Global Health Security Is the Test That Multilateralism Cannot Afford to Fail

Each generation learns, often at the worst possible moment, that disease does not respect borders. Yet this generation is confronting a troubling paradox: the institutions designed to manage transnational health threats are facing shortages of funding, political support, and public trust precisely when they are needed most.

This is not merely a matter of perception; it is a matter of arithmetic. Global military expenditure rose by nearly 10% last year to US$2.887 trillion, roughly thirteen times the world’s investment in development assistance. Meanwhile, the United Nations, on which most countries rely to coordinate responses to global crises, is operating 15.1% below its approved 2025 budget. The Sustainable Development Goals, perhaps the clearest measure of international cooperation, remain only about 35% on track.

These realities have led some observers to conclude that multilateralism is in irreversible decline, that an era of collective action is being replaced by a more transactional and fragmented world. According to this view, global health security will increasingly depend on bilateral agreements and national stockpiles rather than international institutions.

This conclusion is mistaken. Indeed, global health security is precisely the domain in which the value of multilateralism can be most clearly demonstrated, or, if we fail, where its shortcomings will be exposed most dramatically.

Why health security cannot be solved alone

The case against isolated health policies is not ideological; it is epidemiological.

Pathogens do not stop at national borders. Antimicrobial resistance spreads across jurisdictions. Climate-related health risks, including heat stress, shifting disease vectors, and food insecurity, emerge from interconnected systems that no single government can control. Effective response depends on surveillance data, genomic sequencing, scientific collaboration and early-warning systems that must move rapidly across borders.

Countries with robust public health institutions, laboratories and surveillance networks are better positioned to contribute to and benefit from global cooperation.

Strong national health systems remain indispensable. Yet national capacity and international cooperation are not competing objectives; they are mutually reinforcing. Countries with robust public health institutions, laboratories and surveillance networks are better positioned to contribute to and benefit from global cooperation. The COVID-19 pandemic demonstrated that resilience requires technology, domestic preparedness, and international coordination.

What credible multilateralism would actually require

If multilateralism in health security is to overcome its current credibility crisis, it must evolve in four concrete and measurable ways.

First, it must become safer.

No country should be penalized for reporting the truth. South Africa’s identification of the Omicron variant in November 2021 remains a cautionary example. South African scientists rapidly detected and transparently reported the variant using world-class genomic surveillance. Yet many countries responded with travel bans that proved ineffective in preventing Omicron’s global spread while imposing high economic costs on South Africa.

The lesson is clear. Global health security depends not only on detecting threats but also on protecting those who report them. Until countries can share critical information without fear of economic punishment, the incentives for transparency will remain dangerously weak. A system that makes honesty costly encourages silence precisely when speed matters most.

Second, it must become fairer.

The current system relies on countries sharing data, biological samples, and early warnings with the expectation that the benefits of cooperation will be shared equitably. Too often, that expectation has been disappointing. During recent health emergencies, many countries that contributed crucial information found themselves at the back of the queue for vaccines, diagnostics and treatments.

Decisions made during calm periods determine the effectiveness of responses during emergencies.

Equity is not simply a moral aspiration. It is a functional requirement. Future outbreaks will be detected somewhere, and countries’ willingness to share information will depend on whether prior cooperation was rewarded or exploited.

Third, it must become faster.

Pathogens, misinformation and supply-chain disruptions spread at digital speed. Multilateral institutions often move more slowly because they are designed to prioritize consultation, consensus and legitimacy. The challenge is not to choose between speed and accountability, but to prepare governance mechanisms in advance.

Protocols, financing arrangements and decision-making authorities should be agreed upon before crises emerge. Preparedness is fundamentally a governance challenge: decisions made during calm periods determine the effectiveness of responses during emergencies.

Fourth, evidence must be translated into action.

Scientific evidence does not automatically become policy. Research must be contextualized, communicated, and delivered in forms that decision-makers can use under conditions of uncertainty and time pressure.

Universities and research institutions have a crucial role to play in bridging the gap between knowledge and implementation. The challenge is not simply generating evidence but ensuring that evidence informs decisions before events overtake them.

The case for middle powers — and for reform from within

Debates about global governance often focus on major powers such as the United States, China and the European Union. Yet the future of multilateralism may depend just as much on middle powers and regional leaders.

Countries such as Malaysia, Canada, and Kenya demonstrate what constructive leadership can look like. Hosting international discussions is important, but meaningful leadership extends beyond diplomacy. It requires investment in laboratories, surveillance systems, public health infrastructure, and regional coordination mechanisms.

The skepticism directed toward international cooperation is real and cannot be dismissed.

Preparedness is demonstrated through capabilities, not declarations. Countries that translate commitments into operational readiness strengthen the credibility of multilateral cooperation far more effectively than any communiqué ever could.

The encouraging reality is that many more countries possess this potential than current debates often acknowledge.

The verdict will not be written in speeches

The future of multilateralism will not be determined by how eloquently its defenders argue for its importance. It will be determined by whether the institutions it creates deliver tangible results.

Will countries be able to share information without fear of punishment? Will the next nation that identifies a dangerous pathogen receive support rather than sanctions? Will preparedness funding survive future budget cycles? Will One Health approaches genuinely integrate human, animal and environmental health? Will equity be embedded from the beginning rather than added as an afterthought?

These are the questions that matter.

Multilateralism is undoubtedly under pressure. The skepticism directed toward international cooperation is real and cannot be dismissed. Yet being contested is not the same as being obsolete.

If global institutions can demonstrate that they protect people before crises become catastrophes, reward transparency rather than punish it, and distribute the benefits of cooperation as fairly as they distribute its responsibilities, then multilateralism will emerge stronger from this period of uncertainty.

Global health security is not merely one test among many. It is the test that the international community cannot afford to fail.

This article is based on a speech delivered at the Global Health Security Conference in Kuala Lumpur, Malaysia in June 2026.