Global Health in Radiology: Evolution, Challenges, and a Framework for the Future.

Global health in radiology has expanded substantially over the past 2 decades. However, much of the field continues to be described through the language of outreach, volunteerism, and bilateral partnerships. While these concepts reflect an important part of how global radiology work has developed, they do not fully capture the wider systems issues that determine whether radiology services can function effectively over time. In practice, radiology services are shaped by workforce training, equipment procurement and maintenance, digital infrastructure, governance, financing, quality improvement, and evaluation. These factors influence whether imaging services are available, reliable, and able to support equitable care. This narrative review examines the development of global health radiology, distinguishes it from related concepts such as public health and international outreach, and synthesises the literature across major areas, including education partnerships, service development, teleradiology, point-of-care ultrasound, low-field magnetic resonance imaging, artificial intelligence, and interventional radiology capacity building. Particular challenges with radiology in global health settings include high equipment and infrastructure requirements, dependence on maintenance and technical support, and the need for sustained training, oversight, and long-term investment. The literature also demonstrates several ongoing limitations, including fragmented initiatives, limited evaluation frameworks, little attention to patient-centred outcome measurement, inequitable partnership models, and insufficient focus on implementation and financing. This review outlines future directions for global health radiology with relevance to equitable partnership design, sustainable funding, implementation, and alignment with broader health-system priorities.