A new commentary in Nature Health, led by Professor Caesar Atuire, Co-Director of Oxford Global Health, and co-authored with an international group of global health experts, argues that the current transactional phase of global health demands a shift from rhetorical to actionable solidarity.
The authors describe a shift away from cooperation based on shared commitments to improving health for all, towards a model increasingly shaped by geopolitical competition, conditional partnerships, exchange and strategic interests. They argue that this transactional approach risks eroding trust, entrenching inequalities and weakening the collective capacity needed to tackle health challenges that cross national borders.
Against this backdrop, the commentary considers what solidarity should mean in practice. Drawing on research and engagement across five continents through the Global Health Solidarity Project, it introduces a nine-article ‘3-3-3' framework designed to help embed solidarity in global health funding decisions. Developed through workshops, interviews and webinars with community leaders, activists, academics, civil society organisations, national and multilateral health actors, and funders, the framework defines what solidarity is, how it can be enacted, and the ends it should serve: health equity, fairness and justice.
The authors argue that solidarity is more than goodwill or charity. Unlike transactional forms of cooperation based on an expectation of return, solidarity requires action, meaningful participation and attention to power asymmetries. This includes efforts to redistribute decision-making authority and address the structures that perpetuate unequal access to resources, knowledge and care.
The commentary concludes that the question is no longer whether solidarity is needed, but whether it will be institutionalised across global health governance, financing and accountability in an increasingly fragmented global health system.
Read the full commentary in Nature Health: Solidarity is essential in a more transactional global health era.