Millions of people are facing physical, emotional and financial toll of cancer, finds latest WHO report.

By 2050 there will be 35 million cancer cases annually – a 66.7% increase in incidence from 2024.

That is, unless urgent action is taken to improve prevention and access to early diagnosis and treatment, according to a report released Wednesday by the World Health Organization (WHO).

Currently, cancer kills 26,000 people daily and is the second leading cause of death after cardiovascular disease. Fewer than one in three countries include cancer care in their universal health coverage (UHC) packages.

Presently, there are an estimated 20.6 million new cases and close to 10 million deaths annually.

A silver lining is that key policy interventions have led to a 27% decline in tobacco use worldwide since 2010, contributing to reductions in lung cancer cases and deaths in some regions.

But other key preventive measures, including obesity, infections and obsessive alcohol consumption need more assertive action – along with even more progress on tobacco.:

These are the takeaways of the Global Status Report on Cancer 2026 jointly developed with the International Agency for Research on Cancer (IARC).

“Cancer is a deeply personal disease that touches nearly all of us. But whether a person survives cancer should never depend on where they were born or what they earn,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

Cancer remains a global health priority.

According to the report, based on data from 2024, “the leading contributors to cancer cases globally were tobacco use, infections, alcohol consumption, and high body-mass index (BMI) accounting for 15%, 10%, 3% and 2% of all new cancer cases, respectively.”

The report also highlights persistent inequities in access to timely cancer diagnosis and treatment.  While 87% of women with breast cancer survive five years after their diagnosis in high-income countries, only about 42% do so in low-income countries, the report finds.

In terms of infections, human papillomavirus (HPV) is a leading cause of cervical cancer – another leading killer of women in low-income countries who lack access to regular cervical cancer screenings. While HPV vaccine uptake has increased, there are still wide gaps in coverage especially in large parts of Africa, the Middle-East and Asia.

“The inequities documented in this report are not inevitable; they are the consequence of choices, and they can be reversed through stronger and unified action,” Tedros said.

The report is the first comprehensive analysis of the global status of cancer prevention and control, projections of future trends – and progress made since 2010, the baseline year chosen for the analysis.

Along with the progress seen on tobacco, alcohol consumption has fallen, but only marginally, and screenings for breast as well as cervical cancer have improved in both high and low-income countries.

Asia, Europe have large cancer burden

Global incidence of cancer by continent in 2024.

In 2024, Asia accounted for the largest share of cancer cases, with more than half of all cancer cases (50.7%) and deaths (56.5%), reflecting its large population. 


Europe too carried a disproportionately high burden, contributing 21% of global cases and 20% of deaths despite having only about 9% of the world’s population. In contrast, many countries in Africa and parts of Asia experience lower incidence but disproportionately high mortality. 

Nearly four in ten cancer cases globally are linked to preventable risk factors, particularly infections such as human papillomavirus (HPV), hepatitis B and C, and helicobacter pylori, alcohol, tobacco use, high body mass index and insufficient physical activity, highlighting the critical role of prevention. 

Not all preventable risk factors are receiving enough attention, experts noted.

“For obesity, for example, a lot of the prevention strategies that exist today have been implemented or taken in high-income countries, mainly, while in the low and middle-income countries, we see the take-up of these programmes are then much less,” Dr Isabelle Soerjomataram, Deputy Head of the IARC Cancer Surveillance Unit said, speaking at a press conference to launch the report.

Gendered impact of the disease

While lung cancer is the most common form of cancer in men, it is breast cancer in women.

Among the different types of cancer, lung cancer remains the leading cause of cancer death globally.

Overall, lung, prostate and colorectal cancers are among the most common cancers in men, while breast, lung and colorectal cancers account for a substantial share of the burden among women. 

Cancer still carries stigma, especially for women.

“After my own double mastectomy, I struggled with body image, but I knew that that surgery had given me the best chance at life. Yet I met four women who chose to die rather than lose a breast to breast cancer. That is the devastating power of stigma,” said Abigail Simon-Hart, a breast cancer survivor and patient advocate.

Experts drew attention to the impact on men as well. “There’s also the very real impact of cancer on men, and that age-standardized incidence rates for cancer in men is higher, and many men are also being left behind,” said Dr Andre Ilbawi, Team Lead for Cancer Control, WHO.

Major gains but gaps persist 

Patients listen as a staff nurse explains the screening process before they register to be screened for breast and cervical cancer at the RAiSE Foundation center in Niger State on 23 February 2021.

The report notes substantial gains in key policy areas. Apart from the decline in tobacco use contributing to the reduction in lung cancer cases and deaths in some regions, infection-related cancers are also decreasing thanks. This is due to the expanding vaccination coverage and improved water, sanitation and hygiene (WASH) as well as infection prevention and control.

Around 82% of countries now have national cancer control plans, up from 50% in 2010.

In high-income countries, early detection programmes catch most breast cancers and 74% of women have been screened for cervical cancer.

Scientific innovation is accelerating; registered clinical trials have increased at an annual rate of 7.3% between 2005 and 2021.

But essential cancer medicines remain out of reach for many. Availability of the top 20 priority cancer medicines ranges from just 9% to 54% in low- and lower-middle-income countries, compared with 68% to 94% in high-income countries. And the consequences of these gaps are felt most acutely by people living with cancer and their families.

Toll on caregivers, community

Dr Andre Ilbawi, Team Lead for Cancer Control, WHO

Cancer care remains financially and socially devastating for many households.

At least 45% experience financial hardship, more than half report mental health challenges, and nearly all caregivers report strain including unpaid services and social isolation, the WHO’s first-ever survey of people affected by cancer found that covered 4,000 people across 116 countries.

“To succeed against cancer, we must continue to focus on technological innovation, and we must also create the conditions that empower and care for people more holistically,” Ilbawi said.

Image Credits: WHO/Yasin Abdullahi, Unsplash/National Cancer Institute, Global status report on cancer 2026, Etinosa Yvonne/WHO.

Hadiza Barwa, a Community Health Extension Worker trained under the TSTS project, checks on the progress of a pregnancy in Gwale Primary Healthcare Centre in a suburb of Kano, Nigeria.

A Task Shifting/Task Sharing investment in Kano State in Nigeria is empowering community health workers and improving maternal and newborn outcomes

KANO, Nigeria – It is antenatal day at Gwale Primary Health Care Centre (PHC) in the suburbs of Kano, the capital of the state by the same name and the second biggest city in Nigeria.

Hadiza Barwa, a Community Health Extension Worker (CHEW), is in a small consulting room with Saádatu Ado, who is pregnant with her fourth child. The blood pressure check has been done in another room.

Now it is Barwa’s turn. She palpates the abdomen carefully, measures with tape, and looks up. “The foetal heartbeat is normal,” she says. “The pregnancy is measuring around 28 weeks.”

Ado smiles. Barwa smiles back. Then comes a quiet one-on-one covering nutrition, hygiene, what to watch for, and when to come back.

“I did my previous three antenatal visits at a hospital far away from this community,” Ado says as she walks out of the room. “The attitude of health workers here has improved tremendously. That is why most of us, the pregnant women in this community, are now accessing antenatal care and delivering in this facility.” 

She is looking forward to delivering her fourth child here – at a PHC not too far away from her front door.

Addressing health worker shortages

Ado is one of hundreds of pregnant and breastfeeding women who have shifted to Gwale PHC in recent months. The shift is not accidental.

Nigeria’s doctor-to-population ratio stands at 2.9 per 10,000 people. Its nurse-and-midwife ratio is 1.6 per 1,000. Most of those higher cadre health workers are concentrated in secondary and tertiary facilities in cities. 

For a pregnant woman in a rural or semi-urban community, the nearest qualified clinician can be hours away, which is precisely where the risk accumulates. 

Kano State, the second most populous state in Nigeria, has some of the highest maternal mortality rates in the country. In certain Local Government Areas (LGAs) within the state, the figure exceeds 1,000 deaths per 100,000 live births.

Against this backdrop, Nigeria enacted a national Task-Shifting, Task-Sharing (TSTS) policy in 2014, formally expanding what CHEWs are permitted to do. 

The policy has existed for more than a decade. However, making it work at the facility level is a different matter. That is the problem the TSTS investment set out to solve. 

Implemented by Impact Catalysts and Pathfinder International Nigeria, in collaboration with the Kano State Primary Health Care Management Board (KNSPHCMB) and with support from the Gates Foundation, the investment has been running since November 2024 across 145 primary health care facilities in 26 LGAs in Kano State. 

Its aim is straightforward: train and mentor CHEWs to safely provide selected maternal and newborn health services that previously depended on the availability of nurses or midwives.

Complete package of pregnancy care

Hafsat Yahaya has worked at Jaen PHC for 18 years. For most of that time, she was an environmental health assistant, important work, but a long way from the consulting room and further still from the labour ward. 

She believed she could do more,  so she enrolled in a School of Health Technology, qualified as a CHEW five years ago, and has been providing care to her community ever since.

When the TSTS investment arrived at Jaen PHC, Yahaya was nominated by her colleagues to receive the clinical training. 

The training, which ran for more than a week, covered Basic Emergency, Maternal, Obstetric and Newborn Care (BEmONC). This included the prevention, detection and management of postpartum haemorrhage using the E-MOTIVE bundle, management of pre-eclampsia, infant resuscitation, the use of a partograph to monitor the progress of labour, comprehensive antenatal assessment and counselling, postpartum contraception and neonatal vaccination.

It was, in the words of one implementation staff member, a complete package, from the first antenatal visit to postnatal care.

Hafsat Yahaya (right) helped deliver Hassana Umar’s six-week-old daughter in Jaen Primary Healthcare Centre.

Yahaya’s first real test came quickly. A woman was brought to the facility convulsing after delivering at home. Yahaya recognised the signs of eclampsia. On a normal day, Yusif Adamu, the facility in-charge, says, they would have referred the woman immediately to a higher facility. There was every chance she would not have made it. 

“Hafsat stabilised the woman by administering magnesium sulfate before we referred her,” Adamu says. “Since then, she has been a star in this community. People believe she has special skills, and that has attracted many more pregnant women within the community to deliver at this facility”

Yahaya now has a permanent post in the labour room at Jaen PHC. She has delivered many babies. She has prevented and managed postpartum haemorrhage and stabilised women with pre-eclampsia. She has also been running step-down training sessions for her fellow CHEWs at the facility, passing on what she has learned, multiplying the effect of the investment.

It is immunisation day at Jaen PHC, and Yahaya is holding a six-week-old baby. The infant’s mother, Hassana Umar, brought her daughter for vaccination and came to see Yahaya specifically so she could see the child she helped deliver.

 “Hafsat held me throughout the labour until I delivered,” Umar says. “She encouraged me and supported me to walk around the labour room. When I brought my baby for vaccination today, I had to bring her here. I wanted Hafsat to see her.”

Skills and supplies 

The investment does not stop at training. A CHEW who knows how to manage postpartum haemorrhage but has no uterotonics on the shelf is in an impossible position. 

Impact Catalysts and Pathfinder International Nigeria have been working with the KNSPHCMB to ensure that the medications and equipment that CHEWs are now trained to use are available in the facilities where they work.

That list includes magnesium sulfate for eclampsia, the E-MOTIVE bundle for postpartum haemorrhage prevention and management, chlorhexidine gel for cord care in newborns, and manual vacuum aspiration (MVA) kits. For a CHEW at a rural PHC, each item on that list represents a situation that used to end in a referral, and all the uncertainty that came with it.

Safiya Ibrahim is a CHEW at Dawakiji PHC. She has been through the TSTS training and is now under ongoing mentorship. 

“There is nothing as painful as not being able to help a pregnant woman or newborn in distress,” she says. “I have been in situations here where we had to refer women, and we would not know what became of them on the way to a higher facility. I would go home thinking about whether they made it or not.”

That is no longer her reality. Ibrahim has delivered babies, managed PPH, handled retained placenta, and resuscitated newborns. 

She recalls a non-responsive newborn brought to the facility after being delivered at home. Working with her colleagues, she resuscitated the infant. 

She recalls a woman with a retained placenta; she applied the uterine massage and controlled cord traction techniques she had practised in training, the placenta came away, and the bleeding was controlled. 

“We now know how to monitor the progress of labour using a partograph,” she says. “We know how to prevent and manage complications. We know when to refer.” 

There have been no maternal or neonatal deaths at Dawakiji PHC since August 2025, when Ibrahim underwent the training and returned to provide services at the facility.

Mentorship is what makes it stick

Community health extension worker Hafsat Yahaya with Yusif Adamu, who is in charge of Jaen Primary Healthcare Centre.

The training is the foundation. The mentorship is what makes it stick. The TSTS investment engaged 26 senior nurses and midwives, each with decades of clinical experience, to serve as mentors across the 26 LGAs where it operates. 

Each mentor is assigned to one LGA and rotates through the facilities in their area, observing CHEWs at work, assessing their skills, and providing continuous hands-on coaching.

This is a different model from a one-off training followed by a certificate and a return to the status quo. It is designed to build competency over time, to catch mistakes before they become harmful, and to give CHEWs the kind of structured support they need to use new skills safely. The mentors are not supervisors in the traditional sense. They are clinical teachers, showing up at the facility and working alongside the health workers they are developing.

What comes next?

As the investment approaches the end of its implementation period, the question of what comes next is unavoidable. The 145 facilities, the 26 mentors, the medications and equipment, the step-down training sessions have been running on the investment support. What happens when that support ends?

Prof Salisu Ahmad Ibrahim, the executive secretary of KNSPHCMB, is direct about what the Kano State government is taking on: “The improvement we have seen is across board, from documentation to the management of haemorrhage and eclampsia, to referral. It is a testament that the investment has succeeded,” he says. “Even after it rounds up, the state government will take it over and sustain it.”

He offers specifics. From 2027, the state will make budgetary provisions for TSTS implementation and sustainability. As Impact Catalysts and Pathfinder International Nigeria prepare to exit, the Board is planning to wholly take up the initiative. Already, the Board proposes recruiting 18 additional mentors, bringing the total to 44, one for each LGA in the state. These are meaningful commitments. They are also exactly what an investment like this depends on if the gains it has made are not to evaporate the moment the funding cycle ends.

Back at Gwale PHC, Saádatu Ado is preparing to leave. Her blood pressure is good. The baby is in the right position. She will be back in four weeks. 

Three previous pregnancies, three long trips to a hospital that felt far from everything. This one is different. She has been coming here from the beginning, seen by Barwa, whose hands she now trusts. 

She will deliver here, in the community where she lives, attended by a health worker who was trained and mentored and equipped to do exactly this.

That is not a small thing. In Kano State, where the road between a PHC and a hospital can be the difference between a woman surviving childbirth and not, it is the whole thing.

 

Image Credits: Bashar Abubakar/ Impact Catalysts.

The Global Fund has helped to save more than 70 million lives suffering from AIDS, tuberculosis and malaria across the globe.
The Global Fund has helped to save more than 70 million lives suffering from AIDS, tuberculosis and malaria across the globe.

The election of the new executive director for the Global Fund to Fight AIDS, Tuberculosis and Malaria will move forward on schedule, according to a statement released by the organisation on Tuesday, 7 July. This announcement follows rumours that the nomination process might be restarted after the names of several US candidates who were reportedly shortlisted had been disclosed to Health Policy Watch

The roster reportedly omitted a German-backed applicant, sparking frustration in European countries, particularly in Germany, a major donor to the Global Fund.  See related story.

EXCLUSIVE: US Candidates Among Those Shortlisted in Contentious Global Fund Leadership Race

Also on Tuesday, the Trump administration confirmed that it will not impose its expanded global gag rule or other funding conditions on its contributions to the Global Fund, according to a Devex report. The expanded rule, adopted by President Donald Trump last year, restricts the use of US funding not only for abortions but to global health programmes that promote diversity, equity and inclusion – language that hits at the very DNA of most global health initiatives.

Calls for more transparency

Because the multibillion-dollar agency relies heavily on taxpayer contributions to procure lifesaving medicines, some critics have maintained that the Global Fund leadership race should be conducted in a more transparent manner.

Defending its restrictive protocols, the Global Fund statement contended that absolute confidentiality is essential to protect the privacy of high-profile applicants and safeguard the integrity of the proceedings by the Executive Director Nominating Committee (EDNC).

“The Global Fund remains committed to a merit-based, transparent and well-governed selection process that protects the confidentiality of candidates while enabling the Board to identify the strongest possible leader for the organization,” the statement said.

“The names and biographies of the final shortlisted candidates will be published on the Global Fund website once it has been submitted to the Board. Until that stage, candidate information and committee deliberations will remain confidential to protect the integrity of the process, ensure fairness to all candidates and support open deliberations by the EDNC. Other than the final candidates, all other candidate names remain confidential indefinitely,” the statement added.  A final shortlist of “four to five candidates” should be submitted to the Board in late September, the statement added.

The strict confidentiality rules stem from a costly historical precedent, supporters of the process say.  During the 2017 leadership transition, the institution was forced to completely restart its executive director search after leaks to the media.

Nomination schedule on track

As the Global Fund grapples with a massive $5.36 billion funding shortfall for the next grant cycle, the selection procedure unfolds against a highly challenging financial and geopolitical backdrop.

Moving forward, successive rounds of confidential interviews and due diligence assessments are narrowing the applicant pool behind closed doors.

First-round interviews will take place next week, from 12 to 23 July in London, followed by second-round interviews in early September to finalise the shortlist. The finalists will attend a retreat on 1 and 2 October, followed by several weeks of “engagement with Board constituencies” before the Board convenes to make a final decision.

Final appointment of the incoming executive director will then occur during the 56th board meeting in Geneva from 28 to 30 October 2026.

Assuming office during the first quarter of 2027, the newly elected Executive Director must immediately navigate a fractured donor landscape and geopolitical rifts to continue the vital work of the organisation.

New Funding Models Needed as Global Health Faces Growing Financial Strain

Image Credits: European Union.

Delhi’s chief minister, Rekha Gupta (centre) at the announcement of the new EV policy late last month.

After years of stonewalling, the city is finally acknowledging the public health risks of air pollution – launching a major initiative to clean up emissions from the capital’s 10 million vehicles, along with stricter curbs on waste, construction and traffic during winter-time pollution peaks. The most radical measures include: banning new fossil fuel–powered 2 & 3-wheelers and small trucks and ending support for hybrid cars while offering heavy subsidies for “pure” electric vehicles only. Can the measures finally trigger real change?

NEW DELHI – Air pollution has made the headlines in Delhi unusually for the city’s summer season when levels are typically low. The government has announced a series of new policies worth approximately $2.5 billion to improve the quality of air in the world’s most polluted capital. 

There are three major new initiatives. These include a new $1.5 billion Delhi EV policy on July 1; a $1 billion plan to replace old, polluting trucks and buses in Delhi and its suburbs; and mandatory curbs on transport into Delhi, staggered office timings, 50% work-from-home mandate, and other measures between November 1 and February 28, which is the region’s peak pollution season. 

While policy action is centred on Delhi, potentially any other state or city in India – where two-thirds of the world’s 100 most polluted places are located – could use this as a template for adopting similar emissions curbs.  A common thread across the measures is the unequivocal acknowledgement by the government of the link between fossil fuel emissions, air pollution and health. As Rekha Gupta, Delhi’s Chief Minister, said in a social media post, “We want the policy to, step-by-step, help convert Delhi into a pollution-free city.”

EV policy: What’s in, what’s out

Delhi’s EV Policy 2.0 bans new fossil fuel three-wheelers and small trucks, which are the backbone of last-mile delivery of goods, from January 1, 2027. And then, from April 2028, no new fossil fuel two-wheelers will be allowed. Only electric. Two-thirds of Delhi’s 8.7 million vehicles are two wheelers. In terms of the car fleet, meanwhile, financial incentives for hybrid gasoline and electric vehicles also are being terminated.

But there’s a carrot along with the stick.  A series of new subsidies for electric two- and three-wheelers, as well as other types of light goods electric vehicles has been established. 

Subsidies for the purchase of electric cars are also being maintained and even increased, ranging from about $1,000 to 10,000 per vehicle, depending on vehicle type and tapering off over time. 

Delhi’s new EV policy will also include a 100% exemption on road tax and registration fees for electric cars priced up to ₹30 lakh (about $30,000). And vehicle owners who scrap older, more polluting cars and trucks will receive financial incentives of up to $50. 

Electric vehicle being charged in Delhi.

For the light vehicle and car fleet, the focus going forward will be on “pure EVs” as one official put it. 

The government says the policy will cost about $1.5 billion, including subsidies and other tax breaks as well as the cost of new EV infrastructure. At the moment, there is no plan to actually ban conventional gasoline or diesel-powered cars, Gupta has stressed. Rather, the government’s focus will be on incentivizing EVs through the subsidies and tax relief.  

Over time, however, the government may introduce further electrification mandates for different elements of the vehicle fleet, as well as developing a framework to “discourage” the registration of polluting vehicles running on “inefficient fuels”.

Government acknowledges vehicle pollution’s contribution to health risks

Colorfully decorated Delhi freight truck belies its heavy pollution emissions load.

The new policy aims to achieve at least 30% electrification of Delhi’s vehicles by 2030.

This followed a frankl government acknowledgement in June that  air pollution in Delhi-National Capital Region (NCR) remains a “severe public health challenge” particularly during winter months. 

Transport is the single largest pollution source within the city. And vehicular emissions contribute around 23% of Delhi’s PM2.5 during the peak winter months of smog. 

Two-wheelers, which represent  two-thirds of Delhi’s vehicle fleet, contribute to about one third of vehicle emissions of  PM2.5 (a fine pollutant) that penetrate the lungs and into the blood stream and are thus the most health harmful, according to an IIT Kanpur study. This is even more than the emissions from three-wheelers.

Phase out of most polluting diesel trucks

Ministry of Road and Transport official, Mahmood Ahmed, hosts launch of the report ‘Towards Cleaner Freight in Delhi’.

A few weeks before  Delhi’s EV policy announcements, the central government also announced an INR 9,585 crore (almost $1 billion) scheme to replace 200,000 older, and highly-polluting diesel trucks over the next two years in the Delhi region, although it exempted government vehicles. 

The key in this policy is replacing vehicles that fail to meet the newest Indian government emission standard of Bharat Stage 6, equivalent to a Euro 6. 

While electrification of Delhi’s bus fleet is already advancing apace, the Delhi policy stops short of mandating a switch to zero emission heavy duty freight vehicles. 

But a brand-new report on truck pollution in the Delhi region by three prestigious think tanks calls for moving in that direction.

The report, ‘Towards Cleaner Freight in Delhi’ calls for 100% of freight trucks to be electrified by 2035. The report  was produced by the Air Pollution Action Group (APAG),  Indian Institute of Technology Delhi (IIT Delhi), and The Energy and Resources Institute (TERI). The report was publicly launched last month by a senior Ministry of Road and Transport official,  Mahmood Ahmed – reflecting the attention the recommendations are getting in government circles. 

Heavy duty vehicles contribute disproportionately to air pollution

Proportion of vehicle emissions by type of vehicle show heavy duty vehicles (trucks) have an outsized influence.

Delhi’s proposed EV measures are among the most ambitious state-level initiatives to improve air quality by accelerating the transition to zero-emission vehicles (ZEVs), Amit Bhatt, India Managing Director of the International Council on Clean Transportation told Health Policy Watch. 

Electrification of the truck fleet, however, remains a significant gap that still needs to be addressed by the Indian government, he said. 

Heavy-duty vehicles contribute far disproportionately to harmful air pollutants despite being a small share of the vehicle fleet, Bhatt pointed out. In Delhi, trucks contribute nearly a quarter of vehicle pollution emissions throughout the day, but 75% at night. 

At a national level, while medium-and heavy-duty vehicles account for only 3% of the total vehicle stock, they contribute up to 53% of particulate matter emissions from transport nationwide.

 “These measures can significantly reduce emissions from the transport sector and set an important precedent for other states,” Bhatt said. “But Delhi alone cannot eliminate its air pollution; it needs a regional approach. 

As part of that,  freight emissions is “critical,” Bhatt added, saying that the ICCT which works with the government, supports a coordinated regional strategy, including accelerated electrification of interstate freight trucking asl be essential to deliver sustained improvements in air quality across Delhi and the wider region.

Government pledges tougher enforcement of emissions standards on older vehicles 

Older vehicles in Delhi tend to be much more highly polluting, contributing more than a third to ambient air pollution levels.

Another looming challenge remains the enforcement of pollution control standards on fuel-powered vehicles that remain on the roads. Every fuel-powered vehicle on the road must obtain a Pollution Under Control Certificate (PUCC). 

Currently,  the system is plagued with problems -including lax monitoring, and related to that,  allegations of corruption, as well as a lack of more advanced monitoring of key pollutants such as PM2.5 and oxides of nitrogen (NOx) that are the most lethal for health. 

At the launch of the recent IIT-TERI truck report, Ahmed of the Transport Ministry announced that the PUC system would be reformed ahead of Delhi’s peak pollution season. 

“We’ll definitely tighten up the processes. We’ll ensure that the gaming that is happening now, in terms of the vehicle not reaching the centre itself, in terms of the data being manipulated,” Ahmed told Health Policy Watch on the sidelines of the launch. 

While he didn’t go into details, some of the changes under consideration include geo-tagging of vehicles at testing centres, end-to-end encryption of emissions data, mandatory insertion of the testing probe into the vehicle tailpipes and eliminating manual entry of emissions data to reduce manipulation.

However, the reforms do not include testing vehicles for the hazardous PM2.5 and NOx. While such tests are readily available in developed countries, in India the technology is currently more expensive, Ahmed said.  

As Ahmed told Health Policy Watch. “There are technological challenges. As you must understand, these are fine particles. They can even go through the pores of the skin and skin and reach your lungs….More importantly, there’s a cost challenge to it. So [the question is] whether a simple device, located in a small PUC (test) centre, can be that advanced?”

‘Master plan’ to further curb Delhi’s emissions  in peak season

Delhi under winter smog. Along with vehicles, construction dust, coal power generation and household heating are factors.

The Delhi government has also announced a list of mandatory curbs and rules to be implemented between November 1 and February 28 of every year, starting this year. This is the peak pollution season. 

Called the Winter Pollution Master Plan, the measures include: 

  • No fuel sale for vehicles without a valid Pollution Under Control (PUC) certificate around the year.
  • No entry in winter of non-Delhi registered gasoline and diesel vehicles with emissions above  BS/EURO 6  emission standards, except for CNG and electric vehicles, ambulances, fire services and other essential vehicles.
  • Doubling of parking meter charges.
  • Half the employees at government and private offices working  from home on any given day of the week.
  • Office hours  will be staggered to reduce peak-hour traffic congestion.
  • No demolition work and open dust-generating construction activities will be prohibited, except for essential public infrastructure projects.
  • Installation of anti-smog guns (water sprinklers) at large commercial buildings and major construction sites.
  • Stricter curbs on open burning of waste; institutions and neighbourhood welfare associations to be held accountable.
Punjab – Crop waste burning in northern India’s rural areas during late autumn to hasten planting sends volumes of smoke towards Delhi, the nation’s capital.

With the exception of some tweaks, these winter-time curbs are not new. Yet, Delhi’s pollution levels in the peak winter period have  remained extremely hazardous. Data from Centre for Research on Energy and Clean Air (CREA) shows how the October to December PM 2.5 levels have remained at or above 170 micrograms/cubic metre, that is 34 times above WHO’s recommended safe levels, for nine of the past ten years.

Moreover, multiple studies have revealed that almost two-thirds of Delhi’s peak winter time air pollution drifts into the city from surrounding states, well outside the small state’s own boundaries. A leading factor here, is crop waste burning in surrounding rural regions of Punjab and Haryana state – producing smoke that drifts to the city and then hovers over it for days, in the dry season. 

On paper, the national government has adopted an airshed approach, that is, coordinated policy action across multiple state and district jurisdictions in a common geography where the air tends to get trapped. But this approach has clearly had limited success. 

So, the crackdown on polluting vehicles is a radical move for Delhi; it is a benchmark for the rest of India. 

But as one group of concerned parents quickly pointed out, the measure are unlikely to be sufficient if pollution isn’t reduced from other sources – including households, industries, waste and farm fires in surrounding rural regions. “Our response”, concluded the Parents group, is “not good enough.”

 

Image Credits: Chetan Bhattacharji, Delhi State , Chetan Bhattacharji, A-PAG , A-PAG, A-PAG, Raunaq Chopra/ Climate Outreach, Neil Palmer.

Climate-linked migration and displacement affect health in multiple pathways. A new WHO research initiative in the Western Pacific Region aims to find out more.

WHO’s Western Pacific region, the agency’s most populous, is home to nearly two billion people, including some small island nations like Fiji, Tuvalu and the Marshall Islands whose very existence is threatened by climate change.

And yet, no one really knows how many people are on the move due to climate-related extreme weather events that are eroding coastlines, encroaching on communities and curbing traditional economic activities, triggering displacement and migration in small island states and beyond.

To address such gaps, the World Health Organization’s Western Pacific Regional Office recently launched a research agenda asking countries in the region to track such movements, amongst a host of other climate-related health risks.

Central to the initiative is the understanding that climate change, migration or displacement and health are intrinsically linked, said Sandro Demaio, Director of the WHO’s Asia-Pacific Centre for Environment and Health (ACE), in a webinar launching the initiative on Monday.

“Despite the growing recognition that these interconnected issues exist and are playing out in real time, important knowledge gaps remain. We still need a better understanding, more clarity, more commitment, more depth of how climate change influences patterns of migration and displacement, and how these dynamics affect health outcomes,” Demaio said.

The agenda is meant to push countries to create sound evidence, allocate finances and design effective interventions as they draft their national climate and health policies.

In focus: Western Pacific and Asia region


Currently, most studies come from high-income settings. Apart from that, “limited evidence exists on anxiety, trauma, depression, and resilience among people displaced by climate-related events,” said Dr Santino Severoni, Head, WHO Health and Migration.

“More research is needed on children, older adults, pregnant women, people with disabilities, and Indigenous communities affected by climate,” he added.

Push to focus on health of migrant and displaced populations

WHO has released a health and migration research roadmap for the countries in the Western Pacific region.

Recognizing that the Western Pacific region is a large one, WHO has tweaked the agenda to make it more tailored to the Pacific as well as the Asia sub-regions, respectively.

For the Pacific region, the WHO has asked countries to focus on research on cultural loss as the small-island states battle for their survival.

“In the Asian sub-region, the report flags visa status and labor exploitation as major under-research commercial determinants,” said Brian Hall, Director of the Center for Global Health Equity, NYU Shanghai.

Also read: As El Niño Intensifies – WMO Warns Policymakers to Brace for Escalating Impacts on Health Worldwide

Health of migrants central to delivering universal healthcare

WHO has released a health and migration research roadmap for the countries in the Western Pacific region.

Within migrant communities, as well, there are particularly vulnerable sub-groups, including entirely stateless populations, as well as women, children and older people, who may be disproportionately hit.

“Most countries don’t disaggregate health data by migration status, so we’re flying blind on maternal and child health, immunization, and chronic disease in micro populations,” Hall said.

A key WHO ask of the countries is that they also empower communities to lead the research.

“First and foremost, involve the communities from the beginning when the research questions are defined, not only during the data collection. Second, I would say recognize the lived experience of young people as their expertise, because young people in communities on the move should help shape the evidence and inform the policy priorities,” said Salsabila Rashid, youth representative of the New York – based civil society group, Migration Youth and Children Platform.

Image Credits: WHO/Yoshi Shimizu, WHO, WHO.

The World Health Assembly plenary where the historic Pandemic Agreement was approved. It cannot come into effect until the PABS annex is agreed.

The Pandemic Agreement talks resumed at the World Health Organization’s (WHO) headquarters on Monday, kicking off with a public “debriefing” summarising the incremental progress made during informal talks conducted over May and June, followed by a closed session on existing models for sharing data on pathogens with pandemic potential.

Speaking at the opening of the session, WHO Director Dr Tedros Adhanom Ghebreyesus urged member states to keep two simple end goals in sight. Those include: “A future in which pathogen samples and information move quickly, without needless delay; and in which the benefits that come from them reach the people who need them most, fairly and in time.

“The differences that remain are real. They matter to the people you represent, and I respect that,” Tedros added. “But they are not impossible to bridge. So I ask you: focus on what truly matters. Don’t let the urgency fade.”

Detailed summary presented at the resumed PABS negotiations Monday reflects slow, but incremental progress on the many outstanding technical issues.

While those close to the talks confirm that slow progress is being made, this 10-day negotiating session (which ends 17 July) is unlikely to result in an agreed pathogen access and benefit-sharing (PABS) system just yet.

Wide differences remain with regards to how a standardized system for both pathogen registration and eventual benefit-sharing of R&D products could be created and enforced, in light of the multiple approaches being used in reality today.  Those differences – as well as potential bridging solutions – were vividly on display again Monday as member states and observers shared their experiences.

Pathoplexus, the database where the gene sequence for the Ebola Bundibugyo virus was first shared, pointed to the staged data-sharing approach to used by the Uganda-led team that first sequenced the pathogen as an example of a hybrid solution.

Pathoplexus representative addresses the PABS meeting Monday.

“They initially chose a time-limited restricted use option, making data fully open for public health analysis, phylogenetics, and output tools immediately, while protecting the right to publish first,” Pathoplexus noted. Then last week, following publication in a scientific journal, the same data was released “to fully open status,” he said.

“Our current model does not yet solve the question of access and benefit from commercial use, but that question matters urgently. The rapid development of vaccines, diagnostics, and treatments is crucial for outbreak response, and should be facilitated by clear, standardized, and agreed terms,” the Pathoplexus representative stated.

Meanwhile, the South Centre expressed skepticism about a PABS agreement that might embrace too much diversity to pathogen registration and sharing.

“We do have some concerns with some ideas about hybrid approaches,” the delegate stated. “We think that the standardization of the of the way the design of the PABS system is done is essential. Otherwise, this will create other uncertainties and more difficulties, in particular with the reference to what obligations member states will take. We think it’s essential that … the whole system is built on the basis of standard contracts, also to ensure what are the means that member states themselves can, through their own legislatures, support that contractual structure.

“We see that there has been the clear textual line on access stating an obligation for member states to facilitate rapid access. At the same time, you can have provisions domestically to facilitate benefit sharing …..ensuring that benefit sharing from any commercial use requires this payment to the system that goes to the multilateral tax fund. ”

Linkage or not ?

Pharma leaders, meanwhile, stressed that any pathogen sharing system should be “grounded in outbreak reality”  and aim to “reduce rather than increase both legal uncertainty and the restrictions that could delay scientists’ ability to access and use pathogen data.

“We share the objective of ensuring equitable access to medical countermeasures and companies have demonstrated this commitment repeatedly through proactive and voluntary engagement across public health emergencies, including COVID-19, mpox, and Ebola,” said a representative for the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). “However, introducing a cumbersome PABS system will not improve preparedness or access outcomes. In practice, the main bottlenecks have consistently been related to financing, regulation, and delivery – not supply.

“Looking ahead, it is critical that we do not jeopardize the progress achieved in the Pandemic Agreement, including the set-aside mechanism, by introducing a PABS system that is impractical for research and potentially counterproductive. Instead, we should build on existing mechanisms that already enable rapid, open, and effective data sharing, including established international databases, while ensuring that countries are supported and enabled to operationalize agreed access provisions.”

Equity provisions triggered by product registration

Geneva representative, Thiru Balasubramanian delivers KEI’s proposal for two core paragraphs for the PABS annex at Monday’s meeting.

Finally, Knowledge Ecology International suggested that two simple paragraphs should form the core of the final PABS text – clearly committing states to enforce the medicines/vaccines access and equity provisions of the Pandemic Agreement – but without creating any direct linkage to the way pathogen data is accessed for R&D purposes.

“For some time, KEI has taken the position that equity provisions should not be linked to access to PABS materials or data, that governments joining the treaty should be responsible for enforcing the access/equity provisions, and that those provisions should be triggered by the registration and sale of products, not access to information,” said James Love, head of KEI, in a statement on Sunday.

“This is how we suggest it be done, in two short paragraphs,” he added, setting out the first paragraph of the Annex as stating that:

“Each party [to the agreement] shall take all necessary legal, administrative, or regulatory measures to ensure that any manufacturer seeking to register or sell pandemic-related products within its jurisdiction provides verifiable evidence of a legally binding agreement with the World Health Organization (WHO) that addresses access to such products, consistent with Article 12, Paragraph 6, of the Pandemic Agreement.”

Article 12, paragraph 6  stipulates that manufacturers must make available a minimum oof 20% of their real time pandemic production to WHO, half of that as a donation and the other half at “affordable prices.”

A second paragraph in the proposed KEI text would stipulate that the obligations set forth under the PABS Annex apply “exclusively” to products produced to address the public health emergency and “not extend to other uses or indications of the same products,” Love said.

Africa aims to level the playing field

Malawi’s Health Minister Madalitso Baloyi at the UN High Level meeting on HIV/AIDS in June.

It remains to be seen how African nations will respond to the new ideas being tabled as it seeks to assert itself in the PABS negotiations and ensure that citizens of its 54 countries have better access to medicines, vaccines and diagnostics.

At the recent United Nations High-Level Meeting on HIV/AIDS, the African group negotiated as a bloc – bar a handful of countries – and insisted on the inclusion of several paragraphs to encourage wider access to medicines, including local production, technology transfer and reward for innovation. Several Latin American countries also supported this position.

Africa also insisted on a last-minute amendment to the political declaration on HIV, proposing the removal of the phrase “mutually-agreed terms” in relation to technology transfer in three paragraphs of the 15-page declaration. 

“The African group believes that keeping ‘on mutually agreed terms’ in the text, in connection to technology transfer, undermines the key objective to access medicines, vaccines, and medical products, and to boost research and development,” said Malawian Health Minister Madalitso Baloyi on behalf of the Africa Group.

While the political declaration passed, the European Union (EU), Switzerland, Canada and several other countries dissociated themselves from these paragraphs.

Switzerland said that technology transfer should “always be on mutually agreed terms”.

It also objected to a paragraph (85) that committed countries to improving the transparency of markets for HIV-related health technologies, by “publicising production costs and prices of HIV-related products, through global, regional and national mechanisms, thus providing consistent and transparent information for fair price negotiations”.

“There are limits anchored in relevant international law to publicising information, such as production cost. Paragraph 85 raises concern regarding the protection of trade secrets, and more fundamentally, what role of state authorities can be in relation to private sector actors,” said Switzerland.

‘No country alone can fight’

Meanwhile, Tedros and other WHO officials have urged member states to hasten agreement of the PABS system, particularly in light of the recent string of dangerous disease outbreaks, including the Ebola Bundibugyo virus public health emergency declaration.  

“The outbreaks of hantavirus, Ebola and Marburg all show why there is no alternative to international cooperation in the face of international threats. No country alone can fight,” Tedros told a media briefing last week.

The outbreaks are that the risk of another pandemic erupting is “not some distant, hypothetical scenario in a briefing document,” Tedros added in his statement on Monday.

WHO’s head of health emergencies, Dr Chikwe Ihekweazu, said that navigating several public health emergencies simultaneously was a trend which is likely to continue.

“The threats are not going away,” said Ihekweazu. “But hopefully we can get stronger collectively to respond to these.”

Several positive developments had evolved out of the recent threats, he added. These included countries improving their disease response detection and response capabilities,  R & D on new countermeasures, and opportunities for countries to work together under the International Health Regulations, the legally binding rules for country conduct during disease outbreaks.

But, stressed Ihekweazu, the PABS system “absolutely has to be completed” to enable the Pandemic Agreement to be ratified and brought into effect to establish a strong global framework to address disease outbreaks.  See related story: 

https://healthpolicy-watch.news/drc-ebola-outbreak-may-be-much-larger-than-currently-reported/

Image Credits: PABS IGWG7 Debriefing.

Two children engrossed in using their smartphones in a dimly lit setting. A lack of digital governance exposes young people to algorithmic harms and severe health risks, warn WHO and France.
A lack of digital governance exposes young people to algorithmic harms and severe health risks, warn WHO and France.

A lack of youth online safety is a global public health crisis that demands systemic platform regulation to protect children from harm, according to a joint declaration by the French government and the World Health Organization (WHO). They demand urgent digital governance to mandate safe platform redesigns, as nations struggle to enforce easily bypassed social media bans.

While online environments can offer educational and social benefits, poorly governed digital spaces pose grave risks to the physical and mental development of youth, French President Emmanuel Macron and WHO Director-General Dr Tedros Adhanom Ghebreyesus said in the statement released last week. They warn that features including infinite scrolling, autoplay, and push notifications increase the risk of addictive behaviour.

“Our children and young people are not experimental subjects, a captive market, or a commodity,” they asserted.

Calls for ‘pro-child’ digital governance

Macron and Tedros at the One Health Summit in Lyon this year. They demand urgent digital governance.
Global leaders Macron and Tedros push for ‘pro-child’ digital platform regulation.

The leaders warn that unregulated digital marketing exposes vulnerable adolescents to harmful products, echoing public health advocates who accuse the tobacco, alcohol and sugary drink industries of flooding social media to evade advertising regulations.

Furthermore, Macron and Tedros note that, despite its opportunities, generative artificial intelligence acts as a force multiplier for major risks facing youth online, with its long-term impact on children’s emotional development, including their ability to form real life relationships and capacity for empathy, remaining uncertain.

They advocate for a precautionary approach to digital platform design, insisting that such measures are “pro-child” rather than anti-innovation, emphasising that preventing exposure to illegal, extreme, and graphic content is a public health imperative.

Governments and the technology industry must implement transparent data sharing, age-appropriate design, and stronger safety-by-design standards. To enforce these safety standards across the board, the joint mandate calls for independent, longitudinal research and strict corporate accountability.

Legal battles and industry pushback

This push for comprehensive digital governance comes as legal and regulatory pressure against social media platforms is mounting. Recent court rulings in the United States have included a $375 million judgment against Meta in New Mexico and European Union investigations under the Digital Services Act. They have targeted platforms like YouTube and TikTok for designing addictive products.

Technology giants reject allegations that they prioritise engagement over safety, and argue they actively protect younger users. Meta points to its ‘Teen Accounts’ which automatically limit content and contact for under-16s, while TikTok promotes over 50 preset teen safety features.

However, independent researchers argue that existing corporate safeguards fail to address the root problem. They note that technology companies restrict independent data access while continuing to deploy algorithmic features explicitly designed to manipulate the developing brain’s reward systems.

The national ban dilemma

Meanwhile, political efforts to exclude children entirely from social media, like the world’s first national ban for children under 16 in Australia, are facing severe enforcement setbacks.

Early evidence published in the British Medical Journal (BMJ) reveals that over 85% of teenagers easily bypass the restrictions by retaining existing unverified accounts, using fake birthdays, or borrowing devices from parents and older siblings. Daily screen time remains unchanged at up to four hours.

While Macron and Tedros view national age restrictions as a positive sign that governments recognise the public health crisis, they argue that true protection requires more than just the absence of harm. Children’s wellbeing depends on safe digital infrastructure that actively supports healthy development rather than disrupting it.

Big Tobacco is No Longer Selling Cigarettes – It Is Engineering Addiction

Image Credits: Ron Lach via Pexels, WHO / Laurent Cipriani .

El Niño conditions are set to intensify in the July-September, bringing extreme weather conditions to significant parts of the world.

The El Niño conditions that bring extreme rainfall, heat waves and drought to different parts of the world are set to intensify further during the July-September period this year, said the World Meteorological Organization (WMO).

While the Indian subcontinent has to brace for below-normal rainfall, parts of Africa and southern Europe will see above-normal rainfall, according to WMO’s latest update, published Friday.

“El Niño conditions are already underway and are forecast to strengthen rapidly into a strong event – as accurately anticipated by WMO forecasts. This will intensify the chances of drought and heavy rainfall and the risk of heatwaves on land and marine heatwaves in many regions of the world,” said WMO Secretary-General Celeste Saulo.

Both drought and flooding pose big threats to food production in already food insecure parts of the world, while heavy rains that cause flooding create displacement and exacerbate outbreaks of infectious and water-borne diseases such as cholera. Extreme heat, too, exerts mounting pressure on food production, Qu Dongyu, Director-General of UN’s Food and Agriculture Organization has warned.

Europe already reeling from heatwave

Over 1,300 people have died of heatwave in Europe this summer.

The warning comes as large parts of Europe were already reeling under a heatwave that has led to over 1300 deaths.

“It’s the first week of July, it’s the start of what is traditionally the hottest month of the year,” WMO spokesperson Clare Nullis told journalists in Geneva. “And yet already in June we’ve seen record-breaking temperatures in many parts of Europe; just as an example, Germany last weekend saw a new national temperature record of 41.7°C.

The WMO had already warned of El Niño conditions developing in the agency’s June update. Now conditions have further escalated.

See related story here:

El Niño Conditions Will Lead to More Heatwaves, Droughts and Wildfires Over Next Few Months, Warns WMO

What is El Niño

 

El Niño causes the Pacific jet stream to move south and spread further east. During winter, this leads to wetter conditions than usual in the Southern U.S. and warmer and drier conditions in the North.

While a natural phenomenon, more extreme El Niño conditions are a result of the warming of ocean temperatures in the Pacific that affect the wind-patterns in turn.

Normally, strong east-to-west trade winds push warm surface water toward Asia and Australia, allowing cold, nutrient-rich water to build up along the coast of South America.

During an El Niño event, however, warmer-than-average sea surface temperatures and weakened trade winds push warmer water eastward toward the Americas, shifting global weather patterns.

This year the sea-surface temperatures are over 2°C higher than what is typical in several key monitoring areas.

Below normal rainfall in the Indian Subcontinent and above normal in parts of Africa

Multi-model ensemble forecasts from leading global producing centres for the central and eastern equatorial Pacific.

It is therefore likely that the Indian subcontinent and much of Australia will receive below-normal rainfall, while above-normal rainfall is forecasted for the central and eastern equatorial Pacific region.

In west Africa, the Ivory Coast, Ghana and other countries along the Atlantic Ocean’s Gulf of Guinea are projected to receive above-normal rainfall. But on the eastern side of the continent, below-normal rainfall is forecast for already food-insecure countries such as Eritrea, Ethiopia and Somalia along the Horn of Africa coast of the Indian Ocean.

Below-normal rainfall is also forecast for parts of Central America, the Caribbean and northwestern South America. In contrast, wetter-than-average conditions are more likely across portions of the southwestern United States.

Across Europe, forecasts suggest a north-south contrast, with increased chances of above-normal rainfall in southern Europe and below-normal rainfall in northern Europe. However, for Europe, forecast confidence remains lower than in many other regions.

WMO helping countries brace for impact

Celeste Saulo, WMO Secretary-General

WMO said it has begun intensifying its mobilization of information and support services so that countries can brace for the impacts of El Niño.

Regular briefings are being provided across the United Nations system and to humanitarian partners to support preparedness.

“The WMO community has launched an unprecedented mobilization to coordinate activities across the United Nations and at regional level to support governments, humanitarian organizations and climate-sensitive sectors,” Saulo said. “Advanced seasonal forecasts and early warnings are vital to save lives and cushion the impact on our economies and our communities.”

Image Credits: Dikaseva/ Unsplash, WHO / Hedinn Halldorsson, NOAA, WMO.

Leslie Ransammy, Guyana’s Ambassador to the UN in Geneva at a high level event on sexual and reproductive health rights in Geneva in May.

The dramatic global health budget cutbacks in services for maternal and reproductive health and sexually transmitted infections (STIs) have produced 17 million unintended pregnancies, and more than 34,000 preventable maternal deaths in just the first year since cuts were made. 

That recent assessment by French and Washington DC-based analyses, was cited by Guyana’s UN Ambassador in Geneva, Leslie Ramsammy, at a World Health Assembly side event in May. 

And with deep, ongoing cuts in United Kingdom and European global aid budgets, as well as an anti-family planning and anti-choice mood in the US and many African countries, access to services may only worsen – along with the death toll. 

Just last week, eight UN member states, including the United States, Russia and several African nations, and another 14 countries, mostly Middle Eastern, abstained from a vote on the 2026 UN High Level Political Declaration on HIV/AIDs – largely because it reaffirmed sexual and reproductive health rights.  At the last WHA, meanwhile, SRHR captured little space on the formal agenda. 

Against the threats, inspiring models of progress

Guyana’s first lady Arya Ali launches a menstrual hygiene initiative in one of the country’s remote regions in June 2025.

But against the threats and setbacks, there are also inspiring models of progress in low-and middle income countries such as Barbados, Guyana and Malawi, offer models that deserve wider attention, Ramsammy said. 

Processes like the Human Rights Council’s Universal Periodic Review (UPR) can also be harnessed to accelerate progress, Ramsammy and other members of the high level panel convened by the Global Center for Health Diplomacy and Inclusion (CeHDI), also emphasized. 

“Let me urge that we refrain from viewing SRH strictly and merely as a health issue,” Ramsammy said. “Providing voluntary access to contraception and a safe birth environment is not just a medical necessity, it is economic and social capital. 

“Investing in SRHR reduces poverty, bolsters gender equality, and fosters resilience to global crises. 

“When girls and women have the autonomy to make decisions about their own bodies, they are more likely to pursue education, participate in the workforce, and act as equal partners in their relationships. 

Barbados, Guyana and Malawi offer models for Africa and the Caribbean  

Lisa Cummins, Minister of Health, Barbados

Barbados’ progressive SRHR landscape, for instance, includes legal abortion and access to reproductive health services – most delivered free of cost through its primary health care budget, said Lisa Cummins at the CeHDI event. Cummins is also the country’s first female Minister of Health since the 1990s.  

The quality of services is reflected in Barbados’ low maternal mortality rates and high uptake of  HPV vaccine, which prevents cervical cancer.

At the same time, the country is facing challenges in declining donor support for civil society groups that work closely with the government to deliver SRHR services, particularly the Barbados Family Planning Association (BFPA) – as a result of anti-rights activism abroad.

“That is part of a global conversation on external partners attempting to police our bodies – and to determine what we should and should not have access to as women,” Cummins said.  

Expanding SRHR services despite donor cutbacks

Mia Mottley, Prime Minister Barbados, at the UN General Assembly in 2025. She is a global advocate for gender equality, as well as climate sustainability and debt relief.

 But the current government remains committed to maintaining and expanding SRHR services, she asserted. 

“I’m not sure if you’ve ever met my leader,” she quipped, referring to Barbados Prime Minister Mia Mottley, a Global South champion for gender equality as well as for economic and climate justice.  

“But [she] and the first Prime Minister of Barbados, the Honourable Errol Barrow, said something that we all live by – and that is ‘friends of all, satellites of none.’ ”  

So even as outside funding has diminished, the BFPA has broadened services through closer cooperation with the public health system, integrating HIV counseling, maternal counseling, family planning and parental support so “we’re able to support parents in being better parents.”

“We believe in the protection of rights for women and girls. We believe in the preservation of the rights that have been established under the UN system and have been promoted by UNFPA. And we are committed to continuing to support the preservation of these rights,” said Cummins, adding, “That is who we are.”

Harnessing the Human Rights Council’s Universal Periodic Review (UPR) 

The Human Rights Council’s Universal Periodic Review (UPR) is a state-led mechanism that evaluates each country’s human rights obligations and commitments, including the right to health.

One often-overlooked but powerful multilateral lever is the Human Rights Council’s Universal Periodic Review (UPR) process, noted CeHDI’s CEO, Haileyesus Getahun. 

The UPR is a peer review  assessment every four or five years by HRC member states of progress in human-rights related legislation, policies and practices  – including obligations of governments to the right to health and public health measures. 

A recent analysis of the impacts of UPR recommendations across three review cycles (2005–2023) found the recommendations were associated with accelerated improvements in maternal health among high-burden countries.Critical SRHR indicators included in the analysis were maternal mortality rates (MMR), skilled birth attendance (SBA) and contraceptive prevalence (CPR).

Haileysus Getahun, CEO of the Global Center for Health Diplomacy and Inclusion (CeHDI).

Among the more than 400 recommendations assessed across 89 countries, each additional recommendation was associated with a 0.24% faster annual reduction in MMR, a 0.52% faster annual increase in odds of SBA and a 0.21% faster annual gain in CPR.  This is according to the preprint of a study published in June on medRxiv.org by five CeHDI and WHO analysts. 

“This is robust evidence showing that the UPR process is not a mere talk show. It can be an important accountability tool to advance universal health coverage including SRHR ” Getahun said.   

He attributes UPR’s influence to involvement of high-profile ministries like the Cabinet, Foreign Affairs or Justice — which often carry more domestic political clout than health ministries — and parallel assessments by UN agencies and national stakeholders: 

“So these are three independent processes, reviewing previous recommendations and the country’s performance in terms of all the rights where governments have obligations.” 

Malawi sees SRHR as a human right 

Madalitso Baloyi, Minister of Health and Sanitation, Malawi

Africa’s record on SRHR rights and services has been mixed: abortion remains outlawed in many countries and LGBTQI criminalization has limited access to services.

Malawi, however, has made notable progress. It has been a leader in sub‑Saharan Africa in expanding voluntary family planning and reducing teenage pregnancies through access to quality contraceptives.

But the country still struggles with high rates of maternal mortality, gender-based violence and restrictive abortion laws.

“Malawi, through the Ministry of Health, recognizes that sexual reproductive health as a human right as well as a health issue, and we take this issue seriously,” said Madalitso Baloyi, Minister of Health. “We treat SRHR as a current issue, but also an issue that has an effect on future generations.”

Barriers remain: they include limited infrastructure at primary-care level, weak referral and incomplete health information systems that lead to gaps between primary and secondary health tiers, and social stigma. 

With respect to stigma, Baloyi described the disparity in community response: neighbors may mobilize to transport a sick child, but survivors of rape are often left to find their own way to care. 

More joined up financing for SRHR and primary health care services 

A young girl receives a single dose of HPV vaccine at Lisawo primary school in Chiradzulu Malawi – a measure critical to reducing cervical cancer.

The government’s National Health Financing Strategy is prioritizing strengthening primary health care. Plans to introduce a National Health Insurance Scheme are also in the works. And the Ministry of Health aims to give local clinics more control over their own spending in line with local priorities and needs, she said.

“As government, we are looking at how to strengthen primary health care service provision, but the gaps are still there in terms of infrastructure,” she said. “The limited budget impacts quality of care, especially at primary level, while the distances that one travels just to get care is also an issue.” 

Paradoxically, donor cuts have pushed Malawi to increase domestic spending on maternal health by 10%, with knock-on benefits for SRHR, Baloyi said. 

“We are also integrating services — so the same young women who seek SRHR care also receive HIV prevention and treatment as needed. And that can reduce costs and improve outcomes. 

“There’s a silver lining to the ODA budget cuts,” she added. “It’s bad when the budget is shrinking, but it is also giving us, as government, power to deal with our own challenges, our own problems.”

New donor partnerships and targets 

reproductive health
Percilda Manhica, a nurse at Health Center in Manhica, consults a patient, Clara Obadias Matavele, 32, about family planning needs, at the Health Center in Manhica Village, Mozambique.

Panelists agreed that while donor funding may partially rebound, stronger national commitments and new kinds of partnerships are essential. 

“It’s a fact that we will have to confront less funding in the future, so we have to somehow establish a new kind of partnership,” said Germany’s Ambassador to the UN in Geneva, Antje Leendertse.

She proposed that bilateral donor commitments include concrete targets for allocation to women’s health. “Sexual and reproductive health and rights should not be treated as an add-on, one optional thing,” she said.

Antje Leendertse, Germany’s Ambassador to the UN in Geneva.

 “I think there should be some kind of agreement on a kind of goal – such and such percentage of every health engagement of a donor country or a community of donor countries has to flow into women’s health….That would be not only the right thing to do but also the smart thing to do.” She also urged prioritizing SRHR in humanitarian aid.

But such goals have been articulated in the past without achieving the desired effect, Ramsammy pointed out. 

While an informal benchmark of 10% for SRHR has been cited by international parliamentarians and advocacy groups, only 23% of donors allocated more than 5% of their ODA to SHRH, he noted. 

“So I think the call here is that we reiterate and strengthen that commitment,” Ramsammy added.   

“We need predictable financing to safeguard critical programs, including maternal health, family planning, and adolescent health, from growing political and funding pressures.” 

“We need to implement consistent high-quality sexuality education to equip young people with tools to prevent unintended pregnancies, sexually transmitted infections, and sexual coercion need to advance coordinated global and national action among governments, partners, and civil society to protect hard-won gains and ensure no woman, no birth is left behind in access to SRHR within universal health coverage.”

Image Credits: Dominic Chavez/World Bank, News Room , Health Policy Watch , WHO, 2019, Nadia Marini/MSF .

A young man who has been cured of Ebola Bundibundyo speaks to health workers in the DRC.

A trial to test two antiviral therapies on patients with Ebola Bundibugyo Virus started to enrol patients on Thursday – but its exact location in the Democratic Republic of Congo’s (DRC) Ituri province remains secret for security reasons.

This emerged at a World Health Organization (WHO) briefing on Thursday, at which Director General Dr Tedros Adhanom Ghebreyesus revealed yet another Ebola treatment centre in Ituri had been attacked in the past week.

Citing “mistrust and violence” as significant obstacles to addressing the Ebola outbreak, Tedros said that the attack had resulted in the deaths of two people, the centre being set on fire and patients fleeing.

The attack related to the burial of a community member who had died of Ebola, added Dr Chikwe Ihekweazu, WHO’s executive director of health emergencies.

There were 1,406 confirmed Ebola cases and 438 deaths by 30 June, a case fatality rate of over 31%, according to the DRC’s health ministry.

‘Record time’

The PARTNERS trial will assess whether the antivirals, a monoclonal antibody called MBP134 and remdesivir, can improve the outcome and survival rate of people with Ebola in Bundibugyo. It will also evaluate whether combining the two antivirals provides additional benefits.

The WHO-sponsored trial is being coordinated by the DRC’s Institut National pour la Recherche Biomédicale (INRB), the Institute of Tropical Medicine in Belgium, and the University of Oxford in the United Kingdom.  

These two treatments were selected by the WHO Technical Advisory Group “after a thorough review of scientific evidence, including preclinical research and safety data, and evidence from previous outbreak responses”, said the WHO in a statement. 

It is a randomised, controlled trial that is enrolling patients of any age with confirmed Bundibugyo. Aside from the medicine, patients will receive “early supportive care, including oral or intravenous fluids, electrolyte replacement, oxygen support, blood pressure management, and pain control in line with WHO treatment guidelines”, according to the WHO.      

People enrolled in the trial will receive “close support and follow-up for at least 28 days after enrolment,” it added.

Tedros said that the trial had been assembled “in record time, [and] offers real hope that we can deliver concrete results for – and with – the communities at the heart of the outbreak.”

The trial has been established as a platform trial, which allows for additional treatments to be added as they become available following assessment by the WHO Technical Advisory Group.

Dr Vasee Moorthy, WHO R&D Blueprint lead.

INRB Director General Prof Jean-Jacques Muyembe-Tamfum, said that, “by integrating this trial into clinical care, we are giving patients access to promising investigational treatments while generating the evidence needed to improve care for current and future outbreaks. “

“One of the key lessons from recent outbreaks is that research needs to happen alongside the response, not after it,” said Professor Amanda Rojek, the trial lead from Oxford University’s Pandemic Sciences Institute. 

“The PARTNERS trial gives us an opportunity to evaluate potential treatments during the outbreak itself, so that the evidence generated can help inform patient care when it is needed most – in months rather than years,” said Rojek.

DRC Health Minister Samuel Kamba said that the trial demonstrated his country’s “strong commitment to science and research,” and it offered “renewed hope to patients, their families, and affected communities”. 

The trial will conclude once an independent data safety monitoring committee is confident about the results, said WHO R&D Blueprint lead Dr Vasee Moorthy.

“From what we see at the moment, this is going to take some time,” said Moorthy. “We shouldn’t expect that this is going to be over in weeks. It will take some months. It could go even into next year. It could be that we need over 1000 patients enrolled in the trial until we get a definitive answer or it could be earlier if there’s a very high efficacy from the trial.”

Moorthy added that “discussions with the community as absolutely central, because all this is about protecting the community”. 

The trial has “community advisory panels with representatives from all of the relevant trusted stakeholder groups on the ground, including healthcare workers, community leaders, faith groups, and other leaders”, he added.

Image Credits: DRC Ministry of Health.