François Picard welcomes Jozef Síkela, European commissioner for international partnerships. He says global health is at a crossroads. The Covid-19 pandemic showed that such crises are not isolated events, but systemic shocks with far-reaching economic and social consequences. Today, a convergence of pressures is adding to the strain: climate change is driving new diseases, funding is declining, and global health governance is fragmented. He says prevention must replace reaction as the organising principle of global health.