Health systems across the globe are standing at a crossroads. The past few years have tested their resilience in ways few could have imagined. A pandemic laid bare deep inequities. Technological innovations raced ahead of policy and practice. Global challenges like climate change and misinformation have left many questioning how systems built for the past can meet the demands of today, let alone tomorrow. 

Amid these pressures, Health Technology Assessment (HTA) finds itself at a pivotal juncture. Once seen primarily as technical discipline focused on evaluating individual technologies. HTA is now being called to step into a broader, more strategic role. It is no longer enough to ask what works; we need to consider what matters most and what should guide the systems we are shaping. 

The HTAi 2026 Annual Meeting encourages us to recognize HTA's role as a system shaper, a transformative force in designing, governing and redefining what future health systems can achieve. It challenges us to move beyond traditional disciplinary and sectoral boundaries and recognize HTA as a driver of innovation, equity and sustainability. It envisions HTA as a truly global blueprint for shaping resilient, inclusive, and future-ready health systems. 

The challenges are undeniable. Health systems are under strain from rising costs, accelerating digital transformation, and declining public trust. The escalating impact of climate change adds a new layer of urgency, demanding that sustainability be considered not just in economic,. but also environmental terms. Tackling such complex and interrelated challenges, particularly with environmental and social dimensions, requires a collaborative approach. These pressures are shared globally, though they may manifest differently across contexts. For some, the pressures may call for evolving mature HTA systems toward broader stewardship. For others, particularly in low- and middle-income countries where HTA is still emerging, the pressures underscore the need to build capacity to ensure assessments contribute to stronger, fairer systems, as well as improve understanding and appreciation of HTA among HTA stakeholders. 

Yet within these challenges lies opportunity. When understood as a broader evidence-to-policy process, HTA has the power to meaningfully shape health systems. It can bridge sectors, inform priority-setting, and embed values like trust, equity, and inclusion into decision-making. Beyond influencing which technologies enter the system, HTA influences which technologies enter the system, as well as how care models evolve, how limited resources are allocated, how innovation aligns with system 

To fully realize this potential, systems must be prepared, not only in terms of technical capacity, but also in strong governance, effective communication, and a forward-looking perspective grounded in both pragmatism and virtue. HTA must act with agility, scientific rigor, creative, and courage. It must evolve methodologically, embracing a transdisciplinary approach. It must become a connector, linking evidence to policy, aligning diverse stakeholders across sectors and geographies, and helping systems adapt to complexity. This means acknowledging that effective HTA is often mediated by institutional structures, such as HTA agencies, and reimagining their role within a more expansive, globally connected framework. It must also recognize patients and communities not as passive recipients, but as co-creators of solutions. 

HTA's path forward lies in both strengthening its technical foundation as well as broadening its influence - shifting from analysis to action, from assessing interventions to guiding systemic change. It is about building health systems that are resilient enough to withstand future shocks, equitable enough to serve all fairly, and sustainable enough to protect the health of generations to come. 

The conference is a critical platform to advance the conversation. The HTAi 2026 Annual Meeting provides the space, community, and resources to elevate bold ideas, foster honest dialogue, and support concrete action. It is a forum where the global HTA community can collectively imagine its role as a system shaper. creating systems that not only work, but endure over time; that not only innovate, but open doors; and that deliver on the promise of better health for all. 

The future of HTA and of our health systems will be shaped by the choices we make today. Let us make them count.