EU negotiator Americo Zampetti warns that ideological polarization over pathogen access threatens to derail the WHO Pandemic Agreement.
EU negotiator Americo Zampetti warns that ideological polarisation over pathogen access threatens to derail the WHO Pandemic Agreement.

EU negotiator Americo Zampetti warns that ideological polarisation over pathogen access threatens to derail the WHO Pandemic Agreement.

On the eve of the eighth round of talks on an annex to the Pandemic Agreement, the European Union’s (EU) chief negotiator has warned that “ideology” is blocking consensus.

Negotiators meet at the Intergovernmental Working Group (IGWG) at the World Health Organization (WHO) headquarters in Geneva from 14-18 September to thrash out the pathogen access and benefit sharing (PABS) system. 

But little progress has been made over the past year on PABS – or during the four years of talks on the Pandemic Agreement that preceded these talks.

The deadlock is between two camps represented by the EU on the one hand, and an alliance of the African region and Group of Equity countries on the other.

“We are in a world which is very polarised across this particular issue,” Americo Zampetti, Minister Counsellor for Global Health at the EU Delegation to the United Nations, told a recent European Parliament subcommittee briefing this week (7 September).

“The whole agreement, let’s say the mother agreement, is kept hostage by this annex which is very, for lack of a better word, ideologically driven,” Zampetti added.

European Parliament public health lawmakers debate the deadlock surrounding WHO Pandemic Agreement pathogen-sharing negotiations on 7 September.
Members of the European Parliament debate the deadlock surrounding WHO Pandemic Agreement pathogen-sharing negotiations on 7 September.

Other negotiation observers, including Knowledge Ecology International (KEI) and global health academics, have also urged parties to find a more pragmatic solution to the standoff.

Member states must finalise the PABS annex before the Pandemic Agreement, adopted by the World Health Assembly in May 2025, can be opened for member state ratification.

Groundbreaking clauses included in the Pandemic Agreement – including that manufacturers donate a minimum of 10% of medical countermeasures during pandemics and public health emergencies of international concern (PHEIC), and reserve a further 10% for the WHO at cost – cannot be implemented unless the PABS talks succeed. 

Meanwhile, the world’s fastest Ebola outbreak is unfolding in the Democratic Republic of Congo, mpox has re-emerged, and rapid climate change is heightening the risk of epidemics and pandemics.

Two camps

The PABS system will regulate how information about dangerous pathogens should be shared (access), and how the medical products developed from this information (the benefits) are shared.

The Africa Group champions a “federated model”, where regional nodes retain sovereign control over the biological data of pathogens, and pharmaceutical manufacturers are required to sign binding benefit contracts with the WHO before they get access to the data.

This model aims to prevent a repeat of COVID-19 era inequities, where Global South countries rapidly shared pathogen samples but were last in line to receive vaccines and therapeutics. 

By maintaining sovereign data control and requiring binding PABS contracts upfront, developing countries want to ensure that commitments, such as real-time vaccine allocations and technology transfers, are legally secured.

In December 2025, over 80 developing nations – led by the Africa Group and the 33-country Group for Equity – also submitted standard draft contracts to bind pathogen access directly to enforceable benefit-sharing obligations at the IGWG negotiations.

‘Transactional approach’

These nations want manufacturers to pay a subscription to be part of a PABS system,  alongside mandatory technology transfers and non-exclusive licences for pandemic-related vaccines, treatments and diagnostics.

“This transactional approach seems to us very unsuited to get to good results,” said Zampetti. “We need to have common sense prevail.”

Conversely, the European Union advocates a “hybrid model” featuring multi-tiered pathways and open databases. Under this framework, pharmaceutical manufacturers sign private contracts with the WHO, committing at least 10% of real-time production for vaccines, therapeutics and diagnostics during emergencies.

EU negotiators also want to exclude intellectual property rules from the annex, while developing countries insist that benefit-sharing must cover downstream scientific derivatives to prevent commercial developers from circumventing obligations.

While EU officials portray their proposal as the pragmatic option, developing countries argue that non-exclusive pathways risk undermining mandatory benefit-sharing. 

Under open-access systems, provider states lose legal leverage as soon as raw genetic data is downloaded, allowing commercial developers to create products without guaranteeing fair access.

Despite the friction, both competing models share a common technical foundation, based on a WHO Coordinated Laboratory Network for physical samples, WHO-recognised sequence databases, and Unique Persistent Identifiers to ensure end-to-end traceability of pathogen resources.

NGO offers way forward

Knowledge Ecology International director Jamie Love addressing an open session on the Pandemic Agreement.

In a brief issued this week, KEI director Jamie Love writes that a “quid pro quo [approach], linking access to the pathogen samples and digital sequences to equity provisions, has known flaws”.

These flaws include that researchers won’t always need PABS to get access to pathogens or their genomic sequences. And when they don’t, “companies will have little or no incentive to be legally bound to the concessionary sharing of production”.

Love also points out that many countries have already signed agreements to share pathogens outside of PABS, a reference to the terms of bilateral agreements that the United States is pursuing with countries that exchange US support for health programmes for rapid access to pathogen information from outbreaks – with no strings attached.

Love also highlights that attaching too many conditions to access to pathogen information will slow down the response.

Finally, he argues: “With the rise of AI, proving that a specific, locally identified pathogen sequence contributed deterministically to an AI-generated candidate immunogen or small molecule remains technically intractable”.

Instead, KEI argues that countries should ensure that manufacturers obtain contracts with the WHO, “not as a condition of having access to PABS materials and digital sequences, but as a condition of registering and selling products” to address pandemics or public health emergencies of international concern (PHEIC).

Danger of bilateral agreements 

Kenyan Cabinet Secretary Musalia Mudavadi and US Secretary of State Marco Rubio sign the first bilateral agreement in terms of the America First Global Health Policy, in which the US offers health aid in exchange for access to pathogen information.

Meanwhile, academics writing in a recent commentary in The Lancet warn that the delay in reaching agreement is enabling the bilateral agreements to “bypass multilateral systems operationally but also reduce reliance on collectively negotiated multilateral frameworks, such as the Pandemic Agreement”.

This could weaken the collective bargaining power of low-income and middle-income countries, they warn.

“For PABS to remain politically viable, WHO member states might need to show greater flexibility, responsiveness, and willingness to negotiate workable compromises capable of addressing longstanding concerns surrounding equity, manufacturing capacity, technology transfer, and reciprocal benefit sharing,” they argue.

Zampetti also warned against applying principles from the 1992 UN Convention on Biological Diversity (CBD) to pathogen sharing.

The 1992 Convention established national sovereignty over genetic resources, requiring commercial operators to share benefits with provider states. Developing countries insist that CBD-style reciprocity is essential to prevent rich states from monopolising resulting treatments.

However, Zampetti contends that treating lethal pathogens as sovereign assets under these rules creates rigid barriers that hinder emergency response.

“This is a template which is very much unsuited for pathogens,” he said. “Pathogens are not something that you want to conserve.”

The World Health Assembly extended the negotiation timeline to next year’s WHA in May, but progress has been incredibly slow.

“We just need to try to bring it to a conclusion on something that is reasonable,” said Zampetti.

Image Credits: European Union/HPW.

9/11 Lower manhattan Children's health
Smoke continues to rise from Ground Zero following the attack on the World Trade Center in lower Manhattan.

A new CDC research center aims to better understand the possible health effects of those 21 years or younger at the time of their 9/11 exposure.

For the past two decades, the World Trade Center (WTC) health program has pioneered research exploring the health effects of people exposed to the toxic dust and trauma of the 9/11 attacks. Most of this research has focused on people exposed as adults: first responders, emergency personnel, and community members.

Yet some 40,000 children were living in lower Manhattan when hijackers brought down the WTC Twin Towers. The resulting environmental fallout from pulverized buildings that blanketed the area would later be linked to a host of acute and chronic health conditions. Despite this, no systemic study has attempted to fully understand and track the health consequences in the youngest survivors. 

That has left a glaring gap in how exposure to the toxic dust and environmental contaminants affected babies in utero, infants, children, and young adults – a disparity that the Centers for Disease Control and Prevention (CDC) is seeking to close through an Early Life Exposure Research Center.

CDC described the center as “an important first step in addressing this need.” Earlier this year, researchers from the center wrote in an American Journal of Industrial Medicine commentary that ‘[c]ommemorating 25 years since the September 11, 2001, terrorist attacks in New York City allows us to recognize the successful collaboration of community, labor, academia, and government in creating a unique program to monitor and treat environmental health effects in a population of responders and civilian survivors,” but that this September offers an opportunity to “recognize and remedy a gap” in understanding exposure in the youngest survivors. 

The youth research cohort is the result of a December 2022 Congressional mandate to the CDC to track emerging health concerns for those under 21 years old during the attacks.

The news of a research center dedicated to the youngest exposed to 9/11 contaminants comes after a year of turmoil for the CDC, with widespread reductions in workforce across federal agencies.

In February, Department of Government Efficiency (DOGE)-related efforts led to a 20% reduction in WTC program staff, prompting outcry from New York lawmakers, and concerns that certifications to allow treatment of new conditions and cancers would be delayed. 

Decades of research to support survivor and first responder health

A worker stands at Ground Zero Wednesday, Oct. 3, 2001, in New York City.

The 9/11 attacks released unprecedented quantities of complex mixtures of chemicals into the environment. The years of advocacy by affected communities and academics resulted in the passage of the James Zadroga 9/11 Health and Compensation Act–the basis for the WTC Health Program. 

The program was created in 2011 by the CDC’s National Institute for Occupational Safety and Health to provide medical monitoring and treatment of certain WTC-related respiratory diseases, cancers, and mental health conditions. It also funds research into health conditions associated with exposure to dust, debris, and smoke from the 9/11 attacks in New York, Shanksville, and the Pentagon.

In the 25 years since the devastating attacks, more than 1,500 scientific publications have documented the health effects among 9/11-exposed populations, the CDC said.

Among the health effects explored were conditions of the lungs and respiratory tract, cancers, and mental health disorders. This research provided the foundational work for determining which kinds of conditions were linked to 9/11 exposure.

Yet, the authors write that “only a small percentage of those publications have focused on individuals potentially exposed at a young age.” The research that does focus on children found higher rates of asthma and respiratory symptoms among children exposed to the 9/11 dust cloud in Manhattan.

Other studies focused on the negative cardiometabolic and behavioral effects, cancer development, and exposure to toxic forever chemicals. 

But experts and advocates argue that this research only paints a partial picture of the poor health effects children exposed to the disaster may suffer.

“We need to understand the cognitive and neurodevelopmental impacts,” said Dr Joan Reibman, a pulmonologist and professor at NYU Grossman School of Medicine, and an author on the paper arguing for more research. “We need to understand cancer incidence and the characteristics of cancer in this group.”  

Reibman also pointed out that most of the past studies have focused on male populations, leaving a “significant gap in our understanding of the impact on reproductive health.” 

Attention turns to the youngest people exposed

indoor air quality
Children are especially vulnerable to environmental exposures, leading advocates and academics to push for research to fully understand the extent of 9/11-related health effects.

Researchers have long noted that children react differently to chemical exposures than adults. That’s because they experience larger exposures relative to their body size–and their bodies are less able to eliminate chemicals, the CDC said. Children can also have higher exposure to hazards because of crawling, putting their hands in their mouths, and faster breathing rates, said Reibman, whose research focuses on the health effects of WTC chemicals. 

Reibman also notes that though these survivors have a longer lifespan, gives more time for disease to develop, few have been tracked in formal studies.

“Both the WTC Health Program and the [New York City] WTC Health Registry were open to those exposed at a young age, including those exposed in utero,” she said, pointing to the respective CDC and New York programs.

However, Reibman explained that relatively few individuals meet these criteria. Only about 2,400 survivors are enrolled in the CDC program, while 3,200 are enrolled in the NYC program. This prompted a “concerted effort,” Reibman said, to enroll more people into the programs, ultimately leading to a 2022 amendment of the Public Health Service Act to expand the cohort size to include those within 1.5 miles of the WTC sites.

Challenges in studying 9/11 exposures 25 years later

The 9/11 Memorial at the site of the World Trade Centers in New York.

Reibman and others acknowledged the difficulties in piecing together a study large enough to link certain exposures to health outcomes. The WTC Youth Research Coordinating Center “will have to overcome significant barriers to recruitment, which will require the involvement of community groups and novel recruitment techniques,” she said. 

Also needed are an interdisciplinary team of biostatisticians, epidemiologists, and disease specialists to determine the impact of exposures on disease.

Captain Matt Karwowski (Commissioned Corps of the US Public Health Service), chief of the research and evaluation branch at the WTC Health Program, told Health Policy Watch that enrollment would begin after the coordinating center is fully established.

Image Credits: US Coast Guard/Brandon Brewer, US National Archives/ Paul Morse, Courtesy of the George W. Bush Presidential Library, Kelly Sikkema, DHS/Benjamin Applebaum.

August 2026 saw record breaking temperatures to become the joint warmest month alongside July 2023.

Record heat in August this year has made it the joint warmest month alongside July 2023. It was also the first month since November 2025 when global temperatures were 1.65°C higher than the pre-industrial level baseline, shooting the Paris Agreement target of limiting global warming to 1.5°C yet again.

In its latest update, Copernicus, the European Union’s (EU) Earth Observation programme, has also confirmed that this summer was the warmest summer on record for Western Europe.

Scientists attribute this record heat to the combined effect of the burning of fossil fuels and the strong El Niño conditions.

“August 2026 was a remarkable month in the global climate record. It was both the warmest August and the warmest month ever recorded, with global temperatures reaching 1.65°C above pre-industrial levels, marking the return of global temperatures above 1.5°C,” said Samantha Burgess, Strategic Lead for Climate at European Centre for Medium-Range Weather Forecasts (ECMWF).

“Combined with record global sea surface temperatures and the warmest summer on record for Western Europe, these observations show how climate change is driving extremes across both the atmosphere and the oceans. The impacts of these conditions are increasingly being felt by communities, economies and ecosystems across the world,” Burgess said.

See related story:

El Niño Forecast to Be Strongest on Record, Threatening Extreme Weather Through 2027

August 2026 – a record-breaking month

Global-average surface air temperature (°C) for 2023 (orange), 2024 (yellow), and 2026 (dark red). All other years between 1940 and 2025 are shown with grey lines. Data source: ERA5.

Average sea temperature also reached record highs in August over the extra-polar ocean, the water belts adjacent to the Arctic and Antarctic regions.

August 2026 was 1.65°C above the estimated pre-industrial 1850-1900 average, marking the first month above 1.5°C since November 2025. Global leaders hoped to limit global warming to 1.5°C, but this has now been breached more than once.

The period from June to August 2026 was also the joint-warmest period on record globally, on par with record-breaking temperatures in 2024.

Western Europe sees warmest summer on record

(Left) Anomalies and extremes in surface air temperature in June–August 2026. (Right) Average June–August surface air temperature anomalies for western Europe. Anomalies are relative to the June–August average for the 1991-2020 period.
Data source: ERA5

The average temperature over European land in August 2026 was 20.26°C, which is 1.10°C above the 1991-2020 average for the month. This makes it the fourth-warmest August on record.

Overall, summer 2026 (June to August) was the third warmest on record for Europe, behind 2024 and 2022. Heat has killed over 200,000 people over the past four years alone in Europe, according to the World Health Organization (WHO).

Western Europe in particular experienced its warmest summer on record, surpassing the long-standing 2003 record. The 2026 season was marked by a succession of exceptionally early, persistent and intense heatwaves across the region.

“Climate is sometimes seen as a partisan issue: as territory in the culture wars. That is palpably false. And we’ve just seen why: Europe’s summer has been hot as hell. This is the price of global fossil fuel addiction hitting home,” said Simon Stiell, UN Climate Change Executive Secretary, in an address to the European Parliament Committee.

“Understandably, Europe wants affordability, economic stability, energy security, and policy-making autonomy. Clean energy is the surest path to deliver, cheaply and safely,” he said.

Much of the region and large parts of central and eastern Europe also saw widespread dryness in August, in some cases persisting since May, with severe drought conditions reported in France, the UK, Hungary, Romania and Serbia.

In contrast, some regions like western Iberia, the Alpine region, northeastern Europe, eastern Türkiye and adjacent regions saw wetter-than-average conditions that caused local flooding in several areas.

Extreme weather was a global phenomenon

Anomalies and extremes in sea surface temperature for August 2026. Data source: ERA5

In August 2026, Arctic sea ice extent ranked 12th lowest for the month, with particularly low sea ice cover north of Franz Josef Land and Severnaya Zemlya, in the Russian Arctic sector.

Antarctic sea ice extent ranked fourth lowest for August, with below-average sea ice cover most pronounced in the Amundsen Sea and Indian Ocean sector.

Much of the southern USA and northern Mexico, parts of Canada, the Maghreb, part of the Horn of Africa, Siberia, large parts of Central Asia, China, South America, South Africa, and northern Australia were drier than average.

Wetter-than-average regions in August 2026 included the eastern USA and Canada, Alaska, parts of western and eastern Russia, the northern part of the Indian subcontinent, Chile and southeastern Brazil, as well as easternmost Asia, including eastern China, Taiwan and Japan.

Image Credits: Craig Manners/Unsplash, C3S/ECMWF.

  

A person with suspected Ebola arrives at a treatment centre in DRC.

After a gruelling recent Ebola infection, Dr Patrick Oparpio, a gynaecologist based in Bunia in the Democratic Republic of Congo (DRC), has urged health authorities to offer psychological support for Ebola survivors and their families.

This week, the DRC reported 6,843 Ebola cases and 3,310 deaths – a case fatality rate of over 48%  – mostly from Ituri province, where Bunia is situated, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

“I was in a coma for four days, and spent eight days under intubation,” Oparpio told a webinar last week organised by the World Health Organization’s (WHO) Information Network for Epidemics, known as Epi-WIN.

“I was hospitalised for a very long time. When I was discharged from the hospital, I didn’t believe I was going to be able to go back to my regular life or get back to my professional life,” said Oparpio, whose fiancée was also infected but did not survive.

“After I recovered, I had to be taken care of by psychologists. I had to get some therapy. When I look around me, I see orphans. I see people who have lost loved ones who need that psychiatric support. That’s one of the things that the WHO needs to think about as well. I haven’t really seen that being addressed.”

Oparpio, who only went to an Ebola treatment centre several days after falling ill as he initially thought he had malaria, said Ebola survivors could help educate their communities.

“We can talk to those in vulnerable situations to help prevent the spread of the disease,” said Oparpio.

“We are probably better situated to fight against this disease as we’ve already experienced it. We know what it’s like, and we know what our community is thinking, and how to answer some of the questions that they have, and [address] some of the distrust that they have.”

“Some 218 health workers have been infected, but most in the early phase of the outbreak,” Dr Yap Boum told the Africa CDC media briefing on Thursday.

In the past week, an additional health zone, Kayna in North Kivu, reported Ebola cases for the first time. This means 61 health zones are affected in six out of the DRC’s 26 provinces. 

Ituri is the worst-affected province, accounting for 80% of cases. Twenty-eight of its 36 health zones have Ebola cases. However, the outbreak may be stabilising as Ituri reported fewer cases and deaths in the past week than previously.

However, cases continue to rise in Ituri’s neighbouring provinces of North Kivu and Haut-Uélé. North Kivu is the second worst affected province, with 16 of its 34 health zones affected.  However, no new cases have been reported from South Kivu province since 29 May. 

Image Credits: DRC Health Ministry.

A healthcare worker in Ghana prepares a vaccine for administration at a primary health clinic. Recent WHO prequalification of a multi-dose RSV vaccine aims to streamline delivery across low-resource settings.
A healthcare worker in Ghana prepares a vaccine for administration at a primary health clinic. Recent WHO prequalification of a multi-dose RSV vaccine aims to streamline delivery across low-resource settings.

A new three-dose vial presentation of the maternal RSV vaccine received prequalification from the World Health Organization (WHO) on Wednesday, unlocking large-scale distribution across lower-income countries. The decision enables global health alliances to introduce affordable immunisation during pregnancy, protecting newborns from severe respiratory disease.

Respiratory syncytial virus (RSV) remains the second leading cause of infant mortality globally after malaria, claiming over 100,000 lives annually among children under five, according to the WHO. More than 97% of these deaths occur in low- and middle-income countries with a particularly high burden in sub-Saharan Africa, where healthcare facilities often lack specialised respiratory care.

Pregnant women vaccinated in their third trimester with the multi-dose vial, marketed as Abrysvo by Pfizer, transfer protective antibodies across the placenta, shielding infants throughout their first six months of life.

The vaccine showed high efficacy in global clinical trials across high- and low-income settings, according to the European Medicines Agency (EMA). In pivotal Phase 3 clinical trials, it demonstrated 81.8% efficacy against severe RSV-associated lower respiratory disease in the infant’s first 90 days, maintaining 69.4% efficacy through six months.

Gavi, the Vaccine Alliance, welcomed the WHO’s decision on Wednesday and announced it would expand access for lower-income countries.

“The WHO prequalification of a multi-dose RSV maternal vaccine marks an important step towards ensuring that all children, regardless of where they are born, are protected at their very first breath,” said Emily Kobayashi, Director of Vaccine Programmes at Gavi.

Expanding RSV vaccine access in low-income settings

Building on Gavi’s board approval to establish a dedicated maternal programme for its 2026–2030 strategic period, the Vaccine Alliance said that eligible low-income countries can now apply for funding to integrate maternal immunisation into routine healthcare systems.

The RSV vaccine was developed with support from the Gates Foundation and reduces logistical barriers and cold-chain costs for developing health systems by packing multiple doses into a single vial. While monoclonal antibodies offer direct passive protection to newborns, maternal vaccination provides an alternative route by conferring immunity before birth, broadening global prevention options alongside existing antibody therapies.

Ensuring seamless rollout is critical. Even in high-income regions like Europe, implementation of RSV prevention has faced hurdles due to delivery gaps and fragmented funding – a challenge global health officials hope Gavi’s centralized support will prevent in lower-income settings.

Monitoring safety and birth outcomes

Regulatory bodies, including the EMA, authorised Abrysvo after concluding that its protective benefits far outweigh potential risks. Post-authorization surveillance in the United States confirmed that preterm birth rates among vaccinated mothers showed no statistically significant increase and remained within expected background levels.

Routine post-marketing surveillance programmes in Europe and the United States continue to track real-world health outcomes to ensure standard safety monitoring across diverse populations.

See related story:

Immunising for Prosperity: Why Europe Must Treat RSV and Pneumococcal Jabs an Economic Imperative

Image Credits: USAID/Ghana via Flickr.

Outright supporters take part in a Pride march in New York City.

HIV services, mental health and harm reduction programmes have been severely affected by the huge funding cuts to organisations providing services for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people over the past 18 months.

Perversely, organisations in countries with the most repressive conditions for LGBTIQ people have been worst affected by cuts, according to a report released on Thursday by Outright, the international LGBTIQ human rights group.

“Organisations in countries with the harshest living conditions, the least impartial justice systems, the most widespread discrimination, and the deepest divisions between social groups were roughly two to three times more likely to have been affected by the cuts than those in countries at the other end of each measure,” according to the report.

In Ghana and Uganda, the cuts have coincided with draconian laws increasing punishment for same-sex activity – resulting in a spike in attacks on LGBTIQ people and a greater need for support services.

Budgets cut by 50-75% 

Of the 229 LGBTIQ organisations from 94 countries that responded to Outright, 203 lost funding after Donald Trump became president of the United States in January 2025.

The funding cuts have been fast and dramatic, with almost half of the affected organisations losing 50% of their budget, and three-quarters losing at least a quarter.

“The losses concentrate among small, community-rooted groups: 73% operate on annual budgets under $250,000, leaving no reserves to absorb a shortfall of this size.”

After Trump assumed power, the US cut funds for HIV programmes aimed at “key populations” most at risk of infection, including men who have sex with men (MSM) and trans women.

The US State Department also terminated the Global Equality Fund, the public-private partnership launched in 2011 that has distributed over $100 million to LGBTIQ organisations.

Life-saving services stopped

“Half of the affected organisations have cut health services, including mental healthcare. On HIV specifically, 45% have reduced or discontinued prevention, treatment, or care, and 50% named LGBTIQ people living with HIV among the constituencies most affected by the reductions they made,” according to the report.

“The cuts strike directly into lifesaving and dignity-affirming services: HIV testing, treatment adherence support, PrEP information, STI [sexually transmitted infection] prevention, mental health counselling, psychosocial support, harm reduction tools, reproductive health services, health referrals, and safe community-based care.”

The Global Black Gay Men Connect network has also documented significant disruptions to HIV services for key populations, with 77% of the key population organisations it surveyed reported interruptions to the supply of antiretrovirals, pre-exposure prophylaxis (PrEP) and condoms.

In many places, the health services were effective because they were “delivered by trusted organisations that understand the specific risks faced by LGBTIQ people and can help them navigate stigma, discrimination, criminalisation, and fear of exposure”, the report notes.

“The money was pulled out of the places where queer organisations were doing the work that no one else is doing,” Outright’s Alberto de Belaunde told a webinar to launch the report on Thursday.

“The places with the least capacity to absorb the loss are exactly where it is highest.”

Outright’s Alberto de Belaunde.

Deaths, retrenchments

For security reasons, several organisations cited in the report aren’t named, while the countries of a few are withheld. However, the report documents tragic stories from countries as far apart as Nepal and Zimbabwe.

“We are unable to refill medication for our constituents, which has led to defaulting and the death of two of the people who defaulted,” reported a Zimbabwean organisation that provided HIV services for MSM and trans women.

“Funding cuts hit us hard at the community level,” said Kenya’s Mamboleo Peer Empowerment Group. “We had to let go of 100 peer educators, caregivers, outreach workers, and paralegals, the people who were not just staff but trusted faces within the LGBTQ community. 

“These were the individuals who checked in on clients, supported them to stay on HIV treatment, responded to GBV [gender-based violence] cases, and ensured no one felt alone. With their absence, outreach activities stopped almost overnight. Safe spaces went quiet, food support was disrupted, and emergency shelter and evacuation assistance became difficult to sustain.”

Aid workers turn to sex work

Manisha Dhakal, a trans activist from the Blue Diamond Society in Nepal.

Manisha Dhakal, a trans activist from the Blue Diamond Society in Nepal, told the launch that her organisation lost 85% of its funding for an HIV service delivery programme that provided services in 21 districts at 24 service sites. 

Nepal’s HIV epidemic is concentrated in key populations, and the clinics were important to reach these groups. But Blue Diamond has been forced to close clinics and retrench staff.

“Some [Blue Diamond employees] have even been pushed towards the sex work profession because we don’t have a stable income,” said Dhakal.

An estimated 35,000 aid workers lost their jobs in Nepal after the US aid cuts, and for trans people there are few job opportunities other than sex work, according to AP.

Spike in distress calls

“Community need for emergency shelter and protection exploded in the wake of the Anti-Homosexuality Act and state-driven hostilities surrounding our general elections,” said John Grace, the coordinator of the Uganda Minority Shelters Consortium (UMSC). 

“UMSC logged a 283% spike in distress calls to our national crisis hotlines. But over 60 to 70% of the financial support sustaining our protection network vanished overnight,” said Grace.

The impact on UMSC’s work has been significant: “For every 10 emergency relocation and protection requests that we receive weekly from youth that are escaping mob violence or police raids or family rejection, we possess the resources to feed, to house, and protect only about three.”

A significant proportion of the young people UMSC helps are living with HIV, said Grace.

“The desperation is so severe that we have even documented some of the youth trading portions of their life-saving HIV medication on the informal market just for a single meal.”

John Grace, coordinator of the Uganda Minority Shelters Consortium.

An organisation in Malawi has closed its mobile clinics that offered HIV testing and referrals that were “critical in reaching MSM and transgender individuals who face stigma in public health facilities”.

Türkiye’s Kaos GL reported that the UN Refugee Agency (UNHCR) had withdrawn from a “collaborative project for LGBTI+ refugees in 2025, causing the organisation to “shut down the refugee rights program office, lay off staff members and reduce the program activities by 85%.” 

A queer-led organisation in Jordan reported that it has a limited stock of harm reduction tools and kits to minimise the negative health effects of drug use, “which increases the risk of contracting HIV and other STIs”.

No protection for intersex babies

There has always been virtually no funding for intersex people, who are born with reproductive or sexual anatomy, chromosomes, or hormones that do not fit the typical definitions of female or male.

“In many countries, intersex infants and children are subjected to medically unnecessary surgeries and other interventions on their sex characteristics, without their consent,” the report notes.

“The organisations working to end these practices are among the most under-resourced in the global LGBTIQ movement, and several report that funding cuts have forced them to suspend their work documenting cases of medical violence, educating health providers, and supporting intersex children’s families as they navigate medical bureaucracies.”

This means that there is no one “standing between a child and an unwanted, harmful surgery”, the report notes.

Minuscule funding

Neela Ghoshal, Outright’s director of law, policy, and research

Donor government funding for LGBTI communities has always been “minuscule”, amounting to four cents of every $100 in official development assistance in 2023–2024, according to De Belaunde.

“The US has not been the only funder to walk away from or reduce its support for LGBTIQ movements during this period,” said Neela Ghoshal, Outright’s director of law, policy, and research.

“Some other governments, corporations, and foundations have also pulled back. At the same time, organisations are working in a context of growing anti-gender organising, where the gains that we’ve achieved over the last several decades, which were already fragile, are increasingly at risk.”

To address the crisis, the Outright report appeals to potential donors to act immediately, outside standard grant cycles; provide multi-year, flexible funding; restore community-led health services; fund protection for LGBTIQ people, and “direct resources to those bearing the heaviest impacts”.

Image Credits: Outright International.

Saima Wazed sworn in as Director of WHO’s South East Asia Region in February 2024; six months later her mother, Sheikh Hasina was deposed as Prime Minister of Bangladesh.

Saima Wazed, WHO’s Regional Director (RD) for South-East Asia (SEARO) and daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, resigned Wednesday, just a day after South-East Asian member states recommended her termination, WHO confirmed to Health Policy Watch. 

“The previous day, 8 September 2026, the Regional Committee had recommended that Wazed’s appointment as Regional Director be terminated. That recommendation had been due to be considered by the Executive Board,” said a WHO spokesperson in an email. 

The discussion of Wazed was held behind closed doors with no fanfare at the 79th Regional Committee meeting of SEARO member states, which ended today. 

Wazed’s resignation, first reported Wednesday night by Reuters, ends a tumultuous five-year term marked by fraud allegations, a year of leave, and, according to multiple people familiar with the matter, months of pressure from Dhaka on Director-General Tedros Adhanom Ghebreyesus to remove the RD that the new Bangladeshi government has prosecuted for fraud.

Speaking to the Indian Express after submitting her resignation letter, Wazed lashed back – denying all allegations and saying that she had quit “because of “harassment and intimidation” by the WHO Director General, Dr Tedros Adhanom Ghebreyesus. 

“Not allowing for an independent investigation… leaving me on Leave Without Pay as retaliation for requesting an investigation into his conduct… It was becoming mentally and financially impossible for me to cope with this kind of harassment and abuse from him,” she was quoted telling the Express. 

In response, WHO told Health Policy Watch, “this matter has been handled through the appropriate WHO processes in accordance with WHO’s regulatory framework, with due regard for fairness and due process, while safeguarding the interests of the Organization and its ability to fulfil its mandate.”

Dispute in shadow of overthrow of former Bangladeshi prime minister

Sheikh Hasina Wazed, former Prime Minister of Bangladesh in 2020, four years before being ousted.

Other sources close to the matter noted that the termination move came after months of pressure on WHO from the new Bangladeshi government to investigate and dismiss her.   

The sources, who requested anonymity, also contended had been paid at least part of her salary during the leave period. This could not be confirmed independently.

WHO had placed Wazed on leave in mid-2025, after Bangladesh’s Anti-Corruption Commission filed fraud and forgery charges against her in March.

The charges alleged that she misrepresented an honorary doctorate as an academic credential in her original WHO candidacy for the Regional Director’s position, and also had been engaged in improper land deals in Bangladesh.

The fraud charges were brought by the new government after Wazed’s mother, former Prime Minister Sheikh Hasina, fled the country to India on 5 August 2024 following massive student-led protests.

Wazed has denied the charges saying they were politically motivated. 

Separately, WHO had reportedly been investigating alleged irregularities in a travel claim made by Wazed for the reimbursement of some $901 related to a trip to China – something her lawyers have said was due to an administrative error. 

Action after months of pressure  

WHO Regional Director for South East Asia leads a regional member state briefing in Geneva, May 2025; in August she was placed on leave.

According to a diplomatic official involved in exchanges between Dhaka and WHO headquarters, who requested anonymity, representatives of Bangladesh’s interim government warned the WHO Director-General as early as 2025 that inaction on Wazed could prompt Bangladesh to reconsider its position within WHO’s South-East Asia Region, and consider a move into the Eastern Mediterranean Region. 

“The Regional Committee cannot afford another country leaving SEARO, noted one observer, citing Indonesia’s decision to affiliate with the West Pacific Region,” last year.  Currently there are ten WHO member states affiliated with the SEARO region, including: Bangladesh; Bhutan; Democratic People’s Republic of Korea; India; Maldives; Myanmar; Nepal; Sri Lanka; Thailand; and Timor-Leste. 

Tedros finally placed her on ‘leave’ in July. But the WHO statement at the time carefully sidestepped the term “administrative leave” that is typically used in cases involving investigative of wrongdoing, or potential disciplinary action, describing her only as “currently on leave”.

The choice of terms, officials told Health Policy Watch, was deliberate, intended to limit reputational damage both to Wazed and to the Organization.

Another WHO official familiar with the internal investigation, who also requested anonymity, said the investigation into the allegations against Wazed had effectively stalled for much of the period she was on leave.  

During that time, however, Wazed reportedly continued to reside in India, the host country of WHO’s South East Asia Regional Office, and a place where she could have immunity from the arrest warrant issued by Bangladesh. 

Her mother, Sheikh Hasina also has been in India since her government fell – reflecting the traditionally close ties she had maintained with Delhi.

Sheikh Hasina also faces criminal charges in Bangladesh, including over mass killings during the crackdown on protesters that preceded her ouster. Alleged abuses were documented in a UN Human Rights Office of the High Commissioner (OHCHR) report published after her overthrow. She denies wrongdoing.

Wazed’s resignation takes effect immediately; Typically, WHO would be  expected to open nominations for her successor in October.

Image Credits: WHO SEARO/LinkedIn, WHO.

Following his WHO departure, Dr Jeremy Farrar joins PATH to lead operations across Asia, the Middle East, and Europe.
Following his WHO departure, Dr Jeremy Farrar joins PATH to lead operations across Asia, the Middle East, and Europe.

Outgoing WHO Assistant Director-General Dr Jeremy Farrar will lead PATH’s regional division for Asia, the Middle East, and Europe starting in October, the organisation announced in a press release on Wednesday (9 September). Based in Geneva, he joins the executive leadership team to accelerate the delivery of health technologies across these regions.

“Dr Farrar joins PATH at a time when countries are increasingly seeking sustainable ways to expand access to health services and innovations,” the organisation explained in a statement to Health Policy Watch. “His leadership will strengthen our ability to work with governments and partners to deliver lasting health impact across the region.”

Founded in 1977 and headquartered in Seattle, PATH is an international global health non-profit that develops medical technologies for low-resource settings. Operating on an annual budget of over $371 million (2024) – funded primarily by philanthropic foundations and public government grants – the organisation employs approximately 1,600 people across more than 70 countries to advance vaccines, diagnostics, and health system innovations.

Farrar’s appointment targets regional health challenges by connecting scientific innovation directly with local primary healthcare systems to fortify outbreak preparedness, according to the organisation.

Return to regional roots

The appointment, in a sense, returns Farrar to the roots of some of his pre-WHO work and specializations. From 1996 to 2013, he directed the Oxford University Clinical Research Unit in Vietnam before serving for a decade the head of the UK-based Wellcome Trust. He joined WHO in 2023, first as Chief Scientist, then last year taking on this position of Assistant Director-General for Health Promotion, Disease Prevention and Care, under a major reorganization launched by Director General Dr Tedros Adhanom Ghebreyesus after the United States withdrew from the organisation, triggering a budget crisis.

Earlier this year Farrar, perhaps the UK’s best-known scientist, was mooted as a possible successor to Tedros, whose term ends next year. But Farrar later told colleagues and media that he was not interested in competing for the post, which would have also required a formal government nomination. Four candidates have since declared their candidacy, in candidacies nominated by Saudi Arabia, Qatar, Belgium, and Indonesia.

Jeremy Farrar leads regional expansion

In his new role, Farrar will oversee operations connecting governments, research institutes, and medical manufacturers. The appointment aligns with PATH’s Strategy 2030, which focusses on bridging the gap between scientific innovation and real-world impact by strengthening primary healthcare systems and regional partnerships.

His future division managed $35.99 million in regional programme expenses in 2024, according to PATH’s 2024 financial summary. His team will focus on translating scientific breakthroughs into accessible tools for underserved communities.

“Joining PATH at this moment is a very exciting opportunity,” said Farrar in the press release.

He emphasised the need to address health threats with urgency while preparing for future global health shifts.

“Jeremy is an exceptional leader, and we’re very pleased to welcome him to PATH,” added PATH President and CEO Nikolaj Gilbert.

Leadership transition follows WHO departure

WHO headquarters in Geneva experiences leadership shifts following Dr Jeremy Farrar’s departure to join global non-profit PATH.
WHO headquarters in Geneva experiences leadership shifts following Farrar’s departure to join global non-profit PATH.

His arrival at PATH follows his departure from the WHO, where he officially steps down on 30 September. Official statements and an internal communication from WHO Director-General Tedros described the exit as a routine retirement upon reaching the official UN retirement age limit.

However, several sources characterised the exit as unusual, suggesting a resignation. Tedros had reportedly offered Farrar an exceptional contract extension beyond retirement age, which he declined. Following that, the Director-General announced that another longstanding senior WHO official, Bruce Aylward, will step into the ADG role upon Farrar’s departure.

The leadership transition comes ahead of the upcoming election of the WHO Director-General and amidst severe financial and political ruptures.

PATH stated that Farrar was not available to address specific questions regarding his transition or operational priorities before assuming office on 1 October.

Health Policy Watch reached out to the WHO for comments but had received no response by the time of publication.

Image Credits: Flickr – US Mission Geneva.

Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds.
Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds.

Fragmented enforcement and uncoordinated policies fail to stem the illegal tobacco trade in Europe, a new report by the EU Court of Auditors finds. The surge of unregulated novel nicotine products and a shift toward illegal manufacturing sites expose significant regulatory gaps. The auditors demand that Brussels take a more active role to establish a unified strategic framework and standardise market monitoring by 2029.

Nearly one in 10 cigarettes on the European Union (EU) market were produced illegally or smuggled in 2023, and Europe is losing an estimated €13 billion in public revenue annually to the illicit tobacco trade. Regulatory and data gaps hinder the EU in mapping out a coherent strategy to curb the problem, warns a special report by the European Court of Auditors (ECA), released on Tuesday.

“Criminals are succeeding because gaps remain in coordination, information, and enforcement,” said Petri Sarvamaa, leader of the audit, at the press briefing to release the report.

The regulatory and data vacuum directly undermines the WHO Framework Convention on Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products. This legally binding global treaty is designed to protect public health by securing supply chains against illegal tobacco, mandating strict controls and independent tracking systems.

Fragmented policies divide EU enforcement

European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health.
European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health.

However, the EU’s fragmented approach prevents the unified enforcement of these international standards. Finance and health ministries across different countries split the responsibility for implementing the FCTC protocol, locking customs and enforcement agencies out of vital policy dialogues, for example. This administrative division deprives officials of operational insight, undermining coordinated enforcement across the single market, the auditors criticise.

Furthermore, enforcement is deeply fractured because member states apply vastly different legal sanctions and investigative powers to combat illegal tobacco. While national customs agencies in Belgium and Poland possess advanced police powers and warrantless search capabilities to raid illicit factories, but countries such as Romania are constrained to administrative enquiries.

This lack of harmonised penalties encourages criminal organisations to move their activities to nations with more lenient sanctions, the auditors warn.

To close these loopholes, they urge the European Commission to establish a unified strategic direction across the bloc. They recommend that EU officials improve independent data gathering by 2029 to regularly estimate the size of the black market, and promote compliance with strict transparency and integrity rules for any interaction with tobacco manufacturers by 2028.

Surge in illegal tobacco production sites

Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations.
Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations, the European Court of Auditors found.

Although smuggling from non-EU countries persists, the auditors noted a systemic shift as production is moving inside the EU. This relocation from non-EU Eastern European nations like Ukraine and Belarus to locations across the single market enables syndicates to shorten supply chains, operate closer to lucrative consumer markets, and evade external customs controls.

“Illegal production sites have been detected in almost every member state,” said Sarvamaa. “They are really mushrooming across the bloc.”

Criminal enterprises exploit differences in national laws and enforcement capabilities to establish operations where the legal risks are lowest. These clandestine facilities bypass all public health regulations, exposing consumers and workers to severe physical and chemical hazards.

While illicit cigarette factories process bulk raw tobacco leaves in unhygienic environments, illegal facilities producing novel products handle highly hazardous chemical compounds. Many of these black-market substitutes also fail basic safety and composition standards, with some illicit e-cigarettes containing excessive, unregulated nicotine concentrations.

New illicit nicotine products target youth

Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fueling a parallel black market.
Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fuelling a parallel black market.

The current exclusion of tobacco-free nicotine products – such as nicotine pouches – from the EU’s tobacco control framework has also created massive regulatory gaps across the single market. Additionally, because e-cigarettes and heated tobacco products lack harmonised EU tax definitions, member states apply widely divergent excise rates to a rapidly growing market that now accounts for an estimated 13% of the tobacco products market value sold in the EU.

This regulatory and fiscal fragmentation has fuelled a parallel black market, the scale of which was recently exposed by a joint customs initiative across 30 countries. Led by the European Anti-Fraud Office (OLAF), the operation resulted in the seizure of over 94 million pieces and over 2,500 kg/l of tobacco products, e-cigarettes, and related devices.

Beyond lost tax revenue, these black-market activities carry severe health consequences. Investigators warned that consumers who turn to these unregulated substitutes risk inhaling harmful, substandard, and potentially toxic chemical substances produced entirely outside controlled supply chains.

Opaque manufacturer agreements

ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards.
ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards.

To help track illicit trade and verify the authenticity of seized products, approximately half of all EU member states maintain voluntary, confidential Memorandums of Understanding (MoUs) with major tobacco manufacturers. First established in 1999 between Philip Morris International and Italy, these bilateral pacts are designed to facilitate operational cooperation, such as sharing market intelligence and helping customs verify counterfeit machinery or cigarettes.

However, the auditors have strongly criticised these agreements, warning that they risk compromising the strict independence required for national tracking systems. Because these MoUs are not publicly accessible and lack transparency, it is impossible to assess whether they comply with international guidelines on preventing industry interference.

While the auditors emphasised that operational cooperation can offer practical benefits like technical training and counterfeit machine verification, severe conflict of interest risks remain under global health rules laid out in the FCTC protocol.

“The interaction should be transparent, limited and also should comply with international standards … at [the] World Health Organization,” ECA task leader Esther Torrente Heras told the press briefing.

Letting the industry control or influence traceability solutions directly violates the protocol, which strictly prohibits the delegation of supply chain control authority to tobacco firms.

EU regulation lags shifting market

While the European Commission proposed a crucial recast of the Tobacco Taxation Directive last year to modernise fiscal rules and curb the black market, progress has stalled within the divided council. Tax matters require unanimous agreement from all 27 Member States under a special legislative procedure.

This legislative delay leaves raw tobacco – the primary input for illegal manufacturing – without unified EU-wide oversight. The absence of harmonised EU control rules means that cross-border movements cannot be effectively monitored or tracked because most member states only maintain national notification systems.

Under current rules, bulk tobacco leaves can easily circulate across borders without standard EU customs tracking because they are not classified as manufactured tobacco products. Organised crime groups exploit these regulatory gaps to transport raw tobacco and advanced manufacturing machinery between jurisdictions with minimal detection risks.

To close this loophole, the proposed reform would subject raw tobacco to the Excise Movement and Control System (EMCS), a real-time digital monitoring network requiring commercial traders to register shipments and report cross-border movements electronically (although raw tobacco growers performing only drying or curing would remain exempt).

Stalled tax initiatives

Also regarding minimum tobacco excise rates, the EU is currently experiencing a policy stalemate. This legislative deadlock prevents rates from acting as a public health deterrent or reducing market distortions.

While the auditors recommend a comprehensive set of enforcement measures to ramp up the fight against illegal tobacco in the bloc, they fail to call for higher excise taxes on tobacco products. Indeed, the ECA’s special report states that high tax rates simply create a financial incentive for tax avoidance.

Asked on this issue by Health Policy Watch, lead auditor Sarvamaa explained that the court lacked the empirical data to analyse how tax levels drive smuggling. “We do not have the grounds for starting to analyse how much the tax level is a factor in this problem,” he said.

However, the WHO explicitly advocates higher excise taxes as an effective intervention to reduce tobacco consumption. According to the organisation’s technical manual on tobacco tax policy, high-tax nations with strong governance experience much lower smuggling rates than low-tax jurisdictions.

Furthermore, a fully harmonised tax regime across the bloc would effectively eliminate the price differentials that drive cross-border tax arbitrage. Instead of keeping taxes low to prevent smuggling, the WHO found that the most effective way to eliminate black market sales is to strengthen tax administration and secure supply chains.

Ball in Commission court

The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge. 
The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge.

To close these data and regulation gaps, the EU auditors asserted that the Commission must take a far more assertive, leading role in coordinating cross-border enforcement efforts. With the current framework deemed not robust enough, Brussels faces an immense workload to establish reliable, independent market size estimations by the recommended 2029 deadline.

To successfully outmanoeuvre illicit trade, the bloc must transition from its current fragmented, state-by-state approach to a singular, binding policy framework. This requires dismantling national administrative silos and encouraging member states to prioritise strict international treaty compliance and transparency over domestic industry interests.

“The criminals have a good strategy obviously, and I think that we need one too,” said Sarvamaa “Tackling the illegal tobacco trade is about much more than recovering lost tax revenue.”

Only by closing these critical regulatory gaps can the European Union protect the public health of its citizens, and safeguard public finances.

See related story:

Europe is Failing to Curb Tobacco Use – Especially in Women

Image Credits: Mark Stebnicki via Pexels, European Union, European Court of Auditors, pixabay, Paws and Prints via unsplash.

End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023.

The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package.

The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”.

The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday.

Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people.

It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98.

Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative.

However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme.

Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR).

However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes.

Undermining PABS talks

US demands for data and sharing of pathogen information have also been rejected by other African countries.

Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups.

World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. 

The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks.

As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system.

However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system.

Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper.