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Dr. Marcello Tonelli, MD, a kidney specialist and professor at the , is transforming a global commitment to improve kidney health systems into practical actions for governments. The commitment comes from a  at the 78th World Health Assembly, the decision-making body of the  (WHO), and the  of the United Nations General Assembly on non-communicable diseases and mental health.

“We’re starting at 40,000 feet — high-level commitments made by individual countries — and trying to get down to very specific steps, making effective drugs and treatments available to patients and families,” says , president of the  (ISN). 

Tonelli is the lead author of a health policy framework published in  for integrating kidney care into national health strategies, helping countries prevent and treat the disease. 

Tonelli says holding nations accountable will be essential to improve the health of millions of people. The Lancet article states that chronic kidney disease is the ninth leading cause of death worldwide, and is on track to become the fifth leading cause of death by 2050 without concerted action. 

We sat down with Tonelli to learn more about how he helped get kidney health on the world’s agenda. 

Q: Why did kidney disease need to be placed on the World Health Organization’s agenda?

A: Kidney disease affects 850 million people worldwide, yet it remains under‑recognized despite being common, preventable, deadly and treatable. Countries with the weakest health systems face the fastest‑growing burden, but have the least capacity to prevent or treat kidney disease. One of the issues is that people often aren’t identified early enough to receive inexpensive, effective treatments, and, in many low‑resource settings, kidney failure is a death sentence because the people who are affected can’t access dialysis or kidney transplantation. 

Q: What does the new WHO kidney health resolution do?

A: The resolution provides the first global framework for countries to strengthen kidney care. It defines the scale of the problem and commits countries to develop concrete solutions: prevention, early detection, timely treatment, and integration with existing programs for diabetes, hypertension and heart disease. Rather than creating new silos, it encourages countries to build on what they already have. It also requires countries to report back to the WHO every two years on progress, ensuring transparency and sustained momentum. The resolution gives countries a path and will hold them accountable.

Q: Why does this matter for Canada and North America?

A: Even high‑income countries stand to benefit. Canada and the United States do not have national kidney plans, despite having strong kidney-care systems. This gap slows progress on equitable organ transplantation and Indigenous health, and limits the ability to share lessons from high‑performing provinces or states across our countries. The resolution gives organizations like the  additional leverage to push for national planning.

Q: What has been your role in this global effort?

A: I’m only one member of a huge global collective. Leadership came from many countries — Guatemala, for example, sponsored the resolution, with strong support from Thailand and Somalia. The  has been to support, lobby and mobilize stakeholders. It’s taken years. I’ve had to adjust my way of thinking and learn new skills because I’m not a very patient person. Global change takes time, but the potential gains are so large if we can get it right. Now, with the resolution passed, we can focus on implementation, including developing practical tools and detailed guidance to help countries strengthen their health workforces, integrate kidney treatment into primary care, and get the cheap and effective drugs into the hands of patients who need them. 

Q: What role has the university played in this global effort?

A: ԰������’s strong commitment to global health and the (UN’s) Sustainable Development Goals has enabled this work. The university provides the resources, institutional backing and a home in the  — all of these allow people like me to contribute to global health initiatives. This support helps translate advocacy into practical action, advancing kidney care both locally and internationally.

Q: What advice would you give to early career academics interested in global health?

A: I would encourage them to be patient, flexible and open to unexpected opportunities. Some of my most impactful experiences came from projects that initially seemed unrelated to kidney disease. In 2014, I spent a sabbatical year at the WHO headquarters in Geneva, looking at the treatment of noncommunicable diseases following natural disasters and civil conflict. At the time, it simply seemed like an interesting opportunity. I had no idea I’d apply those lessons a decade later, working with the WHO and individual countries to promote kidney health. 

Despite the complexity and abstract nature of global health policy, this work is deeply rewarding. I’ve learned so much, and, when I’m working in the hospital with Alberta patients, it’s surprising and gratifying to see that the challenges they face are similar to those faced by kidney patients all around the world. On the flip side, what we learn from other countries often has immediate applicability to the treatment of people right here in Calgary.