Canada should seize the opportunity to lead on global health challenges and cooperation

In the past two years we have been involved in an expert panel convened by the Royal Society of Canada and the Canadian Academy of Health Sciences on Canada’s past and future global health role. Our report, published on 27 March 2025, aims to provide strategic insights and advice on Canada’s role in global health for the next two decades.1 The need for global leadership in health is clear: growing economic and climate threats, divisive politics, backlash against human rights, and powerful waves of misinformation threaten past gains in global health and cooperation. As we enter a new era shaped by isolationist geopolitics and the US retreating in global affairs, Canada’s role as a middle power, actively engaged in multilateralism, is more important than ever.2

Greater clarity around Canada’s global health role is also relevant to current domestic affairs. The new leader of the Liberal party, Mark Carney, was appointed as the country’s prime minister in March 2025, after the resignation of Justin Trudeau. A federal election will take place on 28 April 2025, which might shift the country’s political leadership and open debates about Canada’s place in the world—including its foreign policy and aid investments. Recent data show that Canada is among the largest funders of global health among Organisation for Economic Cooperation and Development (OECD) countries.3 Canada’s future foreign assistance is uncertain,4 but there is also much opportunity.

Lessons from the covid-19 pandemic support an expanded global leadership role for Canada. The BMJ highlighted in its series on Canada’s pandemic response that future domestic and global health preparedness are interlinked and depend on better data sharing, federal-provincial coordination, and attention to the equity of marginalised groups;5 findings confirmed by other reviews.6 Drawing on this context, our report lays out seven recommendations for Canada to advance domestic and global health together, not as trade-offs, but as mutually dependent policy goals.

We argue that global health cooperation extends beyond providing healthcare services alone. It must include building equitable universal health systems, which are centred on women and primary care. Canada should continue to champion and advance maternal and child health globally as it has in the past two decades through its major investments in the Muskoka Initiative, the Global Financing Facility, and a Feminist International Assistance Policy.7 We recommend leveraging the domestic commitment made in 2024 for free contraceptives across Canada,8 to a global commitment when Canada assumes the G7 presidency in 2025.

Additionally, we recommend that Canada advance a One Health approach to global health security. This would develop preparedness for future health emergencies and value sustainability and equity, leveraging the expertise and experience of Indigenous peoples in Canada where holistic and intergenerational perspectives and knowledge systems closely connect the health of the human, animal, and environment. A further strategic opportunity is revitalising Canada’s historical focus on health promotion—dating back to the 1986 Ottawa Charter—with stronger focus on the commercial determinants of health (until now neglected by Canadian global health investments) and the opioid crisis (which is harming populations at home and abroad).

Workforce in clinical, public health, policy, and research is a critical resource for health. Yet virtually every country in the world is facing a health workforce crisis spanning domestic and global policy frontiers.9 Canada’s approach to its crisis needs to change. The country’s health worker shortages are currently being plugged by a growing reliance on internationally educated health workers who now constitute nearly 15% of the country’s health workforce.10 By not paying for the training of these workers, Canada avoids more than C$1bn (£500m, €600m, $700m) in training subsidies annually, more than half of what it spends on development assistance for health annually. Although these health workers are much needed, recruitment from other countries risks breaching the World Health Organization Code of Conduct for Ethical Recruitment of Health Workers.11 Again capitalising on its G7 presidency, we recommend that Canada establish and convene a global commitment and goal of achieving net zero poaching by 2035.

To engage leadership across these dimensions, we recommend that Canada develop a global health strategy convened by a newly appointed global health ambassador. Among similar high income countries, Canada is the only country other than Italy that lacks a federal global health strategy. This weakens the country’s focus and return on investments. We, therefore, support others in calling for a coherent strategy that has vision, governance, resources, monitoring, and key priorities for federal, provincial, territorial, and Indigenous governments.12 We also recommend that Canada articulate a research and innovation blueprint to complement the global health strategy that incorporates rapidly evolving health technologies.

We hope colleagues across Canada’s global health community and those working in areas of international health and diplomacy that are counting on Canada’s renewed commitments to multilateralism engage with and take forward our recommendations in their respective research, policy, and advocacy communities.