Peter Sands of the Global Fund, Winnie Byanyima of UNAids and the WHO's Jeremy Farrar mark World Aids Day at the UNAids Global Centre in Geneva on 1 December 2025, after a year of funding shocks that have undermined efforts against HIV. (Keystone/Salvatore Di Nolfi)

❝After a year of disruption, global health needs leaders with backbone. Funding shocks, political U-turns and weakened institutions have laid bare the flaws in a global health architecture long overdue for reform – and the need for courageous leadership to stop it from unravelling, writes Priti Patnaik, global health journalist and founder of the Geneva Health Files.

💸NEW YEAR, NEW BUDGET. Agencies across Geneva return to work under much more constrained conditions. After budgets were slashed last year, 2026 will be about living with the cuts.

Midnight oil. The fate was sealed just a couple of weeks ago, when marathon negotiations on the UN’s regular budget at a finance committee dragged on past a 24 December deadline, before the UN General Assembly finally approved the $3.2 billion budget, green-lighting the 15 per cent cut proposed by UN chief António Guterres.

Read more: UN faces dark future if nations don’t act, says analyst ahead of high-level meet

Layoffs, relocations and programme closures are no longer hypothetical. What remains unclear is whether this gutting exercise will have any impact on Washington’s support for international organisations in 2026, as budget discussions drag on since the White House's proposal to slash its assessed contributions by 80 per cent.

Reform or retreat. These painful cuts mark only the first phase of what is shaping up to be a lengthy and politically fraught process. In 2026, discussions will speed up on mandate scrutiny, streamlining humanitarian operations and possible mergers – including a proposal to “sunset” UNAids by the end of the year and fold its expertise into other parts of the UN.

👱‍♂️TRUMP VS MULTILATERALISM. Diplomats will again spend the year guessing president Trump’s next move on the global stage. Will midterm elections pull his focus inward or fuel further “America First” peace-making?

🏔️ALL THE DAVOS MEN. One place to watch out for clues on Trump’s thinking will be at the World Economic Forum, held in Davos from 19-23 January. One thing that will be thin on the ground – at Trump’s behest – are “woke” topics.

Fighting for relevance. WEF will also be under pressure to rebrand itself after a turbulent year that saw its founder and longtime strongman, Klaus Schwab, ousted.

🧴PLASTICS CRUNCH YEAR. On 7 February, Geneva will once again bring the faltering negotiations for a global plastics treaty into focus. Delegates will meet for a one-day session to elect a new chair, after the former chair’s controversial departure left the process in limbo.

Advocates hope the appointment will help reset the talks, including by unlocking agreement on a venue and date for the next negotiating round. But the process could prove messy, with a crowded field of candidates from Chile, Pakistan and Senegal vying for the role.

🚢CAMEROON TRADE CONFERENCE. From 26 to 29 March, the delegates will gather in Yaoundé for the World Trade Organisation’s second-ever ministerial conference in Africa. After a year of tariff threats and arm-twisting by Washington, the custodian of the multilateral trading system faces a credibility test.

Course correction. Expectations are already running low. Stalled talks over dispute settlement reform, fisheries subsidies and agriculture have made little headway and risk confirming rather than reversing the WTO’s drift.

⏳PABS UP. Countries gathering from 18 to 23 May for the World Health Assembly are gearing up for another make-or-break moment. Last year’s pandemic agreement was hailed as a testament that multilateralism is “alive and well”.

This year, they are expected to sort out the last piece of the puzzle, a system for exchanging pathogen data for benefits, so the agreement can go into effect. That is is US transactional diplomacy doesn’t get in the way.

🎂HAPPY BIRTHDAY. The Human Rights Council is turning 20 this year, but the mood couldn’t be less celebratory. The UN rights system is under unprecedented financial strain while human rights regress across regions.

This year, the council also faces a routine review at the hands of the General Assembly, with some countries keen to curb its reach rather than strengthen it.

Trending. The council’s political standing could further erode this year. In 2025, the US and Nicaragua withdrew from the body while Argentina flirted with the idea. Chile’s newly elected president, José Antonio Kast, whose politics and past praise of the Pinochet era have alarmed rights advocates, has proposed that his country follow suit.

👤NEW FACES AT THE TOP. Arguably, one of the most consequential processes of 2026 will be the search for the UN’s next secretary general. Will it finally be a woman? A candidate from Latin America? A technocrat or an outspoken advocate?

As analyst Eugene Chen notes, ideals such as gender parity or regional rotation will ultimately collided with P5 Security Council realpolitik.

Meanwhile, Guterres enters lame-duck territory as he rushes to lock in reforms, which critics say landed at the worst possible time.

All eyes on you. One newly appointed official already drawing attention, is Barham Salih, the new UN High Commissioner for Refugees. The former president of Iraq’s selection broke with the tradition of near-exclusive European leadership at the UNHCR.

With the UN refugee agency grappling with steep funding cuts, starting the year with 5,000 fewer staff and field programmes closed, expectations are running high.