As old powers retreat, the Gulf steps up in global health

As the 78th World Health Assembly gathers this week in Geneva, global health funding and governance are at an inflection point. For decades, Western donors — particularly the US — have dominated the agenda. That era is ending.

In the opening days of President Donald Trump’s second term, executive orders again withdrew US support for the World Health Organization’s core budget, slashed funding for pandemic preparedness and prohibited federal agencies from collaborating on climate-linked health research. These reversals reopen vulnerabilities exposed by COVID-19, even as new global threats — such as pandemics, antimicrobial resistance and climate-driven illness — grow more urgent.

The retrenchment runs deeper. The UN’s AIDS program recently announced cuts of up to 50 percent in staffing and country coverage. Memos circulating within donor circles hint at a larger reshuffling of global governance — including in health. And yet, for all the institutional uncertainty, global health remains indispensable. Strong health systems are not just a moral imperative — they underpin sustainable development, economic stability and geopolitical resilience.

Health spending already represents about 10 percent of global gross domestic product. But more than half the world’s population — about 4.5 billion people — lack access to basic services. For pandemic preparedness alone, the funding gap remains at an estimated $10.5 billion annually, much of it in low- and middle-income countries.

Amid this leadership vacuum, a new axis of influence is emerging from an unexpected quarter: the Gulf.

Gulf Cooperation Council countries are not merely stepping into a donor role — they are reshaping what global health leadership looks like in a multipolar world. With capital, coordination and strategic clarity, nations like the UAE and Saudi Arabia are moving from the margins to the center of the global health architecture.

In March, the Mohamed Bin Zayed Foundation for Humanity launched in Abu Dhabi with the goal of reaching 500 million people across Asia, Africa and the Middle East. The foundation, building on the UAE’s earlier work through the Reaching the Last Mile initiative, focuses on system strengthening, innovation and measurable impact. Its benchmark for success is lives saved — not dollars pledged.

That same mindset underpins the Beginnings Fund, an initiative backed by the UAE, the Gates Foundation, Delta Philanthropies and others, which aims to prevent 300,000 maternal and newborn deaths across 10 low-income countries by 2030.

These are not abstract commitments. They represent a deliberate shift away from bureaucratic, process-heavy aid toward outcomes-based, data-driven investment in health systems.

The Gulf is also establishing itself as a convening force in global health diplomacy.

GCC countries are not merely stepping into a donor role — they are reshaping what global health leadership looks like in a multipolar world. 

Matthew Miller

Saudi Arabia has quietly become one of the WHO’s most important contributors. Since 2018, it has donated more than $385 million, supporting health operations in conflict-affected regions including Palestine, Ukraine, Somalia, Syria and Yemen. The Kingdom ranked among the WHO’s top 20 donors over the past six years and was the fourth-largest contributor to thematic funds in 2022-23.

In February, Riyadh hosted the International Humanitarian Forum, where Saudi Arabia reaffirmed a $500 million commitment to UNICEF and the Global Polio Eradication Initiative. This was more than symbolic. It was a signal of strategic intent.

Abu Dhabi, too, has become a focal point for global health discussion. Its annual Global Health Week convenes government officials, health ministers, CEOs and scientists to discuss topics ranging from artificial intelligence to antimicrobial resistance and sustainable life sciences investment. This year’s event featured 13 health ministers, several major pharmaceutical firms and the visible presence of UAE sovereign wealth funds — all aligned around a vision of preventive, precision-based and tech-enabled health systems.

The WHO will this week debate revisions to the International Health Regulations and new rules on pandemic preparedness. What the moment calls for is not just more funding — it is a different kind of leadership.

The GCC countries are not alone in seeking a more inclusive, representative global health order. But their model — rooted in delivery, backed by capital and framed by a pragmatic, forward-looking vision — is gaining traction, particularly among countries that have long felt marginalized by legacy institutions.

These nations could host a WHO collaborating center or convene a permanent South-South forum to help redistribute governance power. They are already taking action. Through the G20, Saudi Arabia has supported the WHO’s digital health strategy, workforce development programs, vaccine certification systems and campaigns to combat health misinformation — many of them shaped by lessons from the COVID-19 response.

The UAE, meanwhile, played a leading role during COP28, hosting the first-ever Health Day and advancing a joint declaration linking climate and health policy. The country is investing in early-warning systems, genomics and the training of a new generation of global health diplomats. These are not vanity projects. They are the building blocks of a new system — one oriented around results, not rhetoric.

The retreat of traditional donors leaves not only a gap, but a chance to build better. The Gulf model — regional capital, measurable outcomes and an openness to innovation — offers a new template, one that could be adapted well beyond the region.

As ministers and delegates meet in Geneva this week, they will debate how to future-proof global health. But in many ways, that future is already unfolding — in Abu Dhabi, Riyadh and beyond. The question is no longer whether the Gulf is rising in global health. It is whether the rest of the world is ready to keep pace.

• Matthew Miller is a Board Member and Vice Chair of the Maryam Forum Foundation (UK). He advises clients at the nexus of policy, strategy and communications. Miller is also a Senior Managing Director at Teneo. Previously, he was the Managing Director of Richard Attias & Associates, a Global Leadership Fellow at the World Economic Forum, and a management consultant at Oliver Wyman. He holds degrees from Brown University, the Yale School of Management and the London School of Oriental and African Studies.