Strengthening global health cooperation-insights from worldwide WHO collaborating centres.

Background: WHO Collaborating Centres (WHO CCs) are entities designated to provide scientific or technical support to the World Health Organization (WHO) in specific areas. They play a crucial role in global public health efforts; however, their leadership and sustainability present multiple complex challenges. Objectives: The aim of this analysis is to identify the strategic and management challenges faced by WHO CCs and to provide expert recommendations to enhance their sustainability. This study focuses on leadership capabilities as a key driver of successful global health cooperation. Methods: The study employed a three-phase approach: (1) a conceptual framework for strategic management of WHO CCs, (2) empirical testing through qualitative interviews with WHO CCs directors worldwide, and (3) development of actionable recommendations. A flexible sampling strategy was used, including convenience, purposeful, and database-based sampling to ensure diversity across regions, institution types, and health topics. Results: WHO CCs are manageable organizations but face unique strategic (mission alignment, core values, vision), and management challenges (project management, financial constraints, communication barriers).Long-lasting WHO CCs were led by directors whose leadership practices aligned with established models of effective leadership (e.g., self-awareness, strategic positioning, clear, and engaging vision). Key threats included a lack of resources, recognition, or project management skills, misaligned strategic vision, and communication gaps with WHO or the host institution. Conclusion: WHO CCs are vital to global health but require structured strategic management and leadership development. Their strategic management must take into account both the similarities and differences with other organizations. Expert recommendations include securing financial resources, improving WHO- WHO CCs communication, and fostering leadership skills to ensure sustainability and impact.