Global health systems research symposium in Nagasaki, Japan: Building momentum for health systems strengthening and commitment to core values of global health amid headwinds

Since 2025, in addition to financing, the core values of global health-including community engagement, equity, evidence-informed practices, and multilateral collaboration-have been challenged by powerful global leaders. The 8th Global Symposium on Health Systems Research (HSR2024), held in Nagasaki, Japan, in November 2024, generated momentum for health systems strengthening (HSS) not only at the national and subnational levels but also globally, despite growing headwinds. HSR2024 deepened the discussions on key contemporary HSS aspects, including community engagement, health systems resilience in the face of crises, equity, and evaluation of the impacts of HSS interventions from a cross-national perspective. Notably, the Symposium pursued people-centered and rights-based approaches to civic participation in health systems planning and policymaking, and emphasized the crucial interlinkage between health security, including climate resilience and pandemic preparedness, and HSS. By addressing these issues, HSR2024 effectively revitalized the global community's commitment to the core values of global health.