Historic WHA Resolution on Fatty Liver Disease Opens Door for Integration into National NCD Strategies

29/05/2026 Sophia Samantaroy

Steatotic liver disease, commonly known as fatty liver disease, is linked to the same risk factors that cause other leading NCDs – unhealthy diets, obesity, tobacco use and alcohol misuse.

Steatotic liver disease (SLD) was recognized as a “missing piece” of the global noncommunicable disease response in a milestone World Health Assembly resolution last week. With countries making extraordinary progress in combating viral hepatitis, SLD, formerly known as fatty liver disease, is now the fastest-growing chronic liver disease – but far less recognized. Experts and advocates believe the new World Health Asssembly (WHA) decision will trigger more awareness and action in countries and globally.

GENEVA– The WHA’s resolution recognizing steatotic liver disease (fatty liver) as an NCD is a long-awaited milestone for a chronic liver condition that carries a huge global health burden but is dramatically under-recognized, experts and patient advocates say.

“What we aimed to do is get SLD recognized as a non-communicable disease,” Debbie Shawcross, Secretary General of the European Society for the Study of the Liver (EASL) told Health Policy Watch. “Because we know in these populations, people don’t just suffer from liver disease. They also have cardiovascular disease, chronic kidney disease, diabetes, and more.”

Debbie Shawcross, Secretary General, EASL

Until very recently, the biggest focus for liver disease was viral hepatitis: “Rightly so, all our resources went into the pandemic of hepatitis C and B.” But now with vaccines for hep B and an antiviral cure for hep C, “we are realizing that what is left behind is a disease that is unaddressed and accelerating.”

Shawcross spoke at a high level side event sponsored by EASL last Thursday, the same day that the new resolution was approved by WHA.

The event included NCD experts from EASL, the NCD Alliance and the Organization of Economic Co-Operation and Development (OECD), as well as Spain’s Director General of Public Health and the Minister of Health from Egypt, which co-sponsored the WHA resolution along with 15 other countries.

Egypt: a ‘missing piece’ in the global NCD response

Professor Khaled Abdel-Gaffar, Minister of Health, Egypt.

The rapid rise in metabolic liver disorders represents the “next great public health challenge,” said Khaled Abdel Ghaffar, Egyptian Minister of Health, at the EASL event.

Egypt was one of the first WHO member states to sound the global health alarm around SLD after having grappled years earlier with some of the world’s highest rates of hepatitis C infection – and related viral liver disease burden. What followed was a landmark national campaign to eradicate hep C.

But Egypt also suffers from a growing prevalence of diabetes, obesity, and cardiovascular disease – all risk factors for SLD. So early on, it became a champion for recognition of the liver disease as an important NCD.

“Building on our experience and recognizing this urgent global need, Egypt has taken another decisive step in leadership,” said Ghaffar. “We proudly sponsored the landmark WHO resolution steatotic liver disease, a missing piece in the global non-communicable disease response.”

Growing SLD burden closely linked to diabetes and obesity

Comparison of a healthy liver and one with SLD, commonly known as fatty liver disease.

SLD affects an estimated 1.7 billion adults globally – who suffer from the metabolic-associated liver dysfunction. In WHO’s European region alone, some 800,000 people die of advanced liver disease each year – costing some $64 billion annually. Its former name, fatty liver disease, remains in fact, an apt description of the condition insofar as SLD is linked to an excess build up of fat in the liver.

This may be due to heavy alcohol use or to metabolic dysfunctions related to other NCDs, such as: obesity, insulin resistance, hyperglycemia or pre-diabetes, high cholesterol levels, and hypertension. With few early warning signs, the disease can quickly progress to severe inflammation, cirrhosis, and liver cancer.

Globally, the number of new cases of liver cancers have already increased by 50% in the past decade–and are expected to double by 2050. Experts point to SLD as now a major cause of the current surge of liver cancer–which is in turn fueled by rising obesity and diabetes rates.

The resolution highlights the shared NCD risk factors characteristic to the development of SLDs, including unhealthy diets, air pollution, smoking, physical inactivity and consequent obesity, as well as harmful alcohol use. It officially incorporates SLD into the broader umbrella of NCDs addressed by the global health agency.

Member states are urged to integrate SLD into their noncommunicable disease strategies through strengthened prevention, early detection, primary care services, and public awareness. And the resolution calls on WHO to support research, surveillance, and equitable access to diagnostics and treatment.

“For the first time, liver disease receives formal recognition within the global noncommunicable disease agenda,” EASL said in a statement, hailing the resolution as a “turning point” for liver health worldwide.

Now, said Shawcross, it’s up to member states to implement the WHA resolution, moving beyond “siloed approaches” to NCDs to include liver health.

Along with that, countries, supported by WHO, need to ensure more intentional tracking of liver health metrics: “What is not measured is ignored,” she said.

Shift in populations at risk for liver diseases and liver cancers

From left: Moderator Nicola Bedlington; Dr Pedro Gullón, Spanish Ministry of Health; Alison Cox, NCD Alliance; Prof Faisal Abaalkhail, Saudi Society for the Study of Liver Disease and Transplantation; Dr Kerri Elgar, OECD.

In the Gulf region, like in Egypt, there has also been a shift in demand for liver transplants from people with viral hepatitis infections to individuals with SLDs, said Faisal Abaalkhail, president of the Saudi Society for the Study of Liver Disease and Transplantation, at the EASL event. He attributes this to the “huge rise” in obesity and diabetes. His patients are now also younger, something he calls “alarming.”

Abaalkhail’s research and medical practice have pioneered liver transplants in the Gulf region. And in the past ten years, more than a third of the patients requiring liver transplants suffered from some form of SLD, he said.

Early screening and detection are critical, he said, along with standardization of care for all SLD patients.

“We often catch SLD too late,” said Abaalkhai. “We diagnose at the end with complications like cancer and liver failure.”

But a greater emphasis on prevention is also important, he added. That includes better access to GLP-1 treatments for people who are obese or living with type 2 diabetes. With new treatments available, the region now needs to work on prioritizing exactly who can access them–including SLD patients through public health systems and insurance plans. See related story:

WHO Moves to Expand Access to Fast-Acting Insulin and Semaglutide, the Popular Diabetes and Obesity Control Drug

Need to integrate SLD into national NCD strategies

The WHA resolution “highlights the growing recognition of the need to address metabolic conditions in a more integrated way,” said Dr Tedros Adhanom Ghebreyesus.

“Metabolic conditions are becoming an increasingly important challenge globally,” he said in a message to the EASL event. “The rising prevalence of obesity, diabetes, cardiovascular and steatotic liver diseases, are driven by shared risk factors and determinants.”

Added Henri Kluge, WHO European Regional Director: “Globally we are seeing the consequences of a rapidly changing metabolic disease landscape. Obesity, diabetes, cardiovascular diseases, chronic kidney disease and steatotic liver disease are on the rise – interconnected conditions shaped not only by biology but also by the unhealthy environments. “

Spain: tackling SLD as a ‘socially transmitted disease’

In Spain, steatotic liver disease was not included under the country’s NCD strategy until 2024, noted Spain’s Director General of Public Health Pedro Gullón.

That’s when the country adopted the Spanish National Liver Health Plan, recognizing SLD as a public health threat and aligning it with the country’s broader non-communicable disease (NCD) frameworks.

Gullón is hopeful that the political momentum generated by the WHA resolution will prompt other member states to follow Spain’s example.

Meanwhile, Spain is also passing new laws that should help prevent SLD. That includes stricter limits on alcohol consumption and displays in public places, particularly those frequented by children, like sports complexes, stadiums, and schools. Alcohol misuse is a leading cause of cirrhosis and liver cancer.

“These are socially transmitted diseases,” Gullón observed. “When we do these kinds of policies, it’s not just for children, we are doing them for the whole population.”

Closing the gap between WHA promises and delivery

Despite this, civil society groups and watchdogs have been quick to point to the yawning gap between global health promises made by member states at the annual World Health Assembly and delivery on the ground in countries.

Many of the same member states that co-sponsored the liver health resolution have struggled to control the overall rise of other NCDs, said Allison Cox, policy director of the NCD Alliance, at the EASL event.

The NCD Alliance, which is tracking these disparities in its reporting, has argued for several measures to close this gap: protect policymakers from conflicts of interest, strengthen health care systems, and address the harmful commercial determinants of health.

The UN General Assembly’s adoption in December 2025 of the High Level Declaration on NCDs and Mental Health is “encouraging”, Cox said. Formal adoption of the declaration from a meeting in September was delayed for several months by opposition from the United States.

But, “targets don’t save lives. Implementation does,” Cox said.

‘Turning off the tap’- preventing a silent epidemic

New OECD report cites a potential GDP gain of nearly 4% if leading NCD risks were eliminated, averting millions of deaths every year.

The economic co-benefits of addressing liver health are also apparent, argued Kerri Elgar, senior global health advisor at the OECD.

An OECD report published in April concluded that eliminating avoidable NCDs due to risks across six factors (air pollution, harmful alcohol use, unhealthy diet, obesity physical activity and smoking) would not only save millions of lives but also boost average GDP by 3.9%, on average across the 27 countries of the European Union, as well as reducing health expenditures by 40% between 2026-2050.

Elgar noted the “synergies” between chronic diseases and the co-benefits with cardiovascular disease, diabetes, and other non-communicable diseases.

Changing the environments that we live in is crucial to promoting prevention at these synergies, added Cox.

“There’s the old public health adage that we need governments to move away from mopping the floor and turn off the tap,” she said in reference to tackling the upstream risks driving NCDs, including liver disease.

“If they want to stop mopping that floor, that really means tackling commercial determinants of health,” Cox said. “Some of the most cost-effective ways of coping with noncommunicable diseases–like liver disease – is to tackle the modifiable risk factors: smoking, alcohol, unhealthy diets and air pollution, and the dominance of ultra-processed food.”

Image Credits: rawpixel/unsplash, Malingering/Flickr, EASL, Quora, Sophia Samantaroy/HPW , OECD, April 2026.

How to Treat the Disinformation ‘Virus’ Undermining Health and Democracy

28/05/2026 Kerry Cullinan

Disinformation proliferated during COVID-19 and became more organised and intent on undermining trust in science and institutions.

The recent hantavirus outbreak triggered a wave of disinformation along similar lines to the COVID-19 pandemic: the virus was “fake”, “deliberately engineered”, and could be “cured” by Ivermectin.

In the past week, furious community members have attacked and torched tents housing Ebola patients at Mongbwalu General Referral Hospital in the Democratic Republic of Congo (DRC) three times, motivated by misinformation and mistrust.

While anti-science propaganda is not new, AI and social media platforms have enabled deliberate distortions (disinformation) and inaccurate information (misinformation) to proliferate instantly and at enormous scale.

Health is one of the casualties of rising geopolitical division – from Russian bot farms spreading fake COVID-19 information to undermine Western governments, to Western leaders using slurs like “China virus” instead of coronavirus.

Parts of the ‘Big Wellness’ sector are also actively undermining science-based medicines to drive people to their products.

Threat to democracy

Céline Jurgensen, France’s Ambassador to the UN in Geneva.

Céline Jurgensen, France’s Ambassador to Geneva, describes the rapid spread of false information and disinformation as a challenge for both “health security and democratic resilience”.

Post-COVID, there is “increased mistrust towards health authorities, questioning of vaccine policies, and weakening trust in science”, she said.

“This phenomenon has become broader. It’s become ideological, and it’s sometimes institutionalised in its orchestration,” Jurgensen told a roundtable on dis- and misinformation at last week’s World Health Assembly.

Many of the narratives are “anti-system, anti-science” aimed at “creating broad mistrust in public authorities, international organisations including the UN, and researchers”.

Helen Clark, chair of the vaccine platform Gavi and former Prime Minister of New Zealand, calls mis- and disinformation “an existential threat to public health”, representing a “crisis of trust”.

“We see less trust in institutions, science, and vaccines. We see polarisation. We see the disinformation actors who exploit and profit from what they do. We see people using AI chatbots and search engines for health information.”

Kemi Akinfaderin, Fòs Feminista’s chief global advocacy officer, described misinformation and disinformation as “anti-system, is anti-multilateralism, and anti democratic”, requiring solutions that address all these areas, including health.

“The advances that we’ve made in sexual reproductive health and rights, maternal health, and child health have been driven primarily by evidence, and there is a concentrated effort to erode that evidence,” said Akinfaderin.

“We have seen concentrated strategic efforts by anti-rights and anti-gender actors, particularly, to undermine scientific evidence and to create distrust in the system.”

Influencing health outcomes

Robert Mardini, Director General of Geneva University Hospitals.

“Misinformation and disinformation are no longer sitting at the periphery of our challenges, but very much at the core, front and centre of the daily humanitarian response, but also clinical realities,” said Robert Mardini, Director General of Geneva University Hospitals and former head of the International Committee of the Red Cross.

“They influence how patients interpret their symptoms, whether they are they seek care, how they adhere to treatments, and how communities respond to public health recommendations.”

Examples of disinformation are easy to find. Last year, Pakistan introduced the HPV vaccine, which protects against cervical cancer.

“Gavi research found that vaccine-related search of videos on Facebook in Urdu returned vaccine misinformation in 27% of the top-ranked videos, compared to 17% in support of the vaccine,” said Clark.

During COVID-19, a fake letter falsely attributed to a senior physician at the Geneva University Hospital claimed that the vaccine caused infertility, said Mardini.

“In another case, national public health guidance was distorted and went global, falsely suggesting that Switzerland had declared vaccines dangerous,” he added.

Akinfaderin has been confronted with claims in Nigeria and Uganda that contraceptives are linked to infertility and cervical cancer, some even spread by women’s rights organisations.

Kemi Akinfaderin, Fòs Feminista’s chief global advocacy officer.

Brazil’s Secretary of Health, Dr Mariângela Simão, said her country was still dealing with vaccine hesitancy from when Jair Bolsonaro was the president and “was a denialist right of both the pandemic and of vaccines”.

Prof Alexandra Calmy, who heads the HIV unit at the University of Geneva Hospital, said that the day after US President Donald Trump suggested a link between paracetamol and autism in pregnant women, patients at her clinic refused pain relief.

A trust problem

“Misinformation is not primarily a communication challenge. It is a trust problem,” said Mardini.

“Trust must be treated as a strategic public asset,” said Dr Sopon Iamsirithaworn, Deputy Secretary of Thailand’s Ministry of Public Health.

“People don’t follow health measures just because they receive information. What really matters is whether they trust the system and believe in the message they hear.”

But, he added, in Thailand “trust doesn’t come from the centre alone. It is built at the community level with trusted people on the ground, including our village health volunteers who live in the community”.

Health authorities and governments are no match for the speed and scale at which chatbots and generative AI can generate fake information. But there are tools to dismantle some fake news.

Regulating tech platforms

Clark stresses increased access to “quality health information”, a “much better understanding of the real impact of mis- and disinformation on health incomes”, and holding tech platforms accountable for their role in purveying misinformation.

“What might regulators insist that they do to clean up their act and stop being the purveyors of the kind of mis and disinformation that is going to cost people’s lives and health?” she asks.

France has a national strategy for combating disinformation in health, which could inspire some other countries, says Jergensen.

The European Union’s Digital Services Act seeks to “strengthen the responsibility of digital platforms” to clamp down on the spread of illicit or misleading content, she points out.

“We also need to strengthen regional and international ways that we share information, and to cooperate in early warnings.”

Simão notes that, in Brazil’s National Health System in Brazil, there is a legal requirement f to have civil society participation.

Iamsirithaworn stresses speedy responses to misinformation and strengthening governments’ “social listening capacity” to understand what people are hearing and thinking.

Akinfaderin calls for strengthened capacity, particularly in the global south, to challenge the notion that being anti-science is akin to decolonisation.

‘Together for Science and Health’

WHO Chief Scientist Sylvie Briand

WHO Chief Scientist Sylvie Briand stresses the need to “listen, connect, and communicate”.

Her division aims to launch a movement called ‘Together for Science and Health’ to address mis- and disinformation.

Mardini acknowledges that misinformation spreads “faster than our collective ability to counter it”

“We will not solve disinformation by correcting falsehood faster. We must build systemic resilience by strengthening scientific literacy, investing in transparency, reinforcing links between science and communities, and working through trusted international networks.

He also calls for “supporting healthcare workers as trusted communicators”, as they are “the most credible interface between science and society, but they need time, training and institutional backing to play this role”.

“Ultimately, the question is not only how we fight misinformation and disinformation, but whether we create environments where it cannot easily take root and spread.”

Image Credits: EU vs DiSiNFO.

Africa CDC Chief Condemns Ebola Travel Restrictions and Broken Aid Promises

28/05/2026 Kerry Cullinan

Africa CDC Director General Dr Jean Kaseya

International Ebola-related travel restrictions imposed on people from the Democratic Republic of Congo (DRC), Uganda and South Sudan – which has yet to record a single case – are “unacceptable” will have a detrimental effect on the economies of affected countries, said Dr Jean Kaseya, head of the Africa Centres for Disease Control and Prevention on Thursday.

The US was the first to ban travellers from the three countries, with Canada, the Bahamas, Jordan and Bahrain following, but Kaseya said 15 countries have now imposed some form of travel restrictions.

“We cannot stop this outbreak with travel restrictions that Western countries have started to impose on African countries. It even a shame to see a country like South Sudan, with zero suspected cases and zero deaths, under travel restriction. The treatment that Western countries are applying to Africa… it’s not acceptable,” said Kaseya, speaking from the DRC’s capital, Kinshasa.

During the last large Ebola outbreak in 2018, West Africa lost $53 billion or 12% of their GDP, said Kaseya.

By Wednesday, there were 1077 suspected cases in the DRC and 246 deaths, including “three very young doctors” in Bunia in Ituri province, the epicentre of the outbreak, Kaseya reported.

However, more cases are expected as given that the outbreak is centred in a remote and conflict-ridden,

Two countries are affected but 11 countries on their borders are at risk, and Africa CDC is also working with these countries to strengthen their surveillance capacity.

“Tomorrow, I will be in Burundi meeting the president and senior officials to see how the country is getting ready if the cases that we have in South Kivu [in neighbouring DRC] are detected also in Burundi. This is why we are really running –l et me correct myself, we are not running, we are flying – to make sure that we can stop this outbreak very quickly.”

‘Mistrust of Western countries’

Kaseya said that he had visited Bunia in the last few days where he encountered “mistrust of Western countries” by people in the area.

“The question they are asking me is: ‘DG, why after 19 years of this [disease], we still don’t have a vaccine, we still don’t have medicine? A local leader was telling me: ‘If this outbreak was in Europe or in the US, a vaccine and medicines will already be available’,” Kaseya told the media briefing.

Kaseya also condemned countries that had pledged financial support for the outbreak effort only to renege a few days later, saying that he would name them within a week if they did not make good on their promises.

The DRC will contribute $50 million to the effort, but the need is in the region of $319 million.

“On Monday (25 May), we ended the day with a pledge of $498.8 million almost $500 million Since then the figure is going down. Now, as I’m talking to you, the figure is around $290 million We cannot afford to stop this outbreak without resources. We cannot afford to stop this outbreak just with political declaration from some countries,” he said.

Africa CDC has developed a list of priority tasks for all affected sectors, making a particular appeal to communities to trust and protect health workers.

Community members have attacked and torched tents housing Ebola patients at Mongbwalu General Referral Hospital three times in the past week, demanding the bodies of their relatives for burials – unaware that their bodies remain infectious after death. In the latest attack, a seriously ill patient died while trying to escape the burning tent and 18 others fled.

Kaseya said that churches and local radio stations were being mobilised to assist to reach affected communities and provide them with accurate information about the disease and their risks.

The US State Department announced on Thursday that it has “mobilized more than $112 million in bilateral foreign assistance for the Ebola response in less than two weeks”, with an additional $80 million in bilateral assistance to key partners finalised this week.

“These new resources will enable implementing partners to scale up the following critical response activities: PPE procurement and delivery, border screening and surveillance, contact tracing, and diagnostics supplies,” the US State Department said.

WHO Calls for ‘Immediate Ceasefire’ to Enable Ebola Response

28/05/2026 Kerry Cullinan

Members of the Red Cross bury people who have died of Ebola in Rwampara in the DRC, guarded by military personnel after attacks on a treatment facility for Ebola patients.

The World Health Organization’s (WHO) Director General has called for an immediate ceasefire in the eastern DRC to enable officials to address the outbreak of a particularly deadly strain of Ebola, warning that stopping transmission “depends entirely on humanitarian access”.

The DRC’s Ituri province, the heart of the Ebola Bundibugyo virus outbreak, is facing “a catastrophic collision of disease and conflict”, Tedros warned on Wednesday.

The DRC army and the M23 rebel group are locked in combat, largely focused on control over the region’s minerals.

“Ongoing clashes are driving mass displacement, pushing exposed contacts into overcrowded camps and severing critical containment corridors. Frontline workers are risking everything, while attacks on health facilities make tracking cases and their contacts nearly impossible,” Tedros warned.

The Africa Centres for Disease Control and Prevention has warned that the outbreak could infect up to 7,500 people. On 23 May, it reported almost 1000 suspected cases and over 100 deaths.

However, it is difficult to confirm cases as samples from the outbreak zone must travel 1,700 kilometres – often on rudimentary roads – to reach the Institut National de Recherche Biomédicale in Kinshasa, the only facility in the country with the capacity to test for Bundibugyo.

The conflict has also made it difficult for health officials to provide residents with information about the outbreak, for which there are no approved vaccines or treatments, and a death rate of up to 50%.

In the latest attack, a seriously ill patient died while trying to escape the burning tent and 18 others fled.

“We cannot build community trust or isolate the sick while bombs are falling,” said Tedros. “We urge all warring parties to agree to an immediate ceasefire to contain this outbreak. To allow us safe and sustained access for medical teams.”

Travel restrictions

Last week, the United States (US) closed its borders to citizens from the DRC, Uganda and South Sudan, and this week it emerged that US citizens exposed to the virus in these African countries will be quarantined in Kenya rather than flown home.

This week, Canada also closed its borders to the same three countries.

However, a spokesperson for the European Centre for Disease Prevention and Control (ECDC) said on Wednesday that “the risk of infection to the general population in Europe remains very low”, but stressed that it is “crucial to reduce risk by identifying travellers who are symptomatic”.

The ECDC is assisting the European Union and European Economic Area (EU/EEA) to “rapidly detect and isolate anyone infected who is arriving from the regions affected and carry out all necessary control measures”.

It has also deployed an ECDC expert to the Africa CDC to support its response.

Meanwhile, Uganda – which has confirmed 17 cases – has closed its border with the DRC. Within the DRC, flights to Bunia in Ituri have been suspended, both containing the outbreak and making humanitarian efforts more difficult.

Race for vaccines, treatment

Meanwhile, scientists are racing to adapt current Ebola research, which is focused on the more widespread Zaire strain, to address the Bundibugyo outbreak.

There are plans to extend a Phase 3 trial of the oral antiviral treatments, remdesivir (Obeldesivir) and Molnupiravir, to include the highest-risk contacts of people infected with Bundibugyo, testing whether they can stop or minimise infection within the 21-day infection period.

Dr Marie Jaspard, a French infectious disease researcher who heads the Ebola Post-Exposure Prophylaxis (EboPEP) research group, told a WHO scientific webinar earlier this week that scientists are redesigning the protocol as fast as they can, but that suitable high-risk contacts will be able to receive treatment immediately.

Obeldesivir is an oral form of remdesivir, which is suitable for remote settings, although its safety in children and pregnant women has not yet been established.

Molnupiravir, which proved effective against COVID‑19 experience, has shown some efficacy against Ebola in animal studies.

The most advanced treatment candidate for Bundibugyo is MBP134, “a cocktail of two broad-spectrum monoclonal antibodies, capable of neutralising several viral species of Orthoebolavirus”, which has already been tested on primates, according to the French scientific research agency, ANRS.

But this has to be injected, making it less suitable for remote areas such as Ituri.

Meanwhile, DRC Health Minister Roger Kamba said that his country has requested access to a monoclonal antibody tested against all three Ebola strains – Zaire, Sudan, and Bundibugyo – that has been developed in the US.

The DRC has officially requested access to this experimental treatment to launch a clinical trial for confirmed patients.

Image Credits: AP, Africa CDC.

Global Temperatures Head For Record Highs in Next Five Years

28/05/2026 Disha Shetty

Temperature projections from the World Meteorological Organization (WMO) warn that temperatures will rise further in the next five years.

Global average temperatures are likely to reach record levels in the coming five years, the latest report from the World Meteorological Organization (WMO) warns, released amid news that the UK recorded its hottest day in May ever earlier this week.

Temperatures in the Arctic region are expected to continue to be higher than the global mean, according to the report produced by the United Kingdom’s Met Office and released on Thursday.

A record-breaking heatwave is sweeping across Europe, causing misery and deaths in some European countries. On Wednesday, the temperature at Heathrow Airport in London reached 35°C, the hottest day in May recorded in the UK. In some parts of France and in Spain temperatures were higher by as much as 10°C compared to normal.

The WMO’s report suggests that such brutal summers will become the norm in the near future. The annual global mean near-surface temperatures during 2026–2030 are projected to range between 1.3°C and 1.9°C above the 1850-1900 average.

“There is an El Niño predicted for the end of 2026, which increases the chances of the following year, 2027, being the next record-breaking year,” said Dr Leon Hermanson, the report’s lead author.

There is an 86% chance that one of the years between 2026 and 2030 will surpass 2024 as the warmest year on record, according to the update.

Paris Agreement target in danger

The Paris Agreement target of 1.5°C is likely to be breached more often in the coming years.

In 2015, global leaders agreed to try to limit global warming to 1.5°C above the pre-industrial era. The target was seen as being an example of low ambition by several low-lying countries and climate advocates. However, the world briefly breached this target in 2024 when the global average surface temperature was about 1.55 °C.

The WMO report now finds that there is a 91% chance that the global mean near-surface temperature will temporarily exceed 1.5°C above the 1850-1900 between 2026 and 2030.

It is also likely (75% chance) that the 2026-2030 five-year mean will exceed 1.5°C above the 1850-1900 average.

For now, the 2°C mark seems to be safe and some time away. The WMO report said that it is considered exceptionally unlikely (less than 1%) that any single year will exceed 2°C above the 1850-1900 average in the next five years.

With every half-degree temperature rise, the sea levels rise and put communities living in low-lying areas in danger.

Arctic warming at record pace

The Arctic region has been especially affected by climate change.

The Arctic region is fast warming at a record pace. Arctic temperatures over the next five extended northern hemisphere winters (November-March) are predicted to be 2.8°C above average temperatures for 1991-2020. This is more than three and half times that of global mean temperature anomaly over the same period.

Projections of Arctic sea-ice for March 2026-2035 suggest that there will be further reductions in sea-ice concentration in the Barents Sea, Bering Sea, and Sea of Okhotsk.

The rainfall and snowfall patterns are also changing. While some areas are projected to get wetter, others are projected to get drier.

In the tropics and in high latitudes, the precipitation is expected to increase compared to the 1991-2020 reference period. Precipitation is expected to decrease in the subtropics, particularly in the southern hemisphere, where a warmer climate is expected.

For May-September 2026-2030, the report suggests higher precipitation in the Sahel, northern Europe, Alaska and Siberia. But Amazon is likely to be drier during this period which will also make it prone to forest fires.

A guide for policymakers

Small developing island states are highly vulnerable to the effects of climate change and rely on universal diplomatic processes to ensure they hold equal weight to major global powers.

The 1.5°C and 2.0°C levels specified in the Paris Agreement refer to long-term warming sustained over an extended period, and not just one year. Typically, this period is at least two decades long.

Individual years with annual global mean temperatures exceeding these levels do not mean that the long-term temperature goals of the Paris Agreement are out of reach.

These reports are meant to guide policymakers as they formulate policies to reduce global carbon emissions. Around 13 different institutions contributed data to this report, increasing the reliability of the results.

Image Credits: WMO, Unspash/Mika Baumeister, Melissa Bradley, Unsplash/Ernests Vaga.

‘Failure was Never an Option’: South Africa’s mRNA ‘Hub’ Awarded Good Manufacturing Practice Certification

27/05/2026 Kerry Cullinan

Afrigen CEO Prof Petro Terblanche.

Afrigen Biologics, the South African facility that developed an mRNA vaccine from scratch during COVID-19, has become the first African facility to be certified to manufacture investigational biological products for Phase I and II clinical trials.

The facility celebrated receiving its Good Manufacturing Practice (GMP) certification for its mRNA facility in Cape Town from the South African Health Products Regulatory Authority (SAHPRA) on Wednesday.

This means that Afrigen now meets internationally recognised pharmaceutical manufacturing standards.

“Failure was never an option,” said Afrigen CEO Professor Petro Terblanche, while paying tribute to her team, the World Health Organization (WHO), Medicines Patent Pool (MPP) and several key donors.

Almost four years ago – on 21 June 2021 – Afrigen was selected as the “mRNA hub” by the WHO and MPP – along with BioVac and the South African Medicines Control Council.

Afrigen had the “enormous task to develop an mRNA platform, to industrialise it and to transfer technology to 15 partners on four continents in low-middle-income countries representing four billion people”, she added.

“We are ready to support clinical trial material production, advance technology transfer and contribute meaningfully to vaccine and biologics development and manufacturing.”

Afrigen’s 15 partners – including Bangladesh, Brazil, Egypt, India, Nigeria, Ukraine, Serba and Vietnam – are using the knowledge acquired from the hub to develop mRNA products to address a wide range of challenges from cancer to dengue to foot-and-mouth disease in animals.

Huge challenge of sustainability

Charles Gore, head of the Medicines Patent Pool.

MPP head Charles Gore described the developments over the past four years as “mindboggling”, as the programme moved “from concept to regulated manufacturing capacity and a growing global network”.

“The idea that, in Africa, we would have this kind of progress and a cutting-edge technology six years ago, before COVID-19, would have been unthinkable,” said Gore.

“What has developed here [has been] transferred out across LMICs to make the world a better and safer place.”

However, Gore said that the next phase of the mRNA Technology Transfer Programme is to ensure that it is “really sustainable, because there is no point having the capacity if you then walk away and leave it to stagnate”.

This means that Afrigen and its partners will need to make – and sell – high quality products to governments and companies.

As previously reported by Health Policy Watch, the key challenge facing all mRNA hub partners is to ensure that governments procure their vaccines and medicines – although the new start-ups’ products are likely to be more expensive than the giant pharma firms that have been in the business for years and are already supplying large global markets.

Milestone for Africa

Dr Claudia Nannei, WHO’s team lead in product development and manufacturing

WHO Director General Dr Tedros Adhanom Ghebreyesus, told the gathering via a video message that the GMP certification is “an important milestone not only for South Africa and the African continent, but also for global health”.

“Afrigen now serves as a quality-assured strategic platform for regional manufacturing, contributing to secure supply, pandemic preparedness and Africa’s health sovereignty. “

Like Gore, Tedros stressed that the next phase of the programme “must focus on sustainability, strengthening product pipelines, partnerships and long-term capabilities”.

Tedros also thanked the governments of South Africa, Belgium, Canada, France, Germany, and the European Commission for supporting Afrigen.

Dr Claudia Nannei, WHO’s team lead in product development and manufacturing, described the GMP certification as not simply a technical or regulatory achievement.

“It demonstrates that advanced quality assurance mRNA manufacturing capacity can be developed from scratch on the African continent, as long as it’s grounded on scientific excellence.”

Cervical Cancer Elimination Off-Track: Commonwealth Leaders Deploy New Strategies

27/05/2026 Felix Sassmannshausen

Commonwealth leaders, global health experts, and diplomats gather at the inaugural Health Coordination Forum in Geneva to accelerate cervical cancer elimination.

The Commonwealth’s new strategic framework accelerates the elimination of cervical cancer, a highly preventable disease that claims hundreds of thousands of lives yearly. However, shifting global funding and major prevention gaps threaten to derail progress, forcing states to double down on shared digital resources, regional cooperation, and community engagement.

Inside the wood-panelled executive boardroom at the World Health Organization (WHO) headquarters in Geneva, delegates gathered ahead of the 79^th World Health Assembly to discuss strategies on cervical cancer elimination in the Commonwealth, a global association of 56 countries that spans both advanced economies and low- and middle-income countries.

Miriam Mutebi highlights critical global mortality rates.

The atmosphere of the inaugural Commonwealth Health Coordination Forum was charged with a mixture of diplomatic ambition and the sobering reality of continued systemic failures.

“Every three minutes somewhere in the world a woman is dying from cervical cancer,” said Professor Miriam Mutebi, an oncologist and chair of the Commonwealth International Task Force for Cervical Cancer Elimination.

The disease is almost entirely preventable, yet it remains a leading cause of mortality among women worldwide, predominantly in low- and middle-income countries. The human papillomavirus (HPV) drives the vast majority of these fatalities, killing approximately 348,000 women annually.

The Commonwealth bears a disproportionate cervical cancer burden relative to its share of global population.

Low- and middle-income countries bear the highest burden

The Commonwealth bears a disproportionate share of this burden, as shown in a newly published report by the Commonwealth Secretariat, developed in partnership with Roche Diagnostics. Its member states account for 40% of global incidence and 43% of mortality, despite representing only 30% of the world’s population of around 2.7 billion.

While most high-income countries are currently on a trajectory to meet the WHO 2030 targets – demanding 90% vaccination, 70% screening, and 90% treatment coverage – and eliminate cervical cancer by 2050, most low- and middle-income nations lag far behind. At current rates of progress, these countries will only achieve elimination in 2120. Furthermore, without decisive action, projections suggest that new cases in the Commonwealth could rise by 55% and deaths by 62% by the year 2030.

Jennifer Namgyal stresses the need for systems-level policy implementation.

Facing immense challenges, achieving cervical cancer elimination demands massive logistical and financial efforts.

This requires embedding cancer care into primary health systems, integrating HPV vaccination into routine immunisations, and linking screening to existing maternal services, so women do not have to navigate separate systems.

“The challenge is not at all a lack of evidence. It is the absence of a sustained systems-level implementation,” said Jennifer Namgyal, Acting Senior Director of the Social Development, Youth and Gender Directorate at the Commonwealth Secretariat, in an interview with Health Policy Watch.

Regional successes in fighting cervical cancer

Although single-dose HPV vaccines drive regional successes, cervical cancer elimination remains off track across many Commonwealth countries.

The newly released Commonwealth report outlines how low- and middle-income countries successfully leverage political will to scale up national cervical cancer elimination programmes. The compendium features 12 country case studies detailing strategic innovations across HPV vaccination, screening, and treatment.

“Rwanda and Nigeria really show how strong political commitment to scaling national cervical cancer programmes can work,” said Namgyal.

After transitioning to systematic HPV DNA testing in 2020, Rwanda implemented community-based self-sampling and a custom electronic medical record system to track patient data, manage clinic referrals, and automate follow-up reminders. By 2022, the country achieved 93% vaccination coverage among girls aged 9 to 14.

Similarly, Nigeria launched a historic single-dose vaccination campaign, immunising approximately 17 million girls since October 2023 and increasing national coverage from under 10% to over 30%. To reach vulnerable, out-of-school populations, the government strategically distributes these vaccines through markets, religious houses, and mobile clinics.

Other member states offer equally compelling blueprints, such as Zambia’s decentralised screening approach and Belize’s sustained domestic financing.

Shortfalls, ODA cuts and lack of data

Severe data gaps and underfunding threaten the target ten-point-five billion dollar global cervical cancer elimination strategy.

Despite these localised successes, key challenges emerge around funding shortfalls and current ODA cuts across the globe, affecting last-mile delivery of vaccines and screenings by community health workers. As economic growth remains slow or even decreases, countries will face further escalating fiscal shortfalls, forcing them to shrink overall health budgets.

“It is evident to us that there is severe pressure on ODA on multilateral funding, full stop,” explained Namgyal.

To keep elimination efforts on track across 78 low- and lower-middle-income countries (inside and outside the Commonwealth), the WHO estimates that stakeholders must invest $10.5 billion by 2030. The majority of these investments (59%) are required for vaccination programmes, while the rest (41%) is needed for cervical cancer screening and management.

However, pinpointing the funding gap remains difficult as publicly available data exists for only 27 of the 56 Commonwealth countries, and most of that data pre-dates 2020. What little evidence is available shows that funding is largely inadequate, with some countries dedicating less than 1% of their total health budget to cancer control.

Confronting complex epidemiological threats

HPV genotypes covered by current vaccines and percentage contribution in invasive cervical cancer.

The shifting global landscape requires rapid adaptation to address overlapping epidemiological threats, particularly in regions with high HIV prevalence. Women living with HIV are six times more likely to develop cervical cancer compared to the general population, with Sub-Saharan Africa accounting for 85% of women living with both.

Furthermore, the HPV-35 strain has a disproportionately higher prevalence in sub-Saharan Africa, yet it remains untargeted by existing vaccine formulations. This lack of coverage underscores the urgent need to accelerate research to create an updated, polyvalent vaccine, as the genotype accounts for a significant proportion of invasive cervical carcinoma in populations with high HIV prevalence.

To prepare for these advancements, the board of the vaccine alliance Gavi approved the inclusion of improved vaccines in its portfolio in December last year, ensuring they can be made available to countries as soon as they are licensed. When asked about integrating the HPV-35 strain into future vaccines, Namgyal noted that the Commonwealth relies on specialised health organisations for clinical guidance.

“We understand that best practice is established through WHO recommendations and then country-specific epidemiology then informs the rollout in those contexts,” she said.

Sharing resources across vast borders

From left to right: Miriam Mutebi (Commonwealth International Cervical Cancer Taskforce), Sofiat Akinola (Roche Diagnostics), Janneth Mghamba (Commonwealth Secretariat), Jennifer Namgyal (Commonwealth Secretariat), Leslie Ramsammy (Chair, CHCF).

Until then, robust screening programmes and rapid treatment options remain the primary defence against these emerging strains. The Commonwealth’s strategy focusses heavily on transitioning from traditional Pap smears to DNA testing to detect these risks earlier.

The Commonwealth also leverages high-level “South-South” diplomatic strategies and shared resources across the 56 member states. Rather than building isolated infrastructure, countries are leaning into collaborative networks to bypass human resource shortages and financial constraints.

This strategic approach directly responds to the Lancet Oncology Commission roadmap for cancer control, which provides a framework for member states to tackle the rising incidence of the disease. Acting senior director Namgyal emphasised that the priority is translating evidence into country-led action, embedding care within primary health systems, and integrating HPV vaccination into routine immunisations. Ambassador Leslie Ramsammy of Guyana further detailed this collaborative approach during the session, stressing the necessity of leveraging shared clinical capabilities.

To overcome diagnostic bottlenecks without adequate domestic specialists, Guyana invested in a digital pathology laboratory. Through this digital infrastructure, specialists in India and New York now read pathology images created in Guyana, the former health minister said.

Community engagement versus misinformation

Educational toolkits and self-sampling guides combat cultural stigma by empowering women with direct health information.

While diplomatic strategies and shared pathology labs address structural deficits, implementation on the ground requires navigating complex cultural barriers. Global health guidelines recommend engaging communities directly to overcome gender and social hurdles that traditionally hinder vaccination efforts.

The combination of direct community engagement and grassroots mobilisation via youth-focused approaches by NGOs like Girl Effect, alongside advocacy groups such as Zambia’s Teal Sisters and the Belize Cancer Society, creates a comprehensive ecosystem for disease control. Global health leaders now cite Malawi as a champion model after a recent grassroots campaign targeting schoolgirls successfully extended HPV vaccine coverage above 90%.

Another successful strategy involves First Ladies and spouses of Heads of Government across the Commonwealth, whose advocacy proves transformative in breaking silences and reducing misconceptions that prevent women from seeking care. To further lift the stigma, experts recommend gender-neutral vaccination programmes that also include boys.

“Breaking down stigma, making it more accessible and more ordinary to speak about is a very helpful part of that,” said acting senior director Namgyal.

However, this can only succeed if health systems possess the capacity and funding to actually deliver the vaccines and screenings.

Non-binding approach, fiscal constraints

With multilateral funding currently constrained, major hurdles remain because the Commonwealth approach is non-binding. Therefore, the path forward requires a relentless focus on translating high-level commitments into sustainable, community-level solutions.

Guyana’s Ambassador Leslie Ramsammy called for cross-border cooperation.

“This first forum does not end this afternoon – this first forum will continue working until we have that action plan,” said Ambassador Leslie Ramsammy, former Minister of Health for Guyana and permanent representative to the United Nations in Geneva, committed to developing a concrete action plan.

“Economic status and geography should not bring death to our doors.”

However, without ramping up resources, these efforts may struggle to achieve the WHO’s elimination targets.

Until then, women will continue to suffer and die from a disease with established, cost-effective prevention and treatment methods.

Shining a spotlight on snakebites

Millions are bitten by snakes every year, and struggle to access care.

An estimated 5.4 million people worldwide are bitten by snakes each year and around 1.8 to 2.7 million cases of envenomings, according to the WHO.

Most snake bites happen in Africa, Asia and Latin America. They can be fatal, cause paralysis and lead to amputations. While treatments do exist, only a handful of countries produce the antivenoms. Cost and access are both barriers to effective treatment.

Faiz’s career of over two decades was also spent working on diseases like malaria that affect vulnerable populations in low-resource settings.

“His work on snake bite envenoming reminds us of a reality that is too often invisible: the burden of neglected tropical diseases that affect millions of people, particularly in the most vulnerable regions of our planet,” said Robert Mardini, Director of Geneva University Hospitals, at the award ceremony.

Snake bite envenoming was recognised in 2017 by the WHO as a high-priority neglected tropical disease, said Mardini.

“This recognition did not happen by chance. It is the result of years of research, advocacy, and field engagement.

“Fundamental progress in global health happens only when science, field experience and institutions work in collaboration work hand in hand,” Mardini added.

The existing antivenoms, “may not properly reflect the geographical variation that occurs in the venoms of some widespread species,” according to the WHO.

Climate change is worsening inequities in health

Sania Nishtar, CEO of the global vaccine alliance Gavi.

The prize-giving ceremony, co-hosted by the WHO and the Geneva Health Forum, also served as a gathering of global health leaders to discuss ideas.

“There’s an inextricable relationship between animal health, human health, and environmental health. In our line of work, we see it playing out very, very often now. So diseases are appearing in areas where they were not recognisable at one point in time,” said Sania Nishtar, CEO of the global vaccine alliance, Gavi.

She added that while there are funding challenges, many countries have also stepped up their domestic health funding, particularly in Africa, which is a positive sign.

The prize is awarded in honour of Dr Lee Jong-wook, the sixth Director-General at the World Health Organization (WHO), and died at the age of 61 in 2006.

“He believed in equity, he believed in solidarity, and the fundamental right to health for all,” said Saia Ma’u Piukala, regional director of the WHO Western Pacific Region.

“His work [in] expanding access to essential medicines, strengthening preparedness, advancing universal health coverage and investing in health workers and communities continues to shape WHO priorities today,” he added.

Image Credits: WHO, WHO.

Mandates or Markets? Geopolitical Rift Impairs Pandemic Preparedness as Crisis Funds Hit ‘Dangerous Lows’

26/05/2026 Felix Sassmannshausen

From left to right: Suerie Moon (GHC), Viroj Tangcharoensathien (IGWG), Matthias Seiche (Germany), and Maria Van Kerkhove (WHO) discuss pandemic preparedness.

WHO emergency funds are running low, and global health leaders are concerned about a systemic paralysis in pandemic preparedness. In high-level discussions in Geneva, experts explored the geopolitical rifts, pitting the Global South’s demand to treat pandemic tools as legally binding “public goods” against a European push for market-driven surge financing.

As a severe Ebola outbreak spreads among vulnerable populations in the Democratic Republic of the Congo and Uganda, the financial gridlock in global pandemic preparedness funding is taking a measurable human toll. The escalating emergency serves as a grim reminder that “nature does not wait for humans to finish treaty negotiations,” Professor Suerie Moon, co-director of the Global Health Centre (GHC) at the Geneva Graduate Institute, noted at a high-level forum in Geneva.

Maria Van Kerkhove (WHO) warns of dangerously low emergency funds.

Public health leaders warned at the event that the threat from infectious diseases and pandemic preparedness are severely neglected while nations simultaneously ramp up military defence and border security spending.

Expressing her frustration over these skewed global priorities, Dr Maria Van Kerkhove, acting director of the department of epidemic and pandemic management at the World Health Organization (WHO), noted that the agency’s contingency fund for emergencies is “dangerously low right now.”

“You can spend billions of dollars a day on a war, and we don’t have money for this,” she stated, calling the constant struggle for health financing “ridiculous” during the panel discussions.

Co-hosted by the GHC, the WHO, the European Commission, and the governments of Indonesia and Germany, the forum convened a diverse coalition of decision-makers.

Alongside Van Kerkhove, Dr Viroj Tangcharoensathien, vice-chair of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement, and Matthias Seiche, head of health policy and financing at Germany’s Federal Ministry for Economic Cooperation and Development, offered contrasting visions over approaches to crisis funding. They were followed by a technical panel of specialised agencies that explored practical implementation, moderated by GHC’s Head of Policy Engagement, Daniela Morich.

The debate exposed a deep ideological rift: while low- and middle-income countries are demanding legally binding treaties that mandate equitable access to life-saving tools as a universal public good, western states are pushing for market-based financial mechanisms to quickly mobilise capital in the event of a crisis.

Championing pandemic preparedness as a ‘public good’

From left to right: Daniela Morich (GHC), Janet Ginnard (Unitaid), Jutta Reinhard-Rupp (FIND), and Aurélia Nguyen (CEPI).

For the Global South, the solution to this systemic paralysis lies not in ad-hoc charity or voluntary donations, but in strict, enforceable obligations under Article 12 of the WHO Pandemic Agreement. This article establishes the pathogen access and benefit-sharing (PABS) system, the details of which are still being negotiated by the IGWG.

Low- and middle-income nations argue that if they share biological materials with the international community, pharmaceutical companies must be legally compelled to share the resulting vaccines, therapeutics, and diagnostics.

Reinforcing this demand, Tangcharoensathien warned the forum that current voluntary and interim mechanisms are vastly inadequate for pandemic preparedness and major crises. He urged the rapid adoption of the PABS annex to regulate how outbreak-prone pathogens and their genetic sequences are shared globally.

To operationalise this, the African Group and the Group for Equity – representing over 80 countries and roughly 75% of the global population – are pushing for standardised contracts that commercial users must sign before accessing any pathogen materials or sequence information.

Proposed mandates for pathogen sharing, a 1.5% revenue tax, and a 20% production reserve.

Indonesia’s Minister of Health Budi Gunadi Sadikin wants pandemic tools to be seen as public goods.

Under these proposed agreements, which include Standard Material Transfer Agreements (SMTAs) and Data Access Agreements, commercial users generating revenue from PABS materials would be required to contribute up to 1.5% of their gross revenue to a dedicated fund.

Participating manufacturers would also be legally bound to reserve at least 20% of their real-time production for the WHO during a pandemic, providing a minimum of 10% as donations and the remainder at affordable or not-for-profit prices.

Reflecting the urgency of treating these tools as universal rights rather than market commodities, Indonesian Minister of Health Budi Gunadi Sadikin – a likely contender for the post of WHO director-general in the upcoming elections – made a stark plea to the forum. “During crises, we need to make this a public good… You cannot play God through this,” he stated in his keynote speech.

Global health funding agencies on the panel strongly supported the demand for legal accountability.

“At the end of the day, until you have something in a contract, you don’t have access,” said Aurélia Nguyen, deputy CEO of the Coalition for Epidemic Preparedness Innovations (CEPI).

Pointing to the urgent need for legally binding agreements, Nguyen noted that funders must act immediately: “We need to be doing that one by one and making sure those access provisions are built in.”

Europe’s ‘global good’ paradox

The contentious debate on pandemic preparedness is playing out against a broader backdrop of rising geopolitical friction and transactionalism in global health policy, Dr Florika Fink-Hooijer, director-general of the European Commission’s Health Emergency Preparedness and Response Authority (DG HERA), pointed out in her keynote remarks.

Florika Fink-Hooijer (EU) warns of rising transactionalism in health policy.

“We are in a very difficult context,” she warned the forum. “Health has really become transactional.

“Health is something which is a geopolitical instrument. It’s certainly not necessarily treated as a global good, and that we have to bring back,” she urged.

Despite Fink-Hooijer’s appeal for a return to treating health as a global good, the European Union’s approach in practice relies heavily on voluntary partnerships and leveraging a strong private sector.

Fink-Hooijer noted that Europe is investing in mechanisms like joint procurement networks and private-public partnerships to ensure the continent remains “reliable” as a global partner during emergencies.

Recently published official EU policy emphasises that a competitive European health industry is a core pillar of global health resilience.

Contrasting the legally binding Public Good Model against market-driven approaches.

Reliance on private investments

Diverging significantly from the strict, legally binding mandates for corporations demanded by the Global South, high-income blocs – including EU member states, Switzerland, and Norway – are pushing to retain anonymous access to pathogen genetic sequence databases.

To accommodate this, an informal “hybrid model” has recently been floated for the PABS system, which includes an “open route” that would allow commercial users to access data without signing binding contracts.

Matthias Seiche (Germany) emphasises reliance on taxpayer contributions.

This proposal has been sharply criticised by policy experts at the South Centre and a coalition of over 100 non-governmental organisations, including Oxfam and Medicus Mundi International.

However, Europe’s reliance on the private sector extends to pandemic funding, and European representatives warned that idealistic labels do not magically solve the financial realities of crisis response.

Arguing for models that leverage institutional capital, Germany’s senior diplomat Matthias Seiche cautioned the Geneva panel that whether pandemic funding is framed as Official Development Assistance (ODA) or a global public good, it inherently relies on domestic contributions.

“In the end, it is always the taxpayers’ money that has to be combined from countries all over the world,” he said.

Germany champions limited ‘surge financing’

To circumvent the delays of traditional voluntary funding – and provide a market-driven alternative to the mandatory corporate contributions demanded by the Global South – industrialised nations are instead championing the Global Surge Financing Initiative.

First established in 2024 through a memorandum of understanding signed by development finance institutions from G7 nations, the European Investment Bank (EIB), MedAccess, and the World Bank’s International Finance Corporation (IFC), this mechanism aims at pooling institutional capital to rapidly finance advance purchase agreements for lower-income countries.

The surge financing model combines market-based capital, private-sector reliance, and a hybrid PABS system.

Viroj Tangcharoensathien (IGWG) remains sceptical of surge financing.

Providing “fast and flexible capital” – as the initiative’s partners describe it – through this balance sheet approach would bypass the need to appeal to government finance ministers for grants during the crucial early surge of an outbreak.

Seiche noted that Germany is “in very close and concrete discussions together with the World Bank on putting into place a mechanism to mobilise surge financing at a very large and substantial scale.”

However, fellow panellist Tangcharoensathien expressed scepticism about the initiative. Doubting whether the scale-up mechanism could mobilise adequate support, he argued instead for a sustainable and systematic funding mechanism anchored in the Pandemic Agreement.

Furthermore, he cautioned that because regular monetary contributions under the proposed treaty might ultimately be too small to cover massive emergencies, domestic funding remains the key response.

Acknowledging this limitation, Seiche conceded that while the World Bank mechanism has great potential for the initial weeks of a crisis, longer-term responses will still rely heavily on traditional grant funding.

The ‘scrappy’ interim reality

The recent Ebola outbreak serves as a grim reminder that nature does not wait for treaty negotiations.

Despite the stark contrast in approaches having led to a deadlock in negotiations on pandemic preparedness, global health expert Moon is “actually optimistic” and “confident” that negotiators will successfully reach a consensus.

Echoing this sentiment, Van Kerkhove agreed that she is “very hopeful” and “confident it will be finished.” Yet, underscoring that the world cannot wait for these highly complex and contested formal negotiations to conclude, she noted that the WHO and its partners are heavily relying on “scrappy” interim frameworks like the Medical Countermeasures Network.

“We don’t want to get ahead of member states, but we need something that’s in place,” she stated. Noting the urgency of the Ebola response, she added: “But … we can’t wait until it’s done. So that’s why we have these interim mechanisms.”

However, with the WHO’s emergency contingency funds critically depleted, the ultimate test remains one of global priorities. As long as the international community remains willing to fund defence spending effortlessly while leaving pandemic preparedness and health crisis mechanisms drained, the world will remain dangerously exposed to the next pandemic threat.

Member States Support Extending Talks on Pandemic Agreement Annex, Propose New ‘Method’

Image Credits: WHO/Joël Lumbala , Felix Sassmannshausen/HPW.

From Margin to Mainstream: Why Liver Health Should Sit at the Centre of the Global NCD Response

26/05/2026 Jeffrey Lazarus

The 79th World Health Assembly adopted the first-ever resolution on steatotic liver disease (SLD) last week. For those people working outside hepatology, the moment may have seemed unremarkable. In reality, it marks an important shift in how the global health community understands chronic disease, metabolic health and prevention.

SLD affects an estimated 1.7 billion people globally and is closely linked to obesity, type 2 diabetes, cardiovascular disease and alcohol-related harm.

But liver disease matters not only because of its scale. Fat accumulation in the liver is one of the earliest measurable signs of metabolic dysfunction. Long before many people develop cirrhosis, cardiovascular complications or advanced diabetes, the liver is often already signalling that something is wrong.

Importantly, these warning signs can be detected through tools available in routine care: standard blood tests, non-invasive fibrosis scores such as FIB-4, and imaging technologies that can identify fibrosis before symptoms emerge.

In that sense, SLD functions as an early-warning system for the metabolic crisis reshaping societies worldwide – and provides health systems with a critical opportunity to intervene earlier, while disease trajectories can still be changed.

From siloed specialties to integrated care

Yet despite this opportunity, liver health has remained largely absent from noncommunicable disease (NCD) strategies, primary care systems and prevention frameworks.

That omission has consequences. Across countries, liver disease is often identified only after advanced fibrosis, cirrhosis or liver cancer develops. Opportunities for prevention and timely action are frequently missed.

A person attending routine diabetes care may already show elevated fibrosis risk or mildly abnormal liver tests years before serious liver disease develops. Yet these findings often remain disconnected across primary care, endocrinology, cardiology and hepatology.

The problem is not that we lack the tools; what we lack is integration. Much of this earlier risk assessment and intervention could occur in primary care, where obesity, diabetes and cardiovascular risk are already being managed, instead of waiting until people present to specialist clinics with advanced disease.

Recent work from the Global Think-tank on Steatotic Liver Disease and collaborators across Europe has highlighted both the scale of the challenge and the opportunities for action.

A new Lancet Regional Health – Europe Series shows that Europe’s policy readiness to address metabolic dysfunction-associated steatotic liver disease (MASLD) remains low, even though the condition affects roughly one in three adults and is deeply intertwined with obesity and diabetes.

At the same time, the series demonstrates that many of the tools needed for earlier identification already exist: non-invasive fibrosis testing, automated diagnostic pathways, integrated models of care and digital health systems that make risk stratification increasingly feasible outside hepatology clinics.

Challenge of implementation

The policy challenge now is implementation. That means integrating liver health into national NCD plans, embedding fibrosis risk assessment into obesity and diabetes care, strengthening multidisciplinary care pathways, and measuring late diagnosis so health systems can identify missed opportunities for timely care.

Done effectively, this could reduce avoidable hospitalisations, liver cancer and downstream cardiovascular complications while improving long-term population health.

These themes were central to discussions held this week in Barcelona at the flagship annual meeting of the Global Think-tank on Steatotic Liver Disease, where clinicians, researchers, policymakers, civil society representatives and people with lived experience met to discuss the future of integrated metabolic health policy.

What emerged clearly was that liver disease is not a niche hepatology issue. It is a visible manifestation of a much wider failure to address metabolic risk early and coherently across health systems.

Prevention, preparedness and political choices

This broader perspective matters especially at a moment when global attention is once again focused on epidemic preparedness following the WHO declaration last week of a public health emergency of international concern (PHEIC) related to Ebola.

The nature of preparedness differs, of course, for acute infectious disease outbreaks and slower-moving chronic diseases. But they often share an uncomfortable reality: societies frequently fail to align policy and resource allocation with the evidence available to them.

That is particularly true for steatotic liver disease.

Too often, global health debates are framed as a choice between responding to acute infectious threats or investing in chronic disease prevention. That is a false dichotomy.

Healthy populations create wealth. Prevention reduces long-term healthcare costs, strengthens productivity and supports more resilient societies. Health economics models repeatedly demonstrate the significant returns associated with timely intervention, innovation and reduced disease burden.

The WHA resolution matters not simply because it acknowledges the gravity of SLD, but because it creates a foundation for integrating liver health into the global NCD response alongside obesity, diabetes and cardiovascular disease.

The liver is already sending early biological signals about the global metabolic health crisis. The question for us now is whether governments and health systems are willing to act while those signals still point to diseases that can be reversed, delayed, or prevented entirely.

Jeffrey Lazarus is Professor of Global Health at CUNY SPH, head of the ISGlobal Public Health Liver Group and Director of the Steatotic Liver Think Tank

Image Credits: Liv Hospital, The Lancet Europe.