Protecting health across borders requires strong international institutions, shared rules and sustained cooperation between countries
Public health policies are, above all, policies of protection and of guaranteeing rights. They determine the conditions in which people are born, grow up, live, fall ill, age and die. Decisions about how a healthcare system is organised, what services it guarantees or how diseases are prevented are not merely technical matters: they directly affect the lives and dignity of millions of people.
In a deeply interconnected world, these policies cannot be developed in isolation from what happens beyond our borders. Pandemics, health emergencies, climate change, human mobility and inequalities in access to health care remind us that health threats know no borders, and that no country can protect its population on its own.
That is why defending public health also means defending multilateralism, cooperation among countries and the international institutions that make coordinated action possible. It means supporting an international order based on rules, international law and the recognition of health as a human right.
The Covid-19 pandemic taught us that public health is also a matter of security, equity and trust. The hanta-virus outbreak on the MV Hondius in April 2026 once again confronted us with an extraordinary epidemiological situation, involving people of 23 nationalities and rapidly evolving scientific uncertainty. The response could not be exclusively national. The World Health Organization, European institutions and authorities from different countries had to work together to protect passengers and prevent a localised risk from becoming an international emergency.
Spain assumed an important responsibility at that time. More than 450 professionals, together with numerous public administrations and organisations, worked jointly to make a complex operation possible within just a few days. But this effort was not simply the result of our operational capacity. It was possible because institutions, protocols, rules and channels of cooperation had been built over many years.
That is the value of health multilateralism: it is neither an abstract idea nor an exercise in diplomacy. It is a practical instrument for protecting our societies when challenges transcend national borders.
Multilateralism in practice
The International Health Regulations are one of the clearest expressions of this principle. As a legally binding instrument, they provide a common framework through which countries can prevent, detect and respond to international health risks. Respecting and strengthening them means recognising that, when threats cross borders, cooperation is not optional: it is a necessary condition for protecting everyone’s health.
This commitment is particularly important as the international community works to strengthen the global architecture for pandemic prevention, preparedness and response. Concluding the negotiations on the Pathogen Access and Benefit-Sharing system and bringing the WHO Pandemic Agreement to signature and implementation are essential steps towards a fairer, more effective and more resilient international health system. Spain will put all the means at its disposal to help achieve this objective. Multilateralism can count on the commitment of the government of Spain to work constructively and decisively towards this goal. Only through cooperation, solidarity and a strong commitment to international law can we ensure that the lessons of past pandemics translate into greater protection for all.
From global commitments to national policy
This vision is also reflected in Spain’s own health system, founded on the principles of universality, equity and access to health care. For us, health is a right, and public policy has a responsibility to make that right a reality. Defending this principle means not only ensuring access to hospitals, health centres and healthcare professionals, but also addressing the social determinants that shape people’s health.
This commitment is also reflected in Spain’s Global Health Strategy, which provides a framework for our international action to promote health equity, strengthen multilateral cooperation, and contribute to a more resilient and sustainable global health architecture. Spain’s membership on the WHO’s Executive Board enables us to bring to the international debate priorities that are central to our national health policy: strengthening primary health care, protecting healthcare professionals, promoting equity and prevention, and ensuring universal access to health. In the multilateral arena, Spain seeks to advance the same principles that guide our action at home: strong public health systems, prevention, equity, rights and cooperation.
For Spain, therefore, health multilateralism is not an end in itself. It is a means of building a world better prepared to prevent and respond to health emergencies, while reducing inequalities and safeguarding human dignity. Supporting the WHO, strengthening international cooperation and reinforcing the global health architecture are investments in our collective security and in the right to health.
Health knows no borders. Nor should our responsibility to protect it. Because no one is truly safe if others are at risk.
