In global health, many promising innovations struggle to reach their full potential, especially in resource-limited settings. To help address this challenge, the World Health Organization (WHO) and global health leaders could consider establishing a High-Impact Innovations List (HIIL)—a strategic tool to identify and elevate innovations with the greatest potential to improve health outcomes globally. Such lists are not unprecedented as the World Health Organization (WHO) maintains several critical lists to guide global health priorities and ensure equitable access to essential health interventions. One notable example is the Essential Medicines List (EML) created in 1977, to identify and prioritize the most important medicines for public health based on clinical evidence, disease burden, and effectiveness. Regularly updated, the EML guides governments and health organizations in ensuring the availability of essential medicines and prioritizing healthcare resources globally.
List Development
The development of the HIIL would require a diverse team of global health experts, epidemiologists, health economists, technology specialists, and representatives from affected communities. This interdisciplinary team will ensure that the HIIL prioritizes evidence-based, scalable innovations that can have the most population health impact, particularly in resource-constrained settings. The procedure for developing the HIIL would mirror the EML’s successful process, including stakeholder consultations, evidence review, expert evaluation, prioritization, and regular updates. However, it would avoid some of its pitfalls such as challenges in access, affordability, contextual relevance, and insufficient attention to non-pharmaceutical solutions, slow adaptation, and health system strengthening. Additionally, HIIL offers a holistic approach to health, addressing the multi-dimensional challenges of health through a combination of effective medicines, technologies, and robust health systems.
The criteria
The HIIL should prioritize effective, adaptable, and equitable innovations—such as Kangaroo Mother Care, insecticide-treated nets, non-pneumatic anti-shock garment, integrated community case management, and the uterine balloon tamponade—that have demonstrated impact, particularly in addressing global health challenges in low- and middle-income countries. Innovations must align with international priorities like the SDGs, be scalable in resource-constrained settings, and address health disparities. Updated annually, the list will include implementation tools like guidelines, metrics, and case studies to ensure global relevance.
I saw the importance of such criteria in 2016, during my time as one of the inaugural fellows of the Every Woman Every Child Innovation Marketplace—a strategic alliance of global development innovation organizations. My task was to curate and broker promising innovations initially funded by partner organizations with potential for scale-up. One of the key insights from this experience was that the innovations with the highest impact were often not the ones receiving the most attention or funding. Instead, polished, tech-driven, and media-friendly innovations often took center stage. Visibility and branding routinely outweighed evidence and outcomes, sidelining some of the most effective, life-saving solutions—not for lack of merit, but for lack of flash. Therefore, the HIIL’s focus on impact and cost-effectiveness would ensure that innovations offer a high return on investment by improving large population health outcomes while maximizing limited resources.
How the list would work
The WHO would lead HIIL development, advocate for its adoption at global and regional levels, and establish metrics for monitoring and evaluation to support its integration into national health plans. By leveraging its authority and convening power, the WHO can ensure that innovations with the highest potential for impact are prioritized and brought to the forefront.
In addition, HIIL will serve as a strategic guide for policymakers, health organizations, and global health funders to focus their efforts and resources on interventions that can significantly improve health outcomes of all. It will spotlight practical, cost-effective innovations that are scalable in resource-limited settings, ensuring access for the communities that need them most. For innovations that may be more expensive to implement, the WHO will collaborate with global health funding partners to align investment priorities with the HIIL. This collaboration seeks to prevent high-impact solutions from remaining out of reach for underserved populations. Critically, the process will prioritize local leadership and community engagement to ensure contextual relevance and sustainable adoption. By elevating these innovations, the HIIL can enhance global health equity, streamline investments, and accelerate the uptake of life-saving practices across regions.
Beyond Medicine: HIIL’s Broader Health Approach
While the EML plays a critical role in prioritizing medicines that are fundamental to addressing public health challenges, it does not capture the full spectrum of innovations—such as digital health solutions and health systems interventions—that are increasingly vital to strengthening healthcare delivery.
Importantly, HIIL would not be an all-inclusive list but would be a curated selection of the most impactful innovations with the potential to save and improve the greatest number of lives—such as mHealth platforms that enhance maternal health outcomes and insecticide treated nets, which have significantly reduced malaria-related deaths among children. By focusing on such high-impact solutions, it ensures critical innovations receive the attention and resources they need.
HIIL would be where groundbreaking health innovations that have the most significant impact for population health get the elevation they deserve—because the highest impact innovations for saving and improving the most lives should never stay at base camp.
Author: Obidimma Ezezika is an Associate Professor in the Faculty of Health Sciences at Western University, Canada and Director of the Global Health and Innovation Lab.
Competing interest: None
Handling Editor: Neha Faruqui