Lancet Global Health commentary highlights the importance of lived experience in shaping the future of global health
Ahead of the International Congress on Obesity (ICO) 2026 and its inaugural Lived Experience Summit, a new commentary published in The Lancet Global Health is calling for people with lived experience of health conditions to be recognised as essential partners in shaping the future of global health.
The article, Lived experience and global health architecture reform: from afterthought to cornerstone, is co-authored by World Obesity Federation CEO Johanna Ralston alongside lived experience leaders and advocates from Africa, Asia, Europe and North America. Published at a time when global health institutions are considering significant reforms to governance and decision-making structures, the commentary highlights the need to place affected communities at the centre of these discussions.
The article raises concerns that lived experience expertise has been largely overlooked in discussions on global health architecture reform, despite growing evidence that policies, programmes and health systems are more effective when they are designed with meaningful input from the people they are intended to serve.
Lived experience at the centre
"People living with chronic conditions bring invaluable expertise about how health systems function in practice," said Johanna Ralston, CEO of the World Obesity Federation and co-author of the commentary.
"Too often, global health decisions are made about people rather than with them. If we are serious about building more effective, equitable and responsive health systems, lived experience must be recognised as a form of expertise and embedded throughout decision-making processes."
READ THE COMMENT
The commentary also highlights the practical barriers that continue to limit meaningful participation by people with lived experience, including financial constraints, language barriers, visa restrictions, complex technical processes and limited access to decision-making platforms. These obstacles reflect broader structural challenges within the global health system and continue to prevent many voices from being heard where important decisions are made.
To help address these challenges, the publication sets out six priorities for reform:
Shared governance structures
Establish shared governance structures that give lived experience representatives genuine decision-making power.
Accessible participation
Create accessible participation mechanisms, including financial and logistical support.
Evidence and expertise
Broaden definitions of evidence and expertise to value lived experience alongside technical and academic knowledge.
Accountability
Introduce accountability mechanisms to measure progress on inclusion and equity.
Ethical standards
Develop ethical standards that prevent tokenistic engagement.
Community action
Ensure global commitments translate into meaningful action at community level, particularly in low- and middle-income countries.
The publication reflects a growing recognition across global health that lived experience is a critical source of knowledge, expertise and leadership. For the obesity community, this principle is particularly important. People living with obesity frequently encounter stigma, barriers to care and health systems that are not designed around their needs and experiences. Bringing lived experience into decision-making can help create more effective policies, improve care pathways and ensure that obesity responses remain genuinely person-centred.
The commentary also reflects the World Obesity Federation's long-standing commitment to elevating lived experience voices across research, policy and advocacy. Through its global network, the Federation works to ensure that people living with obesity are recognised not only as recipients of care, but as partners whose insights can strengthen programmes, policies and health systems.
Lived Experience Summit at ICO 2026
This commitment will be a central theme of the Lived Experience Summit at ICO 2026, taking place in Mexico City from 27–30 July. The Summit will bring together people living with obesity, advocates, healthcare professionals, researchers and policymakers from around the world to explore how lived experience can inform research, improve care and strengthen advocacy efforts.
Designed to foster meaningful dialogue and collaboration, the Summit will examine ways to address stigma, improve access to care, increase patient involvement in research and ensure that the perspectives of people living with obesity are reflected in the policies and programmes that affect them.
The themes explored in the Lancet Global Health commentary closely align with the objectives of the Summit. Both emphasise the importance of recognising lived experience as a form of expertise and creating opportunities for people affected by health conditions to contribute meaningfully to decisions that shape their lives.
As global health institutions consider the next phase of reform, the commentary highlights an opportunity to rethink who participates in decision-making and how expertise is defined. Its message is clear: people most affected by health policies and systems should not be viewed as stakeholders on the sidelines, but as essential partners in shaping the future of global health.
Read the full commentary in The Lancet Global Health
The full commentary, 'Lived experience and global health architecture reform: from afterthought to cornerstone', is available in The Lancet Global Health.
Read the article