Skills for a changing world: lessons on global health leadership and management

Changes in the global health landscape- including technological advancements, waning budgets, emerging diseases, war and conflict, shifting political agendas and scarce resources—present complex challenges to achieving the global goals of a healthy population and planet. Public health practitioners must be equipped with a broad range of skills to solve problems through their leadership and vision. But successful coordination of efforts to address today and tomorrow’s pressing health issues requires more than just strategic vision; leaders must know how to navigate risks, manage change, and inspire action, despite uncertainty. Leaders must often coordinate responses, measure progress, and mitigate setbacks, all while instilling trust, and motivating and inspiring others to share their vision.

The 10 articles published in this special edition are case studies from around the world which highlight the basic principles of leadership and management across diverse settings, providing examples of common challenges in global health, especially in fragile states or low-resourced settings (1-10). Each article presents a unique case study that brings the key principles of global health leadership and management to life, offering real-world insights into how leaders and managers in the field have navigated complex challenges to achieve their goals. The cases span a range of regions from the Middle East to Africa to Asia and the Americas. They also cover a range of health issues and organizational contexts, and diverse leadership and management styles and approaches, from grassroots mobilization to high-level policy negotiation. They provide real-life examples of the main tenents of leadership in the field, helping to illuminate the strategies and skills that maximized the likelihood of success. This collection reiterates that successful project outcomes often result from a combination of scientific knowledge along with individual characteristics of the leaders themselves. From an analysis of the origins of one of the most successful examples of a large-scale global health programs ever created (PEPFAR) to an exploration of the efforts of local grassroots advocacy organizations, the cases provide blueprints of how to overcome barriers commonly faced in the real-world public health practice.

For example, the importance of collaboration is highlighted by several cases. The article by the Eltayeb and the team at United Nations International Children’s Emergency Fund (UNICEF) outlines the strategies used to increase uptake of vaccination rates through a human-centered design and close collaboration with the community (10). Incorporating communities in the program design and decision-making fostered an increased sense of empowerment and ownership, which improved the program results. Another example is the case by Garzon-Villalba about Plan Fenix in Ecuador, which outlines the many efforts to resolve difficult logistical situations to vaccinate hard-to-reach populations during the coronavirus disease 2019 (COVID-19) pandemic, demonstrating the importance of political commitment combined with public and private collaboration and community engagement (9).

Several cases also call attention to the importance of diplomacy and negotiation skills in global health leadership. This includes the case about ending child marriage in California by Withers and Ngalo (4), and the case on the development of PEPFAR by Andrews (8). These cases serve as reminders that leaders must be adept at uniting and resolving conflicts among many stakeholders, with often competing priorities and agendas.

The cases also illustrate that effective projects are not just about planning; they require careful execution and accountability. The ability to translate a vision into operational realities is key, as leaders will be required to consider the most efficient use of funding, workforce and other resources, and the local cultural context. Several cases also describe the importance of a thorough understanding of the local macro context and careful tailoring of programs to address the barriers faced in that unique setting. This includes the paper by Nguyen et al. on strategies used by Alive and Thrive to provide breastfeeding support in healthcare facilities in Vietnam (5).

Several cases also discuss efforts to increase local capacity amongst the health system, including the workforce, to meet local healthcare needs. The Challenge Initiative, a program tasked to scale-up family planning interventions in more than 200 cities in 13 countries, provides important lessons on leadership and management as discussed in the paper by Rimon, Mirano, and Lokko (7). Another example is the case by Jumbam et al. discusses “The Global Surgery Advocacy Fellowship”, which has trained global surgeons across the globe to improve access to surgical care through skills building, mentorship, and advocacy projects (3). The case by Muhula et al. also describes an innovative way to monitor program impact- through social return on investment- of a program to train the health workforce in South Sudan (2). Whether it is an emergency response to a crisis such as a natural disaster or pandemic, or managing a health workforce, these examples highlight the difficult decisions that leaders often face on how to prioritize scarce resources and some innovative examples of ways to build capacity at local levels to address meet local healthcare needs under challenging financial constraints.

Finally, some of the cases also remind us that more work needs to be done, providing important recommendations on how to address human rights issues still faced by vulnerable populations. This will require them to uphold important values, such as ethical decision-making, a respect for diversity and individual differences, and commitment to equity and human rights. For example, the case by Gopalan, Tong, and Low about refugees and asylum-seekers in Malaysia helps to illustrate the challenges faced by undocumented persons seeking healthcare services (1). The case by Irarrazaval et al. analyzes the leadership and governance approaches that have been effective in strengthening mental health systems in Latin America, which also reminding us that increased efforts are needed worldwide to address rising mental health concerns (6).

This collection is intended for students, professionals, policy-makers and others who are interested in learning what skills, competencies, and characteristics are required to lead and manage in global health. These valuable lessons Intended to be used to foster critical thinking and problem-solving and each article concludes with a set of discussion questions to spark further dialogue within a classroom or training setting. The cases encourage readers to reflect upon the leadership and management lessons illustrated, empowering readers to translate their knowledge and skills into a real-world setting. Learning from the experiences of leaders in the field—from United Nations (UN) agencies to governments, non-governmental organizations (NGOs), and researchers—can be extremely powerful. Understanding the theoretical aspects of management is crucial. However, the practical application of this knowledge on the ground and within communities is also essential. The articles analyze the practical skills needed for working in complex health environments and with challenging topics ranging from pandemic preparedness to mental health to infectious diseases. The cases serve to remind us that technical expertise must be combined with other key skills such as collaboration, intercultural communication, and a commitment to empower others to reach their full potential.

Acknowledgments

None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Public Health and Emergency for the series “Case Studies in Global Health Leadership and Management”. The article did not undergo external peer review.

Funding: None.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://jphe.amegroups.com/article/view/10.21037/jphe-25-26/coif). The series “Case Studies in Global Health Leadership and Management” was commissioned by the editorial office without any funding or sponsorship. M.W. served as the unpaid Guest Editor of the series and serves as an Editor-in-Chief of Journal of Public Health and Emergency from July 2025 to June 2027. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

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4. Withers M, Ngallo J. Leading the fight against child marriage: a review of strategies and skills employed by The California Coalition to End Child Marriage. J Public Health Emerg 2025;9:40. [Crossref]
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Mellissa Withers