Agenda Setting
Formally shapes the global agenda for R&D through joint policy mechanisms endorsed by member states.
Unpacking the Multilateral Architecture for Global Health R&D 2025 Update
Read time: 21 minutes
A complex network of multilateral organizations contributes to the research and development (R&D) and delivery of vaccines, treatments, diagnostics, and other technologies to advance global health.
This resource provides an overview of each organization and how it contributes across five key R&D areas.
Key
R&D Areas
Research and Clinical Development
Directly engages in research and clinical development of new vaccines, treatments, diagnostics, and other biomedical health products.
Financing
Provides substantial financing for basic research and clinical development and/or R&D capacity-strengthening programs.
Regulatory Approval
Conducts or facilitates the regulatory approval of health technologies.
Access & Scale
Supports low- and middle-income countries (LMICs) in scaling up access to health technologies through strengthening their capacity to conduct research, manufacture health products, and procure and implement tools.
Multilateral organizations
Click each row below to expand for more detail. Hover over icons for category names.
Organization
Region
R&D Areas
Specialized technical institution of the African Union (AU), established to support African public health initiatives and strengthen the capacity of public health institutions on the continent to detect, prevent, control, and respond to disease threats.
Research and Clinical Development
Collaborates with private-sector and public-sector partners across the continent to conduct clinical trials. Africa CDC funding could theoretically be used to finance R&D efforts for pandemic preparedness through the African Epidemic Fund, which became operative in 2025; however, little information has been made public on the fund’s expenditures.
Regulatory Approval
Supports the AU’s African Medicines Regulatory Harmonization (AMRH) platform, an AUDA-NEPAD initiative that seeks to create a unified market to foster demand and promote investment in local production and to harmonize and strengthen regulatory processes across the continent to improve product access.
Introduction & Access
Operates strategic partnerships to improve equitable access to health products and strengthen local manufacturing in Africa, including its partnership with the European Union. In response to ongoing outbreaks, Africa CDC provides guidance to facilitate improved product access, such as its list of diagnostics for priority diseases.
Specialized arm of the AU that aims to improve access to safe and effective medical products across the continent and create a regulatory environment for the pharmaceutical industry. As of 2025, 39 out of Africa’s 55 countries have signed or ratified the AMA treaty, binding them to its provisions, and AMA’s inaugural director-general has been appointed.
Regulatory Approval
Aims to harmonize regulations, streamline processes, and bolster laboratory capacities that are crucial to guarantee locally manufactured health products meet global quality standards to ensure the efficient introduction of innovations in the African market.
Technical development agency of the AU that coordinates and implements continental priorities, strengthens member state capacity, and provides knowledge-based advisory. AUDA-NEPAD works across sectors—including science, technology, research, and innovation—and serves as a central coordinating platform linking Africa CDC, the African Medicines Regulatory Harmonization (AMRH) platform, and AMA.
Agenda Setting
Sets continental priorities for science, research, and innovation by providing policy and technical guidance to AU member states and related initiatives like AMRH and AMA to advance Africa’s health innovation agenda.
Regulatory Approval
Supports regulatory harmonization through its leadership of the AMRH initiative, which strengthens national regulatory authorities and promotes convergence of regulatory standards.
Introduction & Access
Strengthens African countries’ institutional capacity to adopt, produce, and scale health products through AMRH and AMA. Promotes regional manufacturing and equitable access to health technologies by mobilizing resources, coordinating partnerships with industry and development partners, and providing technical support for implementation of continental manufacturing and innovation strategies.
Intergovernmental organization of ten Southeast Asian countries that aims to promote economic and security cooperation among its members.
Regulatory Approval
Harmonizes regulatory systems for pharmaceutical products across ASEAN member states, enabling the reduction of trade barriers, collaboration between regulators, and timely access to safe and effective products.
Global nonprofit partnership that brings together public, private, and philanthropic organizations to accelerate the development of vaccines and other medical countermeasures against emerging epidemic and pandemic viral threats. CEPI, in partnership with others, spearheads the 100 Days Mission, the global goal to develop a vaccine against a new viral outbreak with pandemic potential in as little as 100 days.
Financing
Pools funding from public, philanthropic and private donors that invests in R&D projects and efforts to boost manufacturing capacity in underserved regions.
Research and Clinical Development
Directly funds and coordinates R&D of vaccines and platform technologies against priority pathogens with epidemic and pandemic potential. CEPI also supports R&D-enabling activities like epidemiology, advancing international standards for vaccine testing, preparing clinical trial sites, biospecimen sourcing and storage, development of a vaccine adjuvant library, preclinical research models, growing a global network of vaccine testing laboratories, and regulatory strengthening.
Introduction & Access
Supports capacity-strengthening activities of select vaccine manufacturers in LMICs and manufacturing innovations to better enable rapid production and equitable distribution of vaccines during a health emergency. CEPI embeds contractual equitable access obligations into each of its vaccine development funding agreements as an important lever to enable equitable access.
Global non-profit partnership accelerating the early-stage development of innovative products to prevent, diagnose and treat bacterial infections.
Financing
Operates as a pooled financing mechanism, coordinating and leveraging resources from multiple funders (including governments and private foundations) to advance a strategic portfolio of innovative antibacterial products.
Research and Clinical Development
Funds the early-stage development of innovative R&D products to prevent, diagnose, and treat bacterial infections. CARB-X also provides scientific, technical, regulatory, and business support to product developers. As most developers active in early-stage R&D for AMR are small biotech companies or university spinouts, this guidance and support can be critical.
Introduction & Access
Supports work on access, recognizing this needs to begin in early-stage development. All product developers receiving CARB-X funding must produce a stewardship and access plan within 90 days of their product entering pivotal clinical trials, to be updated again upon first regulatory health authority approval and published on the CARB-X website. CARB-X worked with several partners to create the first-ever Stewardship and Access Plan Development Guide to support product developers in producing their plans.
Swiss foundation and global nonprofit dedicated to ensuring equitable access to diagnostics, connecting countries, communities, funders, decision-makers, healthcare providers, and developers to spur diagnostic innovation and make testing an integral part of sustainable, resilient health systems. For more than 20 years, FIND has been at the forefront of revolutionizing diagnostics as a product development partnership, bringing lower-cost, quality diagnosis to those who need it as an essential component of universal health care.
Introduction & Access
In partnership with countries, industry, procurement agencies, and private sector, helps to develop product requirements, tailor testing strategies, generate evidence and support regulatory and policy change to ensure equitable access to accurate, reliable, and affordable diagnostics. Works closely with country partners to support regional manufacturing of diagnostics and provide training through the FIND Academy.
Forum that brings together the world’s seven leading economies to discuss and establish shared priorities for economic development, including on health. Members include Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States.
Agenda Setting
Establishes commitments and shared goals, through the Health Ministerial Meeting, Finance Ministerial Meeting, and Leaders’ Summit, which can influence each nation’s individual investments in health R&D.
Forum that brings together the world’s 20 leading economies to discuss and establish shared priorities for economic development, including on health. Members include Argentina, Australia, Brazil, Canada, China, the European Union, France, Germany, India, Indonesia, Italy, Japan, Mexico, Russia, Saudi Arabia, South Africa, South Korea, Turkey, the United Kingdom, and the United States.
Agenda Setting
Establishes commitments and shared goals, through the Health Ministerial Meeting, Finance Ministerial Meeting, and Leaders’ Summit, which can influence each nation’s investments in health R&D.
Public-private partnership that advances access to new and underused vaccines in low-income countries. It is funded by donor governments and philanthropic organizations and works in close partnership with UNICEF, the WHO, and the World Bank, who hold seats on its governance board, as well as with other private and nonprofit partners and implementing country governments.
Introduction & Access
Provides financial support to eligible countries to procure vaccines and equipment for their immunization programs. By pooling demand across countries, it creates a high-volume, predictable market for vaccines that gives it leverage to negotiate with manufacturers to lower prices. Gavi also operates the African Vaccine Manufacturing accelerator to finance the expansion of the continent’s manufacturing base, and for select diseases, it has also initiated advanced market commitments to incentivize the development of new and improved vaccines that meet country needs.
Innovative financing mechanism that pools funding from governments and philanthropic donors to support LMICs in fighting poverty and inequity by advancing the health of women, children, and adolescents. It is housed at the World Bank and works closely with WHO and other UN agencies, Gavi, and the Global Fund to align financing from these entities with each country’s GFF investment cases.
Introduction & Access
Provides catalytic capital and technical assistance to LMIC governments to develop, finance, and implement health programming, including efforts to introduce and scale up essential health technologies and to improve care for women, children, and adolescents.
International financing and partnership organization that raises funding from government, private, and philanthropic donors to finance performance-based programs, implemented by in-country partners and driven by country-defined needs, to combat HIV/AIDS, tuberculosis, and malaria and strengthen health systems and pandemic preparedness in LMICs. WHO, UNAIDS, and the World Bank hold non-voting seats on the board to facilitate cross-coordination.
Introduction & Access
Supports the distribution and scale-up of treatments, preventative therapies, and other tools. By leveraging its volume buying power through its Pooled Procurement Mechanism, the Fund encourages manufacturers to lower prices, meet global quality requirements, and boost supply capacity. The Fund also adopted a NextGen framework in 2022 to drive equitable access to affordable, high-quality health products by shaping innovation and accelerating new large-scale product introductions. Specifically, the framework includes activities to promote capacity-strengthening for regional manufacturing and drive environmentally sustainable procurement and supply chains.
Multisectoral network of more than 70 countries, nongovernmental organizations, and private-sector actors committed to advancing health security, driving progress toward full compliance with the WHO’s International Health Regulations and other relevant global health security frameworks, and enhancing country capacities to detect, prevent, and respond to infectious disease outbreaks.
Agenda Setting
Facilitates collaboration toward objectives and targets—some of which relate to R&D and access to medical countermeasures—that its members jointly established through Action Packages, which then inform national strategies and activities to strengthen health preparedness. GHSA primarily serves as a body to set agendas, drive collaboration and best practices, and ensure accountability; it is not a substantial direct funder or implementer of health system strengthening activities.
International network of funders investing in research related to new or re-emerging infectious diseases that seeks to improve preparedness and speed up the research response to outbreaks with pandemic potential. It facilitates coordination, information sharing, and guidance.
Agenda Setting
Tracks and analyzes global funding and evidence for pandemic preparedness through its Pandemic Analytical Capacity and Funding Tracker and provides guidance to donors to strengthen coordination for clinical trials through its Funders Living Roadmap for Clinical Trial Coordination.
Regional bank, primarily funded via its member countries, that works to promote development in the Americans and the Caribbean region by providing financial and technical support to member countries and other entities, conducting research and developing innovative solutions to address development challenges, and working with countries and development organizations to channel resources and expertise to the region.
Financing
Finances development projects, including in health technology R&D, manufacturing, and health system strengthening through its IDB Lab.
Introduction & Access
Finances development projects to advance manufacturing and health system strengthening through the IDB Lab, and has a partnership with PAHO to strengthen primary health care and enhance pandemic preparedness across the region.
Autonomous intergovernmental organization within the UN system that promotes the peaceful use of nuclear technology, including nuclear-derived technologies for preventing pandemics stemming from zoonotic diseases.
Introduction & Access
Elevates member states’ ability to identify and respond to emerging zoonotic diseases by providing access to coordinated joint research, training, know-how, expertise, and technology packages that enhance pathogen surveillance and disease diagnostics through IAEA’s Zoonotic Disease Integrated Action initiative.
International financial institution, that is an autonomous entity of the World Bank Group and financed by its member countries, which provides direct investment and advisory services to private-sector, for-profit projects that promote development and poverty reduction in LMICs.
Introduction & Access
Facilitates financing to enable infrastructure and workforce training efforts to support growth in the pharmaceutical sector, expand supply chains for critical raw materials, strengthen procurement systems, boost local manufacturing, enhance diagnosis and treatment capacity, and improve the delivery of health products
Independent, time-limited entity that convenes countries, the private sector, global health institutions, G7, G20, WHO, and CEPI in support of the 100 Days Mission, which aims to fast track the discovery-to-deployment timeline of health technologies within 100 days of the next pandemic threat. It facilitates scientific exchange and monitors progress against the mission.
Agenda Setting
Supports implementation and catalyzes scientific exchange on the progress of the 100 Days Mission to ensure that accurate and approved diagnostic tests, therapeutics, and vaccines are ready to be rapidly produced at scale and deployed.
UN agency that catalyzes and advocates for an accelerated, comprehensive, and coordinated global response to the HIV/AIDS pandemic. UNAIDS helps bring together the HIV-related work of other UN system organizations, including UNICEF, the UNDP, the UNFPA, WHO, and the World Bank. UNAIDS relies on voluntary contributions from governments, bilateral aid agencies, foundations, private-sector entities, and other multilateral bodies.
Introduction & Access
Provides data, strategic guidance, and technical assistance to help LMICs implement and expand access to antiretroviral therapies, pre-exposure prophylaxis, and other HIV treatment and prevention technologies.
UN-backed international organization that works to increase access to essential medicines and other health technologies in LMICs through voluntary licensing and technology transfer. MPP was founded and continues to be funded by Unitaid, with contributions from other donors. Its mandate covers medicines for HIV and HIV-associated comorbidities, hepatitis C, tuberculosis, COVID-19, and other patented treatments on WHO’s model list of essential medicines.
Introduction & Access
MPP partners with patent holders and generic manufacturers to negotiate licenses that allow for the generic production of patented medicines or derivative products, such as new formulations or fixed-dose combinations, for use in LMICs. These non-exclusive licenses promote competition and innovation and help drive down costs to make treatments more affordable and accessible for LMICs. Together with WHO, MPP additionally co-leads the mRNA Technology Transfer Programme, a global initiative that aims to improve health and health security by establishing sustainable, locally owned mRNA manufacturing capabilities in and for LMICs.
Regional branch of WHO that provides technical assistance, promotes health policies, and coordinates responses to health emergencies for the Americas and the Caribbean.
Agenda Setting
Regulatory Approval
Introduction & Access
Expands manufacturing capacities by promoting information exchange and fostering cooperation between countries and partners through PAHO’s Innovation Hub and Production Platform. Increases access to health technologies in offering medicines, diagnostic kits and equipment, vector control supplies, and vaccines to member countries at affordable prices through its Regional Revolving Funds.
Mechanism that supports LMICs in introducing and expanding access to affordable, quality-assured tuberculosis (TB) treatments and diagnostics via a bundle of packaged services tailored to country needs. GDF is housed and administered by the Stop TB Partnership Secretariat, which sits within the UN Office for Special Projects.
Introduction & Access
Acts as both a supply and pooled procuring system to order products and provide technical assistance to facilitate introduction and uptake. GDF also works with suppliers and stakeholders to monitor the adequate supply and sustainable pricing of products, as well as standardizes packaging to simplify drug management for health programs.
International organization, hosted by WHO, that advances innovations for HIV/AIDS, tuberculosis (TB), malaria, and coinfections. Unitaid primarily serves as a grant-making organization that finances implementing partner organizations, such as the MPP, and is predominantly funded by airline taxes and government and philanthropic contributions.
Financing
Invests in late-stage R&D for new drugs, diagnostics, and prevention tools and boosting manufacturing capacity.
Research and Clinical Development
Advances development of health innovations to diagnose, prevent, and treat HIV/AIDS, TB, malaria, and other infectious diseases.
Introduction & Access
Supports a sustainable African manufacturing industry that delivers a range of health products at scale and plans to boost production capacity in other underserved regions in the future. Carries out projects to generate data and evidence to create guidelines for adopting new products, generate market demand, and facilitate the introduction and uptake of products.
UN agency responsible for providing humanitarian and development aid to children worldwide. UNICEF is funded by contributions from governments and private and philanthropic donors and carries out work through regional and country offices worldwide.
Financing
Directly finances projects to advance clinical development for maternal, newborn, and child health (MNCH) needs, including vaccines, diagnostics, and other health technologies and steers investments for novel vaccines from other donors.
Research and Clinical Development
Finances development of MNCH-related innovations and supports health R&D by developing target product profiles to communicate MNCH product needs.
Introduction & Access
Procures more than 2 billion vaccine doses annually for programs in more than 100 countries and works to scale up essential MNCH essential technologies in LMICs. As one of the world’s biggest buyers of vaccines, UNICEF shapes the vaccine market, negotiating for lower prices and enhancing affordability.
Lead UN agency responsible for international development, which supports countries to develop policies, expertise, partnerships, and institutional capabilities to achieve the Sustainable Development Goals. UNDP is funded by voluntary contributions from governments, the private sector, and philanthropy, and its administrator is also the vice-chair of the UN Sustainable Development Group, which coordinates development work across UN agencies, including UNAIDS, UNFPA, UNICEF, and WHO.
Introduction & Access
Supports programming, including the Access and Delivery Partnership, to help LMICs strengthen policies, human resources, health and data systems, and regulations to expand access to essential health products. UNDP also has formal partnerships with the Global Fund and Gavi to support countries in accessing these two entities’ resources and strengthening systems and capacity for implementation and monitoring.
UN agency responsible for advancing sexual and reproductive health worldwide. It works with partner countries to provides access to a wide range of sexual and reproductive health services, with its activities funded by voluntary contributions from governments, the private sector, and philanthropy.
Introduction & Access
Directly procures contraceptives and reproductive health supplies to provide quality assurance and volume pricing for governments and nonprofits and provides technical assistance and supports implementation research to help countries introduce and scale up sexual and reproductive health interventions.
UN program that works to strengthen science, technology, and innovation capacity in the world’s 44 least developed countries. It undertakes a number of activities that broadly support health R&D capacity-strengthening and technology adoption.
Introduction & Access
Helps establish and support national academies of science, performs technology needs assessments to recommend actions for countries to improve their technological capacity, operates training and scholarship programs for scientists and students, and provides free or low-cost access to academic journals. Provides technical assistance and training to facilitate technology transfer agreements and supports the adoption and scale-up of health technologies.
International financial institution, funded by its member countries, that provides loans and grants to the governments of LMICs to finance infrastructure and social service improvements. The World Bank comprises two institutions, the International Bank for Reconstruction and Development and the International Development Association, it houses the GFF, and it’s part of the World Bank Group, which includes the IFC. Furthermore, it participates in several global partnerships, including Gavi and UNAIDS.
The World Bank also houses the Pandemic Fund, developed under Indonesia’s G20 presidency in 2022, which provides a dedicated stream of additional, long-term financing to strengthen pandemic prevention preparedness and response capabilities in LMICs and address critical gaps through investments and technical support at the national, regional, and global levels.
Introduction & Access
Funds projects to build and equip public health laboratories to improve diagnostic, surveillance, and research capacity. Provides financing and technical assistance to countries to procure health innovations and supplies for immunization and other health delivery programs.
UN agency responsible for international public health. WHO’s work is governed by the World Health Assembly, a decision-making body comprised of its member states, and it is financed by assessed and voluntary contributions from member states, as well as contributions from philanthropic donors. Since 2020, WHO has introduced the WHO Foundation to mobilize resources outside of traditional government funding and its Investment Round to broaden the organization’s flexible funding donor base.
Agenda Setting
Establishes international priorities for health R&D through frameworks and resolutions. WHO then translates these priorities into action plans and other efforts to guide health R&D. For example, through the Science Division’s Special Programme for Research and Training in Tropical Diseases (TDR) WHO produces a Health Product Profile Directory defining product needs for neglected diseases. For epidemic-risk diseases, WHO organizes the R&D Blueprint to identify priority diseases and guide product development activities.
Financing
Provides grants to researchers to strengthen R&D capacity and advance research and clinical development to combat neglected diseases through TDR and other programs.
Research and Clinical Development
Plays a direct role in coordinating and conducting research and clinical development of health technologies. WHO’s mRNA hub produces novel mRNA vaccines and shares technology and technical know-how with local producers to produce mRNA vaccines, TDR supports research on neglected diseases, and the agency has helped coordinate and support clinical trials during health emergencies.
Regulatory Approval
Reviews products for safety, efficacy, and quality through its Prequalification program, before prequalifying them for purchase by global procurers. This process facilitates regulatory approval in LMICs, and WHO also undertakes regulatory strengthening activities to support national regulatory bodies. During health emergencies, WHO operates an Emergency Use Assessment and Listing Procedure to guide the use of products on an emergency basis to ensure rapid access.
Introduction & Access
Supports member countries, particularly LMICs, in strengthening R&D capacity. For example, through programs like the Global Observatory on Health Research and Development, WHO tracks indicators of R&D investment and capacity to identify and elevate gaps; WHO’s Global Clinical Trial Forum strengthens the global clinical trial environment and infrastructure; through TDR, it provides training and grants to researchers in LMICs and helps strengthen research networks; and through the Science Division, including TDR, it creates norms and standards for good research practices. It also undertakes a number of activities to support product uptake and access, including providing technical guidance on the appropriate use of technologies and publishing its Essential Medicines and Diagnostics Lists, supporting implementation research through TDR and other programs, providing coordinating networks for information sharing on post-market surveillance, and directly procuring and distributing technologies as part of various health programs.
Other key entities
Beyond the multilateral institutions listed above, there are several key regional and internationally focused entities supporting the global health R&D ecosystem.
For example, regional regulatory bodies like the European Medicines Agency play a critical role in regulating health products and advancing regulatory harmonization. Regional developments banks—including the African Development Bank, Asian Development Bank, and the European Bank for Reconstruction and Development—provide financing to support different R&D activities, depending on the institution, including R&D capacity-strengthening, procurement, and product development. The European and Developing Countries Clinical Trials Partnership brings together European and sub-Saharan African governments to finance clinical development of health technologies for neglected diseases and strengthen African research capacity.
Philanthropic donors, most notably the Gates Foundation and Wellcome Trust, play a significant role in directly financing global health research and product development, through academic institutions, product development partnerships (nonprofit organizations that develop health products in partnership with the public and private sector and operate as pseudo-international organizations, pooling contributions from multiple donor governments to advance R&D of technologies for poverty-related and neglected diseases and health conditions), and private companies, as well as supporting R&D capacity-strengthening in LMICs and the activities of several of the multilateral institutions listed above.
Beyond that, individual governments directly finance R&D and access activities, through bilateral partnerships with other nations, direct grants and contracts, and contributions to product development partnerships (such as the Drugs for Neglected Diseases Initiative, IAVI, Innovative Vector Control Consortium, International Vaccine Institute, Medicines for Malaria Venture, PATH, and TB Alliance to name a few).
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