We are living in a period when the foundations that once sustained global cooperation are being tested, when power can overshadow principle, when norms are bent and when a rules‑based, values‑driven order appears increasingly fragile. The effects are evident across health systems worldwide: care withheld, science disregarded, services interrupted and fundamental rights reduced to empty language. Health is treated as discretionary. Women’s autonomy is challenged. Children’s wellbeing is placed at risk. In this environment, advancing sexual and reproductive health and rights (SRHR) is not optional—it is indispensable and urgently required.

Amid this turbulence, we have adapted our approach to sustain momentum. Our efforts are anchored in three interrelated commitments that define and steady our work.

The first is our circle of concern: the evolving political and financial landscape that profoundly shapes outcomes yet lies beyond our direct authority. To manage this uncertainty, we reinforced our policy intelligence functions, broadened monitoring systems and delivered focused analyses to enable timely, evidence‑informed decisions.

The second is our circle of influence: the sphere where partnership and coordination can redirect trajectories even in restrictive contexts. We deepened collaboration with WHO regional and country offices, UN cosponsors, civil society organizations and collaborating centres to align priorities, anticipate emerging risks and safeguard access to essential services where policy space is contracting.

The third is our circle of control: the core mandate that defines our contribution—producing robust evidence, establishing global norms and standards and assisting countries in translating guidance into effective implementation. This is where scientific independence, technical quality and accountability converge.

These commitments resulted in tangible progress in 2025, detailed in our annual report. We finalized the consolidated global guideline for preventing, diagnosing and treating postpartum haemorrhage, creating a unified benchmark to address the leading cause of maternal mortality. We issued comprehensive guidance on managing diabetes and sickle‑cell disease during pregnancy, addressing critical gaps in care. We introduced the first global guideline on infertility, bringing overdue attention to an equity issue affecting millions. Additionally, we enhanced digital trust by launching a client‑focused content toolkit that supports health services in countering misinformation with clear, reliable information. Collectively, these actions move systems from fragmentation toward coherence and from knowledge toward implementation.

Understanding that evidence alone is insufficient to change realities, we invested in effective translation. In partnership with regional stakeholders, we supported revisions to minimum SRHR service packages and developed costed standards to promote coherent budgeting, procurement and workforce training. We strengthened measurement frameworks, updated maternal mortality estimates and documented implementation experiences to bring operational insight closer to frontline decision‑makers, including in humanitarian contexts. These measures ensure that guidance is not merely published, but practical, scalable and grounded in accountability.

The broader context remains complex. Financing is increasingly limited, fragmented and shaped by political conditions. While expanding domestic resource mobilization is essential, many funding transitions are unfolding in environments marked by fiscal austerity and high debt. Without careful planning, such shifts may simply redistribute vulnerability rather than resolve it—forcing false trade‑offs between investing in SRHR and other health priorities, between prevention and emergency response, and among already marginalized communities. At the same time, growing engagement with the private sector presents both promise and peril. Clear safeguards are critical: alignment with rights‑based public health objectives, transparent financing arrangements, protections against exclusion and a firm expectation that private participation must reinforce—not supplant—public health systems.

Looking ahead, a pressing challenge is the widening divide between available evidence and the complex realities it must address, particularly in fragile and conflict‑affected settings where needs are acute and data scarce. The path forward demands precision, prioritization and discipline—focusing on evidence that preserves access, protects rights and delivers measurable impact despite constraints. This includes defending scientific independence, strengthening research capacity and leadership in low‑ and middle‑income countries and ensuring that every guideline and tool is designed for practical use where the stakes are highest.

These accomplishments, alongside the challenges before us, highlight the central role of partnership. The sustained engagement of Member States, civil society organizations, professional bodies and our UN cosponsors—UNDP, UNFPA, UNICEF, WHO and the World Bank, including the Global Financing Facility—remains essential to maintaining technical rigor, independence and global reach.

In an uncertain global climate, our sense of purpose is unmistakable. We are committed to deepening collaboration, expanding high‑impact research and strengthening the translation of evidence into policy and practice so that SRHR remains fundamental to health, rights and equity worldwide. Despite mounting pressures over the past year, we have demonstrated that advancement is achievable.

We are part of a community grounded in science, guided by rights and driven by measurable impact. My confidence rests in this collective resolve. The way forward is to broaden what is possible—standing firmly for science, insisting on rights and acting with integrity where it matters most.