Has your resilience ever been fractured?
Do you yearn to express solidarity in a pragmatic way?
Have you signed an MOU? (Or even heard of an MOU?)
These sentences contain some of the buzzwords likely to be relevant in the world of global health and development in 2026 according to our informal survey of 20 experts who work in the field.
Their nominations reflect the past year of unprecedented change. The United States dismantled the United States Agency for International Development, terminating billions of dollars in aid. Other Western nations have cut foreign aid as well. Then there are the ongoing crises from climate change and conflict along with the threat of disease threats.
Here are the words and phrases that could be buzzing in the world's ears this year.
Fractured resilience
Resilience, of course, is a trait that everyone wants: The ability to face adversity and stand firm, triumphing over obstacles.
Unfortunately, resilience is as vulnerable as our bones. And in the 21st century, resilience will face mounting challenges.
Here's one example.
Nishad Jayasundara has been traveling to his homeland of Sri Lanka to research chronic health conditions for nearly a decade now. He's an assistant professor of Global Environmental Health at Duke University who's been looking at a rise in kidney disease among men who work as farmers and manual laborers. He says that the heat triggered by climate change, as well as pesticide exposure, are two big reasons for this.
Then Cyclone Ditwah hit in late November. Record rainfall created floods that washed away medical equipment and beds at health centers in Sri Lanka. Clean water for kidney dialysis was unavailable – and delays in dialysis "can mean the end of life for somebody, right?" says Jayasundara. The disaster "essentially halted all health care provisions in some of these places."
Jayasundara calls this an example of fractured resilience — when a series of unfortunate events halts the ability to serve those in need.
The medical issues he is focused on are not confined to Indonesia — kidney disease is also on the increase in parts of South America, Southeast Asia and East Africa.
And in a world of reduced foreign aid, help is not necessarily on the way.
So what's the solution to fractured resilience? The answer is our next buzzword.
Pragmatic solidarity
The late Dr. Paul Farmer coined the term.
A revered leader in global health, Farmer cofounded Partners In Health nearly 40 years ago — a nonprofit that brings health care to countries with great need.
He described "pragmatic solidarity" as empathy linked with practical action to stop the suffering of others.
Sam Kelts, the manager of grassroots strategy at Partners In Health, explains: True solidarity "is to walk with others, to walk with patients, even when it is inconvenient or uncomfortable for you personally."
The pragmatic piece, Kelts says, is to "use whatever resources or privilege or power you have to respond to the needs that you've heard or seen."
As global health faces "unprecedented challenges, including severe funding cuts, institutional restructuring at the WHO and widening health inequities," Dr. Junaid Nabi says "pragmatic solidarity" is timelier than ever.
Nabi is a disciple of Paul Farmer. Nabi, who grew up in Kashmir, specializes in health care reform and innovation and is a senior fellow at the Aspen Institute and a Millennium fellow at the Atlantic Council.
Pragmatic solidarity can "bridge a critical gap in health policy by insisting that compassion must translate into concrete action that addresses both immediate suffering and its structural causes," says Nabi.
In that light, Leah R. Rosenzweig, director of the Market Shaping Accelerator and senior fellow at the Center for Global Development, calls for "aligning moral urgency with practical incentives." In other words: using prizes and a promise of commitment to purchase innovative new products, like "affordable accurate rapid diagnostic tests" that can identify neonatal sepsis, which causes up to 700,000 newborn deaths a year. That way, she says, "life-saving ideas get built, approved and delivered."
But pragmatic solidarity isn't just a mantra for outside donors. It needs to come from within the countries in need as well, says Dr. Ifeanyi Nsofor of Nigeria, co-founder of the Africa Behavioral Science Network.
"I would like to see leaders in LMICs [low- and middle-income countries] practice pragmatic solidarity themselves, particularly as foreign aid continues to decline. The absence of this kind of leadership is a major reason many LMICs have become so donor-dependent."
MOU (Memorandum of understanding)
A memorandum of understanding is essentially a contract between two parties — and that's the strategy that the Trump administration is championing in this new post-USAID era. The America First Global health strategy is signing MOUs with specific countries to spell out what kind of aid will be provided, how U.S. businesses will be part of the picture and the responsibility of the country involved.
So far, the U.S. has signed 14 MOUs with African countries.
The new model is a sharp departure from the way foreign aid has usually been delivered, which has historically been through nonprofit groups that act as partner organizations, says Rachel Bonnifield, director of the Global Health Policy Program and a senior fellow at the Center for Global Development.
Seeing how this type of agreement plays out in 2026, Bonnifield says, will be one of the major stories in global health.
The old aid system has been sharply criticized for its failure to create a path for the recipient country to sustain health interventions. "In some ways, this idea of funding governments more directly is a bit of an overdue reform," she says.
Yet there are risks to the MOU model. This change has happened "very quickly and without much of a transition path," Bonnifield says. She adds that it's not clear what the recourse is, if any, if countries don't meet all the rules and regulations involved. "It's very challenging to set up major HIV programs and malaria and TB programs from nothing within a couple of months," she notes.
Zero-dose children
This term is not new but is a growing concern.
The most recent data from World Health Organization (WHO) and UNICEF estimates there were roughly 14.3 million zero-dose children around the world in 2024 — meaning they did not receive any routine vaccinations. They may live in remote or impoverished areas or their families may be nomadic and thus not able to easily access health care. And they often live in a conflict zone.
Majdi Sabahelzain, a research fellow at the University of Sydney's School of Public Health, gives the example of his home country of Sudan. "We have seen there is a sharp decline in vaccination coverage since the eruption of conflict in April 2023, till now," he says. The number of zero-dose children in the region in 2024 is more than double what it was in 2019, a rise from 800,000 to 1.8 million.
A UNICEF report points out that the conflict has led to multiple outbreaks of polio and measles in Sudan. In a measles outbreak from June 2024 to May 2025, the aid group Doctors Without Borders says that it treated nearly 10,000 patients, with 2,700 severe cases and at least 35 deaths.
The WHO has issued an immunization agenda that aims to halve the number of zero-dose children by 2030.
Disease X
That's the placeholder that scientists use for a yet undiscovered pathogen that could cause the next pandemic.
WHO adopted the term in 2018 as a way to spur thought and preparation about how the world can keep an eye out for … Disease X … and be ready with diagnosis and treatment sooner rather than later. In 2026, it'll still be a buzzword as disease watchers worry about emerging crossover viruses from the animal kingdom.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, isn't exactly optimistic about battling any future Disease X. Compared to 10 years ago, "the technology that we have [to sequence and respond to emerging viral threats] is much higher," he says. "But I wouldn't say we're any more prepared."
"We have all of these [known] threats that are being mismanaged, like measles, like avian influenza, let alone Disease X," Adalja says. The growing distrust when it comes to public health is another factor that can "magnify the ability of a Disease X to take hold."
Decolonization … or …. localization?
In the wake of the disruption of global health aid in 2025, different experts offer different buzzwords for the year ahead.
Some, like Dr. Chris Beyrer, who directs Duke's Global Health Institute, propose "decolonization." That's because wealthy countries have not only a history of supporting health programs in low- and middle-income countries, he says, "but also have a big say in how they were implemented." That practice, says Beyrer, "was maintaining, in some ways, a colonial power structure."
"Well, global health just got decolonized, really overnight," he says. With a pullback in both donations and involvement from the U.S. and other Western countries, Beyrer thinks that "for many governments, it's going to feel like a step toward autonomy and national ownership."
Aunchalee Palmquist thinks the buzzword for the year ahead should be "localization." That's a "mechanism by which decolonization can happen," says Palmquist, an associate professor of the practice in global health and cultural anthropology at Duke's Global Health Institute.
She explains that localization starts with asking: "How do we rebuild a system of global health that's more equitable, that really brings in [local] partners and rebalances power dynamics so the people experiencing the most negative health impacts are the ones leading the charge for the solutions?"
Readers: Do you have a buzzword to propose for the year ahead for the world of global health and development? Send your nomination (and contact info) to globalhealth@npr.org. We may use your contribution in a follow-up article.
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