A Game Change in Global Health: The Best Is Yet to Come.

Health will continue to gather strength as a global public domain if it links itself strategically with other transnational agendas and strengthens its political ability to produce global public goods for health. Three new political spaces offer opportunities to take the global health agenda a significant step forward: the emerging new development paradigm, the post-2015 debates at the United Nations and the dynamics created through the increasing trans-border health challenges the World Health Organization (WHO) must deal with under conditions of globalization. Presently there are concerns whether the major initiatives that have boosted global health in the last 20 years will continue to grow and attract sufficient funding. But the more pertinent question is whether they are still suited to address the major concerns global health faces between now and 2030. In addition many of the global health challenges can only be addressed through actions in sectors other than health and by facing the inherently political nature of health as well as strong opposition from parts of the private sector. A well-financed and rules based governance system - adapted to complex multilateralism - is needed to manage, complement and integrate the many issue-based initiatives. The next era of global health will be judged by its political capacity to ensure global health security, build universal health coverage, address the commercial determinants of non-communicable diseases and reduce global health inequalities. This will require a focus on producing global public goods for health (GPGH) through strong international organizations, in particular the WHO, supported by governments who have the political will and the institutional capacity to practice smart sovereignty, reach beyond the heath sector and engage with non-state actors. © BioMed Central London 2013.