North–South Dialogue on Health: A Path Full of Challenges but Also Real Opportunities for Change

After nearly three years of negotiations among countries, marathon sessions, shifting alliances, and countless rounds of proposals, lobbying, and revisions, the Pandemic Agreement was finally adopted and launched during the 78th World Health Assembly held in Geneva in May 2025. The agreement was the product of extensive dialogue, broad consensus, and the continuous exchange of comments, interests, and critiques among all concerned countries. It aims to strengthen the global response to pandemics by ensuring equitable access to vaccines, treatments, and diagnostics. Most importantly, the agreement explicitly respects national sovereignty by affirming that WHO will not have the authority to impose mandatory policies or measures on any country—thereby establishing a solid foundation for mutual respect and genuine partnership.

The dialogue between the North (wealthy countries) and the South (low- and middle-income countries) has long been central to global development discussions. However, in the health sector, this dialogue becomes more sensitive and complex, as it relates directly to human lives. While the North—including countries with advanced economies—possesses vast financial and technical resources, the South—comprising developing and least developed countries—faces accumulated challenges, including weak health infrastructure, shortages of trained personnel, epidemic burden, and disproportionate impacts from global crises.

With widening disparities between countries, especially in the aftermath of the COVID-19 pandemic, it has become clear that health security is no longer a domestic issue but a shared global responsibility. This calls for a more balanced dialogue and planning process between North and South. However, this path is far from smooth. It is fraught with political, economic, and sometimes cultural challenges that can hinder the development of equitable, non-dependent partnerships.

One of the main challenges lies in the imbalance of power within this dialogue. Often, health initiatives from the North come with conditions or are driven by the North's priorities, with insufficient attention to the specific contexts and needs of the South. This results in unsustainable programs or temporary solutions that fail to generate long-term impact.

On the other hand, some Southern countries face weaknesses in health governance and lack clear mechanisms to negotiate or influence the international cooperation agenda. Disparities in research capacity and challenges in data collection and analysis further limit these countries’ ability to present evidence-based visions and solutions.

Despite these challenges, there are real opportunities to elevate the health dialogue between North and South—if built on knowledge sharing, experience exchange, and a recognition of the value of local communities. In fact, some Southern countries demonstrated flexibility and effective responses that outpaced their Northern counterparts during recent health emergencies, proving that solutions are not the monopoly of any one region.

Advancing this dialogue requires a fundamental shift in the philosophy of global health cooperation: from a logic of aid to a logic of partnership, from top-down directives to joint planning. It is equally essential to support the creation of regional platforms that amplify the voice of the South, consolidate successful experiences, and position Southern countries as active stakeholders—not merely recipients.

In conclusion, while the road to a fair and effective health dialogue between the North and South remains long, it is by no means impossible. By acknowledging shared challenges, respecting unique contexts, and fostering mutual trust, this dialogue can become a powerful tool for improving health and well-being for people everywhere.