The Alliance Lift is a series that spotlights the journeys of Alliance alumni shaping health systems around the world. In this episode, Executive Director Dr Kumanan Rasanathan speaks with Dr John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust, former Global Health Ambassador of Norway, and past Chair of the Alliance Board. Their conversation explores the ideas and experiences that have shaped John-Arne’s approach to health policy and systems research. They discuss what it will take to safeguard health gains in the face of shrinking aid and shifting geopolitics, and how the global health system can better deliver for countries – from investing in research capacity to prioritizing global public goods and equity.