LGBTIQ Groups in Repressive Countries Are Worst Affected by US Funding Cuts 10/09/2026 Kerry Cullinan Outright supporters take part in a Pride march in New York City. HIV services, mental health and harm reduction programmes have been severely affected by the huge funding cuts to organisations providing services for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people over the past 18 months. Perversely, organisations in countries with the most repressive conditions for LGBTIQ people have been worst affected by cuts, according to a report released on Thursday by Outright, the international LGBTIQ human rights group. “Organisations in countries with the harshest living conditions, the least impartial justice systems, the most widespread discrimination, and the deepest divisions between social groups were roughly two to three times more likely to have been affected by the cuts than those in countries at the other end of each measure,” according to the report. In Ghana and Uganda, the cuts have coincided with draconian laws increasing punishment for same-sex activity – resulting in a spike in attacks on LGBTIQ people and a greater need for support services. Budgets cut by 50-75% Of the 229 LGBTIQ organisations from 94 countries that responded to Outright, 203 lost funding after Donald Trump became president of the United States in January 2025. The funding cuts have been fast and dramatic, with almost half of the affected organisations losing 50% of their budget, and three-quarters losing at least a quarter. “The losses concentrate among small, community-rooted groups: 73% operate on annual budgets under $250,000, leaving no reserves to absorb a shortfall of this size.” After Trump assumed power, the US cut funds for HIV programmes aimed at “key populations” most at risk of infection, including men who have sex with men (MSM) and trans women. The US State Department also terminated the Global Equality Fund, the public-private partnership launched in 2011 that has distributed over $100 million to LGBTIQ organisations. Life-saving services stopped “Half of the affected organisations have cut health services, including mental healthcare. On HIV specifically, 45% have reduced or discontinued prevention, treatment, or care, and 50% named LGBTIQ people living with HIV among the constituencies most affected by the reductions they made,” according to the report. “The cuts strike directly into lifesaving and dignity-affirming services: HIV testing, treatment adherence support, PrEP information, [sexually transmitted infection] prevention, mental health counselling, psychosocial support, harm reduction tools, reproductive health services, health referrals, and safe community-based care.” The Global Black Gay Men Connect network has also documented significant disruptions to HIV services for key populations, with 77% of the key population organisations it surveyed reported interruptions to the supply of antiretrovirals, pre-exposure prophylaxis (PrEP) and condoms. In many places, the health services were effective because they were “delivered by trusted organisations that understand the specific risks faced by LGBTIQ people and can help them navigate stigma, discrimination, criminalisation, and fear of exposure”, the report notes. “The money was pulled out of the places where queer organisations were doing the work that no one else is doing,” Outright’s Alberto de Belaunde told a webinar to launch the report on Thursday. “The places with the least capacity to absorb the loss are exactly where it is highest.” Outright’s Alberto de Belaunde. Deaths, retrenchments For security reasons, several organisations cited in the report aren’t named, while the countries of a few are withheld. However, the report documents tragic stories from countries as far apart as Nepal and Zimbabwe. “We are unable to refill medication for our constituents, which has led to defaulting and the death of two of the people who defaulted,” reported a Zimbabwean organisation that provided HIV services for MSM and trans women. “Funding cuts hit us hard at the community level,” said Kenya’s Mamboleo Peer Empowerment Group. “We had to let go of 100 peer educators, caregivers, outreach workers, and paralegals, the people who were not just staff but trusted faces within the LGBTQ community. “These were the individuals who checked in on clients, supported them to stay on HIV treatment, responded to GBV [gender-based violence] cases, and ensured no one felt alone. With their absence, outreach activities stopped almost overnight. Safe spaces went quiet, food support was disrupted, and emergency shelter and evacuation assistance became difficult to sustain.” Aid workers turn to sex work Manisha Dhakal, a trans activist from the Blue Diamond Society in Nepal. Manisha Dhakal, a trans activist from the Blue Diamond Society in Nepal, told the launch that her organisation lost 85% of its funding for an HIV service delivery programme that provided services in 21 districts at 24 service sites. Nepal’s HIV epidemic is concentrated in key populations, and the clinics were important to reach these groups. But Blue Diamond has been forced to close clinics and retrench staff. “Some [Blue Diamond employees] have even been pushed towards the sex work profession because we don’t have a stable income,” said Dhakal. An estimated 35,000 aid workers lost their jobs in Nepal after the US aid cuts, and for trans people there are few job opportunities other than sex work, according to AP. Spike in distress calls “Community need for emergency shelter and protection exploded in the wake of the Anti-Homosexuality Act and state-driven hostilities surrounding our general elections,” said John Grace, the coordinator of the Uganda Minority Shelters Consortium (UMSC). “UMSC logged a 283% spike in distress calls to our national crisis hotlines. But over 60 to 70% of the financial support sustaining our protection network vanished overnight,” said Grace. The impact on UMSC’s work has been significant: “For every 10 emergency relocation and protection requests that we receive weekly from youth that are escaping mob violence or police raids or family rejection, we possess the resources to feed, to house, and protect only about three.” A significant proportion of the young people UMSC helps are living with HIV, said Grace. “The desperation is so severe that we have even documented some of the youth trading portions of their life-saving HIV medication on the informal market just for a single meal.” John Grace, the coordinator of the Uganda Minority Shelters Consortium. An organisation in Malawi has closed its mobile clinics that offered HIV testing and referrals that were “critical in reaching MSM and transgender individuals who face stigma in public health facilities”. Türkiye’s Kaos GL reported that the UN Refugee Agency (UNHCR) had withdrawn from a “collaborative project for LGBTI+ refugees in 2025, causing the organisation to “shut down the refugee rights program office, lay off staff members and reduce the program activities by 85%.” A queer-led organisation in Jordan reported that it has a limited stock of harm reduction tools and kits to minimise the negative health effects of drug use, “which increases the risk of contracting HIV and other STIs”. No protection for intersex babies There has always been virtually no funding for intersex people, who are born with reproductive or sexual anatomy, chromosomes, or hormones that do not fit the typical definitions of female or male. “In many countries, intersex infants and children are subjected to medically unnecessary surgeries and other interventions on their sex characteristics, without their consent,” the report notes. “The organisations working to end these practices are among the most underresourced in the global LGBTIQ movement, and several report that funding cuts have forced them to suspend their work documenting cases of medical violence, educating health providers, and supporting intersex children’s families as they navigate medical bureaucracies.” This means that there is no one “standing between a child and an unwanted, harmful surgery”, the report notes. Minuscule funding Neela Ghoshal, Outright’s director of law, policy, and research Donor government funding for LGBTI communities has always been “minuscule”, amounting to four cents of every $100 in official development assistance in 2023–2024, according to De Belaunde. “The US has not been the only funder to walk away from or reduce its support for LGBTIQ movements during this period,” said Neela Ghoshal, Outright’s director of law, policy, and research. “Some other governments, corporations, and foundations have also pulled back. At the same time, organisations are working in a context of growing anti-gender organising, where the gains that we’ve achieved over the last several decades, which were already fragile, are increasingly at risk.” To address the crisis, the Outright report appeals to potential donors to act immediately, outside standard grant cycles; provide multi-year, flexible funding; restore community-led health services; fund protection for LGBTIQ people, and “direct resources to those bearing the heaviest impacts”. Image Credits: Outright International. EXCLUSIVE: Saima Wazed, WHO’s South-East Asia Regional Director Resigns Day After Member States Recommend Her Termination 10/09/2026 Elaine Ruth Fletcher Saima Wazed sworn in as Director of WHO’s South East Asia Region in February 2024; six months later her mother, Sheikh Hasina was deposed as Prime Minister of Bangladesh. Saima Wazed, WHO’s Regional Director (RD) for South-East Asia (SEARO) and daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, resigned Wednesday, just a day after South-East Asian member states recommended her termination, WHO confirmed to Health Policy Watch. “The previous day, 8 September 2026, the Regional Committee had recommended that Wazed’s appointment as Regional Director be terminated. That recommendation had been due to be considered by the Executive Board,” said a WHO spokesperson in an email. The discussion of Wazed was held behind closed doors with no fanfare at the 79th Regional Committee meeting of SEARO member states, which ended today. Wazed’s resignation, first reported Wednesday night by Reuters, ends a tumultuous five-year term marked by fraud allegations, a year of leave, and, according to multiple people familiar with the matter, months of pressure from Dhaka on Director-General Tedros Adhanom Ghebreyesus to remove the RD that the new Bangladeshi government has prosecuted for fraud. Speaking to the Indian Express after submitting her resignation letter, Wazed lashed back – denying all allegations and saying that she had quit “because of “harassment and intimidation” by the WHO Director General, Dr Tedros Adhanom Ghebreyesus. “Not allowing for an independent investigation… leaving me on Leave Without Pay as retaliation for requesting an investigation into his conduct… It was becoming mentally and financially impossible for me to cope with this kind of harassment and abuse from him,” she was quoted telling the Express. In response, WHO told Health Policy Watch, “this matter has been handled through the appropriate WHO processes in accordance with WHO’s regulatory framework, with due regard for fairness and due process, while safeguarding the interests of the Organization and its ability to fulfil its mandate.” Dispute in shadow of overthrow of former Bangladeshi prime minister Sheikh Hasina Wazed, former Prime Minister of Bangladesh in 2020, four years before being ousted. Other sources close to the matter noted that the termination move came after months of pressure on WHO from the new Bangladeshi government to investigate and dismiss her. The sources, who requested anonymity, also contended had been paid at least part of her salary during the leave period. This could not be confirmed independently. WHO had placed Wazed on leave in mid-2025, after Bangladesh’s Anti-Corruption Commission filed fraud and forgery charges against her in March. The charges alleged that she misrepresented an honorary doctorate as an academic credential in her original WHO candidacy for the Regional Director’s position, and also had been engaged in improper land deals in Bangladesh. The fraud charges were brought by the new government after Wazed’s mother, former Prime Minister Sheikh Hasina, fled the country to India on 5 August 2024 following massive student-led protests. Wazed has denied the charges saying they were politically motivated. Separately, WHO had reportedly been investigating alleged irregularities in a travel claim made by Wazed for the reimbursement of some $901 related to a trip to China – something her lawyers have said was due to an administrative error. Action after months of pressure WHO Regional Director for South East Asia leads a regional member state briefing in Geneva, May 2025; in August she was placed on leave. According to a diplomatic official involved in exchanges between Dhaka and WHO headquarters, who requested anonymity, representatives of Bangladesh’s interim government warned the WHO Director-General as early as 2025 that inaction on Wazed could prompt Bangladesh to reconsider its position within WHO’s South-East Asia Region, and consider a move into the Eastern Mediterranean Region. “The Regional Committee cannot afford another country leaving SEARO, noted one observer, citing Indonesia’s decision to affiliate with the West Pacific Region,” last year. Currently there are ten WHO member states affiliated with the SEARO region, including: Bangladesh; Bhutan; Democratic People’s Republic of Korea; India; Maldives; Myanmar; Nepal; Sri Lanka; Thailand; and Timor-Leste. Tedros finally placed her on ‘leave’ in July. But the WHO statement at the time carefully sidestepped the term “administrative leave” that is typically used in cases involving investigative of wrongdoing, or potential disciplinary action, describing her only as “currently on leave”. The choice of terms, officials told Health Policy Watch, was deliberate, intended to limit reputational damage both to Wazed and to the Organization. Another WHO official familiar with the internal investigation, who also requested anonymity, said the investigation into the allegations against Wazed had effectively stalled for much of the period she was on leave. During that time, however, Wazed reportedly continued to reside in India, the host country of WHO’s South East Asia Regional Office, and a place where she could have immunity from the arrest warrant issued by Bangladesh. Her mother, Sheikh Hasina also has been in India since her government fell – reflecting the traditionally close ties she had maintained with Delhi. Sheikh Hasina also faces criminal charges in Bangladesh, including over mass killings during the crackdown on protesters that preceded her ouster. Alleged abuses were documented in a UN Human Rights Office of the High Commissioner (OHCHR) report published after her overthrow. She denies wrongdoing. Wazed’s resignation takes effect immediately; Typically, WHO would be expected to open nominations for her successor in October. Image Credits: WHO SEARO/LinkedIn, WHO. Jeremy Farrar Joins Global Health Non-Profit PATH Following Unexpected Departure From WHO 09/09/2026 Felix Sassmannshausen Following his WHO departure, Dr Jeremy Farrar joins PATH to lead operations across Asia, the Middle East, and Europe. Outgoing WHO Assistant Director-General Dr Jeremy Farrar will lead PATH’s regional division for Asia, the Middle East, and Europe starting October, the organisation announced in a press release today, 9 September. Based in Geneva, he joins the executive leadership team to accelerate the delivery of health technologies across these regions. “Dr Farrar joins PATH at a time when countries are increasingly seeking sustainable ways to expand access to health services and innovations,” the organisation explained in a statement to Health Policy Watch. “His leadership will strengthen our ability to work with governments and partners to deliver lasting health impact across the region.” Founded in 1977 and headquartered in Seattle, PATH is an international global health non-profit that develops medical technologies for low-resource settings. Operating on an annual budget of over $371 million (2024) – funded primarily by philanthropic foundations and public government grants – the organisation employs approximately 1,600 people across more than 70 countries to advance vaccines, diagnostics, and health system innovations. Farrar’s appointment targets regional health challenges by connecting scientific innovation directly with local primary healthcare systems to fortify outbreak preparedness, according to the organisation. Return to regional roots The appointment, in a sense, returns Farrar to the roots of some of his pre-WHO work and specializations. From 1996 to 2013, he directed the Oxford University Clinical Research Unit in Vietnam before serving for a decade the head of UK-based Wellcome Trust. He joined WHO in 2023, first as Chief Scientist, then last year taking on this position of Assistant Director-General for Health Promotion, Disease Prevention and Care, under a major reorganization launched by Director General Dr Tedros Adhanom Ghebreyesus after the United States withdrew from the organisation, triggering a budget crisis. Earlier this year Farrar, perhaps the UK’s best-known scientist, was mooted as a possible successor to Tedros, whose term ends next year. But Farrar later told colleagues and media that he was not interested in competing for the post, which would have also required a formal government nomination. Four candidates have since declared their candidacy, in candidacies nominated by Saudi Arabia, Qatar, Belgium, and Indonesia. Jeremy Farrar leads regional expansion In his new role, Farrar will oversee operations connecting governments, research institutes, and medical manufacturers. The appointment aligns with PATH’s Strategy 2030, which focusses on bridging the gap between scientific innovation and real-world impact by strengthening primary healthcare systems and regional partnerships. His future division managed $35.99 million in regional programme expenses in 2024, according to PATH’s 2024 financial summary. His team will focus on translating scientific breakthroughs into accessible tools for underserved communities. “Joining PATH at this moment is a very exciting opportunity,” said Farrar in the press release. He emphasised the need to address health threats with urgency while preparing for future global health shifts. “Jeremy is an exceptional leader, and we’re very pleased to welcome him to PATH,” added PATH President and CEO Nikolaj Gilbert. Leadership transition follows WHO departure WHO headquarters in Geneva experiences leadership shifts following Farrar’s departure to join global non-profit PATH. His arrival at PATH follows his departure from the WHO, where he officially steps down on 30 September. Official statements and an internal communication from WHO Director-General Tedros described the exit as a routine retirement upon reaching the official UN retirement age limit. However, several sources characterised the exit as unusual, suggesting a resignation. Tedros had reportedly offered Farrar an exceptional contract extension beyond retirement age, which he declined. Following that, the Director General announced that another longstanding senior WHO official, Bruce Aylward, will step into the ADG role upon Farrar’s departure. The leadership transition comes ahead of the upcoming election of the WHO Director-General and amidst severe financial and political ruptures. PATH stated that Farrar was not available to address specific questions regarding his transition or operational priorities before assuming office on 1 October. Health Policy Watch reached out to the WHO for comments but had received no response by the time of publication. Image Credits: Flickr – US Mission Geneva. EU is Failing to Stem Illegal Tobacco Trade and Rising Health Risks, Auditors Warn 08/09/2026 Felix Sassmannshausen Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds. Fragmented enforcement and uncoordinated policies fail to stem the illegal tobacco trade in Europe, a new report by the EU Court of Auditors finds. The surge of unregulated novel nicotine products and a shift toward illegal manufacturing sites expose significant regulatory gaps. The auditors demand that Brussels take a more active role to establish a unified strategic framework and standardise market monitoring by 2029. Nearly one in 10 cigarettes on the European Union (EU) market were produced illegally or smuggled in 2023, and Europe is losing an estimated €13 billion in public revenue annually to the illicit tobacco trade. Regulatory and data gaps hinder the EU in mapping out a coherent strategy to curb the problem, warns a special report by the European Court of Auditors (ECA), released on Tuesday. “Criminals are succeeding because gaps remain in coordination, information, and enforcement,” said Petri Sarvamaa, leader of the audit, at the press briefing to release the report. The regulatory and data vacuum directly undermines the WHO Framework Convention on Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products. This legally binding global treaty is designed to protect public health by securing supply chains against illegal tobacco, mandating strict controls and independent tracking systems. Fragmented policies divide EU enforcement European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health. However, the EU’s fragmented approach prevents the unified enforcement of these international standards. Finance and health ministries across different countries split the responsibility for implementing the FCTC protocol, locking customs and enforcement agencies out of vital policy dialogues, for example. This administrative division deprives officials of operational insight, undermining coordinated enforcement across the single market, the auditors criticise. Furthermore, enforcement is deeply fractured because member states apply vastly different legal sanctions and investigative powers to combat illegal tobacco. While national customs agencies in Belgium and Poland possess advanced police powers and warrantless search capabilities to raid illicit factories, but countries such as Romania are constrained to administrative enquiries. This lack of harmonised penalties encourages criminal organisations to move their activities to nations with more lenient sanctions, the auditors warn. To close these loopholes, they urge the European Commission to establish a unified strategic direction across the bloc. They recommend that EU officials improve independent data gathering by 2029 to regularly estimate the size of the black market, and promote compliance with strict transparency and integrity rules for any interaction with tobacco manufacturers by 2028. Surge in illegal tobacco production sites Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations, the European Court of Auditors found. Although smuggling from non-EU countries persists, the auditors noted a systemic shift as production is moving inside the EU. This relocation from non-EU Eastern European nations like Ukraine and Belarus to locations across the single market enables syndicates to shorten supply chains, operate closer to lucrative consumer markets, and evade external customs controls. “Illegal production sites have been detected in almost every member state,” said Sarvamaa. “They are really mushrooming across the bloc.” Criminal enterprises exploit differences in national laws and enforcement capabilities to establish operations where the legal risks are lowest. These clandestine facilities bypass all public health regulations, exposing consumers and workers to severe physical and chemical hazards. While illicit cigarette factories process bulk raw tobacco leaves in unhygienic environments, illegal facilities producing novel products handle highly hazardous chemical compounds. Many of these black-market substitutes also fail basic safety and composition standards, with some illicit e-cigarettes containing excessive, unregulated nicotine concentrations. New illicit nicotine products target youth Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fuelling a parallel black market. The current exclusion of tobacco-free nicotine products – such as nicotine pouches – from the EU’s tobacco control framework has also created massive regulatory gaps across the single market. Additionally, because e-cigarettes and heated tobacco products lack harmonised EU tax definitions, member states apply widely divergent excise rates to a rapidly growing market that now accounts for an estimated 13% of the tobacco products market value sold in the EU. This regulatory and fiscal fragmentation has fuelled a parallel black market, the scale of which was recently exposed by a joint customs initiative across 30 countries. Led by the European Anti-Fraud Office (OLAF), the operation resulted in the seizure of over 94 million pieces and over 2,500 kg/l of tobacco products, e-cigarettes, and related devices. Beyond lost tax revenue, these black-market activities carry severe health consequences. Investigators warned that consumers who turn to these unregulated substitutes risk inhaling harmful, substandard, and potentially toxic chemical substances produced entirely outside controlled supply chains. Opaque manufacturer agreements ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards. To help track illicit trade and verify the authenticity of seized products, approximately half of all EU member states maintain voluntary, confidential Memorandums of Understanding (MoUs) with major tobacco manufacturers. First established in 1999 between Philip Morris International and Italy, these bilateral pacts are designed to facilitate operational cooperation, such as sharing market intelligence and helping customs verify counterfeit machinery or cigarettes. However, the auditors have strongly criticised these agreements, warning that they risk compromising the strict independence required for national tracking systems. Because these MoUs are not publicly accessible and lack transparency, it is impossible to assess whether they comply with international guidelines on preventing industry interference. While the auditors emphasised that operational cooperation can offer practical benefits like technical training and counterfeit machine verification, severe conflict of interest risks remain under global health rules laid out in the FCTC protocol. “The interaction should be transparent, limited and also should comply with international standards … at [the] World Health Organization,” ECA task leader Esther Torrente Heras told the press briefing. Letting the industry control or influence traceability solutions directly violates the protocol, which strictly prohibits the delegation of supply chain control authority to tobacco firms. EU regulation lags shifting market While the European Commission proposed a crucial recast of the Tobacco Taxation Directive last year to modernise fiscal rules and curb the black market, progress has stalled within the divided council. Tax matters require unanimous agreement from all 27 Member States under a special legislative procedure. This legislative delay leaves raw tobacco – the primary input for illegal manufacturing – without unified EU-wide oversight. The absence of harmonised EU control rules means that cross-border movements cannot be effectively monitored or tracked because most member states only maintain national notification systems. Under current rules, bulk tobacco leaves can easily circulate across borders without standard EU customs tracking because they are not classified as manufactured tobacco products. Organised crime groups exploit these regulatory gaps to transport raw tobacco and advanced manufacturing machinery between jurisdictions with minimal detection risks. To close this loophole, the proposed reform would subject raw tobacco to the Excise Movement and Control System (EMCS), a real-time digital monitoring network requiring commercial traders to register shipments and report cross-border movements electronically (although raw tobacco growers performing only drying or curing would remain exempt). Stalled tax initiatives Also regarding minimum tobacco excise rates, the EU is currently experiencing a policy stalemate. This legislative deadlock prevents rates from acting as a public health deterrent or reducing market distortions. While the auditors recommend a comprehensive set of enforcement measures to ramp up the fight against illegal tobacco in the bloc, they fail to call for higher excise taxes on tobacco products. Indeed, the ECA’s special report states that high tax rates simply create a financial incentive for tax avoidance. Asked on this issue by Health Policy Watch, lead auditor Sarvamaa explained that the court lacked the empirical data to analyse how tax levels drive smuggling. “We do not have the grounds for starting to analyse how much the tax level is a factor in this problem,” he said. However, the WHO explicitly advocates higher excise taxes as an effective intervention to reduce tobacco consumption. According to the organisation’s technical manual on tobacco tax policy, high-tax nations with strong governance experience much lower smuggling rates than low-tax jurisdictions. Furthermore, a fully harmonised tax regime across the bloc would effectively eliminate the price differentials that drive cross-border tax arbitrage. Instead of keeping taxes low to prevent smuggling, the WHO found that the most effective way to eliminate black market sales is to strengthen tax administration and secure supply chains. Ball in Commission court The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge. To close these data and regulation gaps, the EU auditors asserted that the Commission must take a far more assertive, leading role in coordinating cross-border enforcement efforts. With the current framework deemed not robust enough, Brussels faces an immense workload to establish reliable, independent market size estimations by the recommended 2029 deadline. To successfully outmanoeuvre illicit trade, the bloc must transition from its current fragmented, state-by-state approach to a singular, binding policy framework. This requires dismantling national administrative silos and encouraging member states to prioritise strict international treaty compliance and transparency over domestic industry interests. “The criminals have a good strategy obviously, and I think that we need one too,” said Sarvamaa “Tackling the illegal tobacco trade is about much more than recovering lost tax revenue.” Only by closing these critical regulatory gaps can the European Union protect the public health of its citizens, and safeguard public finances. See related story: Europe is Failing to Curb Tobacco Use – Especially in Women Image Credits: Mark Stebnicki via Pexels, European Union, European Court of Auditors, pixabay, Paws and Prints via unsplash. US to Phase Out HIV Support for Namibia After Data-Sharing Impasse 08/09/2026 Kerry Cullinan End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023. The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package. The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday. Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people. It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98. Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative. However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme. Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR). However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes. Undermining PABS talks US demands for data and sharing of pathogen information have also been rejected by other African countries. Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups. World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks. As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system. However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system. Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper. More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
EXCLUSIVE: Saima Wazed, WHO’s South-East Asia Regional Director Resigns Day After Member States Recommend Her Termination 10/09/2026 Elaine Ruth Fletcher Saima Wazed sworn in as Director of WHO’s South East Asia Region in February 2024; six months later her mother, Sheikh Hasina was deposed as Prime Minister of Bangladesh. Saima Wazed, WHO’s Regional Director (RD) for South-East Asia (SEARO) and daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, resigned Wednesday, just a day after South-East Asian member states recommended her termination, WHO confirmed to Health Policy Watch. “The previous day, 8 September 2026, the Regional Committee had recommended that Wazed’s appointment as Regional Director be terminated. That recommendation had been due to be considered by the Executive Board,” said a WHO spokesperson in an email. The discussion of Wazed was held behind closed doors with no fanfare at the 79th Regional Committee meeting of SEARO member states, which ended today. Wazed’s resignation, first reported Wednesday night by Reuters, ends a tumultuous five-year term marked by fraud allegations, a year of leave, and, according to multiple people familiar with the matter, months of pressure from Dhaka on Director-General Tedros Adhanom Ghebreyesus to remove the RD that the new Bangladeshi government has prosecuted for fraud. Speaking to the Indian Express after submitting her resignation letter, Wazed lashed back – denying all allegations and saying that she had quit “because of “harassment and intimidation” by the WHO Director General, Dr Tedros Adhanom Ghebreyesus. “Not allowing for an independent investigation… leaving me on Leave Without Pay as retaliation for requesting an investigation into his conduct… It was becoming mentally and financially impossible for me to cope with this kind of harassment and abuse from him,” she was quoted telling the Express. In response, WHO told Health Policy Watch, “this matter has been handled through the appropriate WHO processes in accordance with WHO’s regulatory framework, with due regard for fairness and due process, while safeguarding the interests of the Organization and its ability to fulfil its mandate.” Dispute in shadow of overthrow of former Bangladeshi prime minister Sheikh Hasina Wazed, former Prime Minister of Bangladesh in 2020, four years before being ousted. Other sources close to the matter noted that the termination move came after months of pressure on WHO from the new Bangladeshi government to investigate and dismiss her. The sources, who requested anonymity, also contended had been paid at least part of her salary during the leave period. This could not be confirmed independently. WHO had placed Wazed on leave in mid-2025, after Bangladesh’s Anti-Corruption Commission filed fraud and forgery charges against her in March. The charges alleged that she misrepresented an honorary doctorate as an academic credential in her original WHO candidacy for the Regional Director’s position, and also had been engaged in improper land deals in Bangladesh. The fraud charges were brought by the new government after Wazed’s mother, former Prime Minister Sheikh Hasina, fled the country to India on 5 August 2024 following massive student-led protests. Wazed has denied the charges saying they were politically motivated. Separately, WHO had reportedly been investigating alleged irregularities in a travel claim made by Wazed for the reimbursement of some $901 related to a trip to China – something her lawyers have said was due to an administrative error. Action after months of pressure WHO Regional Director for South East Asia leads a regional member state briefing in Geneva, May 2025; in August she was placed on leave. According to a diplomatic official involved in exchanges between Dhaka and WHO headquarters, who requested anonymity, representatives of Bangladesh’s interim government warned the WHO Director-General as early as 2025 that inaction on Wazed could prompt Bangladesh to reconsider its position within WHO’s South-East Asia Region, and consider a move into the Eastern Mediterranean Region. “The Regional Committee cannot afford another country leaving SEARO, noted one observer, citing Indonesia’s decision to affiliate with the West Pacific Region,” last year. Currently there are ten WHO member states affiliated with the SEARO region, including: Bangladesh; Bhutan; Democratic People’s Republic of Korea; India; Maldives; Myanmar; Nepal; Sri Lanka; Thailand; and Timor-Leste. Tedros finally placed her on ‘leave’ in July. But the WHO statement at the time carefully sidestepped the term “administrative leave” that is typically used in cases involving investigative of wrongdoing, or potential disciplinary action, describing her only as “currently on leave”. The choice of terms, officials told Health Policy Watch, was deliberate, intended to limit reputational damage both to Wazed and to the Organization. Another WHO official familiar with the internal investigation, who also requested anonymity, said the investigation into the allegations against Wazed had effectively stalled for much of the period she was on leave. During that time, however, Wazed reportedly continued to reside in India, the host country of WHO’s South East Asia Regional Office, and a place where she could have immunity from the arrest warrant issued by Bangladesh. Her mother, Sheikh Hasina also has been in India since her government fell – reflecting the traditionally close ties she had maintained with Delhi. Sheikh Hasina also faces criminal charges in Bangladesh, including over mass killings during the crackdown on protesters that preceded her ouster. Alleged abuses were documented in a UN Human Rights Office of the High Commissioner (OHCHR) report published after her overthrow. She denies wrongdoing. Wazed’s resignation takes effect immediately; Typically, WHO would be expected to open nominations for her successor in October. Image Credits: WHO SEARO/LinkedIn, WHO. Jeremy Farrar Joins Global Health Non-Profit PATH Following Unexpected Departure From WHO 09/09/2026 Felix Sassmannshausen Following his WHO departure, Dr Jeremy Farrar joins PATH to lead operations across Asia, the Middle East, and Europe. Outgoing WHO Assistant Director-General Dr Jeremy Farrar will lead PATH’s regional division for Asia, the Middle East, and Europe starting October, the organisation announced in a press release today, 9 September. Based in Geneva, he joins the executive leadership team to accelerate the delivery of health technologies across these regions. “Dr Farrar joins PATH at a time when countries are increasingly seeking sustainable ways to expand access to health services and innovations,” the organisation explained in a statement to Health Policy Watch. “His leadership will strengthen our ability to work with governments and partners to deliver lasting health impact across the region.” Founded in 1977 and headquartered in Seattle, PATH is an international global health non-profit that develops medical technologies for low-resource settings. Operating on an annual budget of over $371 million (2024) – funded primarily by philanthropic foundations and public government grants – the organisation employs approximately 1,600 people across more than 70 countries to advance vaccines, diagnostics, and health system innovations. Farrar’s appointment targets regional health challenges by connecting scientific innovation directly with local primary healthcare systems to fortify outbreak preparedness, according to the organisation. Return to regional roots The appointment, in a sense, returns Farrar to the roots of some of his pre-WHO work and specializations. From 1996 to 2013, he directed the Oxford University Clinical Research Unit in Vietnam before serving for a decade the head of UK-based Wellcome Trust. He joined WHO in 2023, first as Chief Scientist, then last year taking on this position of Assistant Director-General for Health Promotion, Disease Prevention and Care, under a major reorganization launched by Director General Dr Tedros Adhanom Ghebreyesus after the United States withdrew from the organisation, triggering a budget crisis. Earlier this year Farrar, perhaps the UK’s best-known scientist, was mooted as a possible successor to Tedros, whose term ends next year. But Farrar later told colleagues and media that he was not interested in competing for the post, which would have also required a formal government nomination. Four candidates have since declared their candidacy, in candidacies nominated by Saudi Arabia, Qatar, Belgium, and Indonesia. Jeremy Farrar leads regional expansion In his new role, Farrar will oversee operations connecting governments, research institutes, and medical manufacturers. The appointment aligns with PATH’s Strategy 2030, which focusses on bridging the gap between scientific innovation and real-world impact by strengthening primary healthcare systems and regional partnerships. His future division managed $35.99 million in regional programme expenses in 2024, according to PATH’s 2024 financial summary. His team will focus on translating scientific breakthroughs into accessible tools for underserved communities. “Joining PATH at this moment is a very exciting opportunity,” said Farrar in the press release. He emphasised the need to address health threats with urgency while preparing for future global health shifts. “Jeremy is an exceptional leader, and we’re very pleased to welcome him to PATH,” added PATH President and CEO Nikolaj Gilbert. Leadership transition follows WHO departure WHO headquarters in Geneva experiences leadership shifts following Farrar’s departure to join global non-profit PATH. His arrival at PATH follows his departure from the WHO, where he officially steps down on 30 September. Official statements and an internal communication from WHO Director-General Tedros described the exit as a routine retirement upon reaching the official UN retirement age limit. However, several sources characterised the exit as unusual, suggesting a resignation. Tedros had reportedly offered Farrar an exceptional contract extension beyond retirement age, which he declined. Following that, the Director General announced that another longstanding senior WHO official, Bruce Aylward, will step into the ADG role upon Farrar’s departure. The leadership transition comes ahead of the upcoming election of the WHO Director-General and amidst severe financial and political ruptures. PATH stated that Farrar was not available to address specific questions regarding his transition or operational priorities before assuming office on 1 October. Health Policy Watch reached out to the WHO for comments but had received no response by the time of publication. Image Credits: Flickr – US Mission Geneva. EU is Failing to Stem Illegal Tobacco Trade and Rising Health Risks, Auditors Warn 08/09/2026 Felix Sassmannshausen Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds. Fragmented enforcement and uncoordinated policies fail to stem the illegal tobacco trade in Europe, a new report by the EU Court of Auditors finds. The surge of unregulated novel nicotine products and a shift toward illegal manufacturing sites expose significant regulatory gaps. The auditors demand that Brussels take a more active role to establish a unified strategic framework and standardise market monitoring by 2029. Nearly one in 10 cigarettes on the European Union (EU) market were produced illegally or smuggled in 2023, and Europe is losing an estimated €13 billion in public revenue annually to the illicit tobacco trade. Regulatory and data gaps hinder the EU in mapping out a coherent strategy to curb the problem, warns a special report by the European Court of Auditors (ECA), released on Tuesday. “Criminals are succeeding because gaps remain in coordination, information, and enforcement,” said Petri Sarvamaa, leader of the audit, at the press briefing to release the report. The regulatory and data vacuum directly undermines the WHO Framework Convention on Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products. This legally binding global treaty is designed to protect public health by securing supply chains against illegal tobacco, mandating strict controls and independent tracking systems. Fragmented policies divide EU enforcement European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health. However, the EU’s fragmented approach prevents the unified enforcement of these international standards. Finance and health ministries across different countries split the responsibility for implementing the FCTC protocol, locking customs and enforcement agencies out of vital policy dialogues, for example. This administrative division deprives officials of operational insight, undermining coordinated enforcement across the single market, the auditors criticise. Furthermore, enforcement is deeply fractured because member states apply vastly different legal sanctions and investigative powers to combat illegal tobacco. While national customs agencies in Belgium and Poland possess advanced police powers and warrantless search capabilities to raid illicit factories, but countries such as Romania are constrained to administrative enquiries. This lack of harmonised penalties encourages criminal organisations to move their activities to nations with more lenient sanctions, the auditors warn. To close these loopholes, they urge the European Commission to establish a unified strategic direction across the bloc. They recommend that EU officials improve independent data gathering by 2029 to regularly estimate the size of the black market, and promote compliance with strict transparency and integrity rules for any interaction with tobacco manufacturers by 2028. Surge in illegal tobacco production sites Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations, the European Court of Auditors found. Although smuggling from non-EU countries persists, the auditors noted a systemic shift as production is moving inside the EU. This relocation from non-EU Eastern European nations like Ukraine and Belarus to locations across the single market enables syndicates to shorten supply chains, operate closer to lucrative consumer markets, and evade external customs controls. “Illegal production sites have been detected in almost every member state,” said Sarvamaa. “They are really mushrooming across the bloc.” Criminal enterprises exploit differences in national laws and enforcement capabilities to establish operations where the legal risks are lowest. These clandestine facilities bypass all public health regulations, exposing consumers and workers to severe physical and chemical hazards. While illicit cigarette factories process bulk raw tobacco leaves in unhygienic environments, illegal facilities producing novel products handle highly hazardous chemical compounds. Many of these black-market substitutes also fail basic safety and composition standards, with some illicit e-cigarettes containing excessive, unregulated nicotine concentrations. New illicit nicotine products target youth Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fuelling a parallel black market. The current exclusion of tobacco-free nicotine products – such as nicotine pouches – from the EU’s tobacco control framework has also created massive regulatory gaps across the single market. Additionally, because e-cigarettes and heated tobacco products lack harmonised EU tax definitions, member states apply widely divergent excise rates to a rapidly growing market that now accounts for an estimated 13% of the tobacco products market value sold in the EU. This regulatory and fiscal fragmentation has fuelled a parallel black market, the scale of which was recently exposed by a joint customs initiative across 30 countries. Led by the European Anti-Fraud Office (OLAF), the operation resulted in the seizure of over 94 million pieces and over 2,500 kg/l of tobacco products, e-cigarettes, and related devices. Beyond lost tax revenue, these black-market activities carry severe health consequences. Investigators warned that consumers who turn to these unregulated substitutes risk inhaling harmful, substandard, and potentially toxic chemical substances produced entirely outside controlled supply chains. Opaque manufacturer agreements ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards. To help track illicit trade and verify the authenticity of seized products, approximately half of all EU member states maintain voluntary, confidential Memorandums of Understanding (MoUs) with major tobacco manufacturers. First established in 1999 between Philip Morris International and Italy, these bilateral pacts are designed to facilitate operational cooperation, such as sharing market intelligence and helping customs verify counterfeit machinery or cigarettes. However, the auditors have strongly criticised these agreements, warning that they risk compromising the strict independence required for national tracking systems. Because these MoUs are not publicly accessible and lack transparency, it is impossible to assess whether they comply with international guidelines on preventing industry interference. While the auditors emphasised that operational cooperation can offer practical benefits like technical training and counterfeit machine verification, severe conflict of interest risks remain under global health rules laid out in the FCTC protocol. “The interaction should be transparent, limited and also should comply with international standards … at [the] World Health Organization,” ECA task leader Esther Torrente Heras told the press briefing. Letting the industry control or influence traceability solutions directly violates the protocol, which strictly prohibits the delegation of supply chain control authority to tobacco firms. EU regulation lags shifting market While the European Commission proposed a crucial recast of the Tobacco Taxation Directive last year to modernise fiscal rules and curb the black market, progress has stalled within the divided council. Tax matters require unanimous agreement from all 27 Member States under a special legislative procedure. This legislative delay leaves raw tobacco – the primary input for illegal manufacturing – without unified EU-wide oversight. The absence of harmonised EU control rules means that cross-border movements cannot be effectively monitored or tracked because most member states only maintain national notification systems. Under current rules, bulk tobacco leaves can easily circulate across borders without standard EU customs tracking because they are not classified as manufactured tobacco products. Organised crime groups exploit these regulatory gaps to transport raw tobacco and advanced manufacturing machinery between jurisdictions with minimal detection risks. To close this loophole, the proposed reform would subject raw tobacco to the Excise Movement and Control System (EMCS), a real-time digital monitoring network requiring commercial traders to register shipments and report cross-border movements electronically (although raw tobacco growers performing only drying or curing would remain exempt). Stalled tax initiatives Also regarding minimum tobacco excise rates, the EU is currently experiencing a policy stalemate. This legislative deadlock prevents rates from acting as a public health deterrent or reducing market distortions. While the auditors recommend a comprehensive set of enforcement measures to ramp up the fight against illegal tobacco in the bloc, they fail to call for higher excise taxes on tobacco products. Indeed, the ECA’s special report states that high tax rates simply create a financial incentive for tax avoidance. Asked on this issue by Health Policy Watch, lead auditor Sarvamaa explained that the court lacked the empirical data to analyse how tax levels drive smuggling. “We do not have the grounds for starting to analyse how much the tax level is a factor in this problem,” he said. However, the WHO explicitly advocates higher excise taxes as an effective intervention to reduce tobacco consumption. According to the organisation’s technical manual on tobacco tax policy, high-tax nations with strong governance experience much lower smuggling rates than low-tax jurisdictions. Furthermore, a fully harmonised tax regime across the bloc would effectively eliminate the price differentials that drive cross-border tax arbitrage. Instead of keeping taxes low to prevent smuggling, the WHO found that the most effective way to eliminate black market sales is to strengthen tax administration and secure supply chains. Ball in Commission court The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge. To close these data and regulation gaps, the EU auditors asserted that the Commission must take a far more assertive, leading role in coordinating cross-border enforcement efforts. With the current framework deemed not robust enough, Brussels faces an immense workload to establish reliable, independent market size estimations by the recommended 2029 deadline. To successfully outmanoeuvre illicit trade, the bloc must transition from its current fragmented, state-by-state approach to a singular, binding policy framework. This requires dismantling national administrative silos and encouraging member states to prioritise strict international treaty compliance and transparency over domestic industry interests. “The criminals have a good strategy obviously, and I think that we need one too,” said Sarvamaa “Tackling the illegal tobacco trade is about much more than recovering lost tax revenue.” Only by closing these critical regulatory gaps can the European Union protect the public health of its citizens, and safeguard public finances. See related story: Europe is Failing to Curb Tobacco Use – Especially in Women Image Credits: Mark Stebnicki via Pexels, European Union, European Court of Auditors, pixabay, Paws and Prints via unsplash. US to Phase Out HIV Support for Namibia After Data-Sharing Impasse 08/09/2026 Kerry Cullinan End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023. The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package. The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday. Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people. It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98. Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative. However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme. Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR). However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes. Undermining PABS talks US demands for data and sharing of pathogen information have also been rejected by other African countries. Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups. World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks. As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system. However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system. Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper. More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
Jeremy Farrar Joins Global Health Non-Profit PATH Following Unexpected Departure From WHO 09/09/2026 Felix Sassmannshausen Following his WHO departure, Dr Jeremy Farrar joins PATH to lead operations across Asia, the Middle East, and Europe. Outgoing WHO Assistant Director-General Dr Jeremy Farrar will lead PATH’s regional division for Asia, the Middle East, and Europe starting October, the organisation announced in a press release today, 9 September. Based in Geneva, he joins the executive leadership team to accelerate the delivery of health technologies across these regions. “Dr Farrar joins PATH at a time when countries are increasingly seeking sustainable ways to expand access to health services and innovations,” the organisation explained in a statement to Health Policy Watch. “His leadership will strengthen our ability to work with governments and partners to deliver lasting health impact across the region.” Founded in 1977 and headquartered in Seattle, PATH is an international global health non-profit that develops medical technologies for low-resource settings. Operating on an annual budget of over $371 million (2024) – funded primarily by philanthropic foundations and public government grants – the organisation employs approximately 1,600 people across more than 70 countries to advance vaccines, diagnostics, and health system innovations. Farrar’s appointment targets regional health challenges by connecting scientific innovation directly with local primary healthcare systems to fortify outbreak preparedness, according to the organisation. Return to regional roots The appointment, in a sense, returns Farrar to the roots of some of his pre-WHO work and specializations. From 1996 to 2013, he directed the Oxford University Clinical Research Unit in Vietnam before serving for a decade the head of UK-based Wellcome Trust. He joined WHO in 2023, first as Chief Scientist, then last year taking on this position of Assistant Director-General for Health Promotion, Disease Prevention and Care, under a major reorganization launched by Director General Dr Tedros Adhanom Ghebreyesus after the United States withdrew from the organisation, triggering a budget crisis. Earlier this year Farrar, perhaps the UK’s best-known scientist, was mooted as a possible successor to Tedros, whose term ends next year. But Farrar later told colleagues and media that he was not interested in competing for the post, which would have also required a formal government nomination. Four candidates have since declared their candidacy, in candidacies nominated by Saudi Arabia, Qatar, Belgium, and Indonesia. Jeremy Farrar leads regional expansion In his new role, Farrar will oversee operations connecting governments, research institutes, and medical manufacturers. The appointment aligns with PATH’s Strategy 2030, which focusses on bridging the gap between scientific innovation and real-world impact by strengthening primary healthcare systems and regional partnerships. His future division managed $35.99 million in regional programme expenses in 2024, according to PATH’s 2024 financial summary. His team will focus on translating scientific breakthroughs into accessible tools for underserved communities. “Joining PATH at this moment is a very exciting opportunity,” said Farrar in the press release. He emphasised the need to address health threats with urgency while preparing for future global health shifts. “Jeremy is an exceptional leader, and we’re very pleased to welcome him to PATH,” added PATH President and CEO Nikolaj Gilbert. Leadership transition follows WHO departure WHO headquarters in Geneva experiences leadership shifts following Farrar’s departure to join global non-profit PATH. His arrival at PATH follows his departure from the WHO, where he officially steps down on 30 September. Official statements and an internal communication from WHO Director-General Tedros described the exit as a routine retirement upon reaching the official UN retirement age limit. However, several sources characterised the exit as unusual, suggesting a resignation. Tedros had reportedly offered Farrar an exceptional contract extension beyond retirement age, which he declined. Following that, the Director General announced that another longstanding senior WHO official, Bruce Aylward, will step into the ADG role upon Farrar’s departure. The leadership transition comes ahead of the upcoming election of the WHO Director-General and amidst severe financial and political ruptures. PATH stated that Farrar was not available to address specific questions regarding his transition or operational priorities before assuming office on 1 October. Health Policy Watch reached out to the WHO for comments but had received no response by the time of publication. Image Credits: Flickr – US Mission Geneva. EU is Failing to Stem Illegal Tobacco Trade and Rising Health Risks, Auditors Warn 08/09/2026 Felix Sassmannshausen Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds. Fragmented enforcement and uncoordinated policies fail to stem the illegal tobacco trade in Europe, a new report by the EU Court of Auditors finds. The surge of unregulated novel nicotine products and a shift toward illegal manufacturing sites expose significant regulatory gaps. The auditors demand that Brussels take a more active role to establish a unified strategic framework and standardise market monitoring by 2029. Nearly one in 10 cigarettes on the European Union (EU) market were produced illegally or smuggled in 2023, and Europe is losing an estimated €13 billion in public revenue annually to the illicit tobacco trade. Regulatory and data gaps hinder the EU in mapping out a coherent strategy to curb the problem, warns a special report by the European Court of Auditors (ECA), released on Tuesday. “Criminals are succeeding because gaps remain in coordination, information, and enforcement,” said Petri Sarvamaa, leader of the audit, at the press briefing to release the report. The regulatory and data vacuum directly undermines the WHO Framework Convention on Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products. This legally binding global treaty is designed to protect public health by securing supply chains against illegal tobacco, mandating strict controls and independent tracking systems. Fragmented policies divide EU enforcement European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health. However, the EU’s fragmented approach prevents the unified enforcement of these international standards. Finance and health ministries across different countries split the responsibility for implementing the FCTC protocol, locking customs and enforcement agencies out of vital policy dialogues, for example. This administrative division deprives officials of operational insight, undermining coordinated enforcement across the single market, the auditors criticise. Furthermore, enforcement is deeply fractured because member states apply vastly different legal sanctions and investigative powers to combat illegal tobacco. While national customs agencies in Belgium and Poland possess advanced police powers and warrantless search capabilities to raid illicit factories, but countries such as Romania are constrained to administrative enquiries. This lack of harmonised penalties encourages criminal organisations to move their activities to nations with more lenient sanctions, the auditors warn. To close these loopholes, they urge the European Commission to establish a unified strategic direction across the bloc. They recommend that EU officials improve independent data gathering by 2029 to regularly estimate the size of the black market, and promote compliance with strict transparency and integrity rules for any interaction with tobacco manufacturers by 2028. Surge in illegal tobacco production sites Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations, the European Court of Auditors found. Although smuggling from non-EU countries persists, the auditors noted a systemic shift as production is moving inside the EU. This relocation from non-EU Eastern European nations like Ukraine and Belarus to locations across the single market enables syndicates to shorten supply chains, operate closer to lucrative consumer markets, and evade external customs controls. “Illegal production sites have been detected in almost every member state,” said Sarvamaa. “They are really mushrooming across the bloc.” Criminal enterprises exploit differences in national laws and enforcement capabilities to establish operations where the legal risks are lowest. These clandestine facilities bypass all public health regulations, exposing consumers and workers to severe physical and chemical hazards. While illicit cigarette factories process bulk raw tobacco leaves in unhygienic environments, illegal facilities producing novel products handle highly hazardous chemical compounds. Many of these black-market substitutes also fail basic safety and composition standards, with some illicit e-cigarettes containing excessive, unregulated nicotine concentrations. New illicit nicotine products target youth Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fuelling a parallel black market. The current exclusion of tobacco-free nicotine products – such as nicotine pouches – from the EU’s tobacco control framework has also created massive regulatory gaps across the single market. Additionally, because e-cigarettes and heated tobacco products lack harmonised EU tax definitions, member states apply widely divergent excise rates to a rapidly growing market that now accounts for an estimated 13% of the tobacco products market value sold in the EU. This regulatory and fiscal fragmentation has fuelled a parallel black market, the scale of which was recently exposed by a joint customs initiative across 30 countries. Led by the European Anti-Fraud Office (OLAF), the operation resulted in the seizure of over 94 million pieces and over 2,500 kg/l of tobacco products, e-cigarettes, and related devices. Beyond lost tax revenue, these black-market activities carry severe health consequences. Investigators warned that consumers who turn to these unregulated substitutes risk inhaling harmful, substandard, and potentially toxic chemical substances produced entirely outside controlled supply chains. Opaque manufacturer agreements ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards. To help track illicit trade and verify the authenticity of seized products, approximately half of all EU member states maintain voluntary, confidential Memorandums of Understanding (MoUs) with major tobacco manufacturers. First established in 1999 between Philip Morris International and Italy, these bilateral pacts are designed to facilitate operational cooperation, such as sharing market intelligence and helping customs verify counterfeit machinery or cigarettes. However, the auditors have strongly criticised these agreements, warning that they risk compromising the strict independence required for national tracking systems. Because these MoUs are not publicly accessible and lack transparency, it is impossible to assess whether they comply with international guidelines on preventing industry interference. While the auditors emphasised that operational cooperation can offer practical benefits like technical training and counterfeit machine verification, severe conflict of interest risks remain under global health rules laid out in the FCTC protocol. “The interaction should be transparent, limited and also should comply with international standards … at [the] World Health Organization,” ECA task leader Esther Torrente Heras told the press briefing. Letting the industry control or influence traceability solutions directly violates the protocol, which strictly prohibits the delegation of supply chain control authority to tobacco firms. EU regulation lags shifting market While the European Commission proposed a crucial recast of the Tobacco Taxation Directive last year to modernise fiscal rules and curb the black market, progress has stalled within the divided council. Tax matters require unanimous agreement from all 27 Member States under a special legislative procedure. This legislative delay leaves raw tobacco – the primary input for illegal manufacturing – without unified EU-wide oversight. The absence of harmonised EU control rules means that cross-border movements cannot be effectively monitored or tracked because most member states only maintain national notification systems. Under current rules, bulk tobacco leaves can easily circulate across borders without standard EU customs tracking because they are not classified as manufactured tobacco products. Organised crime groups exploit these regulatory gaps to transport raw tobacco and advanced manufacturing machinery between jurisdictions with minimal detection risks. To close this loophole, the proposed reform would subject raw tobacco to the Excise Movement and Control System (EMCS), a real-time digital monitoring network requiring commercial traders to register shipments and report cross-border movements electronically (although raw tobacco growers performing only drying or curing would remain exempt). Stalled tax initiatives Also regarding minimum tobacco excise rates, the EU is currently experiencing a policy stalemate. This legislative deadlock prevents rates from acting as a public health deterrent or reducing market distortions. While the auditors recommend a comprehensive set of enforcement measures to ramp up the fight against illegal tobacco in the bloc, they fail to call for higher excise taxes on tobacco products. Indeed, the ECA’s special report states that high tax rates simply create a financial incentive for tax avoidance. Asked on this issue by Health Policy Watch, lead auditor Sarvamaa explained that the court lacked the empirical data to analyse how tax levels drive smuggling. “We do not have the grounds for starting to analyse how much the tax level is a factor in this problem,” he said. However, the WHO explicitly advocates higher excise taxes as an effective intervention to reduce tobacco consumption. According to the organisation’s technical manual on tobacco tax policy, high-tax nations with strong governance experience much lower smuggling rates than low-tax jurisdictions. Furthermore, a fully harmonised tax regime across the bloc would effectively eliminate the price differentials that drive cross-border tax arbitrage. Instead of keeping taxes low to prevent smuggling, the WHO found that the most effective way to eliminate black market sales is to strengthen tax administration and secure supply chains. Ball in Commission court The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge. To close these data and regulation gaps, the EU auditors asserted that the Commission must take a far more assertive, leading role in coordinating cross-border enforcement efforts. With the current framework deemed not robust enough, Brussels faces an immense workload to establish reliable, independent market size estimations by the recommended 2029 deadline. To successfully outmanoeuvre illicit trade, the bloc must transition from its current fragmented, state-by-state approach to a singular, binding policy framework. This requires dismantling national administrative silos and encouraging member states to prioritise strict international treaty compliance and transparency over domestic industry interests. “The criminals have a good strategy obviously, and I think that we need one too,” said Sarvamaa “Tackling the illegal tobacco trade is about much more than recovering lost tax revenue.” Only by closing these critical regulatory gaps can the European Union protect the public health of its citizens, and safeguard public finances. See related story: Europe is Failing to Curb Tobacco Use – Especially in Women Image Credits: Mark Stebnicki via Pexels, European Union, European Court of Auditors, pixabay, Paws and Prints via unsplash. US to Phase Out HIV Support for Namibia After Data-Sharing Impasse 08/09/2026 Kerry Cullinan End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023. The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package. The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday. Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people. It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98. Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative. However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme. Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR). However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes. Undermining PABS talks US demands for data and sharing of pathogen information have also been rejected by other African countries. Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups. World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks. As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system. However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system. Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper. More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
EU is Failing to Stem Illegal Tobacco Trade and Rising Health Risks, Auditors Warn 08/09/2026 Felix Sassmannshausen Fragmented EU regulation fails to stem illegal tobacco manufacturing and smuggling, a new Court of Auditors report finds. Fragmented enforcement and uncoordinated policies fail to stem the illegal tobacco trade in Europe, a new report by the EU Court of Auditors finds. The surge of unregulated novel nicotine products and a shift toward illegal manufacturing sites expose significant regulatory gaps. The auditors demand that Brussels take a more active role to establish a unified strategic framework and standardise market monitoring by 2029. Nearly one in 10 cigarettes on the European Union (EU) market were produced illegally or smuggled in 2023, and Europe is losing an estimated €13 billion in public revenue annually to the illicit tobacco trade. Regulatory and data gaps hinder the EU in mapping out a coherent strategy to curb the problem, warns a special report by the European Court of Auditors (ECA), released on Tuesday. “Criminals are succeeding because gaps remain in coordination, information, and enforcement,” said Petri Sarvamaa, leader of the audit, at the press briefing to release the report. The regulatory and data vacuum directly undermines the WHO Framework Convention on Tobacco Control (FCTC) Protocol to Eliminate Illicit Trade in Tobacco Products. This legally binding global treaty is designed to protect public health by securing supply chains against illegal tobacco, mandating strict controls and independent tracking systems. Fragmented policies divide EU enforcement European Court of Auditors lead Petri Sarvamaa calls for a unified strategy to counter illicit tobacco trade and protect public health. However, the EU’s fragmented approach prevents the unified enforcement of these international standards. Finance and health ministries across different countries split the responsibility for implementing the FCTC protocol, locking customs and enforcement agencies out of vital policy dialogues, for example. This administrative division deprives officials of operational insight, undermining coordinated enforcement across the single market, the auditors criticise. Furthermore, enforcement is deeply fractured because member states apply vastly different legal sanctions and investigative powers to combat illegal tobacco. While national customs agencies in Belgium and Poland possess advanced police powers and warrantless search capabilities to raid illicit factories, but countries such as Romania are constrained to administrative enquiries. This lack of harmonised penalties encourages criminal organisations to move their activities to nations with more lenient sanctions, the auditors warn. To close these loopholes, they urge the European Commission to establish a unified strategic direction across the bloc. They recommend that EU officials improve independent data gathering by 2029 to regularly estimate the size of the black market, and promote compliance with strict transparency and integrity rules for any interaction with tobacco manufacturers by 2028. Surge in illegal tobacco production sites Organized crime syndicates exploit regulatory gaps to move illicit tobacco factories closer to consumer markets across multiple EU nations, the European Court of Auditors found. Although smuggling from non-EU countries persists, the auditors noted a systemic shift as production is moving inside the EU. This relocation from non-EU Eastern European nations like Ukraine and Belarus to locations across the single market enables syndicates to shorten supply chains, operate closer to lucrative consumer markets, and evade external customs controls. “Illegal production sites have been detected in almost every member state,” said Sarvamaa. “They are really mushrooming across the bloc.” Criminal enterprises exploit differences in national laws and enforcement capabilities to establish operations where the legal risks are lowest. These clandestine facilities bypass all public health regulations, exposing consumers and workers to severe physical and chemical hazards. While illicit cigarette factories process bulk raw tobacco leaves in unhygienic environments, illegal facilities producing novel products handle highly hazardous chemical compounds. Many of these black-market substitutes also fail basic safety and composition standards, with some illicit e-cigarettes containing excessive, unregulated nicotine concentrations. New illicit nicotine products target youth Heated tobacco and e-cigarettes now make up 13% of the EU market, but unharmonised tax rules are fuelling a parallel black market. The current exclusion of tobacco-free nicotine products – such as nicotine pouches – from the EU’s tobacco control framework has also created massive regulatory gaps across the single market. Additionally, because e-cigarettes and heated tobacco products lack harmonised EU tax definitions, member states apply widely divergent excise rates to a rapidly growing market that now accounts for an estimated 13% of the tobacco products market value sold in the EU. This regulatory and fiscal fragmentation has fuelled a parallel black market, the scale of which was recently exposed by a joint customs initiative across 30 countries. Led by the European Anti-Fraud Office (OLAF), the operation resulted in the seizure of over 94 million pieces and over 2,500 kg/l of tobacco products, e-cigarettes, and related devices. Beyond lost tax revenue, these black-market activities carry severe health consequences. Investigators warned that consumers who turn to these unregulated substitutes risk inhaling harmful, substandard, and potentially toxic chemical substances produced entirely outside controlled supply chains. Opaque manufacturer agreements ECA task leader Esther Torrente Heras stresses that interactions with tobacco manufacturers must align strictly with WHO transparency and independence standards. To help track illicit trade and verify the authenticity of seized products, approximately half of all EU member states maintain voluntary, confidential Memorandums of Understanding (MoUs) with major tobacco manufacturers. First established in 1999 between Philip Morris International and Italy, these bilateral pacts are designed to facilitate operational cooperation, such as sharing market intelligence and helping customs verify counterfeit machinery or cigarettes. However, the auditors have strongly criticised these agreements, warning that they risk compromising the strict independence required for national tracking systems. Because these MoUs are not publicly accessible and lack transparency, it is impossible to assess whether they comply with international guidelines on preventing industry interference. While the auditors emphasised that operational cooperation can offer practical benefits like technical training and counterfeit machine verification, severe conflict of interest risks remain under global health rules laid out in the FCTC protocol. “The interaction should be transparent, limited and also should comply with international standards … at [the] World Health Organization,” ECA task leader Esther Torrente Heras told the press briefing. Letting the industry control or influence traceability solutions directly violates the protocol, which strictly prohibits the delegation of supply chain control authority to tobacco firms. EU regulation lags shifting market While the European Commission proposed a crucial recast of the Tobacco Taxation Directive last year to modernise fiscal rules and curb the black market, progress has stalled within the divided council. Tax matters require unanimous agreement from all 27 Member States under a special legislative procedure. This legislative delay leaves raw tobacco – the primary input for illegal manufacturing – without unified EU-wide oversight. The absence of harmonised EU control rules means that cross-border movements cannot be effectively monitored or tracked because most member states only maintain national notification systems. Under current rules, bulk tobacco leaves can easily circulate across borders without standard EU customs tracking because they are not classified as manufactured tobacco products. Organised crime groups exploit these regulatory gaps to transport raw tobacco and advanced manufacturing machinery between jurisdictions with minimal detection risks. To close this loophole, the proposed reform would subject raw tobacco to the Excise Movement and Control System (EMCS), a real-time digital monitoring network requiring commercial traders to register shipments and report cross-border movements electronically (although raw tobacco growers performing only drying or curing would remain exempt). Stalled tax initiatives Also regarding minimum tobacco excise rates, the EU is currently experiencing a policy stalemate. This legislative deadlock prevents rates from acting as a public health deterrent or reducing market distortions. While the auditors recommend a comprehensive set of enforcement measures to ramp up the fight against illegal tobacco in the bloc, they fail to call for higher excise taxes on tobacco products. Indeed, the ECA’s special report states that high tax rates simply create a financial incentive for tax avoidance. Asked on this issue by Health Policy Watch, lead auditor Sarvamaa explained that the court lacked the empirical data to analyse how tax levels drive smuggling. “We do not have the grounds for starting to analyse how much the tax level is a factor in this problem,” he said. However, the WHO explicitly advocates higher excise taxes as an effective intervention to reduce tobacco consumption. According to the organisation’s technical manual on tobacco tax policy, high-tax nations with strong governance experience much lower smuggling rates than low-tax jurisdictions. Furthermore, a fully harmonised tax regime across the bloc would effectively eliminate the price differentials that drive cross-border tax arbitrage. Instead of keeping taxes low to prevent smuggling, the WHO found that the most effective way to eliminate black market sales is to strengthen tax administration and secure supply chains. Ball in Commission court The ball for stricter tobacco regulation now lies in the court of the EU Commission, the European auditors urge. To close these data and regulation gaps, the EU auditors asserted that the Commission must take a far more assertive, leading role in coordinating cross-border enforcement efforts. With the current framework deemed not robust enough, Brussels faces an immense workload to establish reliable, independent market size estimations by the recommended 2029 deadline. To successfully outmanoeuvre illicit trade, the bloc must transition from its current fragmented, state-by-state approach to a singular, binding policy framework. This requires dismantling national administrative silos and encouraging member states to prioritise strict international treaty compliance and transparency over domestic industry interests. “The criminals have a good strategy obviously, and I think that we need one too,” said Sarvamaa “Tackling the illegal tobacco trade is about much more than recovering lost tax revenue.” Only by closing these critical regulatory gaps can the European Union protect the public health of its citizens, and safeguard public finances. See related story: Europe is Failing to Curb Tobacco Use – Especially in Women Image Credits: Mark Stebnicki via Pexels, European Union, European Court of Auditors, pixabay, Paws and Prints via unsplash. US to Phase Out HIV Support for Namibia After Data-Sharing Impasse 08/09/2026 Kerry Cullinan End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023. The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package. The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday. Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people. It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98. Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative. However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme. Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR). However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes. Undermining PABS talks US demands for data and sharing of pathogen information have also been rejected by other African countries. Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups. World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks. As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system. However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system. Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper. More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
US to Phase Out HIV Support for Namibia After Data-Sharing Impasse 08/09/2026 Kerry Cullinan End of a 22-year partnership: Former PEPFAR head Dr John Nkengasong (third left) with Namibia’s former health minister Dr Kalumbi Shangula celebrating PEPFAR’s 20th Anniversary in 2023. The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package. The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday. Namibia already covers most of the costs of its antiretroviral treatment programme with its domestic budget, providing free treatment to around 220,000 people. It has surpassed the global HIV “90-90-90 targets” – 90% of citizens with HIV aware of their status, 90% of those with HIV on treatment, and 90% of those on treatment virally suppressed – achieving 96-98-98. Namibia has also almost eliminated mother-to-child HIV transmission, with 97% of babies born to mothers with HIV testing negative. However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme. Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR). However, the Trump administration is replacing PEPFAR and other health grants with new bilateral agreements in terms of its America First Global Health Strategy. These focus on countries’ ability to contain disease outbreaks as well as support for HIV and other key health programmes. Undermining PABS talks US demands for data and sharing of pathogen information have also been rejected by other African countries. Zimbabwe and Ghana have also rejected the US data- and pathogen-sharing demands, while the memorandums of understanding (MOUs) that the US has reached with Kenya and the Democratic Republic of Congo (DRC) both face legal challenges from civil society groups. World Health Organization (WHO) member states are currently in sensitive talks about how to share information about dangerous pathogens, and any medical products that arise from this sharing. The pathogen access and benefit-sharing (PABS) system is the last outstanding piece of the Pandemic Agreement. Namibia has played a central role in representing the African region at the talks. As the US withdrew from the WHO when Donald Trump became president in January 2025, it will not be included in the PABS system. However, the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system. Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper. More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
More Evidence of Link Between Smoking and Infertility 08/09/2026 Kerry Cullinan Women who smoke are at higher risk of infertility. The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility. Impact on men While it is harder to quantify the effect of smoking on men’s fertility, a recent review of 44 studies involving over 60,000 men found that smoking was associated with “an increase in reproductive dysfunction”. Across different populations, more men who smoked had erectile dysfunction and ejaculation problems than those who did not, the report notes. The review also found that smoking may increase the risk of azoospermia (no sperm in semen), asthenozoospermia (poor sperm motility) and teratozoospermia (abnormal sperm shape). E-cigarettes and hookahs There is growing evidence of the impact of e-cigarettes on infertility. A study of over 4,500 women in the United States found that ever use of e-cigarettes was associated with a 20% reduction in fecundability. Two studies that included women who smoked cigarettes or waterpipes (hookahs or shisha) found a similar increased risk of infertility, but no studies specifically address waterpipe use only. Some studies have found that waterpipe smoking may be associated with lower sperm quality, such as less semen volume, lower sperm motility and fewer sperm with a normal shape. A recent study confirmed that hookah smoking may reduce sperm volume, but did not affect motility, so the WHO has recommended more research “to determine the effects of waterpipe smoking on sperm parameters in men”. Impact on infertility treatment Smoking may reduce the success of infertility treatments, but there is “some inconsistency across the studies”, according to the report. Research from 21 studies showed that cigarette smoking was linked to fewer live births and fewer pregnancies, “which indicate that the chances of successful treatment outcomes may be halved by cigarette smoking”, said the report. However, “a more recent, albeit smaller, study involving about 300 women showed no differences in fertilisation or pregnancy rates between women who did and did not smoke cigarettes or between women who did or did not use e-cigarettes and/or waterpipes”. The first report of a link between smoking and infertility was published in 1979 by the US Surgeon General, who reported that women who smoked were more likely to be infertile and experience abnormal menstruation and concluded that smoking may impair fertility. Image Credits: Zaya Odeesho/ Unsplash. Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
Sexual and Reproductive Health is ‘On the Frontline’ of Anti-Science Attacks 07/09/2026 Kerry Cullinan Dankay Kanu (right) was only 13 when she had her son. Sexual and reproductive health services worldwide are under pressure from conservatives. The defenders of sexual and reproductive health and rights are on the frontline of the “heightened hostility to science, fact, and truth, directly facing the anti-science toxic tangles of racism, sexism, and homophobia,” asserted Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. HRP is the United Nations instrument that conducts research in human reproduction and is hosted by the World Health Organization (WHO). Powerful leaders seek to “suppress independent research, cancel academic freedom, and deny scientific evidence” – and are “slashing funding to restrict scientific benefit to the elite”, said Gilmore, addressing a webinar at the start of sexual and reproductive health month, which is held every September. Kate Gilmore, co-chair of the Human Reproduction Programme’s (HRP) Gender and Rights Advisory Panel. “Information platforms, knowledge production and exchange once intended to facilitate open and inclusive exchange of evidence and solutions, are today intentionally distorted for profit, for gain, deliberately designed to give free rein to misinformation and myth-information,” added Gilmore, former UN deputy high commissioner for human rights. “As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore added. HIV and contraception Lianne Gonsalves, a WHO scientist working on sexual health, reminded the webinar of two important trials that had advanced SRH knowledge. The first compared three different contraceptives – the Depo-Provera intramuscular injection, a copper intrauterine (IUD) device, and the levonorgestrel hormonal implant – to test whether any heightened HIV infection. The ECHO trial, conducted at 12 sites in four African countries over three years, found that there was “no statistically significant difference in HIV acquisition risk between the three methods”, said Gonsalves. After the results were published by The Lancet in 2019, the WHO updated its guidelines. “This is a really good example of seeing where there’s an evidence gap that may be prohibiting users from accessing methods that might be a good fit, having the funding and the collaborators available to design a rigorous, robust study and then carry it out,” she said. “And then being able to channel that evidence immediately into impact, into guidelines that countries can then adopt to give access to more [contraceptive] methods to more women.” Progress on gender-based violence The second example involves gender-based violence (GBV). The global statistic that one in three women globally are going to experience physical and/or sexual violence during their lifetime comes from WHO’s landmark 2013 global and regional estimates on violence against women, produced in collaboration with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council. “In 2013, when these estimates first came up, they were launched alongside WHO’s clinical and policy guidelines on intimate partner violence and sexual violence,” said Gonsalves. The estimates ensured that GBV was “recognised as a major public health issue”, resulting in country-based action. “From 80 countries participating in the original estimates, we now have data on GBV from 168 countries [2023], and we’re seeing countries take meaningful efforts”. “As of 2026, just over half of countries have clinical guidelines and protocols. 42% of countries include budgets for the health response and violence against women.” Including pregnant women WHO scientist Mariana Widmer provided a dramatic example of a study that improved outcomes for babies born to women living with HIV, The 2011 WHO-led Kesho Bora study, conducted in Burkina Faso, Kenya, and South Africa, found that women living with HIV who started antiretroviral treatment while pregnant reduced HIV transmission to their babies by 43% and more than halved transmission during breastfeeding. Widmer, who co-leads WHO’s efforts to ensure that pregnant and breastfeeding women are included in clinical research, contrasted these “striking results” with the exclusion of pregnant women from studies during COVID-19. “Pregnant women during COVID-19 were largely excluded from the initial clinical trials, although we knew already that they were at increased risk of severe COVID-19 complications,” said Widmer. She added that pregnant women “need medicines just like everyone else”, but that their bodies go through important changes during pregnancy, and the kidneys and liver can process medicines differently. The WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical trials. Restrictive laws prevent access But scientific evidence often does not reach those who need it most, warned Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s (IPPF) Arab World Regional Office. “In many contexts, especially in my region, restrictive laws and policies directly prevent people from accessing care,” said Makso, who also founded Proud Lebanon. “They also reinforce stigma, discrimination, and the fear of being reported, exposed, or even criminalised. HIV and Mpox are clear examples,” he added. “Many people still avoid services because they fear judgement, breaches of confidentiality, or legal consequences…. People are not hard to reach. Too often, our laws, policies, and health systems make services difficult or unsafe to reach.” From evidence to implementation Dr Njeri Nyamu, a health service provider in Kenya, warned that “it takes time for new evidence to actually become practice”. She gave the example of the hormonal IUD, which was introduced in 2011 in Kenya’s private sector, but only made its way to the government sector 11 years later in 2022. “Service delivery challenges are now plaguing the hormonal IUD intervention, and this is driven primarily by misconceptions, and we think also a lot of provider bias, either due to a lack of proper understanding or training on the hormonal IUD and how it’s administered,” said Nyamu. “Countries need to really reflect on what it actually takes [to introduce scientific innovations] in practice,” said Nyamu. “Whether it’s support supervision, looking at performance data, and ensuring that providers are well capacitated.” Image Credits: Michael Duff/ UNFPA. As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
As Fires Increase, It Will Be Harder to Meet WHO Clean Air Standards 07/09/2026 Disha Shetty Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change. WHO has stressed the importance of complementary and coordinated policies on air quality and climate because they cannot be dealt with in isolation. It has also called for improved monitoring of air pollutants such as fine particulate matter and ground-level ozone, as well as aerosols like black carbon and microplastics. The annual Air Quality and Climate Bulletin, released on Monday, finds that air pollutants like aerosols, particulate matter and surface ozone are not well monitored, despite the harm they can cause to ecosystems. The bulletin, released on the International Day of Clean Air, is based on data and information from WMO’s worldwide tracking system, the Global Atmosphere Watch network. PM2.5 above-average in India, Canada but below-average in China In 2025, PM2.5 concentrations were above the long-term average in northern Canada, part of Russia and western-central Africa due to increased fire activity. Northwestern Spain was also a hot spot because of exceptional fires in late summer 2025. PM2.5 is composed of microscopic particles and droplets of less than 2.5 micrometres (μm) in diameter, and can penetrate deep into the lungs and bloodstream. Industrial activity, agriculture, residential heating and transport, as well as wildfires and dust storms are major PM2.5 sources. In South America’s Amazonia, burning was lower in 2025 than in previous years, contributing to the reduction in levels there. PM2.5 levels continued to be below the long-term average in China in 2025, reflecting a decline in emissions from human activities. India, though, continues to have above average levels because of biomass burning and other pollution. Wildfires, heatwaves, and ozone increase air pollution Extreme wildfires are increasing, with serious health consequences because of the high toxicity of smoke. Even as regulations in Europe and North America have reduced industrial and transport PM2.5 emissions, exposure to fire-related PM2.5 has increased due to the wildfires there. Ground-level ozone pollution that affects human health, agriculture and ecosystems is a growing problem because of heatwaves. high temperatures, stagnant atmospheric conditions and intense solar radiation together promote ground-level ozone formation. Long-term exposure to ozone pollution is associated with increased mortality, primarily through respiratory diseases. “Looking forward, ozone-related health risks are expected to intensify,” the bulletin said. Aerosols travel across continents and worsen air pollution Air pollution in New Delhi in early November 2025. Aerosol particles, tiny solid or liquid particles in the air, can travel far from their sources, across oceans and continents. They can also alter the way the atmosphere reflects sunlight and change the chemical properties of land and water bodies, polluting otherwise clean environments. One example is the deposition of black carbon (soot) on snow and ice, which reduces the amount of sunlight reflected by these surfaces, and can hasten the melting process. Black carbon is a huge problem in the Himalayan region, which has increased the melting of glaciers, leading to disastrous consequences in the region. Also read: Nepal’s Flood: Chilling Example of Climate Devastation Facing Developing Countries Another example is microplastics, formed when plastics break down due to sunlight and other factors. “As plastic production and, critically, mismanaged plastic waste continues to increase, monitoring atmospheric pathways of deposition of microplastics to remote environments will be crucial towards understanding their overall impacts on the Earth system,” says the bulletin. Image Credits: WMO, Unsplash/Matt Palmer, The Week. The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
The World Has Better HIV Tools Than Ever. So Why Is Ending AIDS Getting Harder? 05/09/2026 Health Policy Watch Magda Robalo and Marina Vergueiro “We have better tools now. We can, if we work together and work better, we can conquer AIDS.” For Dr. Magda Robalo, a public health physician and former Minister of Health of Guinea-Bissau, the science behind the HIV response has advanced dramatically, but the social and political environment surrounding the disease may be moving in the opposite direction. Speaking on the latest episode of Global Health Matters, Robalo joined Brazilian activist, filmmaker and poet Marina Vergueiro to reflect on four decades of HIV and AIDS, and on the barriers that remain as the global health community considers what it will take to finally end the epidemic. Vergueiro, who has lived with HIV since 2012, described how treatment has transformed her own life. When she was first diagnosed, she took five pills, including one that required refrigeration. Today, she takes just one. But she warned that medical progress has not been matched by equivalent progress in reducing stigma. “I feel like the more we advance on science and technology for HIV treatment and prevention, the more we go back in time regarding stigma,” Vergueiro said. She also argued that mental health must become a much more central part of HIV care, particularly because depression, shame and isolation can affect whether people seek testing or remain on treatment. “If we don’t look for the mental health crisis together in the same perspective as HIV and AIDS, if we don’t put them together, we are not going to go anywhere,” she said. Robalo similarly called for a more people-centered approach, arguing that health systems must look beyond HIV itself as people living with the virus age and face other health conditions. At the same time, she warned that funding cuts, punitive laws, gender inequality and shifting political priorities could undermine decades of progress. “We had this dream of ending AIDS by 2030, but at the pace we are going, and of course, with other complex issues around the ecosystem, funding, etc., it is becoming more difficult, even though technology is on our side,” Robalo said. For both speakers, finishing the job will require not only better medicines, but renewed political commitment, stronger health systems and a response that treats people living with HIV as whole human beings. Watch the full episode: Watch or listen to more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts
Why Disease Elimination Demands More Than Control 05/09/2026 Health Policy Watch Dr Jamal Ahmed and Dr Stephen Vreden “When you aim to deliver zero, and that is the goal of eradication, what it means is every person, every community, every village is equally important.” That is how Dr. Jamal Ahmed, WHO Director for Polio Eradication, explains why eliminating a disease requires a fundamentally different level of ambition than simply controlling it. Speaking on the latest episode of Global Health Matters, Ahmed joined Dr. Stephen Vreden, Chair of Suriname’s Committee for Prevention of Reestablishment of Malaria, to discuss what it takes to drive a disease burden to zero and how countries can prevent it from returning once elimination has been achieved. Suriname offers one of global health’s more striking recent examples. At the beginning of this century, the country had the highest malaria burden in the Americas. In June 2025, WHO certified it malaria-free, making it the first country in the Amazon region to reach that milestone. Vreden said one decisive change came when Suriname stopped thinking only about malaria control and explicitly made elimination the goal. The country also created a network of people within remote gold-mining communities who were trained to diagnose and treat malaria and distribute insecticide-treated bed nets. “I can easily say that without this network, Suriname would have never been able to eliminate malaria, because these people, they diagnose and treat malaria in places where you are not,” Vreden said. Ahmed said the same principle applies to polio eradication, where community leaders, religious figures, grandparents and local influencers remain critical to reaching children in areas affected by insecurity, migration and mistrust. But both experts warned that reaching zero does not mean the work is finished. “Reaching elimination, being certified for malaria, it certainly doesn’t mean that you can sit back and relax, because you need to prevent reintroduction,” Vreden said. For Ahmed, the remaining fight against polio likewise depends on sustained political commitment, surveillance, rapid response and global solidarity. “Zero doesn’t mean zero locally; it means zero globally, everywhere, across the whole world,” he said. Watch the full episode: Watch and read about more episodes on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Posts navigation Older posts