INTRODUCTION:
global public health decisions are often presented as evidence driven, yet outcomes are frequently shaped by political power, governance structures, and competing stakeholder priorities. traditional conference sessions rarely allow participants to experience these dynamics in real time. this organized session introduces a live, participatory governance simulation to train global public health professionals in systems thinking, negotiation, and ethical decision making under real world constraints.

METHODS:
this interactive one hour session uses a structured global governance laboratory format. participants are assigned stakeholder roles including government ministries, multilateral agencies, community representatives, funders, indigenous leaders, and technical advisors. using a facilitated scenario involving a concurrent public health emergency, resource scarcity, and political pressure, participants engage in timed decision making, negotiation, and consensus building. digital polling and facilitated discussion are used to document decision pathways, tradeoffs, and power dynamics.

RESULTS:
participants actively engage in cross sector negotiation, revealing how governance structures, funding mechanisms, and political incentives influence public health outcomes beyond technical evidence alone. preliminary implementation of this format demonstrates increased participant understanding of political determinants of health, stakeholder alignment challenges, and the ethical consequences of exclusionary decision making. participants report improved confidence in navigating complex governance environments and translating evidence into actionable policy.

CONCLUSIONS:
this session offers an innovative, experiential approach to public health leadership training by transforming governance theory into practice. the global governance lab model strengthens workforce capacity to lead during crises, manage competing interests, and design equitable health solutions. this format is highly adaptable across regions and health topics and contributes to advancing collaborative, ethically grounded global public health decision making.