2026 May 28 Global Consultations Report

Theme: Essential, Not Optional: Strengthening Health Systems to Uphold Health Rights and SRHRJ in Times of Polycrisis 

Introduction

This report consolidates the key discussions, emerging issues, lived experiences, and collective recommendations raised throughout the pre-consultations, learning sessions, and global consultations attended by over 100 organizations and rights advocates from around the world. The global consultations took place from April 21–23, 2026.

This report captures the diverse perspectives and contextual realities shared by participating organizations, movements, and advocates across regions, particularly on how intersecting political, economic, social, and climate crises are affecting health systems and access to sexual and reproductive health, rights, and justice (SRHRJ).

The report also reflects the collective analysis and priorities that informed the development of this year’s May 28 theme and Call to Action. It aims to contribute to ongoing advocacy, movement-building, and cross-movement solidarity efforts toward strengthening equitable, accessible, and rights-based health systems that uphold the right to health for all.

How are political, economic, social and climate crises colliding to undermine our rights?

In 2026, the world is experiencing a polycrisis where overlapping political, economic, social, and environmental crises converge and intensify one another. This is not only reshaping health systems, but systematically undermining the realization of human rights, including the right to health, SRHR, bodily autonomy, equality, and access to life-saving care. It neglects critical areas such as mental health, where under resourced systems fail to provide support and care. These overlapping crises also expose and deepen structural inequalities embedded in global political and economic systems, including legacies of colonialism, extractive economic models, and unequal power relations that continue to shape who has access to health, resources, and decision-making power, and whose rights are routinely denied or deprioritized. 

• Political crises:

This section highlights the risk of health priorities being neglected during political transitions. In 2026, over 40 countries will hold national elections, affecting more than 1.6 billion people globally, presenting both opportunities for progress and risks of further rollback.¹ Anti-rights actors are increasingly coordinated across borders, seeking to capture political and multilateral spaces. In regions like South Asia, some countries have experienced elections and transitions to new governments following youth-led revolutions. These shifts, despite signaling democratic energy,  have resulted in uncertainties in terms of long-drawn policy changes, threatening to push health and SRHR agendas to the sidelines.

• Crises arising  from conflict and geopolitical tensions: 

Across settings affected by conflict, such as Palestine, Sudan, Ukraine, Lebanon, Iran, and the Democratic Republic of the Congo, international humanitarian and human rights law obligations are being severely undermined. Civilians, especially women, girls, and gender-diverse people, face gruesome violations of their rights to health, safety, dignity, and survival. These contexts also reflect violations of the right to be free from gender-based violence, as conflict increases exposure to sexual violence. Forced displacements are happening and health systems and infrastructure, including hospitals and clinics, are attacked, damaged or destroyed, while health workers are displaced, detained, or killed. Access to essential health services, including SRHR services such as contraception, maternal health care, comprehensive care and support for victim-survivors of sexual violence, and safe abortion, is severely restricted, with direct consequences for preventable  morbidity and mortality. Global military expenditure now reaches approximately USD 2.4 to 2.8 trillion annually, significantly exceeding investment in primary health care and gender equality, and reflecting a global prioritization that undermines the right to health.²

• Economic crises:

The persistent underfunding of SRHR represents a failure to fulfill the obligations of the governments under the right to health. Debt burdens, shrinking fiscal space, and market-driven health reforms weaken public health systems and accelerate the shift toward privatized and fragmented, undermining availability, accessibility, acceptability, and quality. Rising out-of-pocket costs and increased taxation to meet the country’s debt obligations further entrench inequality, disproportionately affecting those (women in all of their diversity, people living in poverty, marginalized communities, informal workers)  already excluded from equal enjoyment of rights. Public investment in health, including SRHR, remains chronically insufficient, while militarization, debt servicing, and austerity measures continue to divert resources away from the fulfillment of economic, social, and cultural rights.

• Social crises: 

Attacks against gender equality and bodily autonomy are intensifying. Activists are resisting but civil society organizations and feminist movements, which are essential to the realization of rights through service delivery, accountability, and rights claiming, are increasingly restricted through legal, financial, and administrative measures. Shrinking civic space and rising authoritarian practices further undermine the rights to freedom of expression, association, and participation, all of which are essential to rights-based health governance. The global architecture meant to uphold solidarity and human rights is also weakening. Multilateral reforms, including proposals to merge UNFPA and UN Women, risk diluting mandated responsibilities on SRHR and gender equality, weakening institutional capacity to uphold rights in practice.³ Declining official development assistance (ODA), restrictive funding conditionalities, and shifting geopolitical priorities are further constraining governments’ ability to progressively realize the right to health. Recent data show that ODA provided by Development Assistance Committee (DAC) members and associates fell to USD 174.3 billion in 2025, representing a 23.1% decrease compared to 2024.⁴ 

• Climate and Environmental crises: 

Climate change, recognized by the United Nations as one of the defining crises of our time, further threatens the realization of human rights.⁵ It is accelerating in both scale and severity, driving increased heat exposure, extreme weather events, air pollution, infectious disease transmission, food insecurity, malnutrition, and mental health impacts. These impacts directly undermine the right to health and disproportionately affect marginalized populations, deepening existing inequalities in rights realization. Pollution, toxic waste, rapid and unplanned urbanization, deforestation and resource extraction are not only ecological harms but also direct threats to SRHR and right to health. Toxic air and water pollution is increasing the risk of respiratory illnesses, giving rise to reproductive health complications, and maternal mortality.

As populations concentrate in informal settlements and slums, access to clean water, sanitation, and healthcare becomes precarious. Overcrowding increases risks of communicable diseases, maternal health complications, and gender‑based violence. Women, girls and gender-diverse people in urban poor communities often face heightened barriers to SRHR services including contraception, safe abortion and protection from exploitation, violence and abuse. 

• Economic, Social, Climate, and Environmental crises:

In contexts of austerity and economic instability, conflict, and climate and environmental crises, governments increasingly shift responsibility for health onto individuals and families, undermining governments’ obligation to respect, protect, and fulfill the right to health and reinforcing structural inequality in access to care. These dynamics are rooted in global economic systems that concentrate wealth, reinforce inequality, and limit governments’ capacity to invest in public services and fulfill human rights obligations. They intensify intersecting forms of discrimination, violating the principles of equality and non-discrimination under international human rights law.

Marginalized communities, including adolescents, persons with disabilities, Indigenous peoples, caste- and tribe-affected populations, sex workers, displaced persons, migrants, asylum seekers, refugees, people living with Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), and informal workers, face compounded barriers to realizing their rights to health and SRHR, including dignity, informed consent, and quality care.

Climate-related displacement and economic precarity further erode access to essential services. By 2030, climate change is projected to push an additional 132 million people into poverty, constraining governments’ ability to fulfill economic and social rights.⁶ In humanitarian and climate-affected settings, SRHR services are often among the first rights-based services to be disrupted and the last to be restored, leaving women, girls, and gender-diverse people without critical, life-saving care at the moments they need it most.

• Food scarcity, safety and nutrition crises:

Rising food insecurity, driven by conflict, climate shocks, economic instability, and weak governance, is undermining health and SRHR worldwide. Women, girls and gender-diverse people are often the first to sacrifice meals, deepening gender inequality and exposing them to harmful coping strategies such as early marriage or transactional sex. In Asia and Africa, prolonged droughts and displacement from disasters have left millions food insecure, with pregnant women unable to access adequate nutrition or safe delivery services. In the Pacific Islands, climate‑induced disruptions to agriculture and fisheries have reduced food availability, leaving women and girls vulnerable to malnutrition and limiting access to SRHR services. 

Safe nutritious food is integral to our right to health yet adulteration of food, through contamination, unsafe additives, and poor regulation is a growing threat to health to SRHR. In countries in Asia and Africa and elsewhere, cases of adulterated essentials, including milk and cooking oil, have been linked to malnutrition, reproductive health complications and other chronic illnesses affecting the quality of lives, particularly of those from marginalized communities who lack the purchasing power to buy quality products. Women and children are also disproportionately affected as unsafe food affects pregnancy outcomes, child development and overall bodily autonomy. 

• Digital, mental health, and SRHR crises: 

The polycrisis is not confined to physical systems, it is also unfolding in digital spaces. Digital repression, disinformation, and algorithmic censorship are increasingly restricting access to accurate, evidence-based SRHR information. Human rights defenders face surveillance, harassment, and technology-facilitated gender-based violence, undermining the rights to privacy, safety, and freedom of expression. Civic and digital spaces are therefore becoming contested terrains, where access to rights, information, and participation is actively constrained. 

At the same time, under‑resourced mental health systems fail to meet rising needs, leaving young people especially vulnerable to anxiety, depression, and stigma. These pressures intersect. Digital spaces can both empower and harm, influencing mental health outcomes and shaping attitudes toward bodily autonomy and reproductive rights. For example, across countries in Asia and Africa, young women are increasingly relying on mobile platforms for SRHR information and mental health support. However, in the absence of robust legal frameworks, many face risks of misinformation and cyber‑violence and harassment that exacerbate health challenges and overall wellbeing. 

• Legal and governance crises:

The lack of robust legal frameworks undermines the obligation of the governments to respect, protect, and fulfill the right to health and SRHRJ. Outdated or poorly enforced laws leave communities vulnerable to unsafe practices, discrimination, and denial of services. Weak sexual violence laws, gaps in legislation, and poor implementation of laws meant to end harmful practices perpetuate injustice. In many contexts, close‑in‑age consensual and non-exploitative relationships between adolescents are criminalized, exposing young people to prosecution rather than protection. Laws that fail to address marital rape, that permit child marriage, or that criminalize same‑sex relationships and abortion further erode rights. Without strong legal protections, austerity measures, environmental harms, and social backlash are compounded, reinforcing inequality and eroding trust in institutions. 

What actions are now needed to advance our right to health and SRHRJ in times of polycris?

This moment demands more than mere recognition of the crises and vague commitments. This May 28, we call on governments, global institutions, donors, and all actors of power to move beyond words and act with urgency because true change happens when lived realities, community-led evidence, and collective action shape how systems are designed, financed, and held accountable. 

We demand decisive, collective action from all to confront these intersecting crises, address structural inequalities and reclaim the right to health, and SRHR as a fundamental human right.

Recommendations to funders and donors:

1. Funders and donors on shaping priorities and resource flow to tackle polycrisis

(i) Invest in neglected and underfunded areas of SRHRJ: Increase sustained investment in neglected and underfunded areas of SRHRJ, including menstrual health, midwifery care, endometriosis research and advocacy, and integrated services for people affected by climate change, humanitarian crises, HIV, TB, mental health conditions, and disability. Ensure that research, services, and innovation respond to intersecting inequalities and the evolving needs of crisis-affected populations. Strengthen integrated and person-centered health systems that guarantee continuity of care across the life course, without fragmentation or exclusion. This includes ensuring that all women, girls, and gender-diverse people are meaningfully informed about their options and have access to the full range of evidence-based HIV prevention methods, safe and non-stigmatizing abortion and post-abortion care, and affordable, accessible, and equitable health innovations.

(ii) Provide rights-based, equitable, flexible, and long-term funding: Donors and funders provide direct, flexible, long-term, and core funding for feminist, youth-led, LGBTQIA+, Indigenous, and community-based organizations working on SRHR and health justice and most affected by intersecting crises but remain structurally under-resourced. Provide sustained funding for feminist and social movements, grassroots, last-mile and community led organizations including advocacy, organizing, coalition-building, care work, crisis response, and collective infrastructure. Recognize movements as essential infrastructure for accountability, service delivery, and rights protection in contexts of intersecting crises. 

Recognize and actively protect SRHR defenders, abortion rights activists, acompañantes, and feminist organizations that are operating under conditions of polycrisis, where austerity-driven funding cuts, economic asphyxiation, and defunding restrict their ability to sustain essential SRHR work. End donor complicity in shrinking civic space and ensure funding systems do not expose organizations to heightened risks from criminalization, digital violence, harassment, judicial persecution, and coordinated anti-rights attacks that undermine human rights and health justice.

(iii) Design sustainable funding models: Donors and funders should create quick-response funding mechanisms, supported by a diversified donor and funder base, that are capable of responding rapidly to conflict, climate and natural disasters, and public health emergencies. These mechanisms must ensure continuity of essential services, including SRHRJ, even in crisis contexts. At the same time, funding systems must uphold the principles of local leadership, autonomy, participation, and contextual knowledge. Transform funding models to prioritize equity, decolonial approaches, and the redistribution of resources toward the Global South.

2. Funders and donors to ease access to funding 

(i) Simplify and reform funding processes: Reduce bureaucratic barriers, administrative burdens, and ensure timely disbursement of funds to make funding accessible. Adapt reporting and compliance requirements to be proportionate and accessible, particularly for grassroots, youth-led, and small organisations. Proactively address barriers created by restrictive legal and regulatory environments that limit access to funding, and develop flexible, context-responsive mechanisms to ensure that activists and organisations operating in such contexts are not excluded from critical resources. 

3. Funders and donors to contribute towards the building of resilient health systems

(i) Advance global economic justice and debt relief: Funders and donors must use their influence with global financial institutions to expand fiscal space for health, care, and social protection. Structural drivers such as debt burdens and austerity policies deepen intersecting crises and undermine resilience. By supporting debt relief, rejecting harmful conditionalities, and promoting financing models grounded in equity and rights, funders can ensure governments are able to progressively realize the right to health and SRHRJ, even in contexts of economic instability and compounded crises. Initiatives such as the Debt x Health initiative, of which the Global Fund is a key partner, demonstrate how debt relief can be directly linked to investments in health and serve as critical models that should be scaled, replicated, and made accountable to the communities most affected.

(ii) End all harmful conditionalities and ideological restrictions: Development assistance should be grounded in human rights and equity, not used as a tool of political or ideological control. In times of polycrisis, when barriers to health and justice are already heightened, donors have a responsibility to ensure their funding expands access rather than deepens exclusion, enabling the governments and communities to realize the right to health, SRHRJ. Funders and donors must actively advocate to reverse policies such as the Global Gag Rule that have entrenched barriers and caused lasting harm. Donors and funders can do so by removing all conditions that restrict access to SRHRJ information and services, including abortion‑related restrictions such as the Global Gag Rule.

(iii) Do proactive advocacy: Funders and donors must go beyond reversing harmful restrictions by actively investing in advocacy that strengthens comprehensive SRHRJ services and accountability. In polycrisis contexts, where conflict, climate shocks, economic instability, and public health emergencies converge, this proactive approach ensures accessible, rights‑based funding towards SRHRJ and resilient health systems under the most challenging conditions. 

(iv) Shift accountability toward people, not just funders: Funders must reform funding practices to ensure accountability is directed toward communities and movements rather than solely toward donor priorities, indicators, and reporting systems.

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Notes

¹ Al Jazeera. (2026, January 1). All the big elections to look out for in 2026. https://www.aljazeera.com/news/2026/1/1/all-the-big-elections-to-look-out-for-in-2026 

² Stockholm International Peace Research Institute. (2026, April 27). Global military spending rise continues as European and Asian expenditures surge. https://www.sipri.org/media/press-release/2026/global-military-spending-rise-continues-european-and-asian-expenditures-surge 

³ Fòs Feminista. (2026, January 26). Getting UN80 right: Protecting mandates while improving coordination. https://fosfeminista.org/news-and-stories/getting-un80-right-protecting-mandates-while-improving-coordination/ ‘

⁴ Organisation for Economic Co-operation and Development. (2026, April 9). A historic decline in foreign aid: Preliminary 2025 ODA data. https://www.oecd.org/en/data/insights/data-explainers/2026/04/a-historic-decline-in-foreign-aid-preliminary-2025-oda-data.html 

⁵ United Nations Development Programme. (2018). UN Secretary-General’s climate address. https://www.adaptation-undp.org/un-secretary-generals-climate-address

⁶ World Bank. (2020). Revised estimates of the impact of climate change on extreme poverty by 2030 (Policy Research Working Paper No. 9417).https://documents1.worldbank.org/curated/en/706751601388457990/pdf/Revised-Estimates-of-the-Impact-of-Climate-Change-on-Extreme-Poverty-by-2030.pdf