Nobel Laureates Say Global Health Is Real but Still Painfully Unequal

“Global health is no longer only a medical issue, it is a scientific, political, societal challenge.”

This is how Stefan Kaufmann, from the Max Planck Institute for Infection Biology, set the stage for the first panel at the 2026 Lindau Nobel Laureate Meeting. The panel, which focused on Global Health, is a timely one. Over the past decade, medicine has changed at high speed. Vaccines can be designed within months, while new gene-based therapies, immunology, and new biochemical treatments are quickly being developed. Yet, as Kaufmann pointed out, extraordinary science doesn’t necessarily produce equitable health.

“Millions of people still lack access to medicine that already exists, and the gap between what is scientifically possible and what is globally available and accessible and affordable over the whole world remains far too large.”

So the real question is not only what science can do. It’s also who gets to benefit from it.

Science Has Delivered. The World Has Not

José Manuel Barroso, the former prime minister of Portugal, former president of the European Commission and former chair of Gavi, the Vaccine Alliance, says the past few decades have brought very real progress.

“I think global health is a reality,” Barroso started out. “There has been overall a clear improvement in terms of all indicators,” he added.

Life expectancy is one obvious example. Barroso pointed to his own country, Portugal, where life expectancy has risen from around 50 years a century ago to more than 80 years today. Globally, people are also living longer. Data shows that global life expectancy more than doubled between 1900 and 2023, rising from around 32 years to around 73 years.

But the improvement is uneven. In Africa, despite major gains, average life expectancy remains far below that of Europe. Many countries still struggle with sanitation, clean water, and access to basic medicine. When a crisis hits, these old problems become even sharper.

When a crisis emerges (like the COVID pandemic), these problems become even more acute. “I was chair of GAVI for five years and I saw bad behavior from governments and from corporations. If I have to give a mark like a professor, I would give top marks to scientists, including to those who develop mRNA. Science was responding very quickly [..] but politicians, including some of the most powerful, sophisticated countries, were not ready. Not only in the US, here in Europe, we were not ready for a pandemic. Then, there was bad behavior, not only from the so-called Global North, but sometimes from the Global South too, in terms of embargo and extreme vaccine nationalism.”

“So the situation from a multilateral point of view, I’m afraid, is not good. We now have a fragmented geopolitical order.”

The feeling was echoed by the entire panel. “I think the main obstacle is actually not in science or technology,” said Morten Meldal, who was jointly awarded the 2022 Nobel Prize in Chemistry for his foundational work in click chemistry. “The main obstacle is geopolitical. “

Still, better science can obviously help.

The next revolution is already here

Katalin Karikó is one of the heroes of the COVID pandemic. Her work on messenger RNA (mRNA) helped make possible the rapid development of mRNA vaccines, and we are still only just exploring the possibility that mRNA vaccines can bring.

Karikó, who was awarded the Nobel Prize in Physiology or Medicine 2023, worked for decades to make it possible to use RNA molecules as a medical tool, especially to instruct cells to make proteins that could train the immune system.

The main advantage of mRNA is speed. Traditional vaccine development often requires growing viruses or manufacturing viral proteins in advance. With mRNA, researchers can instead design a genetic instruction for a chosen protein and deliver it into the body. Cells briefly make that protein, and the immune system learns to recognize it.

That flexibility is why mRNA became so important during COVID-19. Karikó argued that the same flexibility could now be used much more widely. The good news, she added, is that RNA is “very cheap.”

“You can make very quickly, like in one hour. Even the template which you generate, it can be done very quickly.”

“And right now there are around 200 clinical trials ongoing using mRNA messenger RNA,” she said. “Half of them are on infectious diseases. They’re trying to make prophylactic vaccines, and this is already in human trials. The other part is mostly in oncology, so there are cancer vaccines.” Meldal’s work could also make medicine faster and more efficient.

Click chemistry is a way of building molecules from smaller pieces with reliability and precision. The idea is often compared to snapping Lego bricks together: chemists use reactions that work cleanly, under mild conditions, and produce useful compounds without many unwanted byproducts. In medicine, click chemistry can link medicines to antibodies, track molecules in cells and design new therapies more efficiently. Meldal described click chemistry as a potentially important tool in this landscape.

“Click chemistry is one speck of light at the end of the tunnel in this gloomy picture,” he said. “And click chemistry can help us combine pharmacophores into new molecules that can actually be active against diseases, or we can create entirely new compounds using click chemistry in very few steps.”
But Frederick Ramsdell, whose work on Foxp3 helped transform understanding of immune regulation, emphasized that “cheap” doesn’t necessarily mean “easy.”

“I think the real challenge for global health is that some of the new technologies that we come up with are actually very complex. They can be very effective, but they’re not easy,” Ramsdell said. “And to translate that globally, I think, is going to require new technologies.”

We are already seeing such effects. In wealthy countries, diseases once treated only by suppression or surgery are now being approached as conditions that might be durably controlled, or even cured. But it’s extremely challenging to bring global access to therapies that require elaborate manufacturing, specialized delivery and intensive monitoring.

The Real Barriers Are Politics, Trust, and Inequality

When we think about improving health, we usually think about fighting disease. But Meldal argued that this view is too narrow.

“I think it’s very important to consider that there are three entangled things that really dominate global health,” he said. One is global warming. The other is conflict, which creates communities living in unhealthy conditions, and the third is the equity that we need to improve. Conflict zones, he warned, can become places where disease spreads and evolves.

“[We have] hot spots of conflict in Sudan, in Gaza, and so on, in the central part of Africa where you have Ebola flourishing at the moment, these hot spots become breeding pots for bacteria and virus in evolution, and that’s really, really bad.”

In this view, global health is not just a fight against individual diseases. It is a fight over the conditions that allow diseases to emerge, spread, and become harder to control. Meldal summed it up with a lesson from his family: “My grandfather said that no society is richer than the poorest one in that society.”

Karikó and Ramsdell also turned to another fragile ingredient: trust. The public, Karikó argued, often sees a broken chain: taxes support science, science creates medicines, and medicines arrive at prices many people cannot pay. She also added that the public can turn against scientists because scientists don’t spend enough time explaining the things they are doing.

“So I feel our responsibility, and all of the scientists, including the young ones, is to explain in simple language the science that what we are doing. Because the gap is huge and people will not understand.”
Yet, remarkably, the panel ended on a very optimistic note.

Barroso, who had spent much of the discussion warning about challenges, looked ahead to artificial intelligence as a force that could transform public health. “I’m really very confident that AI will bring us huge, great improvement in public health,” he said. He also argued that the answer to today’s problems is not less science, but more of it.

Karikó was even more direct. “I am also very optimistic,” adding that she thinks “everything will be better” in ten years’ time.

Meldal agreed, but made clear that optimism did not mean ignoring the forces standing in the way. The solutions, he argued, already exist in large measure. The harder task is using them fairly: “The technologies for solving almost anything is out there already, so we just need to utilize those equitably around the world.” Ramsdell, too, closed with guarded confidence. “Despite my challenges around the geopolitical environment, I actually am very optimistic 10 years from now that we’ll be in a better place.”

Kaufmann gave the final word a careful balance. Global health is neither an illusion nor a finished achievement, he said. It’s a shared responsibility and a remarkable opportunity. “Science continues to deliver extraordinary discoveries,” he concluded. “Our challenge, and that was clearly the consensus here, is to ensure that these discoveries benefit everyone wherever they live.”