As El Niño Bears Down, a Small Hospital in Chad Offers Lessons in Climate Resilience 13/08/2026 Kerry Cullinan Ngouri Hospital in Chad has made itself more climate-resilient. Situated on the edge of the advancing Sahara Desert, Ngouri in western Chad is one of the most vulnerable places in the world to climate change. Heat is already rising in the region as the El Niño advances globally, with hotter sea surface temperatures in the tropical Pacific Ocean driving up land temperatures and triggering severe weather events. The World Meteorological Organization (WMO) predicts that this year’s El Niño will be “strong” – meaning sea surface temperatures at least 2ºC hotter than usual – and it will “intensify steadily and dominate global climate patterns” from now until October, bringing heatwaves, drought, and extreme weather Ngouri Hospital has around 100 beds and serves a population of some 200,000 people. But patients often move out of the hospital buildings to the trees during the day because of the intense heat indoors. Three years ago, the Climate Action Accelerator (CAA), the Alliance for International Medical Action (ALIMA), medical humanitarian NGO Alerte Sante, and Chad’s health ministry launched a project to make the hospital more resilient to climate shocks. Temperatures sometimes reach as high as 47ºC, and El Niño is expected to bring even hotter, drier conditions, CAA’s Alexandre Robert told a World Health Organization (WHO) webinar this week. “The main health risks here are related to heat and malnutrition,” said Robert, adding that malaria cases have also increased, particularly in children. The temperature in the intensive care unit can reach as high as 42ºC, said Robert. Meanwhile, the hospital’s electricity supply was unpredictable. Solutions included painting the hospital roof with a reflective white paint, which has lowered indoor temperatures by around 5ºC, and introducing reliable solar energy – crucial to power the hospital’s blood bank, oxygen concentrators, fridges that store vaccines, and to ensure light during night-time births. Three years on, reliable solar-driven electricity at Ngouri Hospital has improved paediatric, emergency, and laboratory services – and the facility is more resilient to climate change. “The key message is that working on the infrastructure can give very good results in the [improved] quality of care, ” said Robert, stressing the importance of “integrated and participatory approaches” at health facility level. Key aspects of the climate resilience approach at Ngouri Hospital. El Niño affects ‘everyone’ “Everyone will be impacted by El Niño,” said Tereza Zakaria, WHO’s unit head of risk reduction, humanitarian operations and climate change. “We’re feeling the heat, we’re feeling the excess rain, and we’re feeling the drought,” she told the webinar, convened by WHO’s epidemic information network, EPI-WIN, to discuss how to prepare health facilities for El Niño. As the effects will differ from region to region, Zakaria urged all involved parties to integrate meteorological and climate data into health surveillance to ensure a speedy response to the effects of El Niño. Alex Camacho, the Pan American Health Organization’s (PAHO) regional adviser on emergency preparedness and disaster relief, said that El Niño is already affecting his region. On the dry, hot side of the region, Honduras has already assisted more than 50,000 families affected by food insecurity, Bolivia has a nationwide drought and is struggling with fires, and Panama, El Salvador, Guatemala and Nicaragua are also experiencing drought. Meanwhile, Colombia faces up to three million additional food-insecure people. Some of the PAHO region is experiencing wetter conditions, with floods in parts of Brazil and severe storms in other countries. ‘No one can do it alone’ ltaf Musani, WHO director of humanitarian and disaster management, warned that 239 million people “are already struggling to remain alive in humanitarian settings, resulting from conflict, climate shocks, and disease outbreaks”. “Severe funding constraints across the humanitarian system have already disrupted more than 8,000 health facilities, affecting access to care for at least 53 million people,” said Musani. “We are concerned about the potential strength and the magnitude of the current El Niño and what it can mean for global health,” he added. The WMO indicates that “widespread, above-normal temperatures will likely impact us globally”, and “extreme heat can have immediate and serious health consequences”, he added. However, Musani warned that El Niño is not a health sector issue alone. “Protecting people from extreme heat, as well as other El Niño effects, requires coordinated action across health and beyond health “Early action and collaboration are so important. Not a single institution or sector can manage these risks. We need strong collaboration between governments, public health agencies, meteorological and climate services, humanitarian and development partners, researchers, private sector communities, and donors.” CAA has developed a free Climate Action toolbox to guide hospital and health management teams to transition to climate-resilient, sustainable and low-carbon models. It is part of the resources offered by the WHO-hosted Alliance for Transformative Action on Climate and Health (ATACH) to support health facilities. Image Credits: ALIMA. WHO Officials Condemn Trump’s Vaccination Changes 12/08/2026 Kerry Cullinan WHO Director-General Dr Tedros Adhanom Ghebreyesus. Top World Health Organization (WHO) officials are concerned that the United States President Donald Trump’s move to alter his country’s childhood vaccinations via an executive order will endanger children. “WHO is concerned that the changes to immunisation policy in the US are not aligned with the best science,” Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. The order recommends fewer vaccinations, separate vaccinations per clinic visit and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, “Delaying vaccines or separating doses unnecessarily does not make vaccination safer and can leave children unprotected,” said Tedros. Every parent wants to keep their children safe, and vaccines are among the most powerful tools for doing that, making deadly diseases preventable. @WHO is concerned that recent changes to US immunization policy are not aligned with decades of evidence that show when children… pic.twitter.com/vCfgJFrFGK — Tedros Adhanom Ghebreyesus (@DrTedros) August 12, 2026 WHO Assistant Director-General Dr Jeremy Farrar pointed out that the measles vaccine alone had saved 59 million lives. “In many countries, including the United States, there are extensive measles outbreaks, which are causing huge concern,” said Farrar. Measles cases in the US (August 2026). Measles, mumps and rubella are not mild diseases, Farrar said, adding that they can have severe complications: “If anybody has seen a child with post-measles encephalitis, you will remember it for the rest of your life.” Encephalitis is the inflammation of the brain and can cause brain damage. Measles is one of the most infectious diseases, transmitted via infected droplets in the air. Unvaccinated individuals or those with unknown vaccination status represent almost all reported measles cases in the US. US measles cases per vaccination status (August 2026). Making it harder for parents Dr Kate O’Brien, WHO’s director of Immunisation, Vaccines and Biologicals, warned that Trump’s decree is “going in exactly the wrong direction, and there is no evidence that would drive this decision”. “Anything that is done that makes it harder for a parent to get the vaccines their kids need to protect them from what are serious diseases – anything that’s done to make that harder – is not in service of the child,” said O’Brien. “From decades of experience, we know that the more you can enable families to be able to do what they want to do, the higher the coverage and the protection of children is.” Dr Birgitte Giersing, WHO unit head of vaccine research, development and policy, said that 179 of the world’s 194 countries use the MMR vaccination. “Our concern about the breakup of combination vaccines is that these would then actually be far more difficult to deliver. “At the moment, the MMR schedule is a two-dose schedule with those three vaccines,” she said. Breaking it up into three separate vaccinations would potentially mean children need six vaccinations instead of two. Safe and effective “We have extensive scientific evidence that combination vaccines are safe and effective. They enable us to reach [large] populations because there are multiple vaccines within a single shot. They are more acceptable generally to communities, and they really simplify the delivery of vaccines,” said Giersing. “We are very concerned,” concluded Farrar. “WHO provides the global evidence for these vaccines through the Strategic Advisory Group of Experts on Immunisation. “Individual countries, of course, make their own decisions about which policies to implement. But we call on all countries to use the evidence base, use WHO’s advice and guidance, and make the best policy decisions based on the scientific evidence, not on political interference.” Image Credits: Johns Hopkins University. With Over 2000 Dead, Priority is to ‘Break the Chains’ of Ebola Transmission 12/08/2026 Kerry Cullinan An educational poster about Ebola in the DRC. Over 2000 people have died so far in the Ebola Bundibugyo outbreak in the Democratic Republic of Congo (DRC), and the only way to break the chains of transmission is via scaled-up local surveillance, according to the World Health Organization (WHO). “Most concerningly, we see a high proportion of deaths in communities instead of treatment units, outside of known contact lists,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “That tells us there are chains of transmission we don’t know about, and until we know about and break every chain of transmission, we will not stop the outbreak,” he said. “Surveillance is our priority operational challenge. With partners, we’re mapping and pooling resources to strengthen community-based surveillance to bring every suspected case into care and reach the 95% contact tracing target needed to interrupt transmission.” About 90% of the 4,449 official cases and 80% of deaths are in the province of Ituri, with sustained transmission in the towns of Bunia, Rwampara, Nizi and Litha, said Tedros. Most infections happen when people have late-stage disease and are not in treatment, or when their bodies are handled after they have died. “Early clinical care and safe and dignified burials are therefore critical for interrupting transmission, and both depend on the trust of affected communities, which means community engagement and community ownership are essential,” Tedros stressed. ‘Hope is not a strategy’ Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, speaking from the DRC. Partners have set the ambitious goal of ensuring 3,000 beds are available for Ebola patients as soon as possible – but it has taken three months to set up 1,500 beds. Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, said that the moderate scenario for the outbreak was for it to peak within six months. “But this is a highly dynamic outbreak, and unless, as the DG said, we have the community on our side, we’ll be struggling. The last previous outbreak, which happened in a security-compromised situation, lasted about two years=,” said Mahamud. “We don’t want to repeat that. Under the leadership of the government, we are doing everything possible to reduce that, and hopefully in the next six months.” He added: “But hope is not a strategy. We have to have the community on our side, increase the surveillance, and increase our safe and scalable care.” Under-funded Yet the response is only around 50% funded, with $264 million of the $518 million pledged having been disbursed, WHO DRC representative Dr Anne Ancia said that the DRC Government’s latest estimate to address the outbreak was $940 million. She added that most of the money raised so far had gone to partners rather than the DRC government. The DRC government, which has invested $50 million, aims to cover health workers’ salaries with domestic funds eventually, but it was not yet possible given the massive need for additional posts. Tedros said that 21,000 health workers have been tained so far but that the response needs three health workers per patient. Earlier this week, Wellcome Trust gave a $3 million grant to the WHO to expand community intelligence about the outbreak. This will provide authorities with more insight into how people perceive risk, seek care, respond to public health measures and experience the broader social and economic impacts of the outbreak. “Every outbreak is shaped not only by the pathogen, but also by how people understand risk, access care and respond to public health measures,” said Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme. “This investment is about making social analytics part of how outbreak intelligence works in practice. By integrating community-generated evidence throughout the response, we can build a more complete picture of the outbreak and make faster, more effective decisions that ultimately save lives.” Meanwhile, the speed of the outbreak was more likely the result of the difficult conditions, including armed conflict, rather than viral mutation, WHO Chief Scientist Dr Sylvie Briand told the briefing. “Currently, we have not seen any mutation in this virus, and probably the course of the outbreak is currently much more explained by the context in which the virus is circulating, which is an area of conflict with a lot of population mobility,” said Briand. On Monday, researchers reported in Nature that the current outbreak was likely to stem from a new zoonotic spillover from animals to humans, as it was different from the 2007 and 2012 Bundibugyo outbreaks. They deduced this by examining samples from 22 infected people. The Case Against Fauci Was Never About the Origins of COVID-19 11/08/2026 Stefan Anderson Dr Anthony Fauci invoked his Fifth Amendment rights more than 100 times during a Senate hearing, the first time in over 250 congressional appearances across his 54-year career that he declined to answer questions. For nearly three hours on 29 July, the US Senate Homeland Security and Governmental Affairs Committee heard one sentence repeated over a hundred times. “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution.” Dr Anthony Fauci, the 85-year-old retired director of the National Institute of Allergy and Infectious Diseases who guided the American COVID-19 pandemic response across two administrations, sat before the committee and, beyond a brief opening statement, said nothing else. In more than 250 appearances before Congress across his 54-year career, including 14 hours of transcribed interviews with the House Select Subcommittee on the Coronavirus Pandemic in January 2024, Fauci had never before declined to answer a question. But the man who subpoenaed him, Committee chair Senator Rand Paul, had already told the world what he wanted out of the exercise. “The power of some of us must be used for good, like putting Fauci in jail,” Paul tweeted in December 2024. “I want to give him a subpoena and a jail cell.” Fauci’s lawyers argued the hearing amounted to a trap. Any answer, however truthful, could be mined for inconsistencies and forwarded to a Department of Justice that has systematically displayed a disregard for independence from the administration by prosecuting political opponents. Top administration officials indicated as much in the weeks before the hearing. Health Secretary Robert F. Kennedy Jr told Fox News that Fauci “could be subject to perjury prosecution” if any inconsistencies were unearthed during testimony. “Any reasonable person who has followed his unhinged obsession with me would readily come to the same conclusion,” Fauci said. Paul’s crusade dates back to 2021, when he told Fox & Friends the 38-year leader of the National Institutes of Health “could be culpable for the entire pandemic.” A week later, the committee voted along party lines to hold Fauci in contempt and refer the matter for prosecution, the first such action against a former federal health official in modern US history. “Framing public health decisions as matters of criminal intent rather than complex crisis management undermines public faith in medical recommendations, vaccines, and scientific consensus,” said Lawrence Gostin, professor of global health law at Georgetown University. “It is an abuse of power, legally baseless, and sets a dangerous precedent that threatens the future of public health.” ‘Who the f*** did you think you were?’ The stated purpose of the hearing was to uncover the origins of COVID-19, a question of global importance that, six years after the pandemic killed an estimated 25 million people worldwide, remains unresolved. Leading scientific consensus remains that SARS-CoV-2 jumped from bats to humans through contact with infected wildlife at Wuhan’s Huanan wet market. No intermediate animal host has been confirmed, however, and the hypothesis that the virus escaped from the Wuhan Institute of Virology, which studied bat coronaviruses, has never been ruled out. The hearing made no progress on this question. Instead, it bundled political battles over lockdown policy, vaccine safety and the pandemic’s origins into a single prosecutorial narrative aimed at assigning blame for a global catastrophe on a scientist who does not hold the answers to where COVID-19 began, and has no power to compel the Chinese government to release them. “Who the fuck did you think you were?” Senator Bernie Moreno said, accusing Fauci of being a “megalomaniac who was more interested in having met a Kardashian than the suffering of the American people.” His outrage centred on the 2020 arrest of Alecia Kitts, an Ohio mother tased and handcuffed at her son’s middle school football game for refusing to wear a mask, an enforcement action carried out under a statewide order issued by Republican Governor Mike DeWine. Republicans cast Fauci as a shadowy autocrat who unilaterally caused the pandemic, imposed lockdowns and pushed dangerous vaccines on the world, ascribing to a scientific advisor a degree of unchecked power more accurately associated with the leader of their own party. Fauci issued recommendations that were adopted, adapted or rejected by thousands of officials at every level of state and federal government. Governments and health authorities around the world, from the World Health Organization (WHO) to the European Centre for Disease Prevention and Control, reached similar conclusions and imposed similar or stricter measures. The United States was, by most comparative measures, more lax, and also had a higher per-capita COVID death toll than peer nations. Trump’s ‘greatest achievement’? US President Donald Trump claims Operation Warp Speed, the programme responsible for fast-tracking the development of COVID-19 vaccines that have saved millions of lives, as one of his greatest achievements. Many of his most ardent supporters, including his HHS chief, continue to claim they kill people and cause autism. Vaccine misinformation, a defining characteristic of the Kennedy health department, surfaced as well. Senator Ron Johnson referred to COVID-19 vaccines as “experimental gene therapy” and cited misleading adverse event reports as evidence of mass harm. The vaccines were produced under Operation Warp Speed, which President Trump still calls “one of the greatest achievements ever.” Modelling estimates the programme prevented over 3.2 million additional deaths through November 2022. Johnson also claimed Fauci had “sabotaged” ivermectin, an antiparasitic drug instrumental in controlling river blindness in West Africa, which gained a second life during the pandemic as an unproven COVID-19 treatment promoted by anti-vaccine influencers and widely purchased in its veterinary formulation as a horse dewormer. The most comprehensive meta-analysis to date, covering 33 randomised controlled trials, found ivermectin had no effect on COVID-19 mortality. Paul and his political allies also circulated the debunked claim of an 82% vaccine-linked miscarriage rate, a figure derived from a statistical error in a 2021 CDC study that has been refuted repeatedly and repackaged as new evidence, shared as breaking news on Paul’s Twitter on Tuesday. Fauci’s diary Senator Rand Paul and his political allies continued to push inaccurate claims about Fauci and vaccines following the hearing, including the debunked claim that COVID vaccines caused an 82% miscarriage rate in first-trimester pregnancies. Paul released over 1,100 pages of Fauci’s personal diary ahead of the hearing, whose entries became the evidentiary centrepiece of the case against him. The most cited entries date from late January 2020, when Fauci convened urgent calls with virologists. On 31 January, he recorded scientists warning that mutations around the furin cleavage site — a feature found in no other known closely related coronavirus, which enhanced the virus’s ability to infect human cells and contributed to the pandemic’s severity — “could not have occurred naturally.” The next day, Fauci wrote that participants raised the possibility of “deliberate insertion” of the cleavage site through genetic engineering, naming the Wuhan Institute of Virology’s lead researcher, Shi Zhengli, and her gain-of-function work. On 2 February, he told NIH Director Francis Collins: “Please delete this email after you read it.” Paul framed the entries as a cover-up, but they are also consistent with a scientist entertaining all possibilities in the face of genuine uncertainty and crisis. Fauci’s own notes record that “there was not total agreement” on the call. A later entry shows him writing that he is “almost certain that the virus evolved naturally from a species jump, even though I keep an open mind about the possibility of a lab leak.” What followed from those early calls was the Proximal Origin paper published in Nature Medicine in March 2020. The same scientists who privately entertained the possibility of engineering concluded, after further analysis, that the virus was “not a laboratory construct.” The paper became one of the most cited and contested publications of the pandemic. It has been challenged but never retracted, and its core finding — that SARS-CoV-2’s genomic features have natural explanations — has been supported by an array of subsequent research, and natural origin remains the leading hypothesis on the virus’s emergence. Yet the exact mechanism through which it acquired the furin cleavage site remains without a definitive explanation, making it a focal point for proponents of the lab-leak hypothesis and a vital unanswered question about COVID-19’s origins. The $600,000 question The Wuhan Institute of Virology received roughly $600,000 over six years through a US-funded subgrant for bat coronavirus surveillance. Whether that work constituted gain-of-function research remains contested among scientists. The hearing’s central allegation, that Fauci funded gain-of-function research that created SARS-CoV-2, rests on a sub-grant of roughly $600,000 distributed over six years through EcoHealth Alliance to the Wuhan Institute of Virology. The concern over research enhancing the arsenal of viruses is real. In 2014, the US government imposed a moratorium on funding for gain-of-function research. More than 300 scientists signed a statement calling for a pause on experiments creating “potential pandemic pathogens.” The moratorium was lifted in 2017 under a review framework that multiple investigations have found inadequate. Whether the EcoHealth-funded work met the regulatory threshold is genuinely disputed. Richard H. Ebright, a Rutgers University molecular biologist who is a founding member of the Cambridge Working Group on biosafety that pushed for the 2014 US moratorium on gain-of-function research, and a longstanding of biosafety practices at the Wuhan lab, says the EcoHealth-funded work “unequivocally” qualified. Yet Alina Chan, a molecular biologist at MIT and Harvard’s Broad Institute who is herself sympathetic to the lab-leak hypothesis, has disputed the gain-of-function label, saying the work involved “testing naturally occurring SARS viruses, without a reasonable expectation that the tests would increase transmissibility.” Definitional questions aside, the causal chain linking a $100,000-a-year sub-grant, a rounding error within NIH’s roughly $47 billion annual budget, to a global pandemic that killed millions requires assumptions no investigation has substantiated. Fauci did not personally authorise the grant, and has called the leap from EcoHealth funding to pandemic creation “the most ridiculous, majestic leap I’ve ever heard of.” What science says about the origins The earliest known COVID-19 cases in Wuhan cluster in a bullseye pattern around the Huanan seafood market (pink square), including cases with no known link to the market. The Wuhan Institute of Virology (blue dot) sits roughly 10 km southeast across the Yangtze. Source: Worobey et al., Science, 2022. A four-year investigation by the WHO’s Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) concluded in June 2025 that “the weight of available evidence suggests zoonotic spillover, either directly from bats or through an intermediate host.” But it left the lab-leak hypothesis explicitly on the table, with chair Dr Marietjie Venter noting: “Until more scientific data becomes available, the origins of SARS-CoV-2, and how it entered the human population, will remain inconclusive.” WHO Director-General Tedros Adhanom Ghebreyesus echoed that position: “All hypotheses must remain on the table. We continue to appeal to China and any other country that has information to share that information openly, in the interests of protecting the world from future pandemics.” On the zoonotic side, geospatial analysis published in Science showed the earliest cases forming a bullseye centred on the Huanan seafood market, not the Wuhan lab ten miles across the Yangtze. The researchers concluded that “SARS-CoV-2-positive environmental samples were associated with activities concentrated in the southwest corner of the market,” the same section “where vendors were selling live mammals, including raccoon dogs, hog badgers, and red foxes.” Stall-level map of the Huanan seafood market showing SARS-CoV-2-positive environmental samples (red) clustering around wildlife stalls (brown outlines) in the market’s southwest corner, where live mammals including raccoon dogs and civets were sold. The market’s east side, which did not trade live wildlife, shows almost no positive samples. Source: Crits-Christoph et al., Cell, 2024. A study published in Cell found genetic material from “multiple plausible intermediate hosts” in that same corner, concluding that raccoon dogs, masked palm civets, hoary bamboo rats and Malayan porcupines had all “previously been implicated in bat coronavirus cross-species transmission through the animal trade.” Separate phylogenetic analysis identified two viral lineages that diverged before human transmission, consistent with two independent spillovers. “It’s absurd how strong the geographical association is,” evolutionary biologist Michael Worobey, who led the geospatial research, told NPR, estimating the probability of the clustering being coincidental at “one in 10,000.” Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization who co-authored both the Science and Cell studies, has argued the evidence is “consistent with spillover from animals to humans at the Huanan market, under extremely similar circumstances as SARS-CoV-1,” and “incompatible with all lab leak hypotheses proposed.” She has noted that a lab-leak scenario consistent with two lineages would require two independently infected workers both reaching the same market, ten miles from the lab, without infecting anyone en route. No evidence has been produced that the Wuhan lab possessed a close ancestor of SARS-CoV-2. The nearest known relative, a bat virus called BANAL-52, was found by a separate research team in caves in Laos. And while the lab’s presence in Wuhan is frequently cited as a decisive coincidence, China operates 40 to 60 Biosafety Level 3 (BSL-3) labs and over 1,000 BSL-2 facilities nationwide. The EcoHealth-funded work was conducted at a BSL-2 facility, a level that critics and some collaborators later said was inadequate for the coronavirus research underway. The lab-leak case gains ground Animal Source Most Likely Origin of SARS-CoV2 but Missing Chinese Data Leave Findings Inconclusive: WHO Expert Group The lab-leak hypothesis was not always taken seriously. In the pandemic’s first year, prominent scientists and major news organisations dismissed it as a conspiracy theory, and platforms including Facebook and YouTube removed content promoting it. The subsequent accumulation of circumstantial evidence, combined with China’s refusal to share data, has left the door open. Alina Chan of MIT and Harvard’s Broad Institute has made the most scientifically grounded case for a lab origin. She points to the furin cleavage site’s resemblance to the unfunded 2018 DEFUSE proposal, a grant application submitted to the Pentagon’s research agency DARPA by EcoHealth Alliance, the Wuhan Institute and University of North Carolina researchers, which described inserting exactly that type of feature into a SARS-like coronavirus. DARPA rejected it as too risky. Chan also notes that WIV researchers reportedly fell ill with COVID-like symptoms in autumn 2019, and that key evidence found rapidly in the SARS and MERS outbreaks has never surfaced for COVID-19. Chan also maintains “several natural spillover scenarios remain plausible,” and calls for subpoenas of research exchanges rather than prosecution. The Trump administration treats the lab leak as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19”. The page squarely blames the pandemic on its political opponents – specifically Fauci – based on unfounded claims. The CIA and FBI have assessed a research-related origin as more likely, at low and moderate confidence respectively, but the WHO SAGO panel described these intelligence assessments as “very speculative, based on political opinions and not backed up by science.” The Trump administration has gone further, treating the lab leak not as a hypothesis but as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19.” Former Biden White House COVID coordinator Ashish Jha recently told CNN he had changed his mind: “Based on information I learned and based on information I have seen, I have come to conclude that it is more likely to have been a lab leak. No one in the United States knows for sure. The only people who know for sure are officials in China.” China withholds answers Shoppers in Wuhan, China, post-COVID-19 lockdown. Both sides of the debate agree on one thing: the reason the question remains open is China. On 3 January 2020, two days after the world learned of the outbreak, China’s National Health Commission ordered laboratories to hand over or destroy early coronavirus samples. Beijing has confirmed the order. At least 100 individuals with December 2019 symptom onset were sampled; only about 20 sequences have reached international researchers. The Huanan market was shut on 31 December 2019, its animals removed untested, and the site decontaminated. The WIV’s database of 22,000 wildlife samples went offline in autumn 2019 and was never shared. Dr Li Wenliang, the 34-year-old Wuhan ophthalmologist who warned colleagues about a SARS-like illness on 30 December 2019, was detained by police and forced to sign a confession. He contracted COVID-19 and died on 7 February 2020, at age 34. China blocked WHO investigators from entering the country in January 2021, then denied them the requested data. An AP investigation found Beijing “froze meaningful domestic and international efforts to trace the virus from the first weeks of the outbreak.” When WHO proposed a second-phase investigation in 2021 that included audits of Wuhan laboratories, China’s Vice Health Minister rejected the plan outright, calling it “impossible” and saying Beijing would “not accept such an origin-tracing plan as it, in some aspects, disregards common sense and defies science.” China Rejects WHO Plan for Next Phase of COVID Origins Investigation “Persecuting Fauci for trying to answer questions about the virus source in 2020 when we were all misled by the Chinese government is a sideshow,” David Hunter, professor of epidemiology at the University of Oxford, wrote in STAT News. “To blame Fauci for not solving the origin of COVID-19 makes as much sense as blaming a detective in Washington, DC, for not solving a murder in Wuhan.” Meanwhile, the administration accusing Fauci of leaving America vulnerable to COVID-19 is dismantling the infrastructure that would defend it against the next pandemic. Trump’s FY2026 budget proposes cutting NIH by $18 billion, a 44% reduction, and slashing the CDC by roughly half. Georges Benjamin, executive director of the American Public Health Association, has said the cuts will “totally destroy the nation’s public health infrastructure.” The origins of COVID-19 may never be definitively settled. But the hearing made one thing clear: the political apparatus pursuing Fauci is not interested in preventing the next pandemic. It is interested in assigning blame for the last one, while the country that holds the evidence refuses to share it, and the country demanding answers burns down its own capacity to find them. Image Credits: The White House, Worobey et al., Science, 2022., Crits-Christoph et al., Cell, 2024., José Mauquer . ‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order 11/08/2026 Kerry Cullinan ‘MAHA Mom’ Jayme Franklin, US President Donald Trump and US Health Secretary Robert F Kennedy Jr. Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process. Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”. The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”. Virtually the entire world, bar 15 countries, administers single MMR vaccinations, which is easier for parents, children and health facilities. Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism. Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”. Three categories of vaccinations The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox). The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”. Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”. Instead, they should be given based on “shared clinical decision-making”, meaning decisions taken by both parents and healthcare providers. The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”. ‘Disheartening’, ‘dangerous’ and ‘troubling’ A doctor examines a child with measles. Cases of measles are at a 35-year high in the US, mainly thanks to waning confidence in vaccines. Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”. “Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.” Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony. Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review that has guided the US childhood vaccine schedule for decades”. “ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women. Trump ‘doesn’t have the expertise’ Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”. “Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe.” I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h — U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026 ‘Deadly mistake’ Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”. “There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC). Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines. “It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. “Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.” “Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). Circumventing the courts Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”. Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP. However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. This executive order is almost certain to face legal action by health groups. As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
WHO Officials Condemn Trump’s Vaccination Changes 12/08/2026 Kerry Cullinan WHO Director-General Dr Tedros Adhanom Ghebreyesus. Top World Health Organization (WHO) officials are concerned that the United States President Donald Trump’s move to alter his country’s childhood vaccinations via an executive order will endanger children. “WHO is concerned that the changes to immunisation policy in the US are not aligned with the best science,” Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. The order recommends fewer vaccinations, separate vaccinations per clinic visit and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, “Delaying vaccines or separating doses unnecessarily does not make vaccination safer and can leave children unprotected,” said Tedros. Every parent wants to keep their children safe, and vaccines are among the most powerful tools for doing that, making deadly diseases preventable. @WHO is concerned that recent changes to US immunization policy are not aligned with decades of evidence that show when children… pic.twitter.com/vCfgJFrFGK — Tedros Adhanom Ghebreyesus (@DrTedros) August 12, 2026 WHO Assistant Director-General Dr Jeremy Farrar pointed out that the measles vaccine alone had saved 59 million lives. “In many countries, including the United States, there are extensive measles outbreaks, which are causing huge concern,” said Farrar. Measles cases in the US (August 2026). Measles, mumps and rubella are not mild diseases, Farrar said, adding that they can have severe complications: “If anybody has seen a child with post-measles encephalitis, you will remember it for the rest of your life.” Encephalitis is the inflammation of the brain and can cause brain damage. Measles is one of the most infectious diseases, transmitted via infected droplets in the air. Unvaccinated individuals or those with unknown vaccination status represent almost all reported measles cases in the US. US measles cases per vaccination status (August 2026). Making it harder for parents Dr Kate O’Brien, WHO’s director of Immunisation, Vaccines and Biologicals, warned that Trump’s decree is “going in exactly the wrong direction, and there is no evidence that would drive this decision”. “Anything that is done that makes it harder for a parent to get the vaccines their kids need to protect them from what are serious diseases – anything that’s done to make that harder – is not in service of the child,” said O’Brien. “From decades of experience, we know that the more you can enable families to be able to do what they want to do, the higher the coverage and the protection of children is.” Dr Birgitte Giersing, WHO unit head of vaccine research, development and policy, said that 179 of the world’s 194 countries use the MMR vaccination. “Our concern about the breakup of combination vaccines is that these would then actually be far more difficult to deliver. “At the moment, the MMR schedule is a two-dose schedule with those three vaccines,” she said. Breaking it up into three separate vaccinations would potentially mean children need six vaccinations instead of two. Safe and effective “We have extensive scientific evidence that combination vaccines are safe and effective. They enable us to reach [large] populations because there are multiple vaccines within a single shot. They are more acceptable generally to communities, and they really simplify the delivery of vaccines,” said Giersing. “We are very concerned,” concluded Farrar. “WHO provides the global evidence for these vaccines through the Strategic Advisory Group of Experts on Immunisation. “Individual countries, of course, make their own decisions about which policies to implement. But we call on all countries to use the evidence base, use WHO’s advice and guidance, and make the best policy decisions based on the scientific evidence, not on political interference.” Image Credits: Johns Hopkins University. With Over 2000 Dead, Priority is to ‘Break the Chains’ of Ebola Transmission 12/08/2026 Kerry Cullinan An educational poster about Ebola in the DRC. Over 2000 people have died so far in the Ebola Bundibugyo outbreak in the Democratic Republic of Congo (DRC), and the only way to break the chains of transmission is via scaled-up local surveillance, according to the World Health Organization (WHO). “Most concerningly, we see a high proportion of deaths in communities instead of treatment units, outside of known contact lists,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “That tells us there are chains of transmission we don’t know about, and until we know about and break every chain of transmission, we will not stop the outbreak,” he said. “Surveillance is our priority operational challenge. With partners, we’re mapping and pooling resources to strengthen community-based surveillance to bring every suspected case into care and reach the 95% contact tracing target needed to interrupt transmission.” About 90% of the 4,449 official cases and 80% of deaths are in the province of Ituri, with sustained transmission in the towns of Bunia, Rwampara, Nizi and Litha, said Tedros. Most infections happen when people have late-stage disease and are not in treatment, or when their bodies are handled after they have died. “Early clinical care and safe and dignified burials are therefore critical for interrupting transmission, and both depend on the trust of affected communities, which means community engagement and community ownership are essential,” Tedros stressed. ‘Hope is not a strategy’ Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, speaking from the DRC. Partners have set the ambitious goal of ensuring 3,000 beds are available for Ebola patients as soon as possible – but it has taken three months to set up 1,500 beds. Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, said that the moderate scenario for the outbreak was for it to peak within six months. “But this is a highly dynamic outbreak, and unless, as the DG said, we have the community on our side, we’ll be struggling. The last previous outbreak, which happened in a security-compromised situation, lasted about two years=,” said Mahamud. “We don’t want to repeat that. Under the leadership of the government, we are doing everything possible to reduce that, and hopefully in the next six months.” He added: “But hope is not a strategy. We have to have the community on our side, increase the surveillance, and increase our safe and scalable care.” Under-funded Yet the response is only around 50% funded, with $264 million of the $518 million pledged having been disbursed, WHO DRC representative Dr Anne Ancia said that the DRC Government’s latest estimate to address the outbreak was $940 million. She added that most of the money raised so far had gone to partners rather than the DRC government. The DRC government, which has invested $50 million, aims to cover health workers’ salaries with domestic funds eventually, but it was not yet possible given the massive need for additional posts. Tedros said that 21,000 health workers have been tained so far but that the response needs three health workers per patient. Earlier this week, Wellcome Trust gave a $3 million grant to the WHO to expand community intelligence about the outbreak. This will provide authorities with more insight into how people perceive risk, seek care, respond to public health measures and experience the broader social and economic impacts of the outbreak. “Every outbreak is shaped not only by the pathogen, but also by how people understand risk, access care and respond to public health measures,” said Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme. “This investment is about making social analytics part of how outbreak intelligence works in practice. By integrating community-generated evidence throughout the response, we can build a more complete picture of the outbreak and make faster, more effective decisions that ultimately save lives.” Meanwhile, the speed of the outbreak was more likely the result of the difficult conditions, including armed conflict, rather than viral mutation, WHO Chief Scientist Dr Sylvie Briand told the briefing. “Currently, we have not seen any mutation in this virus, and probably the course of the outbreak is currently much more explained by the context in which the virus is circulating, which is an area of conflict with a lot of population mobility,” said Briand. On Monday, researchers reported in Nature that the current outbreak was likely to stem from a new zoonotic spillover from animals to humans, as it was different from the 2007 and 2012 Bundibugyo outbreaks. They deduced this by examining samples from 22 infected people. The Case Against Fauci Was Never About the Origins of COVID-19 11/08/2026 Stefan Anderson Dr Anthony Fauci invoked his Fifth Amendment rights more than 100 times during a Senate hearing, the first time in over 250 congressional appearances across his 54-year career that he declined to answer questions. For nearly three hours on 29 July, the US Senate Homeland Security and Governmental Affairs Committee heard one sentence repeated over a hundred times. “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution.” Dr Anthony Fauci, the 85-year-old retired director of the National Institute of Allergy and Infectious Diseases who guided the American COVID-19 pandemic response across two administrations, sat before the committee and, beyond a brief opening statement, said nothing else. In more than 250 appearances before Congress across his 54-year career, including 14 hours of transcribed interviews with the House Select Subcommittee on the Coronavirus Pandemic in January 2024, Fauci had never before declined to answer a question. But the man who subpoenaed him, Committee chair Senator Rand Paul, had already told the world what he wanted out of the exercise. “The power of some of us must be used for good, like putting Fauci in jail,” Paul tweeted in December 2024. “I want to give him a subpoena and a jail cell.” Fauci’s lawyers argued the hearing amounted to a trap. Any answer, however truthful, could be mined for inconsistencies and forwarded to a Department of Justice that has systematically displayed a disregard for independence from the administration by prosecuting political opponents. Top administration officials indicated as much in the weeks before the hearing. Health Secretary Robert F. Kennedy Jr told Fox News that Fauci “could be subject to perjury prosecution” if any inconsistencies were unearthed during testimony. “Any reasonable person who has followed his unhinged obsession with me would readily come to the same conclusion,” Fauci said. Paul’s crusade dates back to 2021, when he told Fox & Friends the 38-year leader of the National Institutes of Health “could be culpable for the entire pandemic.” A week later, the committee voted along party lines to hold Fauci in contempt and refer the matter for prosecution, the first such action against a former federal health official in modern US history. “Framing public health decisions as matters of criminal intent rather than complex crisis management undermines public faith in medical recommendations, vaccines, and scientific consensus,” said Lawrence Gostin, professor of global health law at Georgetown University. “It is an abuse of power, legally baseless, and sets a dangerous precedent that threatens the future of public health.” ‘Who the f*** did you think you were?’ The stated purpose of the hearing was to uncover the origins of COVID-19, a question of global importance that, six years after the pandemic killed an estimated 25 million people worldwide, remains unresolved. Leading scientific consensus remains that SARS-CoV-2 jumped from bats to humans through contact with infected wildlife at Wuhan’s Huanan wet market. No intermediate animal host has been confirmed, however, and the hypothesis that the virus escaped from the Wuhan Institute of Virology, which studied bat coronaviruses, has never been ruled out. The hearing made no progress on this question. Instead, it bundled political battles over lockdown policy, vaccine safety and the pandemic’s origins into a single prosecutorial narrative aimed at assigning blame for a global catastrophe on a scientist who does not hold the answers to where COVID-19 began, and has no power to compel the Chinese government to release them. “Who the fuck did you think you were?” Senator Bernie Moreno said, accusing Fauci of being a “megalomaniac who was more interested in having met a Kardashian than the suffering of the American people.” His outrage centred on the 2020 arrest of Alecia Kitts, an Ohio mother tased and handcuffed at her son’s middle school football game for refusing to wear a mask, an enforcement action carried out under a statewide order issued by Republican Governor Mike DeWine. Republicans cast Fauci as a shadowy autocrat who unilaterally caused the pandemic, imposed lockdowns and pushed dangerous vaccines on the world, ascribing to a scientific advisor a degree of unchecked power more accurately associated with the leader of their own party. Fauci issued recommendations that were adopted, adapted or rejected by thousands of officials at every level of state and federal government. Governments and health authorities around the world, from the World Health Organization (WHO) to the European Centre for Disease Prevention and Control, reached similar conclusions and imposed similar or stricter measures. The United States was, by most comparative measures, more lax, and also had a higher per-capita COVID death toll than peer nations. Trump’s ‘greatest achievement’? US President Donald Trump claims Operation Warp Speed, the programme responsible for fast-tracking the development of COVID-19 vaccines that have saved millions of lives, as one of his greatest achievements. Many of his most ardent supporters, including his HHS chief, continue to claim they kill people and cause autism. Vaccine misinformation, a defining characteristic of the Kennedy health department, surfaced as well. Senator Ron Johnson referred to COVID-19 vaccines as “experimental gene therapy” and cited misleading adverse event reports as evidence of mass harm. The vaccines were produced under Operation Warp Speed, which President Trump still calls “one of the greatest achievements ever.” Modelling estimates the programme prevented over 3.2 million additional deaths through November 2022. Johnson also claimed Fauci had “sabotaged” ivermectin, an antiparasitic drug instrumental in controlling river blindness in West Africa, which gained a second life during the pandemic as an unproven COVID-19 treatment promoted by anti-vaccine influencers and widely purchased in its veterinary formulation as a horse dewormer. The most comprehensive meta-analysis to date, covering 33 randomised controlled trials, found ivermectin had no effect on COVID-19 mortality. Paul and his political allies also circulated the debunked claim of an 82% vaccine-linked miscarriage rate, a figure derived from a statistical error in a 2021 CDC study that has been refuted repeatedly and repackaged as new evidence, shared as breaking news on Paul’s Twitter on Tuesday. Fauci’s diary Senator Rand Paul and his political allies continued to push inaccurate claims about Fauci and vaccines following the hearing, including the debunked claim that COVID vaccines caused an 82% miscarriage rate in first-trimester pregnancies. Paul released over 1,100 pages of Fauci’s personal diary ahead of the hearing, whose entries became the evidentiary centrepiece of the case against him. The most cited entries date from late January 2020, when Fauci convened urgent calls with virologists. On 31 January, he recorded scientists warning that mutations around the furin cleavage site — a feature found in no other known closely related coronavirus, which enhanced the virus’s ability to infect human cells and contributed to the pandemic’s severity — “could not have occurred naturally.” The next day, Fauci wrote that participants raised the possibility of “deliberate insertion” of the cleavage site through genetic engineering, naming the Wuhan Institute of Virology’s lead researcher, Shi Zhengli, and her gain-of-function work. On 2 February, he told NIH Director Francis Collins: “Please delete this email after you read it.” Paul framed the entries as a cover-up, but they are also consistent with a scientist entertaining all possibilities in the face of genuine uncertainty and crisis. Fauci’s own notes record that “there was not total agreement” on the call. A later entry shows him writing that he is “almost certain that the virus evolved naturally from a species jump, even though I keep an open mind about the possibility of a lab leak.” What followed from those early calls was the Proximal Origin paper published in Nature Medicine in March 2020. The same scientists who privately entertained the possibility of engineering concluded, after further analysis, that the virus was “not a laboratory construct.” The paper became one of the most cited and contested publications of the pandemic. It has been challenged but never retracted, and its core finding — that SARS-CoV-2’s genomic features have natural explanations — has been supported by an array of subsequent research, and natural origin remains the leading hypothesis on the virus’s emergence. Yet the exact mechanism through which it acquired the furin cleavage site remains without a definitive explanation, making it a focal point for proponents of the lab-leak hypothesis and a vital unanswered question about COVID-19’s origins. The $600,000 question The Wuhan Institute of Virology received roughly $600,000 over six years through a US-funded subgrant for bat coronavirus surveillance. Whether that work constituted gain-of-function research remains contested among scientists. The hearing’s central allegation, that Fauci funded gain-of-function research that created SARS-CoV-2, rests on a sub-grant of roughly $600,000 distributed over six years through EcoHealth Alliance to the Wuhan Institute of Virology. The concern over research enhancing the arsenal of viruses is real. In 2014, the US government imposed a moratorium on funding for gain-of-function research. More than 300 scientists signed a statement calling for a pause on experiments creating “potential pandemic pathogens.” The moratorium was lifted in 2017 under a review framework that multiple investigations have found inadequate. Whether the EcoHealth-funded work met the regulatory threshold is genuinely disputed. Richard H. Ebright, a Rutgers University molecular biologist who is a founding member of the Cambridge Working Group on biosafety that pushed for the 2014 US moratorium on gain-of-function research, and a longstanding of biosafety practices at the Wuhan lab, says the EcoHealth-funded work “unequivocally” qualified. Yet Alina Chan, a molecular biologist at MIT and Harvard’s Broad Institute who is herself sympathetic to the lab-leak hypothesis, has disputed the gain-of-function label, saying the work involved “testing naturally occurring SARS viruses, without a reasonable expectation that the tests would increase transmissibility.” Definitional questions aside, the causal chain linking a $100,000-a-year sub-grant, a rounding error within NIH’s roughly $47 billion annual budget, to a global pandemic that killed millions requires assumptions no investigation has substantiated. Fauci did not personally authorise the grant, and has called the leap from EcoHealth funding to pandemic creation “the most ridiculous, majestic leap I’ve ever heard of.” What science says about the origins The earliest known COVID-19 cases in Wuhan cluster in a bullseye pattern around the Huanan seafood market (pink square), including cases with no known link to the market. The Wuhan Institute of Virology (blue dot) sits roughly 10 km southeast across the Yangtze. Source: Worobey et al., Science, 2022. A four-year investigation by the WHO’s Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) concluded in June 2025 that “the weight of available evidence suggests zoonotic spillover, either directly from bats or through an intermediate host.” But it left the lab-leak hypothesis explicitly on the table, with chair Dr Marietjie Venter noting: “Until more scientific data becomes available, the origins of SARS-CoV-2, and how it entered the human population, will remain inconclusive.” WHO Director-General Tedros Adhanom Ghebreyesus echoed that position: “All hypotheses must remain on the table. We continue to appeal to China and any other country that has information to share that information openly, in the interests of protecting the world from future pandemics.” On the zoonotic side, geospatial analysis published in Science showed the earliest cases forming a bullseye centred on the Huanan seafood market, not the Wuhan lab ten miles across the Yangtze. The researchers concluded that “SARS-CoV-2-positive environmental samples were associated with activities concentrated in the southwest corner of the market,” the same section “where vendors were selling live mammals, including raccoon dogs, hog badgers, and red foxes.” Stall-level map of the Huanan seafood market showing SARS-CoV-2-positive environmental samples (red) clustering around wildlife stalls (brown outlines) in the market’s southwest corner, where live mammals including raccoon dogs and civets were sold. The market’s east side, which did not trade live wildlife, shows almost no positive samples. Source: Crits-Christoph et al., Cell, 2024. A study published in Cell found genetic material from “multiple plausible intermediate hosts” in that same corner, concluding that raccoon dogs, masked palm civets, hoary bamboo rats and Malayan porcupines had all “previously been implicated in bat coronavirus cross-species transmission through the animal trade.” Separate phylogenetic analysis identified two viral lineages that diverged before human transmission, consistent with two independent spillovers. “It’s absurd how strong the geographical association is,” evolutionary biologist Michael Worobey, who led the geospatial research, told NPR, estimating the probability of the clustering being coincidental at “one in 10,000.” Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization who co-authored both the Science and Cell studies, has argued the evidence is “consistent with spillover from animals to humans at the Huanan market, under extremely similar circumstances as SARS-CoV-1,” and “incompatible with all lab leak hypotheses proposed.” She has noted that a lab-leak scenario consistent with two lineages would require two independently infected workers both reaching the same market, ten miles from the lab, without infecting anyone en route. No evidence has been produced that the Wuhan lab possessed a close ancestor of SARS-CoV-2. The nearest known relative, a bat virus called BANAL-52, was found by a separate research team in caves in Laos. And while the lab’s presence in Wuhan is frequently cited as a decisive coincidence, China operates 40 to 60 Biosafety Level 3 (BSL-3) labs and over 1,000 BSL-2 facilities nationwide. The EcoHealth-funded work was conducted at a BSL-2 facility, a level that critics and some collaborators later said was inadequate for the coronavirus research underway. The lab-leak case gains ground Animal Source Most Likely Origin of SARS-CoV2 but Missing Chinese Data Leave Findings Inconclusive: WHO Expert Group The lab-leak hypothesis was not always taken seriously. In the pandemic’s first year, prominent scientists and major news organisations dismissed it as a conspiracy theory, and platforms including Facebook and YouTube removed content promoting it. The subsequent accumulation of circumstantial evidence, combined with China’s refusal to share data, has left the door open. Alina Chan of MIT and Harvard’s Broad Institute has made the most scientifically grounded case for a lab origin. She points to the furin cleavage site’s resemblance to the unfunded 2018 DEFUSE proposal, a grant application submitted to the Pentagon’s research agency DARPA by EcoHealth Alliance, the Wuhan Institute and University of North Carolina researchers, which described inserting exactly that type of feature into a SARS-like coronavirus. DARPA rejected it as too risky. Chan also notes that WIV researchers reportedly fell ill with COVID-like symptoms in autumn 2019, and that key evidence found rapidly in the SARS and MERS outbreaks has never surfaced for COVID-19. Chan also maintains “several natural spillover scenarios remain plausible,” and calls for subpoenas of research exchanges rather than prosecution. The Trump administration treats the lab leak as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19”. The page squarely blames the pandemic on its political opponents – specifically Fauci – based on unfounded claims. The CIA and FBI have assessed a research-related origin as more likely, at low and moderate confidence respectively, but the WHO SAGO panel described these intelligence assessments as “very speculative, based on political opinions and not backed up by science.” The Trump administration has gone further, treating the lab leak not as a hypothesis but as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19.” Former Biden White House COVID coordinator Ashish Jha recently told CNN he had changed his mind: “Based on information I learned and based on information I have seen, I have come to conclude that it is more likely to have been a lab leak. No one in the United States knows for sure. The only people who know for sure are officials in China.” China withholds answers Shoppers in Wuhan, China, post-COVID-19 lockdown. Both sides of the debate agree on one thing: the reason the question remains open is China. On 3 January 2020, two days after the world learned of the outbreak, China’s National Health Commission ordered laboratories to hand over or destroy early coronavirus samples. Beijing has confirmed the order. At least 100 individuals with December 2019 symptom onset were sampled; only about 20 sequences have reached international researchers. The Huanan market was shut on 31 December 2019, its animals removed untested, and the site decontaminated. The WIV’s database of 22,000 wildlife samples went offline in autumn 2019 and was never shared. Dr Li Wenliang, the 34-year-old Wuhan ophthalmologist who warned colleagues about a SARS-like illness on 30 December 2019, was detained by police and forced to sign a confession. He contracted COVID-19 and died on 7 February 2020, at age 34. China blocked WHO investigators from entering the country in January 2021, then denied them the requested data. An AP investigation found Beijing “froze meaningful domestic and international efforts to trace the virus from the first weeks of the outbreak.” When WHO proposed a second-phase investigation in 2021 that included audits of Wuhan laboratories, China’s Vice Health Minister rejected the plan outright, calling it “impossible” and saying Beijing would “not accept such an origin-tracing plan as it, in some aspects, disregards common sense and defies science.” China Rejects WHO Plan for Next Phase of COVID Origins Investigation “Persecuting Fauci for trying to answer questions about the virus source in 2020 when we were all misled by the Chinese government is a sideshow,” David Hunter, professor of epidemiology at the University of Oxford, wrote in STAT News. “To blame Fauci for not solving the origin of COVID-19 makes as much sense as blaming a detective in Washington, DC, for not solving a murder in Wuhan.” Meanwhile, the administration accusing Fauci of leaving America vulnerable to COVID-19 is dismantling the infrastructure that would defend it against the next pandemic. Trump’s FY2026 budget proposes cutting NIH by $18 billion, a 44% reduction, and slashing the CDC by roughly half. Georges Benjamin, executive director of the American Public Health Association, has said the cuts will “totally destroy the nation’s public health infrastructure.” The origins of COVID-19 may never be definitively settled. But the hearing made one thing clear: the political apparatus pursuing Fauci is not interested in preventing the next pandemic. It is interested in assigning blame for the last one, while the country that holds the evidence refuses to share it, and the country demanding answers burns down its own capacity to find them. Image Credits: The White House, Worobey et al., Science, 2022., Crits-Christoph et al., Cell, 2024., José Mauquer . ‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order 11/08/2026 Kerry Cullinan ‘MAHA Mom’ Jayme Franklin, US President Donald Trump and US Health Secretary Robert F Kennedy Jr. Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process. Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”. The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”. Virtually the entire world, bar 15 countries, administers single MMR vaccinations, which is easier for parents, children and health facilities. Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism. Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”. Three categories of vaccinations The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox). The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”. Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”. Instead, they should be given based on “shared clinical decision-making”, meaning decisions taken by both parents and healthcare providers. The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”. ‘Disheartening’, ‘dangerous’ and ‘troubling’ A doctor examines a child with measles. Cases of measles are at a 35-year high in the US, mainly thanks to waning confidence in vaccines. Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”. “Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.” Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony. Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review that has guided the US childhood vaccine schedule for decades”. “ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women. Trump ‘doesn’t have the expertise’ Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”. “Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe.” I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h — U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026 ‘Deadly mistake’ Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”. “There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC). Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines. “It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. “Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.” “Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). Circumventing the courts Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”. Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP. However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. This executive order is almost certain to face legal action by health groups. As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
With Over 2000 Dead, Priority is to ‘Break the Chains’ of Ebola Transmission 12/08/2026 Kerry Cullinan An educational poster about Ebola in the DRC. Over 2000 people have died so far in the Ebola Bundibugyo outbreak in the Democratic Republic of Congo (DRC), and the only way to break the chains of transmission is via scaled-up local surveillance, according to the World Health Organization (WHO). “Most concerningly, we see a high proportion of deaths in communities instead of treatment units, outside of known contact lists,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “That tells us there are chains of transmission we don’t know about, and until we know about and break every chain of transmission, we will not stop the outbreak,” he said. “Surveillance is our priority operational challenge. With partners, we’re mapping and pooling resources to strengthen community-based surveillance to bring every suspected case into care and reach the 95% contact tracing target needed to interrupt transmission.” About 90% of the 4,449 official cases and 80% of deaths are in the province of Ituri, with sustained transmission in the towns of Bunia, Rwampara, Nizi and Litha, said Tedros. Most infections happen when people have late-stage disease and are not in treatment, or when their bodies are handled after they have died. “Early clinical care and safe and dignified burials are therefore critical for interrupting transmission, and both depend on the trust of affected communities, which means community engagement and community ownership are essential,” Tedros stressed. ‘Hope is not a strategy’ Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, speaking from the DRC. Partners have set the ambitious goal of ensuring 3,000 beds are available for Ebola patients as soon as possible – but it has taken three months to set up 1,500 beds. Dr Abdi Rahman Mahamud, WHO director for Health Emergency Alert and Response Operations, said that the moderate scenario for the outbreak was for it to peak within six months. “But this is a highly dynamic outbreak, and unless, as the DG said, we have the community on our side, we’ll be struggling. The last previous outbreak, which happened in a security-compromised situation, lasted about two years=,” said Mahamud. “We don’t want to repeat that. Under the leadership of the government, we are doing everything possible to reduce that, and hopefully in the next six months.” He added: “But hope is not a strategy. We have to have the community on our side, increase the surveillance, and increase our safe and scalable care.” Under-funded Yet the response is only around 50% funded, with $264 million of the $518 million pledged having been disbursed, WHO DRC representative Dr Anne Ancia said that the DRC Government’s latest estimate to address the outbreak was $940 million. She added that most of the money raised so far had gone to partners rather than the DRC government. The DRC government, which has invested $50 million, aims to cover health workers’ salaries with domestic funds eventually, but it was not yet possible given the massive need for additional posts. Tedros said that 21,000 health workers have been tained so far but that the response needs three health workers per patient. Earlier this week, Wellcome Trust gave a $3 million grant to the WHO to expand community intelligence about the outbreak. This will provide authorities with more insight into how people perceive risk, seek care, respond to public health measures and experience the broader social and economic impacts of the outbreak. “Every outbreak is shaped not only by the pathogen, but also by how people understand risk, access care and respond to public health measures,” said Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme. “This investment is about making social analytics part of how outbreak intelligence works in practice. By integrating community-generated evidence throughout the response, we can build a more complete picture of the outbreak and make faster, more effective decisions that ultimately save lives.” Meanwhile, the speed of the outbreak was more likely the result of the difficult conditions, including armed conflict, rather than viral mutation, WHO Chief Scientist Dr Sylvie Briand told the briefing. “Currently, we have not seen any mutation in this virus, and probably the course of the outbreak is currently much more explained by the context in which the virus is circulating, which is an area of conflict with a lot of population mobility,” said Briand. On Monday, researchers reported in Nature that the current outbreak was likely to stem from a new zoonotic spillover from animals to humans, as it was different from the 2007 and 2012 Bundibugyo outbreaks. They deduced this by examining samples from 22 infected people. The Case Against Fauci Was Never About the Origins of COVID-19 11/08/2026 Stefan Anderson Dr Anthony Fauci invoked his Fifth Amendment rights more than 100 times during a Senate hearing, the first time in over 250 congressional appearances across his 54-year career that he declined to answer questions. For nearly three hours on 29 July, the US Senate Homeland Security and Governmental Affairs Committee heard one sentence repeated over a hundred times. “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution.” Dr Anthony Fauci, the 85-year-old retired director of the National Institute of Allergy and Infectious Diseases who guided the American COVID-19 pandemic response across two administrations, sat before the committee and, beyond a brief opening statement, said nothing else. In more than 250 appearances before Congress across his 54-year career, including 14 hours of transcribed interviews with the House Select Subcommittee on the Coronavirus Pandemic in January 2024, Fauci had never before declined to answer a question. But the man who subpoenaed him, Committee chair Senator Rand Paul, had already told the world what he wanted out of the exercise. “The power of some of us must be used for good, like putting Fauci in jail,” Paul tweeted in December 2024. “I want to give him a subpoena and a jail cell.” Fauci’s lawyers argued the hearing amounted to a trap. Any answer, however truthful, could be mined for inconsistencies and forwarded to a Department of Justice that has systematically displayed a disregard for independence from the administration by prosecuting political opponents. Top administration officials indicated as much in the weeks before the hearing. Health Secretary Robert F. Kennedy Jr told Fox News that Fauci “could be subject to perjury prosecution” if any inconsistencies were unearthed during testimony. “Any reasonable person who has followed his unhinged obsession with me would readily come to the same conclusion,” Fauci said. Paul’s crusade dates back to 2021, when he told Fox & Friends the 38-year leader of the National Institutes of Health “could be culpable for the entire pandemic.” A week later, the committee voted along party lines to hold Fauci in contempt and refer the matter for prosecution, the first such action against a former federal health official in modern US history. “Framing public health decisions as matters of criminal intent rather than complex crisis management undermines public faith in medical recommendations, vaccines, and scientific consensus,” said Lawrence Gostin, professor of global health law at Georgetown University. “It is an abuse of power, legally baseless, and sets a dangerous precedent that threatens the future of public health.” ‘Who the f*** did you think you were?’ The stated purpose of the hearing was to uncover the origins of COVID-19, a question of global importance that, six years after the pandemic killed an estimated 25 million people worldwide, remains unresolved. Leading scientific consensus remains that SARS-CoV-2 jumped from bats to humans through contact with infected wildlife at Wuhan’s Huanan wet market. No intermediate animal host has been confirmed, however, and the hypothesis that the virus escaped from the Wuhan Institute of Virology, which studied bat coronaviruses, has never been ruled out. The hearing made no progress on this question. Instead, it bundled political battles over lockdown policy, vaccine safety and the pandemic’s origins into a single prosecutorial narrative aimed at assigning blame for a global catastrophe on a scientist who does not hold the answers to where COVID-19 began, and has no power to compel the Chinese government to release them. “Who the fuck did you think you were?” Senator Bernie Moreno said, accusing Fauci of being a “megalomaniac who was more interested in having met a Kardashian than the suffering of the American people.” His outrage centred on the 2020 arrest of Alecia Kitts, an Ohio mother tased and handcuffed at her son’s middle school football game for refusing to wear a mask, an enforcement action carried out under a statewide order issued by Republican Governor Mike DeWine. Republicans cast Fauci as a shadowy autocrat who unilaterally caused the pandemic, imposed lockdowns and pushed dangerous vaccines on the world, ascribing to a scientific advisor a degree of unchecked power more accurately associated with the leader of their own party. Fauci issued recommendations that were adopted, adapted or rejected by thousands of officials at every level of state and federal government. Governments and health authorities around the world, from the World Health Organization (WHO) to the European Centre for Disease Prevention and Control, reached similar conclusions and imposed similar or stricter measures. The United States was, by most comparative measures, more lax, and also had a higher per-capita COVID death toll than peer nations. Trump’s ‘greatest achievement’? US President Donald Trump claims Operation Warp Speed, the programme responsible for fast-tracking the development of COVID-19 vaccines that have saved millions of lives, as one of his greatest achievements. Many of his most ardent supporters, including his HHS chief, continue to claim they kill people and cause autism. Vaccine misinformation, a defining characteristic of the Kennedy health department, surfaced as well. Senator Ron Johnson referred to COVID-19 vaccines as “experimental gene therapy” and cited misleading adverse event reports as evidence of mass harm. The vaccines were produced under Operation Warp Speed, which President Trump still calls “one of the greatest achievements ever.” Modelling estimates the programme prevented over 3.2 million additional deaths through November 2022. Johnson also claimed Fauci had “sabotaged” ivermectin, an antiparasitic drug instrumental in controlling river blindness in West Africa, which gained a second life during the pandemic as an unproven COVID-19 treatment promoted by anti-vaccine influencers and widely purchased in its veterinary formulation as a horse dewormer. The most comprehensive meta-analysis to date, covering 33 randomised controlled trials, found ivermectin had no effect on COVID-19 mortality. Paul and his political allies also circulated the debunked claim of an 82% vaccine-linked miscarriage rate, a figure derived from a statistical error in a 2021 CDC study that has been refuted repeatedly and repackaged as new evidence, shared as breaking news on Paul’s Twitter on Tuesday. Fauci’s diary Senator Rand Paul and his political allies continued to push inaccurate claims about Fauci and vaccines following the hearing, including the debunked claim that COVID vaccines caused an 82% miscarriage rate in first-trimester pregnancies. Paul released over 1,100 pages of Fauci’s personal diary ahead of the hearing, whose entries became the evidentiary centrepiece of the case against him. The most cited entries date from late January 2020, when Fauci convened urgent calls with virologists. On 31 January, he recorded scientists warning that mutations around the furin cleavage site — a feature found in no other known closely related coronavirus, which enhanced the virus’s ability to infect human cells and contributed to the pandemic’s severity — “could not have occurred naturally.” The next day, Fauci wrote that participants raised the possibility of “deliberate insertion” of the cleavage site through genetic engineering, naming the Wuhan Institute of Virology’s lead researcher, Shi Zhengli, and her gain-of-function work. On 2 February, he told NIH Director Francis Collins: “Please delete this email after you read it.” Paul framed the entries as a cover-up, but they are also consistent with a scientist entertaining all possibilities in the face of genuine uncertainty and crisis. Fauci’s own notes record that “there was not total agreement” on the call. A later entry shows him writing that he is “almost certain that the virus evolved naturally from a species jump, even though I keep an open mind about the possibility of a lab leak.” What followed from those early calls was the Proximal Origin paper published in Nature Medicine in March 2020. The same scientists who privately entertained the possibility of engineering concluded, after further analysis, that the virus was “not a laboratory construct.” The paper became one of the most cited and contested publications of the pandemic. It has been challenged but never retracted, and its core finding — that SARS-CoV-2’s genomic features have natural explanations — has been supported by an array of subsequent research, and natural origin remains the leading hypothesis on the virus’s emergence. Yet the exact mechanism through which it acquired the furin cleavage site remains without a definitive explanation, making it a focal point for proponents of the lab-leak hypothesis and a vital unanswered question about COVID-19’s origins. The $600,000 question The Wuhan Institute of Virology received roughly $600,000 over six years through a US-funded subgrant for bat coronavirus surveillance. Whether that work constituted gain-of-function research remains contested among scientists. The hearing’s central allegation, that Fauci funded gain-of-function research that created SARS-CoV-2, rests on a sub-grant of roughly $600,000 distributed over six years through EcoHealth Alliance to the Wuhan Institute of Virology. The concern over research enhancing the arsenal of viruses is real. In 2014, the US government imposed a moratorium on funding for gain-of-function research. More than 300 scientists signed a statement calling for a pause on experiments creating “potential pandemic pathogens.” The moratorium was lifted in 2017 under a review framework that multiple investigations have found inadequate. Whether the EcoHealth-funded work met the regulatory threshold is genuinely disputed. Richard H. Ebright, a Rutgers University molecular biologist who is a founding member of the Cambridge Working Group on biosafety that pushed for the 2014 US moratorium on gain-of-function research, and a longstanding of biosafety practices at the Wuhan lab, says the EcoHealth-funded work “unequivocally” qualified. Yet Alina Chan, a molecular biologist at MIT and Harvard’s Broad Institute who is herself sympathetic to the lab-leak hypothesis, has disputed the gain-of-function label, saying the work involved “testing naturally occurring SARS viruses, without a reasonable expectation that the tests would increase transmissibility.” Definitional questions aside, the causal chain linking a $100,000-a-year sub-grant, a rounding error within NIH’s roughly $47 billion annual budget, to a global pandemic that killed millions requires assumptions no investigation has substantiated. Fauci did not personally authorise the grant, and has called the leap from EcoHealth funding to pandemic creation “the most ridiculous, majestic leap I’ve ever heard of.” What science says about the origins The earliest known COVID-19 cases in Wuhan cluster in a bullseye pattern around the Huanan seafood market (pink square), including cases with no known link to the market. The Wuhan Institute of Virology (blue dot) sits roughly 10 km southeast across the Yangtze. Source: Worobey et al., Science, 2022. A four-year investigation by the WHO’s Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) concluded in June 2025 that “the weight of available evidence suggests zoonotic spillover, either directly from bats or through an intermediate host.” But it left the lab-leak hypothesis explicitly on the table, with chair Dr Marietjie Venter noting: “Until more scientific data becomes available, the origins of SARS-CoV-2, and how it entered the human population, will remain inconclusive.” WHO Director-General Tedros Adhanom Ghebreyesus echoed that position: “All hypotheses must remain on the table. We continue to appeal to China and any other country that has information to share that information openly, in the interests of protecting the world from future pandemics.” On the zoonotic side, geospatial analysis published in Science showed the earliest cases forming a bullseye centred on the Huanan seafood market, not the Wuhan lab ten miles across the Yangtze. The researchers concluded that “SARS-CoV-2-positive environmental samples were associated with activities concentrated in the southwest corner of the market,” the same section “where vendors were selling live mammals, including raccoon dogs, hog badgers, and red foxes.” Stall-level map of the Huanan seafood market showing SARS-CoV-2-positive environmental samples (red) clustering around wildlife stalls (brown outlines) in the market’s southwest corner, where live mammals including raccoon dogs and civets were sold. The market’s east side, which did not trade live wildlife, shows almost no positive samples. Source: Crits-Christoph et al., Cell, 2024. A study published in Cell found genetic material from “multiple plausible intermediate hosts” in that same corner, concluding that raccoon dogs, masked palm civets, hoary bamboo rats and Malayan porcupines had all “previously been implicated in bat coronavirus cross-species transmission through the animal trade.” Separate phylogenetic analysis identified two viral lineages that diverged before human transmission, consistent with two independent spillovers. “It’s absurd how strong the geographical association is,” evolutionary biologist Michael Worobey, who led the geospatial research, told NPR, estimating the probability of the clustering being coincidental at “one in 10,000.” Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization who co-authored both the Science and Cell studies, has argued the evidence is “consistent with spillover from animals to humans at the Huanan market, under extremely similar circumstances as SARS-CoV-1,” and “incompatible with all lab leak hypotheses proposed.” She has noted that a lab-leak scenario consistent with two lineages would require two independently infected workers both reaching the same market, ten miles from the lab, without infecting anyone en route. No evidence has been produced that the Wuhan lab possessed a close ancestor of SARS-CoV-2. The nearest known relative, a bat virus called BANAL-52, was found by a separate research team in caves in Laos. And while the lab’s presence in Wuhan is frequently cited as a decisive coincidence, China operates 40 to 60 Biosafety Level 3 (BSL-3) labs and over 1,000 BSL-2 facilities nationwide. The EcoHealth-funded work was conducted at a BSL-2 facility, a level that critics and some collaborators later said was inadequate for the coronavirus research underway. The lab-leak case gains ground Animal Source Most Likely Origin of SARS-CoV2 but Missing Chinese Data Leave Findings Inconclusive: WHO Expert Group The lab-leak hypothesis was not always taken seriously. In the pandemic’s first year, prominent scientists and major news organisations dismissed it as a conspiracy theory, and platforms including Facebook and YouTube removed content promoting it. The subsequent accumulation of circumstantial evidence, combined with China’s refusal to share data, has left the door open. Alina Chan of MIT and Harvard’s Broad Institute has made the most scientifically grounded case for a lab origin. She points to the furin cleavage site’s resemblance to the unfunded 2018 DEFUSE proposal, a grant application submitted to the Pentagon’s research agency DARPA by EcoHealth Alliance, the Wuhan Institute and University of North Carolina researchers, which described inserting exactly that type of feature into a SARS-like coronavirus. DARPA rejected it as too risky. Chan also notes that WIV researchers reportedly fell ill with COVID-like symptoms in autumn 2019, and that key evidence found rapidly in the SARS and MERS outbreaks has never surfaced for COVID-19. Chan also maintains “several natural spillover scenarios remain plausible,” and calls for subpoenas of research exchanges rather than prosecution. The Trump administration treats the lab leak as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19”. The page squarely blames the pandemic on its political opponents – specifically Fauci – based on unfounded claims. The CIA and FBI have assessed a research-related origin as more likely, at low and moderate confidence respectively, but the WHO SAGO panel described these intelligence assessments as “very speculative, based on political opinions and not backed up by science.” The Trump administration has gone further, treating the lab leak not as a hypothesis but as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19.” Former Biden White House COVID coordinator Ashish Jha recently told CNN he had changed his mind: “Based on information I learned and based on information I have seen, I have come to conclude that it is more likely to have been a lab leak. No one in the United States knows for sure. The only people who know for sure are officials in China.” China withholds answers Shoppers in Wuhan, China, post-COVID-19 lockdown. Both sides of the debate agree on one thing: the reason the question remains open is China. On 3 January 2020, two days after the world learned of the outbreak, China’s National Health Commission ordered laboratories to hand over or destroy early coronavirus samples. Beijing has confirmed the order. At least 100 individuals with December 2019 symptom onset were sampled; only about 20 sequences have reached international researchers. The Huanan market was shut on 31 December 2019, its animals removed untested, and the site decontaminated. The WIV’s database of 22,000 wildlife samples went offline in autumn 2019 and was never shared. Dr Li Wenliang, the 34-year-old Wuhan ophthalmologist who warned colleagues about a SARS-like illness on 30 December 2019, was detained by police and forced to sign a confession. He contracted COVID-19 and died on 7 February 2020, at age 34. China blocked WHO investigators from entering the country in January 2021, then denied them the requested data. An AP investigation found Beijing “froze meaningful domestic and international efforts to trace the virus from the first weeks of the outbreak.” When WHO proposed a second-phase investigation in 2021 that included audits of Wuhan laboratories, China’s Vice Health Minister rejected the plan outright, calling it “impossible” and saying Beijing would “not accept such an origin-tracing plan as it, in some aspects, disregards common sense and defies science.” China Rejects WHO Plan for Next Phase of COVID Origins Investigation “Persecuting Fauci for trying to answer questions about the virus source in 2020 when we were all misled by the Chinese government is a sideshow,” David Hunter, professor of epidemiology at the University of Oxford, wrote in STAT News. “To blame Fauci for not solving the origin of COVID-19 makes as much sense as blaming a detective in Washington, DC, for not solving a murder in Wuhan.” Meanwhile, the administration accusing Fauci of leaving America vulnerable to COVID-19 is dismantling the infrastructure that would defend it against the next pandemic. Trump’s FY2026 budget proposes cutting NIH by $18 billion, a 44% reduction, and slashing the CDC by roughly half. Georges Benjamin, executive director of the American Public Health Association, has said the cuts will “totally destroy the nation’s public health infrastructure.” The origins of COVID-19 may never be definitively settled. But the hearing made one thing clear: the political apparatus pursuing Fauci is not interested in preventing the next pandemic. It is interested in assigning blame for the last one, while the country that holds the evidence refuses to share it, and the country demanding answers burns down its own capacity to find them. Image Credits: The White House, Worobey et al., Science, 2022., Crits-Christoph et al., Cell, 2024., José Mauquer . ‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order 11/08/2026 Kerry Cullinan ‘MAHA Mom’ Jayme Franklin, US President Donald Trump and US Health Secretary Robert F Kennedy Jr. Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process. Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”. The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”. Virtually the entire world, bar 15 countries, administers single MMR vaccinations, which is easier for parents, children and health facilities. Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism. Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”. Three categories of vaccinations The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox). The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”. Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”. Instead, they should be given based on “shared clinical decision-making”, meaning decisions taken by both parents and healthcare providers. The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”. ‘Disheartening’, ‘dangerous’ and ‘troubling’ A doctor examines a child with measles. Cases of measles are at a 35-year high in the US, mainly thanks to waning confidence in vaccines. Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”. “Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.” Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony. Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review that has guided the US childhood vaccine schedule for decades”. “ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women. Trump ‘doesn’t have the expertise’ Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”. “Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe.” I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h — U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026 ‘Deadly mistake’ Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”. “There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC). Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines. “It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. “Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.” “Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). Circumventing the courts Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”. Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP. However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. This executive order is almost certain to face legal action by health groups. As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
The Case Against Fauci Was Never About the Origins of COVID-19 11/08/2026 Stefan Anderson Dr Anthony Fauci invoked his Fifth Amendment rights more than 100 times during a Senate hearing, the first time in over 250 congressional appearances across his 54-year career that he declined to answer questions. For nearly three hours on 29 July, the US Senate Homeland Security and Governmental Affairs Committee heard one sentence repeated over a hundred times. “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment of the Constitution.” Dr Anthony Fauci, the 85-year-old retired director of the National Institute of Allergy and Infectious Diseases who guided the American COVID-19 pandemic response across two administrations, sat before the committee and, beyond a brief opening statement, said nothing else. In more than 250 appearances before Congress across his 54-year career, including 14 hours of transcribed interviews with the House Select Subcommittee on the Coronavirus Pandemic in January 2024, Fauci had never before declined to answer a question. But the man who subpoenaed him, Committee chair Senator Rand Paul, had already told the world what he wanted out of the exercise. “The power of some of us must be used for good, like putting Fauci in jail,” Paul tweeted in December 2024. “I want to give him a subpoena and a jail cell.” Fauci’s lawyers argued the hearing amounted to a trap. Any answer, however truthful, could be mined for inconsistencies and forwarded to a Department of Justice that has systematically displayed a disregard for independence from the administration by prosecuting political opponents. Top administration officials indicated as much in the weeks before the hearing. Health Secretary Robert F. Kennedy Jr told Fox News that Fauci “could be subject to perjury prosecution” if any inconsistencies were unearthed during testimony. “Any reasonable person who has followed his unhinged obsession with me would readily come to the same conclusion,” Fauci said. Paul’s crusade dates back to 2021, when he told Fox & Friends the 38-year leader of the National Institutes of Health “could be culpable for the entire pandemic.” A week later, the committee voted along party lines to hold Fauci in contempt and refer the matter for prosecution, the first such action against a former federal health official in modern US history. “Framing public health decisions as matters of criminal intent rather than complex crisis management undermines public faith in medical recommendations, vaccines, and scientific consensus,” said Lawrence Gostin, professor of global health law at Georgetown University. “It is an abuse of power, legally baseless, and sets a dangerous precedent that threatens the future of public health.” ‘Who the f*** did you think you were?’ The stated purpose of the hearing was to uncover the origins of COVID-19, a question of global importance that, six years after the pandemic killed an estimated 25 million people worldwide, remains unresolved. Leading scientific consensus remains that SARS-CoV-2 jumped from bats to humans through contact with infected wildlife at Wuhan’s Huanan wet market. No intermediate animal host has been confirmed, however, and the hypothesis that the virus escaped from the Wuhan Institute of Virology, which studied bat coronaviruses, has never been ruled out. The hearing made no progress on this question. Instead, it bundled political battles over lockdown policy, vaccine safety and the pandemic’s origins into a single prosecutorial narrative aimed at assigning blame for a global catastrophe on a scientist who does not hold the answers to where COVID-19 began, and has no power to compel the Chinese government to release them. “Who the fuck did you think you were?” Senator Bernie Moreno said, accusing Fauci of being a “megalomaniac who was more interested in having met a Kardashian than the suffering of the American people.” His outrage centred on the 2020 arrest of Alecia Kitts, an Ohio mother tased and handcuffed at her son’s middle school football game for refusing to wear a mask, an enforcement action carried out under a statewide order issued by Republican Governor Mike DeWine. Republicans cast Fauci as a shadowy autocrat who unilaterally caused the pandemic, imposed lockdowns and pushed dangerous vaccines on the world, ascribing to a scientific advisor a degree of unchecked power more accurately associated with the leader of their own party. Fauci issued recommendations that were adopted, adapted or rejected by thousands of officials at every level of state and federal government. Governments and health authorities around the world, from the World Health Organization (WHO) to the European Centre for Disease Prevention and Control, reached similar conclusions and imposed similar or stricter measures. The United States was, by most comparative measures, more lax, and also had a higher per-capita COVID death toll than peer nations. Trump’s ‘greatest achievement’? US President Donald Trump claims Operation Warp Speed, the programme responsible for fast-tracking the development of COVID-19 vaccines that have saved millions of lives, as one of his greatest achievements. Many of his most ardent supporters, including his HHS chief, continue to claim they kill people and cause autism. Vaccine misinformation, a defining characteristic of the Kennedy health department, surfaced as well. Senator Ron Johnson referred to COVID-19 vaccines as “experimental gene therapy” and cited misleading adverse event reports as evidence of mass harm. The vaccines were produced under Operation Warp Speed, which President Trump still calls “one of the greatest achievements ever.” Modelling estimates the programme prevented over 3.2 million additional deaths through November 2022. Johnson also claimed Fauci had “sabotaged” ivermectin, an antiparasitic drug instrumental in controlling river blindness in West Africa, which gained a second life during the pandemic as an unproven COVID-19 treatment promoted by anti-vaccine influencers and widely purchased in its veterinary formulation as a horse dewormer. The most comprehensive meta-analysis to date, covering 33 randomised controlled trials, found ivermectin had no effect on COVID-19 mortality. Paul and his political allies also circulated the debunked claim of an 82% vaccine-linked miscarriage rate, a figure derived from a statistical error in a 2021 CDC study that has been refuted repeatedly and repackaged as new evidence, shared as breaking news on Paul’s Twitter on Tuesday. Fauci’s diary Senator Rand Paul and his political allies continued to push inaccurate claims about Fauci and vaccines following the hearing, including the debunked claim that COVID vaccines caused an 82% miscarriage rate in first-trimester pregnancies. Paul released over 1,100 pages of Fauci’s personal diary ahead of the hearing, whose entries became the evidentiary centrepiece of the case against him. The most cited entries date from late January 2020, when Fauci convened urgent calls with virologists. On 31 January, he recorded scientists warning that mutations around the furin cleavage site — a feature found in no other known closely related coronavirus, which enhanced the virus’s ability to infect human cells and contributed to the pandemic’s severity — “could not have occurred naturally.” The next day, Fauci wrote that participants raised the possibility of “deliberate insertion” of the cleavage site through genetic engineering, naming the Wuhan Institute of Virology’s lead researcher, Shi Zhengli, and her gain-of-function work. On 2 February, he told NIH Director Francis Collins: “Please delete this email after you read it.” Paul framed the entries as a cover-up, but they are also consistent with a scientist entertaining all possibilities in the face of genuine uncertainty and crisis. Fauci’s own notes record that “there was not total agreement” on the call. A later entry shows him writing that he is “almost certain that the virus evolved naturally from a species jump, even though I keep an open mind about the possibility of a lab leak.” What followed from those early calls was the Proximal Origin paper published in Nature Medicine in March 2020. The same scientists who privately entertained the possibility of engineering concluded, after further analysis, that the virus was “not a laboratory construct.” The paper became one of the most cited and contested publications of the pandemic. It has been challenged but never retracted, and its core finding — that SARS-CoV-2’s genomic features have natural explanations — has been supported by an array of subsequent research, and natural origin remains the leading hypothesis on the virus’s emergence. Yet the exact mechanism through which it acquired the furin cleavage site remains without a definitive explanation, making it a focal point for proponents of the lab-leak hypothesis and a vital unanswered question about COVID-19’s origins. The $600,000 question The Wuhan Institute of Virology received roughly $600,000 over six years through a US-funded subgrant for bat coronavirus surveillance. Whether that work constituted gain-of-function research remains contested among scientists. The hearing’s central allegation, that Fauci funded gain-of-function research that created SARS-CoV-2, rests on a sub-grant of roughly $600,000 distributed over six years through EcoHealth Alliance to the Wuhan Institute of Virology. The concern over research enhancing the arsenal of viruses is real. In 2014, the US government imposed a moratorium on funding for gain-of-function research. More than 300 scientists signed a statement calling for a pause on experiments creating “potential pandemic pathogens.” The moratorium was lifted in 2017 under a review framework that multiple investigations have found inadequate. Whether the EcoHealth-funded work met the regulatory threshold is genuinely disputed. Richard H. Ebright, a Rutgers University molecular biologist who is a founding member of the Cambridge Working Group on biosafety that pushed for the 2014 US moratorium on gain-of-function research, and a longstanding of biosafety practices at the Wuhan lab, says the EcoHealth-funded work “unequivocally” qualified. Yet Alina Chan, a molecular biologist at MIT and Harvard’s Broad Institute who is herself sympathetic to the lab-leak hypothesis, has disputed the gain-of-function label, saying the work involved “testing naturally occurring SARS viruses, without a reasonable expectation that the tests would increase transmissibility.” Definitional questions aside, the causal chain linking a $100,000-a-year sub-grant, a rounding error within NIH’s roughly $47 billion annual budget, to a global pandemic that killed millions requires assumptions no investigation has substantiated. Fauci did not personally authorise the grant, and has called the leap from EcoHealth funding to pandemic creation “the most ridiculous, majestic leap I’ve ever heard of.” What science says about the origins The earliest known COVID-19 cases in Wuhan cluster in a bullseye pattern around the Huanan seafood market (pink square), including cases with no known link to the market. The Wuhan Institute of Virology (blue dot) sits roughly 10 km southeast across the Yangtze. Source: Worobey et al., Science, 2022. A four-year investigation by the WHO’s Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) concluded in June 2025 that “the weight of available evidence suggests zoonotic spillover, either directly from bats or through an intermediate host.” But it left the lab-leak hypothesis explicitly on the table, with chair Dr Marietjie Venter noting: “Until more scientific data becomes available, the origins of SARS-CoV-2, and how it entered the human population, will remain inconclusive.” WHO Director-General Tedros Adhanom Ghebreyesus echoed that position: “All hypotheses must remain on the table. We continue to appeal to China and any other country that has information to share that information openly, in the interests of protecting the world from future pandemics.” On the zoonotic side, geospatial analysis published in Science showed the earliest cases forming a bullseye centred on the Huanan seafood market, not the Wuhan lab ten miles across the Yangtze. The researchers concluded that “SARS-CoV-2-positive environmental samples were associated with activities concentrated in the southwest corner of the market,” the same section “where vendors were selling live mammals, including raccoon dogs, hog badgers, and red foxes.” Stall-level map of the Huanan seafood market showing SARS-CoV-2-positive environmental samples (red) clustering around wildlife stalls (brown outlines) in the market’s southwest corner, where live mammals including raccoon dogs and civets were sold. The market’s east side, which did not trade live wildlife, shows almost no positive samples. Source: Crits-Christoph et al., Cell, 2024. A study published in Cell found genetic material from “multiple plausible intermediate hosts” in that same corner, concluding that raccoon dogs, masked palm civets, hoary bamboo rats and Malayan porcupines had all “previously been implicated in bat coronavirus cross-species transmission through the animal trade.” Separate phylogenetic analysis identified two viral lineages that diverged before human transmission, consistent with two independent spillovers. “It’s absurd how strong the geographical association is,” evolutionary biologist Michael Worobey, who led the geospatial research, told NPR, estimating the probability of the clustering being coincidental at “one in 10,000.” Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization who co-authored both the Science and Cell studies, has argued the evidence is “consistent with spillover from animals to humans at the Huanan market, under extremely similar circumstances as SARS-CoV-1,” and “incompatible with all lab leak hypotheses proposed.” She has noted that a lab-leak scenario consistent with two lineages would require two independently infected workers both reaching the same market, ten miles from the lab, without infecting anyone en route. No evidence has been produced that the Wuhan lab possessed a close ancestor of SARS-CoV-2. The nearest known relative, a bat virus called BANAL-52, was found by a separate research team in caves in Laos. And while the lab’s presence in Wuhan is frequently cited as a decisive coincidence, China operates 40 to 60 Biosafety Level 3 (BSL-3) labs and over 1,000 BSL-2 facilities nationwide. The EcoHealth-funded work was conducted at a BSL-2 facility, a level that critics and some collaborators later said was inadequate for the coronavirus research underway. The lab-leak case gains ground Animal Source Most Likely Origin of SARS-CoV2 but Missing Chinese Data Leave Findings Inconclusive: WHO Expert Group The lab-leak hypothesis was not always taken seriously. In the pandemic’s first year, prominent scientists and major news organisations dismissed it as a conspiracy theory, and platforms including Facebook and YouTube removed content promoting it. The subsequent accumulation of circumstantial evidence, combined with China’s refusal to share data, has left the door open. Alina Chan of MIT and Harvard’s Broad Institute has made the most scientifically grounded case for a lab origin. She points to the furin cleavage site’s resemblance to the unfunded 2018 DEFUSE proposal, a grant application submitted to the Pentagon’s research agency DARPA by EcoHealth Alliance, the Wuhan Institute and University of North Carolina researchers, which described inserting exactly that type of feature into a SARS-like coronavirus. DARPA rejected it as too risky. Chan also notes that WIV researchers reportedly fell ill with COVID-like symptoms in autumn 2019, and that key evidence found rapidly in the SARS and MERS outbreaks has never surfaced for COVID-19. Chan also maintains “several natural spillover scenarios remain plausible,” and calls for subpoenas of research exchanges rather than prosecution. The Trump administration treats the lab leak as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19”. The page squarely blames the pandemic on its political opponents – specifically Fauci – based on unfounded claims. The CIA and FBI have assessed a research-related origin as more likely, at low and moderate confidence respectively, but the WHO SAGO panel described these intelligence assessments as “very speculative, based on political opinions and not backed up by science.” The Trump administration has gone further, treating the lab leak not as a hypothesis but as a closed case. In 2025, it took down government websites providing COVID-19 health information and replaced them with a White House page titled “Lab Leak: The True Origins of Covid-19.” Former Biden White House COVID coordinator Ashish Jha recently told CNN he had changed his mind: “Based on information I learned and based on information I have seen, I have come to conclude that it is more likely to have been a lab leak. No one in the United States knows for sure. The only people who know for sure are officials in China.” China withholds answers Shoppers in Wuhan, China, post-COVID-19 lockdown. Both sides of the debate agree on one thing: the reason the question remains open is China. On 3 January 2020, two days after the world learned of the outbreak, China’s National Health Commission ordered laboratories to hand over or destroy early coronavirus samples. Beijing has confirmed the order. At least 100 individuals with December 2019 symptom onset were sampled; only about 20 sequences have reached international researchers. The Huanan market was shut on 31 December 2019, its animals removed untested, and the site decontaminated. The WIV’s database of 22,000 wildlife samples went offline in autumn 2019 and was never shared. Dr Li Wenliang, the 34-year-old Wuhan ophthalmologist who warned colleagues about a SARS-like illness on 30 December 2019, was detained by police and forced to sign a confession. He contracted COVID-19 and died on 7 February 2020, at age 34. China blocked WHO investigators from entering the country in January 2021, then denied them the requested data. An AP investigation found Beijing “froze meaningful domestic and international efforts to trace the virus from the first weeks of the outbreak.” When WHO proposed a second-phase investigation in 2021 that included audits of Wuhan laboratories, China’s Vice Health Minister rejected the plan outright, calling it “impossible” and saying Beijing would “not accept such an origin-tracing plan as it, in some aspects, disregards common sense and defies science.” China Rejects WHO Plan for Next Phase of COVID Origins Investigation “Persecuting Fauci for trying to answer questions about the virus source in 2020 when we were all misled by the Chinese government is a sideshow,” David Hunter, professor of epidemiology at the University of Oxford, wrote in STAT News. “To blame Fauci for not solving the origin of COVID-19 makes as much sense as blaming a detective in Washington, DC, for not solving a murder in Wuhan.” Meanwhile, the administration accusing Fauci of leaving America vulnerable to COVID-19 is dismantling the infrastructure that would defend it against the next pandemic. Trump’s FY2026 budget proposes cutting NIH by $18 billion, a 44% reduction, and slashing the CDC by roughly half. Georges Benjamin, executive director of the American Public Health Association, has said the cuts will “totally destroy the nation’s public health infrastructure.” The origins of COVID-19 may never be definitively settled. But the hearing made one thing clear: the political apparatus pursuing Fauci is not interested in preventing the next pandemic. It is interested in assigning blame for the last one, while the country that holds the evidence refuses to share it, and the country demanding answers burns down its own capacity to find them. Image Credits: The White House, Worobey et al., Science, 2022., Crits-Christoph et al., Cell, 2024., José Mauquer . ‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order 11/08/2026 Kerry Cullinan ‘MAHA Mom’ Jayme Franklin, US President Donald Trump and US Health Secretary Robert F Kennedy Jr. Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process. Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”. The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”. Virtually the entire world, bar 15 countries, administers single MMR vaccinations, which is easier for parents, children and health facilities. Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism. Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”. Three categories of vaccinations The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox). The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”. Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”. Instead, they should be given based on “shared clinical decision-making”, meaning decisions taken by both parents and healthcare providers. The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”. ‘Disheartening’, ‘dangerous’ and ‘troubling’ A doctor examines a child with measles. Cases of measles are at a 35-year high in the US, mainly thanks to waning confidence in vaccines. Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”. “Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.” Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony. Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review that has guided the US childhood vaccine schedule for decades”. “ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women. Trump ‘doesn’t have the expertise’ Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”. “Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe.” I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h — U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026 ‘Deadly mistake’ Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”. “There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC). Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines. “It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. “Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.” “Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). Circumventing the courts Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”. Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP. However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. This executive order is almost certain to face legal action by health groups. As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
‘This is so Wrong’: Experts Condemn Trump’s Vaccination Order 11/08/2026 Kerry Cullinan ‘MAHA Mom’ Jayme Franklin, US President Donald Trump and US Health Secretary Robert F Kennedy Jr. Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process. Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”. The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”. Virtually the entire world, bar 15 countries, administers single MMR vaccinations, which is easier for parents, children and health facilities. Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism. Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”. Three categories of vaccinations The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox). The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”. Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”. Instead, they should be given based on “shared clinical decision-making”, meaning decisions taken by both parents and healthcare providers. The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”. ‘Disheartening’, ‘dangerous’ and ‘troubling’ A doctor examines a child with measles. Cases of measles are at a 35-year high in the US, mainly thanks to waning confidence in vaccines. Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”. “Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.” Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony. Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review that has guided the US childhood vaccine schedule for decades”. “ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women. Trump ‘doesn’t have the expertise’ Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”. “Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”. “Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe.” I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h — U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026 ‘Deadly mistake’ Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”. “There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC). Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines. “It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. “Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.” “Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). Circumventing the courts Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”. Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP. However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. This executive order is almost certain to face legal action by health groups. As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
As Heat Increases Women’s Vulnerability to Violence, Researchers Seek More Sensitive Policies 11/08/2026 Disha Shetty Eighty-one-year-old Felisa Cuc leads others down the path to her home in rural Sepur Zarco, Guatemala, as the women try to protect themselves from the heat. Heat disproportionately affects women. CHENNAI, India – Women in drought-prone areas are at a higher risk of intimate partner violence during the hot summer months, but heat action plans being drafted by cities and countries rarely account for this public health issue. The unique vulnerability of women to intensifying climatic events such as heatwaves was at the centre of discussions at a recent conference organised by the Chennai-based research institute, MS Swaminathan Research Foundation (MSSRF). In the hot and humid coastal city of Chennai in southern India, women farmers, grassroots organsations, academics and experts from around 32 institutions, including two United Nations (UN) agencies, shared their experiences. “[The] key aim was to bring out issues and challenges related to women’s access to land, water and food in the context of agricultural or fisheries sectors. This included livestock, pastoralists and related occupations,” said Dr Soumya Swaminathan, the former World Health Organization (WHO) chief scientist who chairs the institute. “We also wanted to see if there are policy gaps or blind spots that we could collectively address,” she told Health Policy Watch. The UN has declared 2026 as the International Year of the Woman Farmers to draw attention to women in agriculture. However, the danger is that once 2026 is over, the world will move on from the focus on women in agriculture, said Dr Israel Oliver King ED, who heads the biodiversity programme at MSSRF. Heat and the rise in violence against women Research from India links heatwaves to a rise in intimate partner violence. Almost three-quarters (72% ) of women in drought-prone areas reported a rise in intimate partner violence during the summer months of April-June, according to preliminary results from an ongoing study led by researchers at MSSRF. The study involved over 1,050 women across seven Indian states, and is part of a larger study on the impacts of heat on the health of men and women. “Our aim is to build more evidence to touch base with the government and say, gender [vulnerability] is not a small thing,” said Dr Mohan Kumar, MSSRF’s director of health and nutrition, who is leading the study. He explained that, while geographical and socio-economic vulnerability has always received attention, gender vulnerability has not. “These deliberations will help us to actually pitch the importance of thinking of gender as the main rider in the climate vulnerability component,” Kumar said. What makes women more vulnerable to climate impacts is a combination of gender roles in their home and society, limited ownership of land and limited mobility. For instance, on a hot summer day, it is socially acceptable for men to take off their shirts to cool down but not for women, who are expected to wear several layers of clothing even in extreme heat. Recognizing women’s role in land, food and water systems Women in agrarian communities often act as custodians of seeds and biodiversity. While women do a substantial chunk of agricultural work in India, they have not been recognised as farmers by government policies or communities in the past because they do not usually own the land. While this is now changing, women’s role as custodians of seeds and agrobiodiversity is yet to be recognized, speakers said. Aditi Mukherji, the principal scientist of climate action at the International Livestock Research Institute in Kenya, said that women’s livestock knowledge is essentially genetic information. As men and women often do different tasks, they notice different parts of the agricultural and livestock systems, and when women’s voices are taken into account, policies are better, Mukherji added in a virtual address to the conference Women are often responsible for nursing sick livestock, and thus they notice climate-related signs of stress early, she added as an example. Mainstreaming gender conversations Dr Soumya Swaminathan, former WHO chief scientist and chair of MSSRF speaking at the conference in Chennai. Kumar also added that while conversations on how climate change is affecting women have picked up in recent years, the pace of research remains slow. “Bringing focus on this topic is the first step in closing research or policy gaps,” Swaminathan said. “Research is needed in the gap areas and, if done in partnership with communities, can lead to meaningful and sustainable change,” she added. Image Credits: UN Women/Ryan Brown, Unsplash/Nikita Kozlov, MSSRF. White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
White House Attempt to Control Science Grants is Blocked – For Now 10/08/2026 Kerry Cullinan White House Office of Management and Budget (OMB) Director Russell Vought. The plan by the White House Office of Management and Budget (OMB) to subject all United States research grants to political oversight has been halted by the US Senate – at least for now. A clause preventing the OMB from introducing any new rules was included in the non-partisan temporary spending Bill passed by the Senate in the early hours of Saturday morning. But the Bill is not yet law, and the fate of the OMB’s new law now lies with the US Congress, which will decide after its August recess whether to adopt the Senate’s resolution. The OMB’s proposed new law would enable political appointees to review all government grant proposals and to terminate existing grants if they did not align with political priorities – explicitly specifying that all awards “demonstrably advance the President’s policy priorities”. It would also prevent research on gender and diversity, equity and inclusion, and heavily restrict international scientific collaborations. OMB director Russell Vought, a key author of the right-wing Project 2025, wanted to introduce the new regulations in October. Massive outcry But the proposal sparked a massive outcry from the scientific community, with scientists stating that the new regulation undermines the non-partisan award process and politicises science. Republican Senator Susan Collins, the chair of the Senate Appropriations Committee, said after the Senate resolution was passed that she was pleased that the “bipartisan agreement prevents the Office of Management and Budget (OMB)’s proposed rule regarding federal financial assistance from taking effect. “I advocated for significant changes to the proposed rule in a July 6 letter to the agency, citing its potential to politicize grants and harm small, rural communities, families, and biomedical research,” Collins added. Her Democratic counterpart and committee deputy, Senator Patty Murray, said that the Bill “blocks implementation of OMB’s corrupt new grants rule for the duration of the [continuing resolution]. “The proposed rule would systematically politicize federal funding and allow Trump officials to cancel grants at any time for any reason. Enabling this rule would only give Trump the greenlight to take even more federal funding hostage.” Murray added that, while Republicans rejected “killing the proposed rule outright, I’m going to keep fighting to put a stop to it once and for all, and I will keep pressing my Republican colleagues to do exactly that”. Earlier, the Senate Democratic caucus warned that the proposal “exceeds OMB’s statutory authority, undermines Congress’s constitutional power of the purse, and would allow the President to weaponize federal grants for political purposes”. Reacting to the news, the Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) applauded Collins and Murray for the temporary block on the OMB’s ambitions. “This is an important step toward ensuring that objective merit, not political alignment, remains the primary criterion for grant awards. The OMB rule would undermine Congress’ authority by allowing the termination of federal grants by the political party in charge without cause and without any recourse for grantees,” the organisations noted. “IDSA and HIVMA call on the House of Representatives to pass the Senate continuing resolution as soon as possible to ensure uninterrupted support for research, public health programs and access to health care, especially in rural communities and among populations vulnerable to communicable diseases.” Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
Pakistan’s HIV Surge Exposes Infection Control Failures at Health Facilities 10/08/2026 Rahul Basharat Rajput Undercover footage by the BBC filmed Taunsa health workers re-using needles and syringes multiple times while inoculating children. ISLAMABAD – Pakistan was once considered a low-prevalence country for HIV, but a series of outbreaks has infected hundreds of children and exposed fundamental weaknesses in its healthcare system. Southern Pakistan has been particularly affected, with HIV outbreaks linked to healthcare facilities documented at Taunsa in Punjab, Karachi’s Kulsim Bai Valika (KBV) Hospital, and previously in Larkana and other districts. Some 331 children are estimated to have been infected with HIV at Tehsil Headquarters (THQ) Hospital in Taunsa since last October, and investigators have blamed their infections on preventable lapses in infection prevention and control (IPC). Unlike outbreaks in many countries, where HIV transmission is primarily driven through sexual contact, repeated investigations in Pakistan have instead pointed to unsafe medical injections, poorly regulated blood transfusions and failures in sterilisation practices. Despite the alarm being raised about the rise in children’s infections earlier in the year, an undercover expose by the BBC in April showed that health workers continued to use the same needles and syringes on several children at the facility. Rise in new infections Officials from the Common Management Unit, the government department dealing with HIV/AIDS, malaria and tuberculosis, reported to Parliament’s Standing Committee on Health last month that approximately 14,000 new HIV infections were detected during 2025, a figure far higher than previous annual reports. Although the country’s health ministry attributes much of the increase to expanded screening, which rose from around 37,000 people tested in 2020 to more than 374,000 in 2025, the rise has intensified concerns over persistent transmission in healthcare settings and among vulnerable populations. For many health experts, HIV has become a barometer of Pakistan’s broader health system, revealing broader weaknesses in regulation, governance, surveillance and primary healthcare that extend well beyond the virus itself. “Every outbreak should have been a lesson,” says Professor Hasan Abbas Zaheer, a World Health Organization (WHO) adviser on blood safety. “Similar failures continue to emerge in different provinces, indicating that the underlying problems have not been resolved.” Zaheer believes that Pakistan is facing a broader collapse of infection prevention and control. Unless hospitals, laboratories and blood banks consistently adhere to internationally accepted standards – and regulators enforce those standards – the country is likely to continue responding to outbreaks after they occur rather than preventing them, he argues. Taunsa and Karachi outbreaks The Taunsa outbreak illustrates the consequences of these failures. Between late 2024 and early 2025, more than 330 children were infected, with three-quarters of infections occurring in children younger than five years. Investigators found little evidence that their mothers were living with HIV, making mother-to-child transmission unlikely. Instead, the investigation pointed towards healthcare-associated transmission through unsafe injections, blood transfusions and inadequate infection control. Instead, the investigation documented multiple breaches of basic clinical practice. Standard infection prevention protocols were often absent or ignored, while intravenous infusion sets were reportedly reused, waste disposal systems were inadequate and appropriate paediatric auto-disable syringes were unavailable. Larger syringes that were designed for hospital procedures were sometimes used repeatedly in paediatric care, increasing the risk of cross-contamination. Meanwhile, a government investigation into an HIV outbreak involving 130 people – mostly children – at Karachi’s government-run Kulsum Bai Valika Hospital reported back last month. It blamed the increase in HIV cases documented from last October on failures in sterilisation procedures, improper handling of single-use syringes, inadequate supervision, poor biomedical waste management and weak compliance with infection prevention guidelines. Provincial authorities have since suspended dozens of healthcare workers and administrators while strengthening treatment services for affected children. Ban on substandard syringes The Pakistani government has banned substandard injections to curb HIV. Last month, following a high-level review of the HIV outbreaks ordered by Prime Minister Shehbaz Sharif, officials recommended several reforms aimed at strengthening infection control, improving surveillance and tightening regulation of medical devices. These include a nationwide ban on the manufacture and use of substandard syringes. The Drug Regulatory Authority of Pakistan (DRAP) has also approved the phase-out of conventional disposable 1cc and 10cc syringes from January 2027, extending earlier regulations that already required auto-disable syringes for smaller volumes. The decision follows years of evidence linking syringe reuse to HIV outbreaks. Investigations into recent clusters consistently identified unsafe injections as one of the principal drivers of transmission. In many facilities, particularly where infection prevention standards are weak, single-use syringes and intravenous equipment have reportedly been reused or handled improperly, allowing blood-borne viruses to spread between patients. Systemic problems Experts caution, however, that focusing solely on syringes risks overlooking broader systemic issues. Unsafe injections are often a symptom rather than the root cause of the problem. Weak regulation of private clinics, inadequate inspection systems, inconsistent enforcement of infection control standards and shortages of trained healthcare workers all contribute to an environment in which unsafe practices can persist. Former federal health minister and WHO official Dr Zafar Mirza argues that the recurring outbreaks should be viewed as evidence of wider governance failures. The Taunsa outbreak, he said, exposed shortcomings not only in infection prevention but also in blood safety, healthcare regulation, disease surveillance and accountability. Although a government task force has proposed reforms across these areas, implementation has remained slow even as new clusters continue to emerge. Inadequate surveillance While unsafe medical practices have attracted the greatest public attention, Pakistan’s surveillance system represents another major vulnerability. The Ministry of Health estimates that more than 84,000 people are currently registered as living with HIV and receiving care through the national programme. However, officials acknowledge that the true burden is substantially higher – and the WHO and UNAIDS put the figure at over 350,000 people. Federal Health Minister Mustafa Kamal recently said that approximately 20,000 additional infections remain unreported, despite a dramatic expansion of HIV testing capacity over the past five years. Health authorities argue that the sharp increase in reported infections partly reflects improved case finding rather than an explosion of transmission. Screening capacity has expanded tenfold since 2020, enabling health workers to identify infections that previously remained undiagnosed. But weak surveillance continues to limit Pakistan’s ability to detect emerging hotspots before they become full-scale outbreaks. The Taunsa investigation also found that hospitals and clinics lacked reliable digital reporting systems, standard case notification procedures and mechanisms for sharing surveillance data between districts and provinces. These gaps delayed recognition of transmission patterns and slowed public health responses. Tracking patients after diagnosis also remains a major challenge. Parliamentary discussions highlighted the problem of “missing patients”: individuals who register at antiretroviral therapy (ART) centres but subsequently discontinue treatment or are lost to follow-up. Without effective counselling and monitoring, these interruptions increase the risk of poorer health outcomes and continued HIV transmission. Public health specialists argue that surveillance should extend beyond simply counting new diagnoses. It should also identify transmission networks, monitor healthcare-associated infections, evaluate infection prevention practices and rapidly detect clusters before they spread. Zaheer believes Pakistan could strengthen these efforts by integrating surveillance data across provinces and using digital technologies, including artificial intelligence, to identify emerging hotspots in real time. Stigma limits HIV response While Pakistan has expanded HIV testing and treatment services in recent years, prevention has not kept pace with the changing nature of the epidemic. The number of government-supported antiretroviral therapy (ART) centres has more than doubled from 44 in 2020 to 97 in 2025, with plans to increase the network to around 166 facilities. But access remains uneven, particularly outside major cities. For many Pakistanis, HIV testing is still not part of routine primary healthcare. Instead, people are often tested only after they develop symptoms, require surgery, donate blood or are identified during an outbreak investigation. Stigma remains one of the greatest barriers. Health officials told the Parliamentary health committee that fear of discrimination discourages many people from seeking testing or treatment, while misconceptions about HIV continue to fuel secrecy and delayed diagnosis. The Pakistan Medical Association (PMA) has also warned that thousands of infections remain undetected because people are reluctant to access healthcare services for fear of being ostracised by their families or communities. Pakistan’s HIV epidemic remains concentrated among people who inject drugs, men who have sex with men, transgender people and sex workers. These groups frequently encounter discrimination in healthcare settings and are often excluded from mainstream health programmes. Community organisations have long argued that HIV services remain overly dependent on donor-funded outreach projects rather than being integrated into routine primary healthcare. WHO Representative in Pakistan Dr Luo Dapeng, Pakistan’s Health Director General Dr Ayesha Majeed Isani, and UNAIDS Director in Pakistan, Trouble Chikoko, lead an HIV awareness walk Hidden sexual networks? Although the outbreak primarily affected children infected through unsafe healthcare practices, investigators also warned of “hidden sexual networks” operating largely outside existing surveillance and prevention programmes. Without confidential testing, community outreach and culturally appropriate prevention services, these networks could sustain HIV transmission while remaining largely invisible to health authorities. Women also face distinct barriers. Although Pakistan has made progress in preventing mother-to-child transmission, reproductive health services and HIV care are often delivered separately, limiting opportunities for routine screening and counselling during pregnancy. Many women are diagnosed only after a spouse or child tests positive, reflecting broader gaps in sexual and reproductive healthcare. The PMA has urged the government to make confidential, rapid HIV testing available free of charge across primary and secondary healthcare facilities, while investing in training for healthcare workers to reduce discrimination and improve counselling. It has also called for greater access to modern biomedical prevention strategies alongside expanded treatment services. Although antiretroviral medicines suppress the virus and dramatically reduce the risk of transmission, they depend on early diagnosis, uninterrupted drug supplies and sustained patient engagement. Without addressing stigma, expanding community-based prevention and ensuring equitable access to care, many people will continue to enter the health system only after they become seriously ill—or after an outbreak has already occurred. Could long-acting HIV prevention change the response? While Pakistan struggles to contain healthcare-associated outbreaks, the global HIV response is entering a new era defined by long-acting prevention technologies that could dramatically reduce new infections. Lenacapavir, a long-acting injectable medicine administered only twice a year, has demonstrated almost total prevention of HIV transmission in clinical trials. Researchers also reported progress on other long-acting technologies, including injectable combinations that provide both contraception and HIV prevention, three-month vaginal rings and real-world implementation of a monthly injectable cabotegravir in African countries. Global health experts increasingly view these medicines as potential game changers, particularly for people who struggle to take daily oral pre-exposure prophylaxis (PrEP). Receiving two injections a year could substantially improve adherence while reducing the risk of HIV transmission among people at elevated risk of infection. But Pakistan has yet to establish broad access to conventional HIV prevention services. Oral PrEP remains available only through limited pilot initiatives and donor-supported programmes. Long-acting injectable prevention is therefore unlikely to become widely accessible without significant investment, regulatory approval and financial support from international partners. Experts nevertheless argue that Pakistan should begin preparing now rather than waiting for the medicines to become widely available globally. Planning for procurement, regulatory approval, healthcare worker training and financing could enable the country to introduce new prevention technologies more rapidly once prices fall and generic versions become available. Mirza believes Pakistan’s response must move beyond emergency outbreak management towards a comprehensive public health strategy that integrates infection prevention, disease surveillance, blood safety, governance and community engagement. Zaheer also sees an opportunity to modernise Pakistan’s surveillance systems through digital technologies. Better integration of laboratory data, hospital reporting and provincial surveillance could help identify emerging clusters before they expand into large outbreaks. Artificial intelligence, he argues, could assist health authorities in recognising transmission patterns, predicting hotspots and directing scarce resources towards areas of greatest need. Yet specialists caution that new policies and regulations alone will not prevent future outbreaks if enforcement remains weak. Previous bans on conventional syringes were inconsistently implemented, allowing unsafe products to remain widely available. Likewise, investigations following successive HIV outbreaks have repeatedly identified similar failures in infection prevention despite earlier recommendations. Image Credits: BBC, Wuestenigel/Flickr, Hamid Inam/ WHO Pakistan. Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
Alarming Ebola Spread Raises Question of Viral Mutation 07/08/2026 Kerry Cullinan DRC President Felix Tshisekedi (left) meeting WHO Director General Dr Tedros Adhanom Ghebreyesus (right) and other health officials this week. Over 4,000 Ebola Bundibugyo cases and 1,800 deaths have been recorded so far in the Democratic Republic of Congo (DRC) – numbers so alarming that health experts intend to research whether the virus is mutating to become more infectious. This was revealed by Dr Jean Kaseya, the Director General of Africa Centres for Disease Control and Prevention, at a media briefing on Thursday. In the past 12 weeks, the current outbreak has grown at eight times the pace of the world’s biggest Ebola outbreak, which took place in West Africa between 2018 and 2020. Every day in the past week, 75 new cases and 35 deaths have been recorded. Kaseya said that he and World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus had agreed on Wednesday “to conduct a study to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented”. Tedros, Kaseya and Dr Mohamed Janabi, WHO’s Africa regional director, led a joint high-level mission to the DRC and Uganda earlier in the week, including a meeting with DRC President Felix Tshisekedi. Following the two-day mission, the two organisations called for “an urgent scale-up of the community-led Ebola response in the DRC, with stronger early detection, contact follow-up, access to care, support for frontline health workers and faster delivery of resources to affected communities”. Tedros also said: “Building trust and respecting local traditions, including around safe and dignified burials, are essential to reaching affected communities and stopping transmission.” Community engagement Kaseya said one of the main purposes of the delegation’s visit to Bunia, one of the Ebola hotspots in the DRC, was to listen to communities. “We didn’t go there to blame them. We didn’t go there to tell them what they have to do. We went there to listen. I had a room of more than 100 people coming from organisations, associations, coming from those who were infected with Ebola, and young people, women. All of them were sharing a critical message: We are not involved, and we want to be involved.” Kaseya said that internet connectivity via Starlink will be extended to all villages in Ituri to enable timely data and information about the outbreak. After Bunia, the delegation met with Tshisekedi and other top government officials in the DRC capital of Kinshasa and resolved to take the outbreak response to the village level in Ituri’s 6,542 villages to reach people more effectively. The outbreak has not yet reached Kinshasa, but on Thursday the DRC government stopped a boat with 200 passengers from reaching the capital after a patient with suspected Ebola symptoms had disembarked and died. The boat had been travelling from Kisangi in the north-east to Kinshasa but had been stopped about 65km from the capital and all passengers were tested. Kinshasa has a population of around 17 million. Striking health workers Health workers protesting outside the Ituri governor’s residence over unpaid wages this week. Tedros added that, in their meeting with Tshisekedi, they discussed “the need to continue to protect and support frontline health and community workers, including by ensuring they have adequate personal protective equipment, and are compensated for their work”. Around 140 health workers have been infected with Ebola in the current outbreak. There have been several protests and strikes by health and other workers involved in the outbreak response over unpaid wages. Health workers in Ituri protested outside the governor’s office on Thursday, saying that they have not been paid salaries or allowances since May. In mid-July, health workers at Bunia General Hospital in northeastern Ituri went on strike, saying that they had not been paid since the outbreak started despite working under difficult conditions. Healthcare workers and grave diggers at the Rwampara General Hospital, also in Ituri, went on strike over unpaid wages in early July. However, Kaseya told the media briefing that it was the responsibility of the DRC government, not their outbreak partners, to pay their health workers. “We will not hear again about the strikes of health workers. The government yesterday told me that they have money to pay health workers,” he insisted. But he added that some funding is available from the “humanitarian budget” for free healthcare services to all people in Ituri and North Kivu provinces, which are worst affected by Ebola. Since the start of the outbreak, the DRC government has offered free health services to those living in these provinces to encourage people to go to health facilities. More deaths in communities than facilities One of the most disconcerting aspects of the DRC outbreak is that most deaths are being recorded in communities, not health facilities. Last week, 67% of Ebola deaths were in communities, usually identified via tests administered after death. “The contact lists don’t mean anything because it is not accurate,” said Kaseya, once again highlighting weaknesses around tracing people who have been in close contact with confirmed cases. On average, around 10 contacts per patient in the DRC have been recorded in comparison to 40+ in Uganda, which contained its Bundibugyo outbreak at 20 cases. Kaseya also revealed that the bed occupancy rate in Ituri province, one of the hotspots, ranged between 56-69% – way lower than in Nord Kivu, where Ebola treatment centres were 128-157% full. Several treatment centres in Ituri have been attacked and burnt in the past. Uganda’s case fatality was 10% in comparison to the DRC’s 44%, and Kaseya suggested this could be because every patient was given the antiviral medicine, Remdesivir. A trial to test Remdesivir’s efficacy against Bundibugyo is currently underway in the DRC, along with another antiviral known as MPP134. However, only 68 people have been recruited so far. US pledges more funds Meanwhile, the US State Department announced on Wednesday that it intends to provide an additional $242 million in funding for “immediate Ebola response and preparedness efforts in the region and humanitarian assistance related to the outbreak”. “The Department of State’s assistance announcements to combat the outbreak have now exceeded $512 million in direct assistance, enabling implementing organizations to expand the ongoing response in Africa,” said the State Department, adding that it had already made $350 million available for “critical humanitarian assistance in the DRC, South Sudan, and Uganda”. Kaseya said that, taking into account the latest US contribution, $472 million had been released and almost $700 million was expected. Image Credits: Aljazeera. EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts
EXCLUSIVE: Here is the ‘Final Text’ of UN Political Declaration on Pandemics – Although its Adoption is Far From Guaranteed 06/08/2026 Kerry Cullinan The current Ebola outbreak is the fastest the world has ever seen, yet the draft Political Declaration on Pandemics lacks a practical plan to protect the world from future pandemics. United Nations member states are almost certain to break the silence on the final draft of the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) that was sent to them recently– but likely for all the wrong reasons. Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July. The silence procedure means that member states have a certain period during which to object – or break the silence – otherwise the text is regarded as agreed on. Health Policy Watch can exclusively share the UN HLM on PPPR Political Declaration Final Text for Silence Procedure. However, it is unlikely to be adopted unchanged. The text identifies all key problems haunting the world’s pandemic preparedness, but its key weakness is its failure to provide concrete steps to address these. Ideological red flags Yet, as recent UN negotiations have shown, the red flags for member states are unlikely to be the lack of a sound implementation plan but rather ideological objections. For example, the text identifies climate change as one of the issues straining developing countries’ pandemic prevention, preparedness and response. But at the recent HLM on Road Safety last month, the United States was the lone vote against that political declaration – in part because it mentioned climate change. The PPPR declaration also recognises that women and girls are among the groups disproportionately affected by pandemics, and calls for “gender equality” to be mainstreamed “into all policies and programmes”. It also calls for “universal access to sexual and reproductive health care services” by 2030, and the reaffirmation of “commitments to ensure universal access to sexual and reproductive health and rights (SRHR) in accordance with the Programme of Action of the International Conference on Population and Development (ICPD) and the Beijing Platform for Action”. The ICPD, adopted by 179 member states in 1994, calls for the “universal access to a full range of reproductive health services, including family planning”. Meanwhile, the Beijing Platform, adopted a year later by 189 member states, establishes that all people have “the right to attain the highest standard of sexual and reproductive health” and that their right to make reproduction decisions should be “free of discrimination, coercion and violence”. However, SRHR has become highly contested in the UN, with several countries claiming that, by linking sexual and reproductive health to rights, the UN and the World Health Organization (WHO) are trying to promote universal access to abortion. In recent years, conservative countries – several countries in the Middle East and Africa, the Trump administration’s US, Russia and Pakistan – have objected to the term “sexual and reproductive health and rights” during UN and WHO sessions. The positive aspects of the text “The final draft contains positive language on foundational elements that – fully acted upon – would lead to a stronger pandemic readiness system,” according to a group called The Friends of the HLM on PPPR. The co-convenors of this group are The Elders, FOUR PAWS, The Independent Panel for Pandemic Preparedness and Response and Resilience Action Network International (rani). The positive aspects identified by The Friends include that it welcomes the adoption of the Pandemic Agreement and amendments to the International Health Regulations (2005) and calls for the timely conclusion of the pathogen access and benefit-sharing (PABS) negotiations. It also promotes geographically diversified research, development and manufacturing of health tools, and calls for “the need for financing preparedness”. The group also approves of “recognising a One Health approach to prevent spillover of pathogens from animals to humans” and “the importance of data, tools and assessments that facilitate action-oriented plans, and science and evidence-based monitoring”. And the real problems… Helen Clark, co-chair of The Independent Panel and a member of The Elders. But Helen Clark, on behalf of The Friends’ co-convenors, notes: “At a time when the Ebola Bundibugyo emergency is now the second largest Ebola outbreak in history, we need measurable commitments which put effective multi-sectoral plans into action, serious money on the table, and ensure real accountability. “The ultimate test of this declaration is simple: will its implementation make the world measurably safer? Member States have an opportunity now to ensure that it does,” adds Clark, who is co-chair of The Independent Panel and a member of The Elders. The Friends identify four key gaps in the draft and urge “an infusion of urgency and ambition”. The first weakness is the lack of “concrete commitments or timelines” to fill the financing gap, including the $15 billion needed annually to prepare for pandemics. “The complexity and slowness of disbursing funds for the current Ebola emergency and the question marks around funding for successful tests, treatments, and vaccines underscores the dire need for reliable and rapidly disbursed surge financing,” The Friends note, recommending “a financing tracker to ensure transparency and identify areas where gaps persist”. Weakness Two lies in the failure to “strengthen the capacities of veterinary, animal, and environmental health services” given that more than 70% of emerging infectious diseases in humans are zoonotic,– including the recent mpox, Andes hantavirus and Ebola Bundibugyo outbreaks. The third weakness is its failure to recognise current gaps in monitoring, “including monitoring of equitable access to medical countermeasures, operational readiness, financing, and the social dimensions of resilience”. Finally, The Friends highlight that the Secretary General gets almost five years to report back on the implementation of the political declaration. “This is too late to follow up on commitments from this meeting, and will take momentum from an already neglected agenda,” they note, proposing a report within three years instead. The HLM is set for 25 September, the last Friday of the UN General Assembly. The date has been criticised by the Independent Panel and others, as many delegations leave New York on that day and may not attend. Many hope that high-level political engagement at the HLM will give fresh impetus to the PABS talks, the final piece of the Pandemic Agreement, which have made little progress for months. Inequality fuels pandemics Meanwhile, a recent study published in the New England Journal of Medicine warns that the “dominant model of pandemic preparedness has focused on technical capacities: stronger laboratories and surveillance, more effective vaccines and medicines, faster emergency response”. Yet, argue the authors, including Nobel Prize-winning economist Joseph Stiglitz, some of the most “prepared” countries have mounted the most ineffectual responses in real time. “Among the officials and experts charged with stopping pandemics, the current understanding of what drives pandemic risk for the world is proving to be insufficient. The missing element, we believe, is inequality,” say Stiglitz and co-authors Matthew Kavanagh, Monica Geingos, Winnie Byanyima and Michael Marmot, for the Global Council on Inequality, AIDS, and Pandemics. “The co-occurrence of increasing pandemic frequency and increasing inequality is not coincidental – it reflects a self-reinforcing cycle: inequality makes outbreaks more likely to become pandemics, then drives their severity and duration, while pandemics deepen inequality, making future outbreaks harder to control and fueling the next cycle,” they argue. They argue for an “inequality-informed response” to prepare for pandemics, proposing four approaches. The first involves addressing the social determinants that drive outbreaks to become pandemics, for example, ensuring social protection including expanded unemployment insurance and paid sick leave “so people can follow public health guidance without impossible trade-offs”. The second activity involves “strengthening visibility, governance, and trust” by establishing multisectoral governance bodies that include government officials, community organisations, and scientific leadership. The third involves reforming the international financial architecture to enable “sovereign debt-suspension mechanism for distressed nations during pandemic emergencies”, International Monetary Fund special drawing rights during pandemics and expanded pandemic lending facilities. The fourth measure involves equitable access to pandemic science and technologies, including “open licensing for publicly funded biomedical research with pandemic relevance” and expanded regional manufacturing capacity for “cutting-edge medicines and vaccines for today’s major diseases”. Image Credits: X/Tedros Adhanom Ghebreyesus. Posts navigation Older posts