed to protect countries with the weakest health systems and the rights of individual workers as they migrate. This includes schemes such as the Medical Training Initiative, a long-running scheme that offers short-term training posts to doctors from lower-middle-income countries, where they can get up to 2 years’ experience in the NHS before returning home.

The UK recognises the need to support developing countries with their workforce development, especially around workforce planning and utility. During the 2021 to 2022 financial year, DHSC supported Health Partnerships through the Building the Future International Workforce Programme to address the shortages of health workers and increase capacity and training access and management in Ghana, Uganda, and Somaliland. These partnerships brought together UK institutions and local partners to address locally identified health workforce priorities. We will continue to support this work through the WHO.

Our Health Systems Strengthening Position Paper and the Ending Preventable Deaths of Mothers, Babies and Children Approach Paper set out what we will do to deliver our commitment of ending preventable deaths of mothers, babies and children by 2030. This will be taken forward through a consolidated approach with 11 flagship countries, complemented by a campaign of action. We will provide continued support to key multilateral organisations including the Global Financing Facility, Gavi, the Vaccine Alliance and the Global Fund, helping Gavi to reach its target of immunising 300 million children between 2021 to 2025 and the Global Fund to scale up access to effective HIV, TB and malaria prevention and treatment.

Defending and promoting comprehensive sexual and reproductive health and rights (SRHR) is central to ending preventable maternal, baby and child deaths and achieving gender equality. These are issues long championed by the UK. We will be bold to defend and progress action, for example by continuing to resist any attempt to roll-back on SRHR and gender equality commitments at multilateral fora and by demonstrating political leadership to counter pushback on safe abortion. We will champion, support and mobilise more funding for the Africa-led movement to end female genital mutilation.

We will build upon our leadership and experience to protect lives from the health threats posed by climate change, malnutrition and lack of access to clean air, water and sanitation. We will drive the implementation of the commitments on climate and health we secured from over 60 countries at and since COP26 to build climate resilient and sustainable health systems, including through advocacy work, a new global alliance, and elevating health in climate negotiations. We will help to tackle the global food and humanitarian crises in Africa. We will integrate nutrition across our ODA portfolio and scale up actions to prevent and treat child malnutrition, including by increasing the availability, affordability and quality of malnutrition prevention and treatments. We will support improved access to healthy diets, including through R&D to produce climate resilient and nutritious crops. We aim to improve the reliability and resilience of water supply, sanitation and hygiene services that can reach entire populations, improving how the sector is managed and financed, and increasing its profile, not least in climate negotiations.

We will build our international public-private partnerships, drawing on LMIC and UK expertise in science, research and innovation to ensure equitable and affordable access to new products, supplies and services for mothers, babies, and children. This will support work to prevent the most serious infectious diseases and improve maternal and reproductive health including through the provision of new medicines, better diagnostic technologies, and new vaccines, and by supporting research and innovative strategies to end preventable deaths.

Case study: Training and mentorship on emergency obstetric and newborn care

The FCDO Maternal and Newborn Health programme in Kenya aims to sustainably improve the quality of maternal, newborn and child health services through a health system strengthening approach. The programme provided pre- and in-service training and mentorship on Emergency Obstetric and Newborn Care, improving the supply of essential health products and promoted the use of appropriate low-cost high impact technologies. The programme trained 11,500 health care workers and enhanced pre-service training in 42 medical training colleges.

To create the right environment for health workers to use their skills, the programme also supports legislative processes in several counties to secure domestic funding for health services, aiming to ringfence health revenue for use by the facilities that have generated this revenue.

Case study: Kenya bilateral agreement on health worker recruitment

In June 2021 the UK government signed a Bilateral Agreement with the Kenyan Government to initiate a programme of managed nurse recruitment to the UK. Kenya has a surplus of trained nurses, many of whom are unemployed, so the intention was to give these nurses a potential for employment in the UK health system.

Over the course of the next 18 months, the 2 governments worked together to develop an implementation plan that allowed Kenya to manage the outflow of nurses, while assuring their quality. In return, the UK moved Kenya to the amber list, which meant the NHS could only recruit nurses through the processes outlined in the Bilateral Agreement. This approach was trialled with Oxford University Hospitals NHS Foundation Trust before being rolled out to a small cohort of other interested NHS organisations in England and Scotland.

Moving forward, the Kenyan Government will look to build capacity in its assurance process to accept more candidates and the process will be opened up to all NHS employers across the UK.

Objective 4

Advance UK leadership in science and technology, strengthening the global health research base of UK and partner countries, while supporting trade and investment.

The UK government will continue to invest in science and technology (S&T) programmes and capability to improve human, animal, plant, environmental and climate-related global health outcomes. We aim to consolidate our position as a world-leading research base – with a strong health and life sciences sector – to support healthy lives and build global resilience to health threats. We will work to increase the impact of policy-relevant evidence generated by S&T investments, support international partnerships for R&D, and facilitate the scale-up of proven interventions into use. We will work in partnership with researchers and institutions in low and middle-income countries to ensure technologies are accessible and affordable to improve global health outcomes, offering UK expertise in science, technology and wider health. We will take a One Health approach to S&T through, for example, complementary R&D investments in plant and livestock diseases.

Domestically, we are investing in innovative medical technologies to support the UK health and care system, as set out in the medical technology strategy. One example of this is through the NHS Artificial Intelligence (AI) Lab’s £123 million investment in the safe, ethical and effective deployment of AI through the AI in Health and Care Award Programme. This programme is supporting the testing and evaluation of AI technologies across 99 UK hospital sites to improve people’s health and wellbeing, support the NHS workforce and increase productivity. The NHS AI Lab also led work to develop an international consensus across the G7 health track on the evaluation of AI medical devices. Members agreed to principles that support the development and deployment of AI or machine-learning enabled medical devices across jurisdictions and work continues in international assurance pathways across the Global Digital Health Partnership. We will use initiatives like this as an opportunity to maximise our relationships with our global partners to share and exchange knowledge on medical technologies and solutions, supporting people across the world to live longer, healthier and more independent lives.

Much of the work within S&T underpins the delivery of the other objectives of this Framework. For example, investment and work in innovative technology and research to support the development of vaccines, treatments and diagnostics helps combat the threat of antimicrobial resistance (objective 1) and improve maternal and reproductive health to end preventable deaths (objective 3). The work here will also build on the UK Science and Technology Framework (PDF, 998 KB) published in March 2023 that outlines how S&T will be the major driver of prosperity, power and history-making events this century.

The UK will invest in a portfolio of global health research projects that address major global health challenges and the evolving global burden of disease. This includes expanding research into strengthening health systems for Universal Health Coverage and ending preventable deaths and on building resilience to tackle threats such as future pandemics and climate change. We will support equitable partnerships for developing collaborative and sustainable research capacity in the UK, with international partners and in low and middle-income countries. We will invest in cutting-edge, policy-relevant global health research and development to drive health outcomes and health equity, including improving our knowledge of non-communicable and chronic diseases, sexual and reproductive health and rights, nutrition, health security and the infectious diseases of poverty. To achieve this, we will harness the research commissioning expertise of the UK’s research funders, working through UK Government research delivery agencies such as the National Institute of Health and Care Research (NIHR), and UK Research and Innovation (UKRI), including the Research Councils. We will continue to work through FCDO’s Research Programme Consortia (RPCs) which support multi-country partnerships to develop and support take-up of high-quality research evidence.

We will utilise the expertise of the UK’s life sciences industry and academia as well as our public-private partnerships, to improve global health outcomes. In doing so, we will ensure threat assessment and preparedness, secure strategic advantage in S&T and lead a global campaign on ‘open science for global resilience’ making the case for a secure, collaborative approach to science that ensures low and middle-income countries have access to knowledge and resources that can support improved resilience. We will work closely with industry and academia to deliver our commitment to research and development in pursuit of the 100 Days Mission. This will strengthen the economy by supporting the global life sciences industry and building on the lessons learned during the COVID-19 pandemic to ensure safe and effective new vaccines, treatments and diagnostics are available to save lives in the UK and abroad. The UK Government will also continue to invest in Product Development Partnerships and other international public-private partnerships which harness the strengths of academia and industry to accelerate the development of new diagnostics, treatments, and vaccines where the private sector is unwilling or unable to invest alone, taking an end-to-end approach to ensuring affordable and equitable access. This includes the CEPI which is contributing to the 100 Days Mission through new vaccine development and delivery for infectious diseases with epidemic and pandemic potential, including Ebola and COVID-19.

We aim to deliver on the UK as a global hub for life sciences as set out in the Life Sciences Vision and as an international partner of choice for life sciences, healthcare and public health supported by key functions such as Healthcare UK. This will be underpinned by an ever improving genomic and health data infrastructure and the creation of a world-class business environment in the UK that supports and encourages global health research activity. Life sciences are identified in the Integrated Review 2023 as a priority sector for growth and as part of this we will work to strengthen the UK’s position as a leading global hub for trade and investment. Working with trade partners, particularly through new trade and bilateral agreements, we aim to reduce regulatory barriers and improve collaboration. This will support global health improvements in countries around the world, whilst fostering trade opportunities and bolstering resilience in the UK supply chain.

Case study: Improving surgical outcomes

NIHR’s Global Health Research Units support equitable research partnerships between researchers and institutions in the UK and those in low and middle-income countries, to address global health challenges.

The NIHR Unit on Global Surgery – led by the University of Birmingham – improved surgical outcomes during the COVID-19 pandemic. The Unit pivoted to support surgeons across 7 global research Hubs to understand how best to protect surgical patients from infection with COVID-19, keeping surgery as safe as possible. In collaboration with more than 1,650 hospitals in 116 countries, the findings have led to production of global guidance for surgical services, translating research evidence into real-world global health policy. The NIHR Unit on Global Surgery now forms the largest surgical collaborative in the world.

Going forward

The Global Health Framework provides a shared and ambitious commitment from the UK Government to advance global health. We will seek to maximise the impact of these ambitions through our portfolio of investments and activities and engagement with key partners around the world on a bilateral and multilateral basis as well as with global partners from industry, academia, funders, and civil society organisations. Over the next 2 years, we will progress the key activities for the 4 objectives as set out in this publication. At the end of this period, we will review progress to consider if and how activity needs to be realigned to make further progress towards SDG-3.

The delivery of the Framework will require a well-led structure, supported across government departments, with clear roles and responsibilities. This will be overseen by ministers from DHSC, FCDO, Defra, DSIT and DBT. Progress will be regularly monitored by officials and issues will be reviewed by ministers to ensure progress and accountability.

The Framework provides the opportunity to build conversations with countries and regions across the world that may have their own strategies. We are ambitious to build on existing relationships and to identify new opportunities for collaboration to tackle the issues we are facing together.

Female doctor. iStock

1. One Health is an integrated, unifying approach that aims to sustainably balance and optimise the health of humans, animals, plants and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent. The approach mobilises multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development. (Definition agreed by the One Health High Level Expert Panel) ↩

2. The Quadripartite Memorandum of Understanding provides a legal framework for the World Health Organization, the World Organisation for Animal Health, the Food and Agriculture Organization of the United Nations and the UN Environment Programme to tackle the challenges at the human, animal, plant and ecosystem interface using a more integrated and coordinated approach. This framework also contributes to the reinforcement of national and regional health systems and services. ↩

3. IR 2023: Catalysing international work to prevent the next global health crisis, building on the achievements of our G7 Presidency to broker more ambitious international agreements on pandemic preparedness and response, strengthen health systems, drive more equitable access to affordable vaccines, drugs and diagnostics, and tackle antimicrobial resistance. ↩

4. 70% of emerging diseases and almost all known pandemics are zoonoses – are caused by microbes of animal origin. ↩

5. Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination (who.int) (PDF, 175 KB) ↩

6. The International Health Regulations (2005) provide an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. They are an instrument of international law that is legally-binding on 196 countries, including the 194 WHO Member States. The IHR require all signatories to have the ability to a) detect acute public health events in a timely manner, b) assess public health events and report those that may constitute a public health emergency of international concern and c) respond to public health risks and emergencies. ↩

7. Global Health Initiatives refers to organisations that integrate the efforts of stakeholders around the world to mobilise and disburse funds to address health challenges. They do so by supporting implementation of health programmes in low and middle-income countries, including the Global Fund to Fight AIDs, TB and Malaria, Gavi the Vaccine Alliance, and the Global Financing Facility (GFF). ↩