From discovery to delivery: a systems-based pathway for translating science into global and humanitarian health impact.

Global and humanitarian health impact pathways consist of multiple well-understood stages: setting strategic and policy priorities, scientific discovery, solution development, industry efforts, harnessing delivery systems and meaningful policy and public engagement. Yet it is in the transitions between these stages that progress is often lost. This Commentary argues that breakdowns at 'baton pass' handover points - just as much as challenges within each stage of the pathway - are a major source of unrealised impact. It proposes an end-to-end 'science-to-health' pathway framework to help actors identify where progress is stuck, diagnose underlying vulnerabilities, and select targeted systems-based leverage points to strengthen these baton passes. The leverage points are the 6Rs: Resources, Roles, Relationships, Rules, Routines and Results. Four case examples - antimicrobial resistance, oral cholera vaccine deployment, mpox response in Africa and an illustrative donor health portfolio - show how the tool can guide strategic and operational decisions across diverse health and institutional contexts.