First global survey of 93 nations shows two-thirds include these populations in health plans, but none provide equal access to undocumented migrants.

More than 60 countries now include refugees and migrants in their national health policies, according to a new World Health Organization (WHO) report tracking progress on commitments first set out by the World Health Assembly in 2019.

The finding, drawn from a survey of 93 member states, is the first systematic count of how countries are implementing a resolution that called on governments to ensure refugees and migrants have access to health services, are included in national health planning, and are counted in health data systems.

“Many countries have begun integrating refugee and migrant health into national strategies,” said WHO Director-General Tedros Adhanom Ghebreyesus. “Yet gaps remain, particularly in collecting and using migration-related health data, ensuring participation of refugees and migrants in decision-making, and guaranteeing access to care for all, regardless of legal status.”

“Like anyone else, refugees and migrants need uninterrupted, affordable and equitable access to health services wherever they are,” Tedros said.

While WHO called the findings “encouraging,” the picture the report paints is difficult to read clearly. What “inclusion in a national health policy” actually means for care access for migrants and refugees varies widely – and the report does not name which countries fall where.

Two-thirds of the 93 surveyed countries said they include refugees and migrants in their health policies. When asked what level of access different groups receive, 16 countries said refugees can access services on a par with the host population, 14 extended that standard to documented migrant workers, and 11 to asylum seekers.

No country surveyed reported providing equal access to migrants in irregular situations – those living without legal status or formal documentation. The positive examples the report does name – from Belgium to Chile – are presented as case studies.

Only 37% of countries routinely collect and disseminate migration-related health data. Fewer than 40% train health workers in culturally responsive care. Just 30% have run campaigns to counter misinformation or discrimination, the report found. The report is the first systematic quantification of these indicators, further blurring the picture of progress, as there is no baseline to compare against.

The data is also entirely drawn from a voluntary survey completed by member states with no independent verification, meaning the results are unvetted self-assessments.

The report explicitly does not rank countries on the success, impact or implementation of their policies, and “did not assess the level of implementation or impact of any given initiative,” meaning real-world outcomes “cannot be evaluated,” it said.

The survey also contains no questions about financing, meaning a country can report including refugees in its national health policy while allocating no dedicated budget to deliver on it.

“Rather than ranking countries on their progress,” the report notes, it seeks to identify how key gaps can be addressed going forward.

The report comes as conflict, climate change and economic insecurity displace more people than ever before.

More than one billion people live as refugees or migrants worldwide, though over 800 million remain within their own borders. There are 405 million international migrants, 36.8 million refugees, 8.4 million asylum seekers and 83.4 million internally displaced people.

Dr Santino Severoni, head of WHO’s Special Initiative on Health and Migration and lead author of the report, said it was intended as a roadmap for coordinated action across governments, UN agencies, civil society, academia and migrant communities themselves.

“The health of refugees and migrants is not a marginal concern: it is a defining issue of our time,” Severoni said. “By acting now, countries can ensure that refugees and migrants are not left behind, and that health systems are stronger, fairer and more prepared for the future.”

Data ’emergency’, exclusion from emergency plans 

Progress roadmap for the World Health Assembly Resolution on migrant and refugee health.

The new report follows a first edition published in 2022, which was a literature review of around 82,000 documents that established the scale of health disparities facing refugees and migrants worldwide. Two further progress checks are planned for 2027 and 2029, ahead of the 2030 deadline set by WHA member states for full implementation.

The 2022 report identified fragmented data collection as the central structural obstacle to effective policy. That remains unresolved. Severoni described the situation as “almost an emergency.”

“It’s not because data is not collected, but because they are collected in a very fragmented way, which makes it very, very difficult for us to have a full picture,” he said.

Just 42% of countries include refugees and migrants in emergency preparedness or disaster risk reduction plans. Irregular migrants – those without legal residency status – are entirely absent from those frameworks, even as the crises that drive displacement, from war to climate-related disasters, intensify.

“We cannot talk about refugee and migrant health without also addressing emergencies,” said Dr Chikwe Ihekweazu, WHO’s executive director for health emergencies. “Whether it’s a conflict, a climate-related crisis or an epidemic that forces movement, these crises expose the fragility of health systems and magnify the vulnerabilities of all those already at risk.”

Population groups among refugees and migrants included in national health policies,
legislation, strategies or plans.

“This is not only an equity issue — it is a global health security risk,” he added. Excluding displaced populations from health systems, he said, weakens the collective capacity to detect and respond to outbreaks and crises. “Health does not begin and end at borders.”

WHO is calling on governments to strengthen disaggregated health data collection, tailor policies to specific migrant groups including those in irregular situations, involve refugees and migrants in health governance, train health workers in culturally responsive care, and protect and expand financing.

“The phenomena of displacement is unfortunately happening more frequently in countries with fragile systems, fragile economies and limited domestic resources,” Severoni said. 

“There is almost no mention of irregular migrants in those emergency plans and response or in disease risk reductions, there is no systematic approach in assessing the system to see how their system is really functioning, how efficient and effective it is.”

“This is really a call for action to keep the promise of sharing a bit of responsibility in managing those emergencies,” he added.

Political wave washes away progress

Political sentiment in many wealthy nations has turned against expanding access for migrants, refugees and asylees. 

The report highlights progress in some countries. Chile has embedded migrant community representatives in municipal health councils, with direct input into maternal and mental health priorities.

Belgium has run a national intercultural mediation programme since 1999; as of late 2024, 113 trained mediators were working across 76 hospitals and community health centres.

Yet the report’s release comes as several wealthy nations move to restrict refugee and migrant healthcare, driven by economic pressures and political campaigns questioning whether asylum seekers and refugees should be entitled to publicly funded care.

In the United States, legislation passed in 2025 changed the definition of “eligible alien” for Medicaid eligibility, cutting coverage for many lawfully present immigrants, asylees, refugees, and trafficking and domestic violence survivors.

On 1 May, its northern neighbour Canada will start requiring refugees and asylum seekers to pay out of pocket for essential health services previously covered under its Interim Federal Health Program. 

The programme “has provided basic health coverage to people fleeing war, genocide, torture, and persecution since 1957,” according to the Migrant Rights Network. Services affected include medications, dental care, mental health, vision and physiotherapy.

Across the Atlantic, Germany extended to 36 months the period in which asylum seekers are restricted to emergency-only care, doubling the previous threshold of 18 months.

In France, a similar fight is playing out over the future of its Aide Médicale de l’État programme, which provides medical care to undocumented migrants. Critics say the programme encourages migration and is an undue cost to taxpayers, though it accounts for just 0.5% of national public health spending.

International funding for refugee health has also fallen sharply. UNHCR’s 2025 budget stands at $10.6 billion, of which only 23% had been secured at mid-year. The agency has warned that up to 12.8 million displaced people could be left without life-saving health interventions this year.

“Around the world, more than one billion people are on the move, seeking safety, opportunity and dignity,” Tedros said. “Investing in refugee and migrant health is both ethically essential and strategically beneficial. Supporting their health and inclusion strengthens health systems and benefits everyone.”

Image Credits: Wikipedia Commons.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, addressing IGWG6 on Saturday evening.

With no agreement in sight, World Health Organization (WHO) member states curtailed talks on the Pandemic Agreement annex five hours earlier than scheduled on Saturday night, resolving to meet again within a month for a further five days of negotiations.

Member states will reconvene between 27 April and 1 May to negotiate further on the Pathogen Access and Benefit Sharing (PABS) annex, with the hope of tabling the annex at the World Health Assembly (WHA) in May.

The PABS annex is intended to ensure, on equal footing, the rapid sharing of pathogens with pandemic potential and the fair and equitable sharing of benefits arising from their use, including vaccines, diagnostics and therapeutics.

Addressing the tired delegates of the Intergovernmental Working Group (IGWG) after six days of intense talks, WHO Director General Dr Tedros Adhanom Ghebreyesus said that their efforts had not been wasted. 

“At the same time, we must be candid,” said Tedros. “Despite best efforts, differences remain on key issues. These are not trivial matters. They go to the heart of equity, access, sovereignty and global solidarity. It’s therefore understandable that more time is needed to bridge these gaps in a meaningful and durable way.”

Tedros expressed support for IGWG’s decision to resume negotiations in about four weeks. 

“This pause is not a setback. It’s an opportunity. It allows us to reflect, to consult further with our capitals, and to return with renewed clarity and flexibility, not to keep negotiating indefinitely, but to continue and to close the deal.”

However, tension was palpable at the start of the sixth – and supposedly final – round of talks last Monday when the African region rejected the Bureau’s draft of the PABS Annex.

Leading Africa’s position, South Africa and Namibia proposed that the draft text circulated by the IGWG Bureau on 9 March should be disregarded in favour of the on-screen text considered at the end of the fifth IGWG meeting on 14 February.

African regional ambassadors had resolved to stick to this text as they had not had time to consult their capitals on the new draft, Namibia reported.

After some tension during the closed session, member states accepted this position.

The message from one African country after another was that they would not allow a repeat of the inequity seen during the COVID-19 pandemic, and would not compromise on certain key issues. These include that the countries sharing pathogens need guaranteed benefits, and that the PABS annex needs “legal certainty”, including contracts for commercial users of pathogen information.

Burkina Faso, speaking for the WHO Africa and Egypt, Sudan, Libya and Somalia, noted that registration should be mandatory for all users of the PABS system, benefit-sharing obligations should be clearer, and there should be more capcity-building –including technology transfer – for developing countries.

Christoph Benn (left) and Patrick Silborn
Christoph Benn (left) and Patrick Silborn

Global health is facing a funding crisis. Aid is shrinking, debt is rising, and the needs are only increasing. According to Christoph Benn of the Joep Lange Institute and Patrik Silborn of UNICEF Afghanistan, health systems will need to fundamentally rethink how they finance and sustain care.

On a recent episode of the Global Health Matters podcast, host Gary Aslanyan was joined by these two experts, who said “innovative finance” has become central to discussions on sustaining health systems.

Benn said that while the term is widely used, few agree on what it actually means. He described it as a “spectrum” of approaches, ranging from philanthropic grants and conditional funding to private-sector investment models that expect financial returns.

“It has frustrated us deeply that so many people are talking about innovative finance, but very few actually know what they’re talking about,” Benn said.

Silborn emphasised that these mechanisms should not be treated as one-size-fits-all solutions. Instead, financing models must be designed around specific problems whether that means raising new funds, improving efficiency, or linking payments to measurable outcomes.

Drawing on his experience in Rwanda, Silborn described how a results-based funding model tied disbursements directly to performance, helping the country to maintain progress against major diseases despite reduced funding.

Both experts stressed that private-sector engagement requires a clear understanding of incentives.

“Private corporations are not charities,” Benn said. They can, however, contribute through marketing partnerships, technical expertise, or investment models that align financial returns with social outcomes.
Looking ahead, Benn pointed to targeted taxes and debt swaps as among the most scalable tools. Still, both warned that innovative finance is not a substitute for public responsibility.

“It only works when it is designed to solve real problems in specific contexts,” Benn said, underscoring that strong systems and governance remain essential to any lasting solution.

Listen to the full episode >>

Read more about Global Health Matters podcasts on Health Policy Watch >>

Image Credits: Global Health Matters podcast.

Dr Garry Aslanyan and Axel R. Pries
Dr Garry Aslanyan and Axel R. Pries

Global health leaders say the world needs to rethink how it approaches health, arguing that outdated systems, narrow thinking, and lack of coordination are slowing progress at a time of growing challenges.

Speaking on the Global Health Matters podcast, Axel Pries, president of the World Health Summit, told host Dr Gary Aslanyan that improving health outcomes will require broader cooperation across sectors, stronger communication, and a shift toward prevention.

Listen to the full episode >>

Pries said it was “clear that we needed politics, civil society and also the private sector.” He argued that global health can no longer be driven by governments and medical professionals alone, and that progress depends on open collaboration between actors with different interests.

While concerns remain, especially around the private sector, he said these partnerships are key to turning research into real-world results.

He also pointed to shifting global power, saying institutions created after World War II need to adapt to a more multipolar world. Countries like India, Brazil, and those across Africa should have a bigger role in shaping global health. At the same time, he said core values, especially a shared commitment to health equity, must stay the same.

Pries also highlighted challenges in how global health is communicated. Too often, the term is misunderstood as a niche issue affecting distant regions, rather than something that directly impacts everyday life.

“It’s everything, everywhere. It’s at our doorstep,” Pries said.

Looking ahead, he called for greater engagement from finance and political leaders, and a stronger focus on prevention rather than crisis response.Without that shift, he warned, health systems will remain reactive rather than resilient.

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: Global Health Matters podcast.

“Cervical cancer has become a mirror of global health inequity:” Ambassador Leslie Ramsammy, Guyana (center). Left, UN Ambassadors Clara Delgado and Antje Leenderste of Capo Verde and Germany. Right, CeHDI CEO Haileyesus Getahun and Colin Murdoch, Organisation of Eastern Caribbean Statees (OECS).

The Human papillomavirus (HPV35), globally associated with only 2% of invasive cervical cancers (ICC), has a disproportionately higher prevalence in sub‐Saharan Africa, reaching rates of 22-30% in some countries among women with ICC lesions, according to a new study. Recently, a high-level panel called for redoubled efforts in HPV vaccination, screening and treatment to meet the WHO Global Strategy targets for 2030 – and eliminate cervical cancer by 2050 worldwide. 

Midway along the route toward the WHO 2030 targets for cervical cancer elimination, some 340,000 women a year, mostly in low-income countries, are still dying from cervical cancer – due to the dearth of simple solutions like screening, treatment off pre-cancerous cells, and low HPV vaccination coverage for adolescent girls.

Meanwhile, HPV 35—a genotype of the HPV virus that is steadily spreading throughout Africa—is not targeted by existing vaccine formulations. This highlights the urgent need to speed up research and development to create an updated vaccine.

At the same time, success stories from a handful of developing countries such as Rwanda demonstrate that the 2030 targets for 90% HPV vaccine coverage, 70% screening and 90% treatment can be attained – when political will exists. Meeting those targets would put countries on track to meeting the global elimination goal of less than 4 cervical cancer cases annually per 100 000 women as early as 2050.

Those were key messages emerging from a recent high-level seminar on a Cervical Cancer-Free Future, convened by the Center for Global Health Development and Inclusion (CeHDI) together with the UN in Geneva  ambassadors of Barbados, Germany, Guyana and Malawi.

“Although cervical cancer is both preventable and curable when detected early, it remains the fourth most common cancer and cause of cancer death among women worldwide,” said Guyana’s ambassador, Leslie Ramsammy. “In Guyana, for example, it is the number two cause of cancer deaths among women. For some countries, it’s the number one cause of cancer death among women each year.”

About 600,000 women annually are diagnosed with cervical cancer, representing 6.5% of new cancer cases and 7.7% of cancer deaths. And 94% of cervical cancer deaths occur in developing countries. As such, “cervical cancer has become a mirror of global health inequity,” he added.

The goal: global elimination of cervical cancer by 2050 

Countries must reach the WHO 2030 targets for diagnosis and treatment in order to reach the goal of cervical cancer elimination by 2050.

Most developed countries are on a trajectory to meet the WHO 2030 goals and moving on from there, to eliminate cervical cancer as a public health risk by 2050.

However, developing countries are on a much longer trajectory. And at current rates of progress, most will only reach elimination in 2120, said Ramsammy.

“Today’s High-Level dialog is a call to change the trajectory for elimination from 2120 to earlier… closer to 2050 when many European countries and North America would have achieved elimination.”

Said Ramsammy, “The question is no longer whether cervical cancer can be eliminated, but when and whether the world will mobilize the political will and resources needed to ensure that no woman dies from a preventable disease. Just as international collaboration led to the eradication of smallpox, the global community can work together to end cervical cancer.”

Incidence rates in African countries 10–20 times higher than 2030 goal

Cervical cancer incidence and mortality are heavily concentrated in low-and middle-incomee countries of Asia, Africa and Latin America.

Most developed countries already have a cervical cancer incidence of between 10-4 cases annually per 100 000 women – with 4/100 000 being the elimination threshold.

But many countries in Africa have cervical cancer incidence of 60-70 or even eighty cases annually per 100 000 women, said Nathalie Broutet, of the University of Sydney, Australia, citing Malawi and Eswatini as examples. As a former WHO staff member, Broutet helped draft the WHO cervical cancer elimination strategy, which was approved by the World Health Assembly in 2020.

To get on course for elimination “we need to reach the 2030 targets, which are 90% HPV vaccination coverage; 70% of women screened with a high performance, twice in a lifetime; and 90% of women detected with a cervical disease treated,” she said.

In terms of vaccination, for instance, apart from the region of the Americas, which has almost reached 80% coverage, all other WHO regions remain far behind the 90% goal for 2030. “So, the work that we have to do to reach 90% is enormous,” said Broutet.

Better adapted vaccines – the missing HPV 35 genotype 

Nathalie Broutet, University of Sydney aand former WHO cervical cancer specialist.

However, along with more uptake of HPV vaccination, HPV vaccines need to be better adapted to the needs of girls and women in low- and middle–income populations. And recent research undertaken by CeHDI together with the International Agency for Research on Cancer (IARC) is pointing to a big gap in Africa.

That is the lack of vaccine coverage for the HPV 35 genotype, which now a common subtype of the virus in Africa, in comparison to the rest of the world.

“This is a genotype which is very common in African countries, which is responsible for around even more than 4% of cervical cancer cases in Africa,” said Broutet. “Yet this genotype is not included in the current HPV vaccine.”

One brand-new study points to an even higher incidence, said Haileyesus Getahun, CEO of CeHDI, citing a new review of the “Burden of HPV 35 in African Cervical Pathologies” in the journal Medical Virology.

That peer-reviewed study published this month, cites HPV35 prevalence of 19-30% in Mozambique, 22-26% in Kenya, 17% in South Africa and 11% in Zimbabwe and Tanzania among women with ICC lesions. In women with pre-cancerous lesions, rates of 20-26% were found in Botswana and Tanzania.

In sharp contrast, studies from China, Canada, Sweden and Europe pointed to a prevalence of less than 1%. Globally, the prevalence among women with ICC lesions was only 2%.

“Specifically, HPV35 has been more frequently associated with precancerous cervical lesions and accounts for a significant proportion of ICC [invasive cervical carcinoma] (4%–10%) in these populations, with a higher fraction than that observed in other regions,” concludes the authors from the University of Cape Town, South Africa; as well as medical research faculties in Tanzania, Botswana and Zimbabwe.

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

Overcoming the key problems in service delivery 

For cervical cancer, school-based HPV vaccination delivery is critical.

There are cited three key problems in service delivery, vaccination gaps, lack of access to low-cost HPV testing and related laboratory services; and lack of access to cancer treatments, such as radiation therapy, which are out of reach in most rural clinics and in the public health systems of many urban centres.

To overcome the challenges, global experts recommend the following:

School-based vaccination – This is the first time a vaccine must be delivered to an adolescent population, leading to challenges with both disinformation as well as the need to put new systems in place.

“We know in countries that use school- based delivery has been quite a success,” said Broutet. “Gender-neutral vaccination can improve the coverage and lift barriers that we see regarding the HPV vaccination of girls-only; and strong community engagement – communication needs to be in place.

In Dwazark Community, Freetown, Sierra Leone, students at St. Augustine School receive the HPV vaccine to protect against cervical cancer.

Shift from Pap smears to HPV testing  – In high income countries with high rates of cervical cancer screening, the most used test remains the Pap smear – a cytology-based test. In low income countries BIA or bioimpedance screening, which uses electrical signals to detect abnormal cells, has been widely used as well due to its low–cost and rapid results.

But WHO as well as many national health systems are now recommending a shift to HPV testing, widely regarded as more accurate and ultimately more cost-efficient. That involves  testing specifically for the human papillomavirus genotypes that are the most common cause of cancer.

“Even in countries that we think reach 70% coverage, there is a lot of work to be done to switch out the existing technology, which is basically cytology, and in low-income countries, BIA. Instead, all countries need to switch toward HPV testing,” says Broutet. “And we need also to ensure that innovation is available, and one of them is self-sampling, so self-collection and also urine samples. We need to ensure that all countries have access to this technology.”

Self-screening and community-based treatment  – Treatment immediately following screening is the third basic tool needed to reach elimination targets. Such treatment can remove pre-cancerous cells before they develop further.

“Mobile screening clinics can be an option to increase coverage, task shifting to community health workers,” said Broutet. “This expands coverage. And finally, digital registry [of screening results]. We need to follow up and track women who have been screened to ensure those with a positive test have been treated.”

Improving vaccine composition   

HPV 35 is one of five highly invasive genotypes not now covered by vaccines, responsible for an outsized proportion of cancers in Africa.

Improving vaccine composition is also a critical mission, said Getahun. Together with IARC, CeHDI is supporting an even more thorough African and global review of the evidence on the HPV 35 genotype and its burden.

“Our collaboration with IARC will help generate the evidence needed to inform the development of next-generation HPV vaccines that better reflect regional disease patterns, including the burden of HPV 35 in sub-Saharan Africa,” he observed.

“Going forward we hope this will stimulate dialogue with the manufacturers, countries, WHO and global procurement partners such as Gavi and Unitaid to ensure that this genotype is included in the next generation of vaccines, particularly those deployed in Africa.”

Currently, none of the main HPV vaccine manufacturers, which include the UK- and USA-based GSK and MSD(Merck), as well as the Serum Institute of India and two Chinese firms include HPV 35 in their vaccine formulations.

However, a 14-valent vaccine by another leading Chinese pharma innovator, Sinocelltech, has a 14-valent vaccine SCT1000 in Phase 3 trials with some 18,000 women, which includes the HPV 35 genotype.

“Especially in regions with high HIV prevalence, such as sub-Saharan Africa, the application of polyvalent HPV vaccines (including HPV 35) is essential, as people living with HIV are more prone to multiple HPV infections requiring broader protection,” state an October 2025 review by Chiara Paternostro and Elmar Joura, of the Medical University of Vienna.

Gavi board: approved inclusion of improved vaccines once available 

HPV vaccine – Gavi has approved inclusion of improved formulations to protect against more genotypes once available.

Asked by Health Policy Watch about the need and potential to update existing vaccines to include the HPV 35 genotype, Gavi, the Vaccine Alliance, said its board had in 2025 approved the inclusion of improved vaccines covering more virus genotypes in its portfolio as soon as they become available:

“Current HPV vaccines are designed to protect against the large majority (70%) of cervical cancers. The importance of this evolving research is that we now have a better understanding of the disease burden of HPV-35 in countries across Africa, which Gavi supports – as well as how that burden is expected to increase over time as other types decrease due to improved vaccine coverage,” a Gavi spokesperson said.

“While there are currently no licensed vaccines that provide protection against HPV‑35, the Gavi Board in December 2025 approved, based on WHO and SAGE guidance, an expansion of Gavi’s portfolio so that higher-valent vaccines can be made available to countries as and when they come available. We encourage our manufacturing partners to work with us in helping bring this about.”

WHO pointed to a recent systematic review by WHO/IARC  (Wei et al. 2024) confirming that  HPV35  is part of  the remaining known 10 HPV causal genotypes, it causes only about 5% of cases worldwide, “but with some notable regional variations, including a higher proportion (~4%) for HPV 35 in Africa than in other regions.”

“Currently, HPV35 is not among the types covered in the two existing, licensed (highest valency)  HPV9 vaccines that contain the same  7 oncogenic types (16,18, 31, 33, 45, 52, and 58),” a spokesperson said. “We are aware additional work is being done on HPV35 that may provide more information on this strain and its contribution to cervical cancer burden– in particular, in the African region. In future that may inform vaccine developers in their choice for additional HPV type to be included in ‘even higher valency’.”

Rwanda: on track to beat 2050 global elimination target    

Two girls sit together after receiving their HPV vaccinations at their primary school in Masaka, Rwanda, a country that is on track to reach the 2050 goal for cervical cancer elimination.

But vaccination is not in itself an answer. It must be part of a multi-pronged approach.

“Over the next 50 years, scaling up screening and treatment could avert up to 14.6 million deaths, three times more than vaccination alone,” noted Cabo Verde’s UN Ambassador in Geneva Clara Delgado and a member of the Unitaid Executive Board.

Since 2019, Unitaid has introduced HPV testing, self-sampling methods and portable thermal ablation treatment devices (for removal of precancerous lesions) across approximately 50  low- and middle income countries, driving down costs significantly.”

Bulk procurement has reduced HPV test prices by 40% and the costs of thermal ablation by 45% “making these lifesaving tools affordable where they are needed most.”

But just as important are country models that work, she stressed, citing Rwanda, South Africa, Malawi and the Philippines as “champion” examples.

“For example, in Rwanda with Unitaid’s partnership since 2019, a national screen and treat program now operates in over half of the country. Women in rural communities are being reached through HPV self-collection kits, a simple, dignified approach that brings services closer to home, breaking barriers of distance, stigma and cost.

As a result of the partnership, Rwanda is on track to beat the 2030 elimination targets by three years, “proving that elimination is not just possible, but achievable.”

Repeating the success of smallpox eradication  

“Just as international collaboration led to the eradication of smallpox, the global community can work together to end cervical cancer by 2050,” said Ramsammy, “Today we have an opportunity to elevate cervical cancer elimination on the multilateral agenda as a matter of equity, gender justice and the right to health.”

Said Getahun, “At a time when global solidarity and multilateralism are under strain, health diplomacy is more important than ever in strengthening North–South and South–South cooperation and advancing the global effort to eliminate cervical cancer.”

Adds Broutet, “We have a generation to end cervical cancer, and we have the tools,” citing  national elimination targets; sustainable financing; regional cooperation to decrease the price of the tools and investing in treatment infrastructure as key political levers.

“The science exists, the roadmap exists, but the inequity persists. Political will determines the outcome.”

Most important is the need to address gender inequities.

“Each country of the world needs to understand, what are these drivers of inequity in their own country?” she said, citing the late WHO director Mahmoud Fathalla, who once said: “women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

Image Credits: UNICEF, WHO , N. Broutet/WHO, ecancer.org, Murahwa et al, Reviews in Medical Virology, 33 March 2026, Broutet, Gavi, HPV World .

US President Donald Trump shocked partners when he announced an immediate freezing of all international health aid shortly after assuming power in January 2025.

The rapid withdrawal of international health aid by the United States (US) constitutes a public health emergency of international concern (PHEIC), according to Professor Matthew Herder and colleagues writing in the BMJ this week.

According to the World Health Organization’s (WHO) International Health Regulations, a PHEIC is “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response”. 

“Multiple estimates predict reduced US funding will lead to millions of deaths by 2030,” argue Herder, from the Dalhousie University’s school of law in Canada, Professor Roojin Habibi from Ottawa University, Fatima Hassan, director of Health Justice Initiative in South Africa, and Andrew Hill, visiting research fellow at the University of Liverpool in the UK.

The Trump administration’s funding freeze on the US President’s Emergency Plan for AIDS Relief (PEPFAR), resulted in “the sudden closure of treatment services for thousands of people with HIV/AIDS”, while the stop-work orders imposed on the US Agency for International Development (USAID) “immediately reduced HIV testing and treatment”.

If this aid is not resumed, UNAIDS estimates that there could be six million HIV-related deaths – a 10-fold increase on 2023 mortality – and nine million new HIV infections by 2030.

Meanwhile, cuts in funding for malaria, tuberculosis and other diseases are expected to “risk millions more deaths in the coming years”, they argue.

“If the Trump administration follows through on its threat to halt funding for Gavi, the Vaccine Alliance, alter the US childhood vaccination schedule, and fundamentally change its approach to pandemic preparedness as part of its America First global health strategy, vaccine preventable diseases and deaths are likely to resurge, both in the US and abroad,” they note.

Meanwhile, ceasing US funding for United Nations agencies, including UN Women and the UN Population Fund, “threatens to end services that support sexual rights and reproductive health in more than 150 countries.”

Mobilise resources

In response, they want the World Health Organization (WHO) to declare a PHEIC in order to galvanise resources to address the US actions.

They argue that the US actions amount to an “extraordinary event” within the definition of the IHR, and that an “event” is not limited to the “manifestation of disease” but extends to any “occurrence that creates a potential for disease.” 

“The main interpretive issue in this case is whether the political actions of the US amount to a public health risk through the ‘international spread of disease’,” they acknowledge.

While the “spread of disease” hasn’t fully materialised yet, “we are in a state of anticipation that numerous outbreaks of infectious diseases will occur as treatment and public health programmes reliant on US funding shut down around the globe”.

They argue that, while a PHEIC “has never been declared because of the political actions of a single country, risk is the paramount consideration, and the US’s recent decisions have greatly amplified the risk of multiple international outbreaks of disease”.

However, should the WHO declare a PHEIC, this can help to “mobilise collaboration, assistance, and financing across member states” and also enable countries to issue “compulsory licences, overriding the patent rights of pharmaceutical companies, to improve access to essential medicines to treat HIV, malaria, tuberculosis, and other diseases.”

Social media giants are liable for harming young users, according to two landmark court rulings in the United States this week that order Meta and YouTube to pay millions in damages.

On Wednesday, a Los Angeles jury found that Meta (parent company of Facebook and Instagram) and YouTube were liable for creating addictive products that had led to a young user developing depression and anxiety.

The court ordered Meta to pay $4.2 million and YouTube $1.8 million in compensation to the woman identified only as KGM, now aged 20.

KGM’s lawyers accused the companies of creating products as addictive as cigarettes and online gambling, using features like infinite scrolling and algorithm-based recommendations.

On Monday, a New Mexico jury found that Meta had misled its social media users into thinking its platforms were safe, yet sexual predators were able to contact and exploit children.

It ordered Meta to pay $375 million in damages for violating state consumer protection laws in the case, which was brought ​​by New Mexico Attorney General Raúl Torrez.

“Meta executives knew their products harmed children, disregarded warnings from their own employees, and lied to the public about what they knew,” Torrez told The Guardian after the ruling.

A two-year Guardian investigation revealing how Facebook and Instagram had become “marketplaces for child sex trafficking” was cited several times in the complaint.

Big Soda, alcohol companies ‘flood’ social media

Vital Strategies accuses Coca-Cola of “sportswashing” their sugary drinks via sponsorships.

Meanwhile, soda and alcohol companies are flooding social media platforms with a “constant stream of content” that evades outdated advertising regulations, according to Vital Strategies, a global public health organisation.

The consumption of sugary drinks and alcohol is linked to several noncommunicable diseases, including diabetes, cancer and cardiovascular disease. 

By embedding their brands in “sports highlights, influencer content and viral moments” rather than traditional advertising, these industries are generating billions of impressions, according to Vital.

Using its digital media monitoring tool, Canary, Vital’s researchers tracked how Coca-Cola’s sponsorship of the FIFA World Cup and alcohol companies’ use of festivals, cultural events and celebrities in Brazil, Mexico, the Philippines, and South Africa “integrated brand promotion into people’s everyday online experiences”.

“Companies are using culture, entertainment and social media to make harmful products – like alcohol, tobacco and sugary drinks – seem normal and unavoidable,” said Sandra Mullin, senior vice president at Vital.

“This undermines critically important policies to reduce consumption, like curbing marketing to kids and taxing these products. Governments cannot rely on social media to self-regulate: We need to implement proven policies that protect health.” 

Vital Strategies called on governments to implement comprehensive marketing policies that span both digital and physical environments, particularly youth spaces where exposure is highest. 

It also called on governments to ban harmful industries from sponsoring sports events, and increase taxes on alcohol, tobacco and sweetened beverages to reduce consumption.

“One moment in a stadium can become millions of online impressions,” said Vital vice president Nandita Murukutla and Canary lead. “That’s how today’s marketing machines work: amplifying exposure across digital platforms where young people are constantly engaged. This isn’t passive advertising; it shapes behaviour. Governments must respond with urgency.”

Image Credits: Unsplash, Vital Strategies.

Image Credits: Pete Lewis/ UK Department for International Development, Abdirahman Ahmed Aden.

Civil society organisations held a protest outside the European Parliament in Brussels last week, urging the EU to support a fair and equitable PABS Annex.

A snail would have a faster passage than the Pandemic Agreement talks currently underway in Geneva, according to a briefing on Wednesday by civil society observers – some of whom mooted the possibility of World Health Organization (WHO) member states voting on the outstanding annex to break the deadlock.

Only one portion of a single paragraph has been “greened” – fully agreed – since the sixth meeting of the Intergovernmental Working Group (IGWG) started on Monday, according to Third World Network’s KM Gopakumar.

At the opening session, African countries rejected the latest draft text proposed by the IGWG Bureau, and a closed session of the meeting finally agreed to revert to the text of IGWG 5, reported Professor Lauren Paremoer, a member of the People’s Health Movement.

Member states are negotiating the one outstanding piece of the Pandemic Agreement – the Pathogen Access and Benefit Sharing (PABS) system, which will govern how dangerous pathogens should be shared and how any benefits that accrue from this information are also shared. 

Numerous countries, particularly in Africa, want the assurance that if they share pathogen information, they will be able to benefit from any vaccines, therapeutics or diagnostics (VTD) that are developed as a result.

They also want the PABS Annex to include standard contracts with pharmaceutical companies, setting out the terms of access and benefit-sharing.

Several European countries – notably those with powerful pharmaceutical industries – argue that compulsory benefit-sharing will stifle research and development. 

They are also against set contracts, giving companies “a lot of wriggle room” to negotiate terms of benefit-sharing, said Gopakumar.

Some European countries also favour allowing parties to use pathogen information without registration as a PABS user – something that the civil society representatives said would enable them to bypass any obligations to share benefits.

There is also a dispute over when countries will receive a share of the benefits. According to the current draft, the WHO will receive a donation of 10% of vaccines or medicines produced by the pharmaceutical companies that sign up to PABS during a pandemic only, not a public health emergency of international concern (PHEIC).

Voting to break deadlock?

Pedro Villardi, representing Public Services International – a trade union federation with over 30 million members, more than half of whom are health and care workers – warned that a binding benefit-sharing system is essential to protect frontline health workers.

“If we don’t have a benefit-sharing system that truly works with binding commitments, the risk is that, when we face the next pandemic, frontline workers will not receive priority access to [VTDs] and we will have the same tragedy that we had during the COVID-19 pandemic.”

“Some delegations are framing the non-conclusion of these negotiations as a failure of multilateralism,” said Villardi.

But he warned that a weak PABS system would undermine the global solidarity that multilateralism was supposed to build.

“So if we need [to reach an agreement], why don’t we vote? We have a majority of countries pushing for equitable provisions… and we have a few countries that are opposing these measures and defending the position of the pharmaceutical industry and other big corporations.”

Villardi said that voting had happened on other issues, including a recent vote at the WHO Executive Board meeting in February on an Israeli proposal on Palestine.

“The WHO Essential Medicines List was created through a vote,” he added.

Civil society briefing (clockwise from top left): Rajnia Rodrigues, Lauren Paremoer, Alessandra Tisi, Guilherme Faviero, KM Gopakumar and Pedro Villardi.

Pressure to adopt ‘stripped down’ Annex

Guilherme Faviero, director of the AIDS Healthcare Foundation Global Public Health Institute, warned that member states are under mounting pressure to “accept a stripped-down annex that is devoid of meaningful benefit-sharing provisions and adequate legal guarantees”. 

However, the PABS Annex is supposed to address the “deep structural inequities within the global health system” exposed by the COVID-19 pandemic, said Faviero. 

“Pathogen samples and genomics sequence data moved quickly across borders, but life-saving technology did not and this is precisely what this Annex must solve,” said Faviero.

“Despite months of good faith efforts by delegations to advance text-based negotiations, the European bloc and key developed countries have been resistant to commonsense proposals to operationalise equity and ensure that these commitments, that are set forth in Article 12 of the Pandemic Agreement can be implemented successfully on an equal footing.”

He blamed the “delaying tactics of the European bloc” for the current impasse, adding that “civil society organisations have coalesced around very clear principles that should be reflected in the agreement”.

‘Europe to blame’

Alessandra Tisi, executive secretary of the Geneva Global Health Hub (G2H2), agreed: “The biggest threat to the successful outcome of this negotiation is the position of the European Union and other developed countries. Basically, they just keep rejecting key proposals from developing countries, and we have now arrived at this deadlock.”

Tisi said that some of the positions of the European Union contradicted its own internal regulations and other international agreements.

“The European Union was a very vocal, if not the main proponent, of the creation of a WHO Pandemic Agreement back in 2020. So it’s very hard to understand why, rather than advancing health for all and trying to build a more equitable and resilient healthcare architecture, it actually reinforces the very same status quo which has caused the pandemic in the first place.”

WHO Deputy Representative to Sudan, Dr Hala Khudari, addresses the UN press briefing in Geneva following the deadly hospital attack.
WHO Deputy Representative to Sudan, Dr Hala Khudari, addresses the UN press briefing in Geneva following the deadly hospital attack.

Millions of civilians in Sudan have lost their primary access to medical care following a lethal drone attack on the Al Daein Teaching Hospital in East Darfur on the evening of Eid al-Fitr.

The death toll from the 20 March assault has risen to 70, with 146 people now documented as injured, according to the World Health Organization (WHO), which updated casualty figures on Tuesday.

“An attack on a hospital is not only an attack on a building, it’s an attack on people seeking care, on health workers risking their lives to save others, and on the very possibility of survival at times of crisis,” said Dr Hala Khudari, WHO Deputy Representative to Sudan, during a UN press briefing in Geneva.

Among the casualties from this latest strike were seven women, 13 children, one doctor, and two nurses. Eight other health workers sustained injuries.

This hospital attack exacerbates a widening humanitarian catastrophe fuelled by the lethal use of drones, widespread starvation, and severe violations of international law as the country approaches its third year of armed conflict.

The medical centre served as a critical referral hub for more than two million residents across East Darfur and nine surrounding localities. With the facility entirely out of service following the attack, critically ill patients must now undertake a perilous 160-kilometre journey to reach the nearest functioning specialised clinic, WHO pointed out.

UN demands accountability for hospital attack

WHO Director-General Tedros Adhanom Ghebreyesus shared these images of the Al Daein Teaching Hospital in East Darfur, showing the extensive structural destruction.
WHO Director-General Tedros Adhanom Ghebreyesus shared these images of the Al Daein Teaching Hospital in East Darfur, showing the extensive structural destruction.

While the perpetrators of the attack remain unidentified, both the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) extensively deploy relatively cheap, high-tech drones.

The hospital is in territory held by the RSF, but the SAF has denied attacking the hospital in the rebel-held area.

According to the UN Human Rights Office, these lethal weapons had already killed over 500 civilians. primarily in the Kordofan region, between 1 January and 15 March, even before the recent deadly strike in Darfur.

This widening drone warfare is now spiralling across Sudan’s borders into neighbouring Chad, severely endangering refugee populations in border towns like Tine. By repeatedly bombing protected clinics, the warring factions are directly defying international humanitarian law.

“Continued patterns of such attacks striking civilians and destroying civilian infrastructures… may amount to war crimes,” UN Human Rights Office spokesperson Marta Hurtado said on Tuesday during the press briefing in Geneva.

Attacks on Healthcare: Devastating New Norm as Hotspots Like Sudan Are Overlooked

Medical facilities benefit from strict legal protection and only lose this status under exceptional circumstances. Disregarding these global norms severely damages health systems and completely paralyses local medical infrastructure.

The destruction of the Al Daein Teaching Hospital reflects a grim global trend, where hospital attacks are increasingly becoming a hallmark of present-day armed conflict.

Violence decimates healthcare system, compounds suffering

Since the civil war in Sudan erupted in 2023, hundreds of healthcare facilities have been damaged, and health workers killed, kidnapped, or arrested.
Since the civil war in Sudan erupted in 2023, hundreds of healthcare facilities have been damaged, and health workers killed, kidnapped, or arrested.

The violence further strains a health system that has been systematically dismantled over nearly three years of fighting. Since the civil war first erupted in April 2023, the WHO has verified over 200 attacks on medical facilities, leaving only 60% of the nation’s clinics operational.

These relentless assaults have claimed the lives of more than 2,000 individuals, effectively dismantling the nation’s fragile healthcare system.

Medical professionals have paid a devastating price, with independent tracking data from Insecurity Insight documenting that at least 186 health workers have been killed, 112 medical staff arrested and another 15 kidnapped during the ongoing conflict.

The collapse of medical care compounds an unprecedented humanitarian emergency. According to the latest Integrated Food Security Phase Classification (IPC) analysis, 21.2 million Sudanese currently face high levels of acute food insecurity.

While this reflects a slight improvement – declining by 3.4 million people in the previous months due to gradual stabilisation and improved humanitarian access in states like Khartoum, Al Jazirah, and Sennar – the overall crisis remains catastrophic. Restricted access and the destruction of agricultural capacity continue to transform the former regional breadbasket into an epicentre of starvation.

Relief efforts persist amid devastation

Over 14 million people have been forced to flee their homes in Sudan, creating one of the world's largest displacement crises.
Over 14 million people have been forced to flee their homes in Sudan, creating one of the world’s largest displacement crises.

The civil war has triggered a widespread displacement crisis, forcing over 14 million people to flee their homes, with nearly 9.6 million internally displaced and almost 4.5 million seeking shelter in neighbouring countries. Heavy rains and severe flooding have further exacerbated this public health crisis by accelerating major outbreaks of cholera, malaria, and dengue fever across the nation.

The suffering of these vulnerable populations is continually prolonged by external actors who fuel the underlying conflict. While international aid agencies struggle to deliver relief, foreign powers complicate the crisis by continuing to supply weapons to both sides despite a UN arms embargo on Darfur.

Despite the hospital attack and the ongoing violence, international health organisations and local volunteers continue to secure vital victories on the ground. Together with health authorities, UN agencies and humanitarian NGOs are actively working to sustain and revitalise remaining facilities.

Following the recent strike, WHO and partners coordinated alternative healthcare sites and utilised pre-positioned medical supplies sufficient to support approximately 40,000 people over three months. Teams are currently moving additional trauma kits from warehouses in Abéché, Chad, to support rapid-response medical teams.

Image Credits: @DrTedros/WHO, Felix Sassmannshausen/HPW, Insecurity Insight.