With a new government in place, Canada must lead on pandemic preparedness

“If the United States does not want to lead, Canada will.”1 These were the comments of Canada’s new prime minister Mark Carney prior to his recent election.

As a leader deeply familiar with global systems and economic resilience, having served as governor of the Bank of Canada and Bank of England, Mark Carney is uniquely positioned to integrate global health security—and the link between global health and the economy—into Canada’s broader vision for international engagement, trade, and national security.

The world is at a critical point in global health governance. Institutions designed to coordinate global health efforts are under increasing strain as major powers such as the US retreat and public trust in multilateralism continues to decline. Canada has an opportunity to fill this vacuum and lead a renewed approach to global health governance, while simultaneously tackling domestic priorities.

We echo the findings of a recent expert panel convened by the Royal Society of Canada and the Canadian Academy of Health Sciences2: Canada is strategically poised to lead in global health cooperation based on its historical and ongoing efforts.3 Rebuilding trust in the global health system requires a government willing to act as a bridge between low and high income countries and between populist pressures and multilateral imperatives.

Global health efforts also have important economic implications. For over a century, governments have worked to balance collective responses to public health emergencies while minimising disruption to trade and travel. The International Health Regulations (IHR), embody this fragile balance.4 Today, this global health security balance is under pressure on two fronts.

Low and middle income countries have long experienced the IHR, serving primarily high income nations.5 Persistent inequities in surveillance capacity, vaccine access, and emergency funding remain unresolved, though being discussed in the current pandemic accord negotiations.6 At the same time, growing populism in high income countries has fuelled scepticism and withdrawal from international cooperation.7 These twin pressures have left the global health system fragile—and populations everywhere increasingly disillusioned and at risk.

Canada can offer a different approach. As a high income country that experienced its own struggles with public trust and misinformation during the covid-19 pandemic, Canada understands the domestic tensions that can undermine global cooperation.8 As a middle power with strong diplomatic ties, it is also well positioned to forge partnerships grounded in mutual respect. With a new prime minister who has experience on the international stage, the conditions are ripe for a renewed leadership role in global health.

There are immediate opportunities to act. Amendments to the IHR—emphasising equity and capacity building—are set to take effect in late 2025.9 Canada can help countries meet their new obligations by providing technical knowledge and assistance, as well as financial support.10

Looking further ahead, Canada must help shape the next generation of pandemic governance. While countries recently reached consensus on a pandemic accord text, the accord must overcome two key hurdles: first, it must be adopted by countries at the upcoming World Health Assembly, and second, countries must work together to develop a fair and equitable system for pathogen access and benefit sharing under the accord.11 Canada must resist pharmaceutical industry influence12 and support the pandemic agreement on both counts.

Canada can lead by example in supporting the World Health Organization (WHO) as it grapples with growing mandates and shrinking predictable funding.13 As a result of the announced US withdrawal, the organisation faces a shortfall of $600m through the end of 2025, and nearly $2bn for its 2026-2027 biennium.14 Amid forced cuts to the organisation, a greater investment in WHO’s institutional capacity would, in turn, allow Canada to play a more prominent role in global health governance.

Canada has chosen a government which values global institutions while many others have recently chosen more populist governments. The Carney government has an opportunity to align pandemic preparedness with key foreign policy goals: diversifying trade, securing the economy, enhancing diplomatic relations, and asserting Canada’s role as a principled, constructive global actor. Canada’s contributions in this regard could serve as a model for other nations.