On World Health Day 2025, the theme is healthy beginnings, hopeful futures. In light of increasing development sector spending cuts, Susan Mackay – Health Expert at Acasus – gives her thoughts on how the health community can still take strides forward for citizens.
This year's theme for WHO's World Health Day, 'healthy beginnings, hopeful futures', lands at a time of great disorientation for global health and development. With cuts and development sector priorities realigning, it is easy to feel like we are walking into a hurricane. But from where we stand at Acasus – deeply embedded in government systems, and walking shoulder-to-shoulder with leaders, frontline workers, and local communities – we see hope. Not blind optimism, but something more powerful: possibility thinking.
As the conductor and leadership coach Benjamin Zander puts it, possibility thinking is not about denying difficulty or clinging to superficial positivity. It is about making a conscious decision to believe that change is possible. At Acasus, we believe that hope begins when brave change becomes real – and 'brave change' is what has inspired us to strive for change over the past 12 years.
Courage in complexity
Across some of the world's most complex health and governance contexts – from Pakistan to the DRC, or Afghanistan to Ethiopia – we have seen firsthand how progress is not born from perfect conditions, but from imperfect people making brave decisions in the face of challenging circumstances.
We have learned that when we use data wisely – not too much, not too little, but just enough – it gives leaders the courage to act. We have seen how dashboards that highlight the right indicators can sharpen focus and unlock energy and motivation. We have seen how adaptive leadership, grounded in real-time problem solving, can outpace top-down directives wired to the status quo. And we have witnessed the profound impact of coaching and mentoring in building the confidence and capability of health leaders who must navigate bureaucracy, politics, and pressure every minute of every day.
But perhaps most importantly, we have seen how embedding a team inside government – not just advising from the outside – can help aspirational public sector visionaries, modernisers and innovators travel the long road of change. When we show up consistently, listen deeply, and 'walk the walk' with our counterparts, transformation begins to feel possible. And in parallel, we are increasingly partnering with citizen-led organisations to amplify citizen voices and develop the leadership of those who will ultimately create and sustain the change.
Immunisation as a foundation of hope
As we approach World Immunization Week later this month, we are especially proud of the work Acasus has done to help governments deliver life-saving vaccines to children and families.
In Pakistan, our close partnership with government stakeholders over several years led to one of the fastest increases of immunisation coverage ever recorded. Through the smart use of data, real-time tracking, and improved health worker performance, the government and partners reached millions of children who had previously been missed.
This work is now expanding across broader primary health care systems, from maternal health to early childhood care, with the same belief: if we can build primary care systems that work right from the start of life, we build stronger foundations and hope for the future.
From divergent thinking comes clarity
One of the ways that Acasus adds value is by bringing divergent thinking into the practical implementation space. Where others see overwhelming complexity, we search for the relatively simple – those few leverage points that can unlock systemic change. We believe that when we focus on what truly matters, clarity emerges.
This mindset has allowed us to support leaders as they make bold shifts in strategy, culture, and delivery – despite political instability, resource constraints, and at times, open hostility to reform. Our sharpest learning? Even in uncertainty, the combination of grounded data, courageous leadership, and embedded support can literally move mountains – and systems.
Hope, not as a luxury – but a strategy
While we do not downplay any of the difficulties of recent funding cuts or the shock and exhaustion felt across the global health sector, we believe that these challenges can become catalysts if they force us to rethink our approach. Hope is not naive. It is a leadership strategy.
Healthy beginnings are not guaranteed – but they are possible. And from healthy beginnings, hopeful futures emerge for children vaccinated against preventable disease, mothers receiving respectful care, and communities involved in making decisions about their health systems.
On this World Health Day, we at Acasus are doubling down on brave change. Because possibility thinking, combined with smart action, still has the power to move even the most formidable peaks and entrenched systems.
And if we connect with data, people, and our purpose, then even in the most difficult of moments, we will find the resources and reasons to believe.
Healthy beginnings, hopeful futures. Let's make them possible – together.
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References:
• "Life lessons from Beethoven's Symphony No. 9" TED Talk by Benjamin Zander, April 2023.
