Converging crises demand major pivots in global collaboration to protect vulnerable women, children, and adolescents

As conflict, climate change, and economic instability converge into a global “permacrisis,” leading health experts and policymakers gathered for a PMNCH High-Impact Dialogue to issue an urgent warning: the traditional humanitarian response is no longer enough to save the world’s most vulnerable. 

The webinar, titled “Lifelines in Crisis: Prioritizing Women’s, Children’s, and Adolescents’ Health,” highlighted a sobering reality that more than 50% of all maternal and child deaths now occur in fragile and conflict-affected settings. Experts argued that the international community must pivot from reactive, "top-down" aid toward a model of health sovereignty, where local systems are empowered and financed to maintain essential services. 

The heavy toll of the permacrisis 

The dialogue opened with a stark look at how the intersection of war and environmental collapse is undoing decades of progress. Beyond the immediate violence of conflict, the climate crisis is now a primary driver of pregnancy complications, preterm births, and stillbirths. 

Zulfi Bhutta, Co-Director of the SickKids Centre for Global Child Health, emphasized that the damage to children and adolescents in these zones is not just physical but generational. He noted that displacement and the breakdown of health infrastructure create long-term developmental scars that require a shift toward building resilient, rather than just reactive, systems. 

“Never has there been such an acute crisis with such a large proportion of the world's children living in complex crises, in conflict settings... And these are children who are not only affected by the acute consequences of living in conflict zones, mortality, deaths due to trauma, but also egregious mental health consequences, and developmental consequences,” Zulfi Bhutta.   

Lale Say, Unit Head, Sexual and reproductive health integration in health systems, World Health Organization, also noted the challenges in maintaining maternal health services amid instability. The recent WHO technical brief offers analysis as to why pregnant women living in certain countries are more likely to die in childbirth and provides case studies of how frontline teams are working to maintain maternal health services in Colombia, Ethiopia, Haiti, Myanmar, Papua New Guinea, and Ukraine. 

Given the increasingly volatile geopolitical situation across the Eastern Mediterranean region, Khalid Sideeg, Regional Adviser for Newborn, Child and Adolescent Health, WHO EMRO, explored how practical strategies, including enhancing country leadership, decentralization of services, and prioritizing evidence-based interventions for WCAH, have proven most effective to ensure continuity of care in complex crises. 

Moving toward health sovereignty and accountability  

A central theme of the discussion was the concept of health sovereignty, the ability of a nation and its local communities to define and fund their own health priorities. Flavia Bustreo, Vice Chair of the Fondation Botnar Board, argued that relying on volatile external aid cycles is a recipe for failure in a world of tightening fiscal space. 

The panel discussed how innovative local financing mechanisms can shield Sexual and Reproductive Health and Rights (SRHR) and maternal care from being treated as ‘add-ons' during emergencies. Agnès Soucat of the Agence Française de Développement (AFD) highlighted the need for countries to align climate and humanitarian funding to maximize ‘co-benefits,’ ensuring that a dollar spent on climate resilience also strengthens the local community health facilities, which can deliver a significant proportion of SRMNCAH services.  

Maria Guevara, International Medical Secretary, MSF International, reminded the forum that innovation cannot replace political will. She called for greater accountability when health needs are systematically neglected and when healthcare workers themselves come under attack. 

“There is an urgent need to look at metacrisis situations, at the broken human systems that are driving crises today, and look at it from the interdependent and ecosystem approach. We have to drive the narrative, reimagine ethical systems that are in equilibrium with earth’s systems,” Maria Guevara. 

Jemilah Mahmood, Professor and Executive Director of Sunway Centre for Planetary Health, noted the Planetary Health approach, which encourages governments, institutions, and private sectors to understand that health is central to economic development, peace, and security. She also noted the role of health workers, as trusted members of communities, in helping push for accountability on climate and health action.  

“We have a very strong voice, we need to use our own agency, we need to start rising and speaking up, and actually demanding accountability,” Jemilah Mahmood.  

Way Forward 

The webinar also highlighted the newly formed PMNCH Cross-constituency Working Group on WCAH in Crisis and Climate Contexts, which aims to provide strategic guidance on partner engagement and cross-constituency efforts to prioritize WCAH in crises and climate contexts, aligned with the 2026-2030 PMNCH Strategy.  

The webinar concluded with a call to integrate WCAH, including SRHR, into the core of humanitarian and climate crisis response.  

In his final note to the group, Rajat Khosla, Executive Director of PMNCH, called for momentum, “to build a sense of urgency and activism in what we do and how we move forward, because there is nothing less expected of us in this time.”