A Global Agenda for 2025–2028: Promoting, Delivering, and Protecting Health «Part Fifteen»

The key enabling factors embedded in the theory of change reflect the conditions required within the World Health Organization (WHO) Secretariat to ensure its ability to deliver on its role and commitments under the Fourteenth General Programme of Work (GPW 14). These enabling factors align with WHO’s corporate outcome of strengthening organizational performance and include: enhancing the capacities and capabilities of WHO country offices; realizing a WHO with sustainable and flexible financing; developing a motivated and fit-for-purpose workforce; and ensuring a more effective, efficient, and accountable WHO.

This requires strengthened vertical and horizontal integration and ways of working within and across the three levels of WHO.

The assumptions and risks highlighted in the theory of change mainly relate to external factors that could affect the overall achievement of GPW 14 strategic objectives and shared outcomes. These are risks that have the potential to undermine the collective actions of Member States, the Secretariat, partners, and key stakeholders in delivering this global health agenda. They are often closely interconnected and include the following:

A lack of sustained political commitment and prioritization of agreed international health goals. This risk is linked to the challenging global context in which GPW 14 is being implemented, characterized by multiple and overlapping crises. Mitigating this risk requires countries and their supporting stakeholders to emphasize international health goals and commitments in the face of competing priorities.

In such a challenging environment, maintaining the level of political commitment needed to bring the world back on track toward achieving health-related Sustainable Development Goals and sustaining the investments required to ensure resilient and future-ready health systems may be difficult.

As a result, GPW 14 places strong emphasis on health leadership, advocacy, communications, and partnerships as key levers to keep health priorities high on the political agenda throughout the four-year GPW 14 period.

Insufficient financing for critical health priorities. This risk acknowledges that GPW 14 will be implemented during a period of economic uncertainty and geopolitical change, with significant implications for health spending at both domestic and international levels. In this context, it is essential to: generate robust evidence for investing in health; increase the efficiency of health and development spending; demonstrate the co-benefits of health outcomes for investments in other sectors; and strengthen data-driven advocacy to sustain political commitment.

In addition, Member States, the WHO Secretariat, partners, and stakeholders will need an adaptive management approach to ensure that available resources are directed or redirected to where they are most needed.

Major unforeseen events requiring significant reallocation of health system capacity at national, regional, or global levels. This risk reflects the experience of the COVID-19 pandemic and the recognition that public health emergencies have substantial impacts on ongoing health programs and systems. Large-scale resource reallocation to response efforts can significantly disrupt other services and programs, particularly if sustained over long periods.

GPW 14 therefore emphasizes major investments in health financing, services, and the health workforce to substantially increase resilience and maintain essential services in the face of such shocks, as well as major investments in preparedness, response, and business continuity capacities to reduce the scale, duration, and impact of these events.

The misuse of new and emerging technologies, such as artificial intelligence, in a rapidly evolving communications environment can accelerate the spread of misinformation and disinformation. This risk recognizes that such technologies, when leveraged through expanding communication networks and digital platforms, can dramatically increase the speed and volume of information production and dissemination.

The spread of misinformation and disinformation can undermine trust in scientific evidence, data, and knowledge, potentially leading to doubts about the safety and effectiveness of health interventions and reducing trust in health care systems and providers.

For this reason, GPW 14 places strong emphasis on strategic communications and advocacy to raise awareness and inform evidence-based decision-making; on education, learning, and empowerment of the health and care workforce; on community engagement to support health literacy (including through digital tools); and on governance, regulation, and the appropriate and responsible use of artificial intelligence in health.