Lived experience and global health architecture reform: from afterthought to cornerstone

Global health architecture reform is underway, and we are worried. In March 2026, WHO called for comments1 on its plan to reimagine global health as part of the UN80 process. The first draft of the framework did little to suggest seizing this moment to address root causes and longstanding issues that hamper the impact of WHO. Our greater concern was the absence of any reference to lived experience as either a principle or a constituent group. Despite indications of the WHO commitment to engagement,2 the framework made no mention of those whom the new architecture is meant to serve.