WHO Director General in Germany for Series of High Level Meetings – What’s At Stake?

14/04/2026 Elaine Ruth Fletcher & Editorial team

WHO Director General Dr Tedros Adhanom Ghebreyesus meets with members of the German Bundestag in a series of high-level meetings this week in Berlin.

As WHO Director General Dr Tedros Adhanom Ghebreyesus visits Germany, a high stakes week for Germany’s future role in the World Health Organization agency may be unfolding in Berlin.

On Monday, Tedros began a two-day high-level visit to Germany at the invitation of the World Health Summit where he has served as a patron.

The visit also reportedly includes meetings requested by Tedros with Minister of Foreign Affairs Johann Wadephul, Minister of Health Nina Warken, and Berlin Mayor Kai Wegner as well as members of Germany’s Bundestag, or Parliament. Germany’s Chancellor Friedrich Merz, meanwhile, declined a request from the Director-General to convene a meeting, Health Policy Watch learned.

The question is this: what exactly is Tedros doing in Berlin, and why is he prioritizing bilaterals with German ministers a month before the World Health Assembly?

According to a WHO spokesperson, the answer is simple: he is in Berlin “at the invitation” of the World Health Summit.

“On Monday, 13 April, he attended the WHS-organized high-level dinner, ‘From Crisis to Resilience: Innovating for Health,’ which focused on the future of international organizations and the role of Germany and Europe in a changing global order.

In addition, “the Director General is meeting with key German stakeholders, including the Federal Minister of Health and the Mayor of Berlin, to reaffirm Germany`s role as a strategic partner and champion of multilateral global health.

“The visit aims to strengthen cooperation on pandemic preparedness, global health reform and sustainable financing, while highlighting the WHO Hub in Berlin as a global asset made possible through Germany`s support,” the WHO spokesperson added.

However, diplomatic sources told Health Policy Watch that the meetings have less to do with the World Health Summit and more to do with the pending loss of German voluntary donations to WHO – as well as Germany’s positioning in the upcoming race for WHO Director General.

German cuts to WHO funding

WHO’s Pandemic and Epidemic Intelligence team meeting with WHO’s DG Dr Tedros Monday in Berlin.

Following the US withdrawal from the WHO, Germany has emerged as the Organization’s largest member state donor. But it is reportedly cutting back its voluntary contributions in both 2026 and 2027 and it is unclear whether it will come through with all of the $262.2 million in funding pledged at the World Health Summit in October 2024 for the years 2025-2028.

Since that 2024 commitment, only $67.7 million has been delivered. The remaining $200 million pledged remains in question.

Germany’s plans to halve its annual funding for the Berlin-based WHO Hub for Pandemic and Epidemic Intelligence from €30 million to €15 million, were reported by Health Policy Watch in January.

Meanwhile, despite dramatic budget cuts and layoffs of at least 25% of the workforce over the past 16 months, WHO still faces an estimated $640 million budget gap for the current 2026-2027 biennium, according to a Director General’s report at the February 2026 Executive Board meeting.

WHO disclosed plans for a 25% staff cut in November 2025 with professional staff at low and mid-level hit hardest. But a budget gap of $640 million remains.

Will Germany put forward a candidate for DG ?

Another likely issue in bilateral discussions is the election campaign for the next WHO Director General. That is expected to kick off formally later this month or in early May when Tedros issues a call to WHO member states to nominate candidates.

Former German Health Minister Karl Lauterbach.

Two influential German health policy actors have been eyeing the race, as reported in February by Health Policy Watch and German media outlets. Those include former German Health Minister Karl Lauterbach and Paul Zubeil, deputy director general of European and International Health Politics in the German Ministry.

Both bring distinct strengths along with potential trade-offs. While Lauterbach is widely known, his prominent role in the COVID-19 response made him a more polarizing figure domestically, which could affect how he is received on the global stage.

Paul Zubeil, German Ministry of Health, at the World Health Summit in Berlin in 2025.

Zubeil, who currently oversees all funding to WHO and UNAIDS on behalf of the German Federal Ministry of Health, is highly regarded in expert circles for his decades of experience in fragile and complex settings and his deep understanding of global health systems. The key question is whether he has the political backing to mobilize a German nomination.

Deferring or not?

Within German political circles, there is a debate underway, however, about how the country should position itself in the DG race.

“German opinion on whether there should be a candidate [for WHO DG] is highly disputed inside and outside of ministries. German foreign policy might just have other problems right now than running a [WHO] campaign,” said one expert on the European arena.

And recently, German Chancellor Merz’s fractious coalition of conservatives and the centre-left, has been further strained by the geopolitical challenges of the war in Iran and the consequent sharp hike in fuel prices.

In what are likely to be Tedros’ final strategic engagements with Germany before the race begins, he is understood to be encouraging his counterparts in Berlin not to enter the contest and instead back allied candidates, according to WHO sources. Tedros’ own personal preferences in the race, while the subject of informal speculation, have yet to emerge.

For Berlin, the implications of deferring any nomination of a German candidate is politically significant. Germany, despite being a major multilateral donor, does not have anyone serving in the top posts of the UN system. Its one remaining shot to secure a major global leadership role over the next five years is the WHO Director-General race, so it is not surprising that Germany had been considering nominating a candidate.

But not putting forward a candidate may be the least favorable option of all, others argue.

“To defer to the current WHO DG’s preference rather than put forward its own candidate would not just be a missed opportunity. It would raise serious questions about judgment and independence at a moment when leadership in global health is under intense scrutiny,” said one German diplomatic source.

Germany in WHO’s Executive Board calculus

WHO European Region Executive Board representation – the allocation of three-year terms is by three country groupings.

While Berlin debates its position in the DG race, its near-term role in the Executive Board, WHO’s governing body, is also unclear. In late January or early February 2027, the EB will screen and select three candidates among the slate of DG nominees to be voted on by member states at the May 2027 World Health Assembly.

That gives the 34-member WHO governing body with immense power to sway the final outcome of the race.

Currently, Germany does not have a seat on the Board so its say on the final three candidate slate will be shaped by broader European Union currents and Policies.

It will have a chance to return to the EB at the May 2027 WHA, as member states elect a new DG.

At that time, four European member states will rotate out of the eight EB seats allocated to European Region members.

But the complex subregional grouping system that the European Region uses to select EB representatives will continue to represent a critical constraint for the success of a German EB candidate. That’s because Germany is a member of the European region’s Group A countries, where only one seat is available.

It will be competing with Iceland and Luxembourg, which both expressed interest in the seat at an informal Regional consultation in late 2025, according to documents from the meeting seen by Health Policy Watch.

France’s EB position is more secure

The 158th WHO Executive Board meeting on 8 February, the final day of its last session.

That means three countries would likely be competing directly for a single position, with two guaranteed to be eliminated.

Former Health Minister and WHO Academy Executive Director Agnès Buzyn – potential French nominee?

At the same time, France, which is also eyeing at least three nominees for the DG race – including Agnès Buzyn, Anne-Claire Amprou and Marisol Touraine – sits within the Region’s Group B where two Executive Board seats are available. As a Permanent Member of the United Nations Security Council, France benefits from extra privileges rotating into one of the available positions more frequently than other member states.

This means France will almost definitely secure a Board seat in 2027, even if its DG candidate is unsuccessful, while Germany does not have the same privilege.

Meanwhile, Group C, which includes the Russian Federation, Israel, and Turkey – as well as Balkan and Central Asian member states – will have one vacant seat in 2027 with Romania and Moldova already expressing interest.

So, whether by design or by drift, Germany risks being edged out of both the WHO Executive Board and the broader WHO leadership conversation, critics say.

Largest OECD donor with the lowest UN boardroom profile

This comes at a time when Germany has also become the largest provider of official development assistance (ODA) for the first time, with total aid reaching $29.1 billion, according to the 2025 Organisation for Economic Co-operation and Development report released last week.

Despite that historic financial weight, Germany has not managed to parry funding into multilateral power.

Until 2025, Germany held one senior role through Achim Steiner, who served as Administrator of the United Nations Development Programme until his term concluded. However, he remained a relatively low-profile figure across the system, with limited recognition beyond core development circles.

Berlin’s subsequent attempt to secure the top role at the UN High Commissioner for Refugees fell short, with its candidate Niels Annen, a former parliamentary State Secretary at the Federal Ministry of Economic Cooperation and Development, losing out to Barham Salih, the former President of Iraq.

Even with the cutbacks in support to WHO, Germany is likely to continue ranking as one of the largest member state donors to the global health agency for the foreseeable future

But here, too, critics argue that financial power as a donor to the UN system shouldn’t come with such explicit strings attached. “What’s the message? I pay and you vote for me or…? Sounds like the USA!” one observer told Health Policy Watch.

Decisive moment in Berlin vis a vis Washington DC?

Financial considerations aside, relations between Germany and Washington are at one of their lowest points in decades, with US President Donald Trump repeatedly attacking his European allies over defense, trade, and alignment with US priorities.

At the same time, Merz has warned of a deep rift between Europe and the US, while still insisting that transatlantic cooperation must be preserved.

That is exactly where the WHO race becomes more than a health decision. It becomes a diplomatic lever.

At a time when Washington is increasingly transactional and relationship-driven, Berlin putting forward a credible nominee could signal alignment, rather than distance, some sources who spoke with Health Policy Watch, asserted.

Said one, “It could demonstrate that Germany is willing to lead where it matters, to reset the course of WHO and do so in a way that keeps the US anchored in global institutions rather than drifting further away.”

Image Credits: X/DrTedros, X/Dr Tedros, WHO , Steffen Prößdorf, Health Policy Watch , Amélie Tsaag Valren.

Delhi Has a New Plan to Fight Its Toxic Air, But Will it Deliver?

13/04/2026 Chetan Bhattacharji

Delhi air pollution during peak pollution days in mid-November.

Delhi’s new action plan 2026 promises to double the bus fleet, deploy more smog guns, and impose pollution-linked curbs on fuel sales. But experts warn of missing enforcement muscle and dodging hard decisions.

DELHI – The world’s most polluted capital has a new air quality action plan, but the Delhi state government is yet to release the details – more than a week after the Chief Minister Rekha Gupta announced it.

A press release with sketchy details on the Air Pollution Mitigation Action Plan 2026 has been welcomed by experts and civil society, but cautiously; a follow-up draft electric vehicle (EV) policy has more details on how to phase out certain categories of fossil-fueled vehicles over the next two to three years to improve air quality.

How effective are smog guns?

However, the government plans to double down on questionable measures such as anti-smog guns and water sprinklers on a “large scale”. According to an Indian Institute of Technology (IIT) Delhi finding, spraying water had a very small impact on the small particulate matter in the air, PM2.5, and this was limited to an area up to 200 metres from the machine.

Last year, the government released the Air Pollution Mitigation Plan 2025. Some of the policy proposals are the same, such as a curb on entry of old goods vehicles, the deadline for which has been postponed by a year. But the scale of other promises, such as a lot more buses and EV chargers, has grown significantly.

Delhi Chief Minister Rekha Gupta announced the Air Pollution Mitigation Action Plan 2026 on 3 April. It follows the Air Pollution Mitigation Plan 2025.

Scepticism is understandable given that Delhi’s average PM2.5 pollution has hovered around 100 micrograms for the last seven years. Earlier this year, the government announced a target of a 15% reduction in the annual average PM2.5 level for 2026. The new plan doesn’t mention this, but the list of promises is long and ambitious.

Details of Delhi’s Air Pollution Mitigation Action Plan

Vehicular and transport curbs

Curbs on fuel sale: ‘No PUC, No Fuel’ – vehicles without a pollution-under-control (PUC) certificate will not be sold fuel at pumps. Cameras will use digital tracking to identify them.
Curbs on old goods vehicles: Starting 1 November 2026, only the most recent emission standard BS-VI (Bharat Stage), CNG (compressed natural gas), or electric goods vehicles will be allowed into Delhi. Last year’s plan had promised the same thing by 1 November, 2025.
Doubling the bus fleet: A target fleet of 13,760 buses by 2028-29, more than double the current 6,100, with a heavy focus on electric models. Last year’s plan promised 5,004 electric buses.
Adding more than three times the current number of EV charging points: 32,000 charging points over the next four years, almost triple the current 8,800, and a new EV Policy 2026 targeting commercial fleets. Last year’s plan promised 18,000 EV chargers.

Traffic and dust management

Eliminating 62 traffic congestion Hotspots: Using an “Intelligent Traffic Management System”.
Anti-smog guns for roads and large buildings: Large-scale deployment of mechanical sweepers and water spray systems to control dust.
Paving & greening: 3,500 km of roads and the planting of 7 million trees and shrubs in a year. Incidentally, just weeks earlier, the chief minister had announced plans to recarpet 750 km of roads as a step to improve the air quality.

Waste and construction monitoring

Removing Delhi’s garbage mountains: South Delhi’s Okhla site by July 2026, North Delhi’s Bhalswa by December 2026, and East Delhi’s Ghazipur by December 2027. Past deadlines to rid the national capital of these towering landfills were missed. Seven months ago, the deadline set by Gupta for all three was December this year.
AI Oversight: Rollout of portal for real-time, geo-tagged monitoring of construction sites to prevent dust leakages.
Biomass ban: Complete ban on biomass burning with penalties for violators and the distribution of electric heaters as alternatives.

“Clean air is not a luxury, it is a fundamental right, and we are committed to delivering it,” said Gupta at the launch, promising strict timelines, accountability, “new” solutions and engagement with the public and technical experts.

Delhi’s air is dependent on the seasons. This view, after rain, shows its potential for clean air.

However, experts and environmentalists point out measures in this list which need to change or are missing. The aim is to reduce pollution by reducing the sources of pollution.

‘Pollution-under-control’ system needs to change

Delhi’s traffic contributes to some 18% to 24% or air pollution, depending on the season. There are almost 8.8 million vehicles on the road, up 7.9% from the previous year. Over two-thirds are two-wheelers, while an estimated 1.2 million vehicles visit daily from neighbouring cities.

Vehicles also account for 60% of nitrogen oxide (NOx) emissions in Delhi and neighbouring region, which can have devastating health effects, including higher risk of asthmatic attacks, coughing, wheezing, chronic lung disease, heart disease, strokes and lung cancer among others. NOx also contributes to the creation of other pollutants like ozone and fine particulate matter PM2.5, equally damaging to human health.

Fossil fuel vehicles in Delhi without a valid pollution-under-control certificate will be barred from buying fuel, according to a proposed action plan by the government.

Caption: Fossil fuel vehicles in Delhi without a valid pollution-under-control certificate will be barred from buying fuel, according to a proposed action plan by the government. Source: CMO Delhi’s account on Instagram.

But the PUC certificate, which the government has vowed to police, doesn’t measure NOx or PM2.5, which is a critical gap according to Amit Bhatt, managing director for India at the International Council for Clean Transportation (ICCT), a research organisation.

“The key limitation of the existing PUC system is that it is a stationary test and does not capture emissions under real-world driving conditions.

However, the actual impact on human health occurs when vehicles are operating on the road. Therefore, it is important to reimagine vehicular emission testing to better reflect real-world conditions and align with public health priorities,” Bhatt told Health Policy Watch.

Bhavreen Kandhari, a prominent environmentalist, warns of another danger of continuing with the old PUC regime.

“Continued reliance on the PUC system, widely considered outdated/corrupt without scaling robust real-time emission monitoring, weakens enforcement,” says the founder of Warrior Moms, an air quality activist group.

New EV plan announced

However, the Delhi government has announced details for a new, draft EV policy, vehicles contributing up to almost a quarter of the megacity’s pollution and identified as the fastest growing pollution source.

It promises a rapid push for EVs in all categories by providing incentives from subsidies for new EVs to incentives for scrapping fossil-fuel vehicles.

Proposed subsidies range from a few hundred dollars for two-wheelers up to about $2,500 for cars, and about $1,000 for trucks in the first year of the policy.

These incentives will be phased in, ending by 2030. Private EV four-wheelers don’t get any subsidies but are exempt from road tax and registration fees for vehicles costing up to about $32,000.

The policy also provides a roadmap for phasing out fossil-fueled vehicles in certain categories. Petrol and diesel vehicles will no longer be added to delivery and ride aggregator fleets in Delhi from this year, while only electric auto-rickshaws will be registered from next year, and only electric two-wheelers will be registered in Delhi from 1 April, 2028.

“The proposed Delhi EV Draft Policy 2026 is a significant step towards establishing a clean, accessible and sustainable transport system in the capital,” Chief Minister Gupta says.

Break-up of Delhi’s vehicular pollution

The draft provides no data on how much each category contributes to the 24% of vehicular pollution in Delhi. However, Health Policy Watch has learnt that a recent, yet-to-be-published study estimates that a quarter of vehicular pollution is from two-wheelers, which number over five million in Delhi.

The share of three-wheelers for goods is even more than this. Trucks of various sizes are estimated to contribute about a fifth of the pollution, while the share from private cars is under 10%.

Notably, buses, which are either CNG-fueled or electric, contribute the least, which is why the government’s move to more than double the fleet holds promise.

Are ‘smog guns’ effective?

A visible part of Delhi’s pollution control measures has been smog guns, atop trucks and buildings. These are essentially water-mist cannons and sprinklers. The new action plan persists with them to control dust and vehicular pollution.

But a recent study by the Council on Energy, Environment and Water pointed out that putting these on top of large buildings would cover less that 0.5% of Delhi’s area, or about 3-7 square km. This assessment was based on last year’s Air Pollution Mitigation Plan. The new criteria details are yet to be released.

The truck-borne versions cover more distance as they drive along the main roads, spraying water, but their effectiveness in reducing pollution is equally questionable.

A study by the Indian Institute of Technology (IIT) Delhi found that while smog guns reduce average PM2.5 greatly immediately after sprinkling, the benefit reduces sharply over the next 2-3 hours, and the overall effect after 24 hours was 8%. The range of efficacy is limited to just about 100 to 200 metres on either side of the machine, the research found.

A smog gun on a Delhi road. An IIT-Delhi study has questioned the effectiveness in reducing air pollution.

Measures like smog towers, cloud seeding and even smog towers have been called cosmetic changes and red herrings. While pollution control agencies have ditched smog towers, the Gupta government is planning to continue with cloud seeding trials this year again – despite last year’s fiasco and criticism – although the action plan doesn’t mention it.

Action plan silent on firecrackers

But while there are gaps, several commentators have welcomed the new plan.

It offers “real hope”, says Jyoti Pande Lavakare, a clean air advocate and author of the memoir, “Breathing Here is Injurious to Your Health”.

But the critical missing piece, she says, is the Delhi government’s silence on banning firecrackers. “Without a complete ban, at least from October to March, Delhi’s winter pollution peaks are unlikely to see a significant fall,” she wrote in an opinion piece.

That, however, is not likely, as the Rekha Gupta government had gone to court to lift the ban and got it overturned.

Kandhari calls for deeper reforms. Regional sources, including industrial pollution in NCR (national capital region) and non-compliant thermal power plants within a 300 km radius, remain insufficiently addressed, she points out.

Governance challenges, staff shortages, weak enforcement capacity and fragmented institutions compromise implementation.

“Overall, the plan prioritises visible, technocratic solutions while neglecting deeper structural and institutional reforms needed for sustained air quality improvement,” says Kandhari.

Old plan, but stiffer targets

HPW reached out to pollution-control officials for comment but had not received this at time of publication.

Meanwhile, the government has promised a hard line backed by budgetary allocation and measurable outcomes.

During the peak pollution season, October to January, when PM2.5 levels can be 30-40 times above the WHO’s safe guidelines, the government may consider staggered office timings, work-from-home directives and additional restrictions on polluting vehicles for immediate relief, which is the same as previous years.

It all boils down to implementation. If the chief minister drives her new action and holds officials accountable for reducing pollution, old wine in a new bottle may still work.

Image Credits: Chetan Bhattacharji, CMO Delhi, CMO Delhi.

Digital Tools Can Transform Maternal and Child Health – But Access Barriers Need to be Addressed

13/04/2026 Louise Kpoto & Rajat Khosla

Several digital tools are available to help African women during pregnancy – but millions of women, particularly in rural areas, don’t have access to the internet while data costs too much for poor families.

Each year, hundreds of thousands of women die from complications related to pregnancy and childbirth that are well understood and largely preventable.

Most of these deaths occur in low and middle-income countries, with sub-Saharan Africa carrying the greatest burden. At the same time, millions of families continue to face financial barriers to essential health services, with out-of-pocket costs still accounting for a significant share of health spending.

These outcomes are not inevitable. They reflect choices about how health systems are prioritised, financed, and delivered.

As governments gather this week for the 59th Session of the Commission on Population and Development, there is an opportunity to refocus attention on what will determine progress in the years ahead.

This year’s emphasis on technology is both timely and necessary, but it must be anchored in a broader commitment to equity, financing, and access to quality care, particularly for women, children, and adolescents.

Digital tools to enable informed decisions

Sexual and reproductive health and rights are central to this agenda. Yet access to these services remains uneven, and in many contexts increasingly contested. Today, more than 200 million women globally still lack access to modern contraception.

Ensuring that women and adolescents can make informed decisions about their health is not only a matter of rights. It is fundamental to public health and long-term development outcomes.

Technology and scientific research offer practical pathways to address some of these gaps. Across the Global Leaders Network for Women’s, Children’s and Adolescents’ Health countries, digital tools are already improving access to information, strengthening referral systems, and supporting frontline health workers.

In Kenya, a toll-free digital hotline provides around-the-clock guidance on contraception, sexual violence, and mental health to young women in marginalised communities, reaching tens of thousands of callers annually who would otherwise have had nowhere to turn.

In Tanzania, a mobile application co-designed with community health workers and beneficiaries is improving continuity of care for maternal, child, and adolescent health by connecting facilities, community workers, and local drug dispensing outlets through a shared digital referral system.

New mothers in Khayelitsha in South Africa get guidance from the Mom Connect app. But only women with a mobile phone and data can benefit from this digital tool.

In South Africa, the MomConnect platform has helped register pregnant women attending antenatal clinics in the public health system, delivering targeted health information throughout pregnancy and early infancy directly to women’s mobile phones, including in rural communities where in-person support is harder to access consistently.

Across Ethiopia and Malawi, governments are investing in integrated health information systems that give decision-makers a clearer picture of where services are reaching people and where they are not.

And in Liberia, a WhatsApp-based mobile referral system, MORES, linking rural health facilities to district hospitals has shown to improve the transfer of obstetric emergencies and cut the time to emergency caesarean section significantly.

Barriers to digital health

But the promise of digital innovation will only be realised if we address the scale of the barriers that remain.

As of 2024, internet penetration in Africa reached 40%, yet more than 900 million people on the continent remain offline, and in rural areas, the internet penetration stands at just 28%.

The average cost of 1GB of data on the continent consumes nearly 6% of monthly income, more than three times the level the United Nations considers affordable.

Women, older adults, and people in conflict-affected settings face the steepest exclusion, and research consistently shows that digital health innovations tend to reach more affluent, urban populations first, deepening the very inequalities they are designed to address.

Demographic change makes this work more urgent, not less. Across much of Africa, Asia, and the Global South, populations are young and growing. This can be a source of economic dynamism and social innovation, but only if the right investments are made.

A young population without access to quality education, health services, and economic opportunity is not a dividend. It is a pressure point.

The question before us is not whether population growth presents challenges. It is whether we will make the investments that convert demographic potential into genuine human progress.

Domestic investment in health

The path forward requires prioritisation of domestic investment in health, including reproductive, maternal, newborn, child, and adolescent health. Financing decisions must be aligned with population needs and supported by stronger coordination across sectors, including health, finance, and planning.

At the same time, international partners have a role to play in supporting country-led strategies and ensuring that resources are predictable and aligned.

Technology and research should support these efforts, not operate in isolation from them. Expanding access to digital infrastructure, reducing the cost of connectivity, and investing in local research capacity will be essential to ensure that innovation contributes to equitable outcomes.

The cost of inaction is not borne by those who choose it. It is borne by the woman who cannot reach a health facility in time, by the adolescent girl who has no one to turn to, by the newborn who does not survive the first day of life. For their sake, and for the kind of world we want to build, we cannot afford to step back from this agenda.

Dr Louise Kpoto is the Minister of Health of Liberia

Rajat Khosla is executive director of the Partnership for Maternal, Newborn & Child Health (PMNCH).

Image Credits: Unicef.

Europe Has the Tools to Stop Paediatric RSV. Why Are So Few Countries Using Them?

13/04/2026 Andrew Ullmann & Michael Moore

Unimmunised infants are at a high risk of respiratory infections such as RSV and pneumococcal disease.

Andrew Ullmann and Michael Moore

For six decades, respiratory syncytial virus (RSV) in infants was a public health problem without a solution.

According to the European Centre for Disease Prevention and Control (ECDC), an estimated 250,000 children under five are hospitalised each year across Europe due to RSV infection, overwhelming paediatric wards each winter, and leaving families with lasting emotional and financial scars – yet clinicians have almost nothing to offer beyond supportive care.

That era is over. Since 2022, the European Union (EU) has authorised safe and effective RSV prevention tools: long-acting monoclonal antibodies for infants and maternal vaccines for pregnant women.

The European Centre for Disease Prevention and Control (ECDC) now reports that 23 EU/EEA countries recommend RSV immunisation. The science is settled. The tools are available. The tragedy now is no longer a lack of medicine; it is a lack of political will for timely access.

Troubling divide

The first few seasons of implementation have revealed a troubling divide. Some countries moved decisively and are seeing dramatic results. Others remain held back by structural barriers, political inertia, and fragmented delivery systems.

Between us, we have spent decades on both sides of this equation — one of us (Ullmann) spent eight years in the German Bundestag while holding a chair in infectious diseases; the other (Moore) served as an Independent politician for over a decade and served as Health Minister in the Australian Capital Territory.

We have made the case for public health interventions and had to decide whether to fund them. That dual perspective compels us to say plainly: the remaining barriers to RSV prevention in Europe are not scientific. They are political, structural, and communicative – and every one of them is solvable.

From left to right: Ben Deighton, Monbi Stefanova Chakma, and Dr Michael Moore at the “Communicating the Science of RSV Prevention More Effectively to Policymakers” workshop on the sidelines of the ReSViNET Conference

Europe’s first real-world seasons: a scorecard

The data from the 2023/24 and 2024/25 RSV seasons tell a clear story.

Spain set the benchmark. The region of Galicia was among the first in Europe to roll out a monoclonal antibody, achieving over 90% uptake and an 82% reduction in infant RSV hospitalisations.

The multi-country REACH study, presented at ESPID in 2025, confirmed a 69% reduction in infant RSV hospitalisations across Spain in 2024/25 compared with the pre-immunisation season of 2022/23. Crucially, once Galicia moved, other Spanish regions followed – no health authority wanted to be the one that failed to protect its children.

Italy demonstrated that rapid scale-up is achievable. A central recommendation provided political cover for regional health authorities, and the approach of starting with infants born during the RSV season before expanding to universal coverage proved effective. Lombardy’s 2024/25 campaign showed marked reductions in both emergency department visits and hospitalisations. Some Italian regions achieved coverage rates above 85%.

Germany’s first season under the STIKO recommendation was promising but incomplete. Coverage reached 54% for pre-season infants — a notable achievement for a newly introduced programme — and RSV incidence in children under one year dropped by more than half.

At the University Hospital of Würzburg, postnatal coverage reached 68%. One finding should focus minds: every severe RSV case requiring paediatric intensive care during that season occurred in unimmunised infants. Yet, a parental acceptance study at German university hospitals found that while only 14% of parents actively declined, nearly a third remained undecided. This is not an opposition problem. It is an information gap — and therefore fixable.

UK’s cautionary tale

The United Kingdom chose a different path, opting for maternal vaccination as its primary strategy. The REACH study measured a 26.7% reduction in infant RSV hospitalisations compared to Spain’s 69% with monoclonal antibodies.

Maternal vaccine uptake reached 53% overall, with some disparities: coverage among Black British-Caribbean women was as low as 28%, compared to 61% among White British women.

This is not a failure of the vaccine itself, which has demonstrated efficacy in clinical trials. It is a cautionary lesson in what happens when a single-modality strategy is deployed due to a possible lack of awareness and without adequate attention to delivery infrastructure and equity.

Participants at the workshop: “Communicating the Science of RSV Prevention More Effectively to Policymakers” on the sidelines of the ReSViNET Conference in Rome.

The barriers that data alone won’t fix

In our work with RSV advocates and public health professionals across multiple countries, we hear the same obstacles described again and again – and very few of them are about the evidence.

The first and perhaps most consequential barrier is framing. RSV is still widely perceived as a paediatric problem rather than a population-level public health issue. This distinction matters more than it might seem because it determines which budget line pays for prevention, which ministry owns the policy, and how much political capital a government is willing to spend.

When RSV is reframed as a workforce issue – parents unable to work, productivity losses, the strain on family wellbeing – and as a health system capacity issue – emergency departments overwhelmed, elective procedures delayed – the political calculus changes entirely.

The second barrier is infrastructural. Consider the Netherlands, where a high proportion of births occur at home. Midwives are typically the first point of contact in healthcare, but they are not authorised to administer monoclonal antibodies.

By the time a newborn reaches a health centre, days or even weeks may have passed – a critical window during which infants are most vulnerable to severe RSV infection.

Similar delivery pathway gaps exist across Europe, wherever immunisation programmes assume hospital-based birth as the default. One size does not fit all.

Third, terminology itself creates confusion. The distinction between vaccines and monoclonal antibodies is meaningful to clinicians but baffling to parents and policymakers alike.

In a post-COVID environment where vaccine hesitancy remains elevated, this confusion is not neutral – it generates unnecessary resistance. Countries that adopted the simple framing of “RSV prevention” rather than expecting the public to navigate technical distinctions achieved markedly higher uptake.

Finally, and this is something we can speak to from direct experience, policymakers respond to different incentives than clinicians.

A health minister facing competing demands from cancer services, cardiovascular disease, mental health, and social care will not be moved by cost-effectiveness ratios alone.

They need to understand cost savings – hospital beds freed up this winter, emergency departments decongested this season, and parents returning to work this month.

The distinction is not academic. One of us (Ullmann) observed it repeatedly in the Bundestag. Many policymakers are not really interested in a cost-effective solution. They want to know what can save money quickly. And the public health officials who write guidelines and allocate regional budgets are equally important — and far too often overlooked in advocacy strategies.

From left to right: Dr Andrew Ullmann, Roberto Adriani, and Prof Federico Martinón-Torres at the “Communicating the Science of RSV Prevention More Effectively to Policymakers” workshop on the sidelines of the ReSViNET Conference.

What the successful countries did right

The lessons from Spain and Italy are transferable, and they go well beyond the clinical evidence.

Both countries benefited from national-level recommendations that gave political cover to regional health authorities. In Spain, once Galicia published its results — crucially, not just in Spanish but also in English-language journals — other regions came under immediate pressure to follow suit. Publication strategy became an advocacy strategy.

RSV prevention through monoclonal antibodies has an unusual advantage: the impact is visible within a single season. Unlike some immunisation programmes, where benefits accumulate over years, the before-and-after effect of RSV immunisation is evident across the entire health system. Doctors, hospital managers, and nursing staff all notice when paediatric wards are less full during winter. This immediacy is a powerful tool for sustaining political commitment.

Coalition-building proved essential. Success came about when paediatricians, academic researchers, patient groups, and the media worked in concert. In Spain, sustained media coverage of RSV outbreaks created public demand that reinforced the clinical evidence. Advocates did not simply publish papers and hope for the best; they built and maintained relationships with journalists and editors over time.

And a practical insight that should not be underestimated: delivering monoclonal antibodies in the birth centre, as part of routine newborn care, removes friction. It eliminates the need to recall families, avoids missed appointments, and carries inherent credibility. When something is administered as standard care in the first days of life, parental trust follows naturally.

What Europe must do now

As we approach the 2026/27 RSV season, we see five priorities.

First, every EU/EEA country should have a funded RSV infant immunisation programme in place, either through the public health authority or through the mandatory health insurance, as applicable.

Twenty-three countries now recommend immunisation, but not all have backed that recommendation with funding.

Second, messaging must be unified and simple. “RSV prevention” should be the standard term and should be easy to implement in the health care system. Health literacy is a system responsibility, not a burden to place on parents navigating a newborn’s first weeks.

Third, delivery pathways must be designed on a country-by-country basis. Countries with high rates of home birth, decentralised health systems, or fragmented primary care need tailored strategies, not imported models.

Fourth, we must invest in advocacy infrastructure. Clinicians and public health professionals need structured support in communicating with policymakers and the media. The ability to translate science into politically compelling arguments is a skill – and one that can and should be taught. Science alone has never been sufficient to drive implementation. It takes people who can carry that science into the rooms where decisions are made, and these are parents and physicians.

Fifth, countries must commit to rapid, transparent publication of their outcomes. Spain’s early results created a demonstration effect that accelerated adoption across Europe. Every country implementing RSV prevention owes it to the continent – and to the families it serves – to publish what it finds, quickly and in English, so that the evidence base continues to grow.

The season ahead

The science has delivered. The tools are here. What is needed now is the political courage to ensure funding for these programmes, the structural imagination to deliver them across the diverse healthcare settings across Europe, and the communication skills to sustain public and political support that makes implementation possible.

Every RSV season without comprehensive prevention is a season of preventable hospitalisations, preventable family suffering, and preventable strain on health systems that are already under immense pressure. We have waited sixty years for these tools. We should not waste another winter.

Dr Andrew Ullmann is a former member of the German Bundestag (2017–2025) and professor of infectious diseases at the University Hospital of Würzburg in Germany.

Dr Michael Moore AM is chair of the World Federation of Public Health Associations’ (WFPHA) International Taskforce on Immunisation, Minister for Health in the government of the Australian Capital Territory (1998–2001), and former president, of the WFPHA (2016–2018) in Australia.

Image Credits: Alamy.

Pandemics Are Not Just Biological Crises

12/04/2026 Health Policy Watch

People typically think of pandemics in terms of their biological consequences, but science journalist Laura Spinney argues that their impact is shaped just as much by human behaviour and language.

On a recent episode of “Dialogues,” part of the Global Health Matters podcast series, Spinney joined host Garry Aslanyan to discuss the lessons of the 1918 influenza pandemic. Spinney is the author of Pale Rider: The Spanish Flu of 1918 and How it Changed the World.

She argues that despite its global ramifications, the so-called “Spanish flu” remains largely absent from collective memory. Its impact extended far beyond Europe and North America, with countries like India suffering some of the worst losses, and it influenced the course of major wars, independence movements, and even the arts.

“The 1918 pandemic accelerated the pace of change in the first half of the 20th century and helped shape our modern world,” Spinney said.

Central to this understanding is the role of language. The way a pandemic is named shapes how it is perceived, and the term “Spanish flu” is, in hindsight, a misnomer that obscures its global nature.

Naming informs how people assign blame, assess risk, and respond to a crisis. Early in the HIV epidemic, for instance, labelling the disease as “gay-related” distorted public understanding and fueled stigma.

As Spinney explains “When there is an outbreak of [infectious] disease somewhere, it has to be named quite quickly because you can’t respond to it if you can’t talk about it.”

At the same time, she suggests global health must move toward a more inclusive linguistic approach. While English dominates international discourse, relying on a single language poses significant risks in managing health crises in a multilingual world.

Listen to the full episode >>

Image Credits: Global Health Matters Podcast.

Trump’s 2027 Budget Deepens Cuts to Global and Domestic Health

10/04/2026 Kerry Cullinan

The proposed elimination of “disease-specific account” is likely to mean the end of the US President’s Emergency Plan for AIDS Relife (PEPFAR).

US President Donald Trump wants to eliminate $4.3 billion from the US government’s global health budget, including all funding for the Pan-American Health Organization (PAHO), the World Health Organization’s (WHO) regional organisation for the Americas.

His proposed budget for 2027, which needs to be approved by the US Congress, includes a 42% increase – some $445 billion – for defence, including “$1.1 trillion in base discretionary budget authority” for the Department of War.

In contrast to the lavish military budget, deep cuts are proposed to domestic health programmes, with an overall 12,5% reduction in the Department of Health and Human Services (HHS) budget.

Domestic cuts include $923 million less for HIV/AIDS, $561 million less for maternal and child health, a $576 million cut to mental health (including suicide prevention, substance use prevention and treatment) and a $872 million cut to health workforce programs.

The Centers for Disease Control and Prevention (CDC) is allocated $663.8 million, the same amount as previously and the budget claims that CDC “will play a key role in implementing an America First approach to global health to replace the functions of the World Health Organization.”

Driving these cuts is Russell Vought, head of the White House Office of Management and Budget. Vought, former vice-president of the right-wing think tank Heritage Foundation, co-authored Project 2025, the conservative blueprint for governance being followed by the Trump administration.

No money for ‘corrupt’ PAHO

When Trump announced that the US would leave the WHO on his first day in office in January 2025, he made no mention of PAHO, and US officials have continued to interact with the other 34 member states in the regional body.

However, the US has not paid its membership fees (called assessed contributions) to PAHO since 2024, and owes the body over $134 million.

In his latest budget ask, Trump describes the WHO and PAHO as “corrupt organizations [that] have shown no independence from inappropriate political influences, such as when the WHO aided in the COVID-19 coverup.”

In February, PAHO projected a 19% reduction in its 2026/27 budget, and is cutting 17% of staff. Its 2024/24 budget was $820 million, which means a $155 million cut. Measles and dengue are surging in the region, while health services in the Caribbean have been badly affected by extreme weather events.

WHO staff in the Americas region (PAHO) researching mosquitos to better understand the distribution of disease-carrying species.

No more disease-specific aid

In a death knell for the US President’s Emergency Plan for AIDS Relief (PEPFAR), the proposed budget for the US State Department will “eliminate disease-specific accounts”.

The reason given is that this will “provide the Department crucial agility to address the actual needs of each recipient country—across HIV/AIDS and other infectious diseases such as malaria, tuberculosis, and polio—to strengthen global health security and protect Americans from disease.

PEPFAR, started by Republican President George W Bush, is the US government’s most successful aid programme, credited with saving 25 million lives and preventing millions of new HIV infections.

However, the Trump budget claims 60% of its funds were “wasted”. It also makes the misleading claim that “PEPFAR funded health workers who performed over 21 abortions in Mozambique”.

The US has not allowed its foreign aid to be used to fund or lobby for abortions since it enacted the Helms Amendment in 1974.

Four Mozambican nurses, whose salaries were partly covered by PEPFAR, did not know that they could not provide abortions (which are legal in Mozambique) if they received PEPFAR funding, as previously reported by Health Policy Watch.

PEPFAR’s own compliance mechanisms identified the violation, and it took “immediate corrective action with the partner”, including ensuring that Mozambique repaid PEPFAR for the nurses’ salaries, the plan said in a statement.

Anti-contraception bias

There is no funding ask for contraception or reproductive health. The budget also contains several disparaging references to contraception, something that Project 2025 also takes issue with, preferring “natural contraception”.

The proposed budget disparages PEPFAR for “promoting reproductive health education and access to birth control and other harmful programs couched under ‘family planning’ in Ghana.”

“The Budget would ensure no funding supports abortion, unfettered access to birth control, and also eliminates funding for circumcision and Lesbian, Gay, Bisexual, Transgender, and Queer services to better focus funds on life-saving assistance.” according to proposal.

“The United States should not pay for the world’s birth control and therapy.”

New ‘America First Global Health Strategy’ bilaterals

DRC Health Minister Dr Roger Kamba, US Charge D’Affaires Ian McCary, DRC Prime Minister Judith Tuluka Suminwa at the signing of the bilateral health MOU

Included in the State Department Budget is $5.1 billion to “execute” its America First Global Health Strategy (AFGHS), the bilateral Memorandums of Understanding (MOUs) with individual countries.

“The President’s new vision of bilateral health assistance eliminates bloated Beltway Bandit contracts, does more with fewer dollars, and transitions recipient countries to self-reliance,” according to the budget.

By 10 April, the State Department had signed 30 bilateral global health agreements. The latest is with the Philippines, signed on 9 April (no details available, including the amount involved).

It follows an MOU with Cambodia, the first in Asia, signed on 6 April. The US will provide $30.8 million over five years for infectious disease prevention and response capabilities, including “accurately identify pathogens of epidemic and pandemic potential before they spread internationally” and “a robust network of laboratories” aimed at eliminating malaria in Cambodia.

A day before this, a bilateral was signed with Tajikistan, the first in the South and Central Asia region, involving $38 million in US aid over the next five years to “support Tajikistan’s efforts to combat HIV/AIDS and tuberculosis, while bolstering disease surveillance and outbreak response.”

Way forward

The US Congress still needs to approve the budget and may well authorise more money, particularly for domestic health.

In February, Congress approved a $50 billion Foreign Affairs Bill, including $9.4 billion for global health for the fiscal year 2026, almost three times larger than Trump’s request for $3.8 billion.

White House budget head Vought will testify before the House budget committee on Trump’s request next Wednesday.

Image Credits: Gage Skidmore, International AIDS Society, PAHO/WHO.

Record ODA Cuts: Top Donors Slash Aid as Global Health Risks Grow

10/04/2026 Felix Sassmannshausen

Five major economic powers – led by the US – drove nearly 96% of 2025’s global aid funding reduction.

Historic declines in Official Development Assistance (ODA) have set international aid back a decade, prompting civil society warnings that the ODA cuts will further devastate funding for global health, education and social protection.

The Organisation for Economic Co-operation and Development (OECD) released preliminary data showing total global aid fell by 23.1% in real terms during 2025, marking the most severe single-year contraction ever recorded.

“It’s deeply concerning to see this huge drop in ODA in 2025, due to dramatic cuts among the very top donors,” Carsten Staur, chair of the OECD Development Assistance Committee (DAC), said in a press statement.

While a few countries exceed the United Nations target of allocating 0.7% of their gross national income to foreign aid, the world’s major economic powers have abruptly withdrawn their support. This collective retreat was highly concentrated, with five top nations driving 95.7% of the total global reduction.

German Development Minister Reem Alabali Radovan.

The United States alone accounted for three-quarters of the overall drop after slashing its budget by nearly 57%. Germany, France, the United Kingdom and Japan all reported significant decreases alongside the US, marking the first time these top providers simultaneously shrank their budgets.

This collective retreat resulted in Germany becoming the single largest global provider for the very first time, despite reducing its own overall aid by over 17%.

“Despite painful cuts, we stand by our international responsibility,” Reem Alabali Radovan, Germany’s development minister, said. “This is existential for millions of people in light of extreme global challenges, crises and wars.”

Core development and humanitarian aid slashed

Drastic ODA cuts threaten the basic survival and essential infrastructure of the world’s most vulnerable.

Beneath the headline figures, the OECD data highlights severe structural shifts that are draining funds from vulnerable countries precisely when their economic burdens are mounting.

“Fiscal pressures on developing countries are growing, and the ongoing conflict in the Middle East represents a significant risk for global growth and food security,” OECD Secretary-General Mathias Cormann said during the data launch.

According to the OECD data, vital humanitarian aid plunged by almost 36%, accelerating the reversal of a five-year growth trend, while bilateral assistance to sub-Saharan Africa fell by 26.3%. Core development programming also suffered its largest historical contraction, dropping by over 26%.

Multilateral contributions similarly faced severe constraints, declining by 12.7% overall across the international landscape. Core funding to the United Nations (UN) system experienced a 27% decline, marking the largest annual drop on record for the global body.

Global health advocates warn these broader funding contractions arrive just as major initiatives, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, the Vaccine Alliance, face critical cuts.

Geostrategic and economic pivot reshapes aid

EU humanitarian supplies face uncertainty as European institutions pivot funding toward regional security and domestic interests.

The recent ODA cuts expose a stark geostrategic pivot, as major donors increasingly prioritise immediate regional security and domestic economic interests over broad human development. Beyond the massive volume drops from individual nations, European Union (EU) institutions accelerated this downward trajectory by reducing their overall assistance by 13.8%.

Adding to the shifting landscape, bilateral funding to Ukraine fell by 38.2%, yet when including EU institutional funds, total assistance to the nation still exceeded the combined aid given to all Least Developed Countries.

Civil society organisations warn that these institutional funding choices will inflict direct damage on fragile communities and dilute the core purpose of international cooperation.

“Though framed as part of the ‘paradigm shift’, EU Institutions and EU Member States have already been cutting grants to those who need them the most,” Mafalda Infante from Plataforma Portuguesa das ONGD said in a joint press release by Concord, a European confederation of development NGOs.

Critics argue this controversial policy shift toward mutual interests heavily disadvantages vulnerable states by increasingly designing cooperation to benefit European companies.

“In order to support the reduction of poverty and inequalities the EU should dedicate more ODA to sectors like health, education and social protection, but today’s figures show another path being taken,” the NGOs stated.

Projections remain grim

OECD projections indicate a continued decline in global aid through 2026, extending a historic downward trend.

Despite the gloomy overarching narrative, several nations have demonstrated a steadfast commitment to sustaining international development. Eight member countries actually increased their assistance in 2025, resisting the broader fiscal pressures that drove the global reductions.

Notably, Denmark, Luxembourg, Norway and Sweden continued to exceed the UN target of allocating 0.7% of their gross national income to foreign aid. Additionally, 12 non-DAC countries increased their collective development finance by 4.5% to reach $13.3 billion.

However, these non-DAC providers shifted their direct funding from multilateral contributions to country-to-country assistance. Nations like Qatar and the United Arab Emirates drove this growth, with the UAE specifically directing its bilateral funds to immediate regional development and humanitarian crises in the West Bank and Gaza Strip.

Looking ahead, the OECD projects an additional 5.8% decline in global aid for 2026, raising alarms over the international community’s ability to respond to future shocks.

“I can only plead that DAC donors reverse this negative trend and start again to increase their ODA,” DAC Chair Staur said.

Drastic UK Aid Cuts Hit Fragile African Health Systems

Image Credits: ‪Salah Darwish via Unsplash, Felix Sassmannshausen/HPW, Bundesregierung/Steffen Kugler, European Union, OECD.

EXCLUSIVE: China to Join WHO Executive Board – Among the Countries to Screen Candidates for Next Director General

09/04/2026 Editorial team

WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva in February. His term ends in August 2027.

Several WHO member states about to join the Executive Board have dubious human rights records, but they will shortlist Director General candidates at the Organization’s most consequential period in a generation.

The World Health Organization (WHO) Executive Board does not make headlines. It should. This is the body that screens Director General candidates, whittles the field down to three, and presents them to the World Health Assembly (WHA) for confirmation.

Whoever is confirmed to the board at this year’s WHA in Geneva in May will have an outsized say in who leads the world’s most important health organization at arguably its most precarious moment. And precarious is putting it kindly. Member states are fleeing, including the historically largest donor, the United States, which said it had officially completed its withdrawal in January.

Right now, across all six WHO regions, the deals are being done to determine who fills the rotating seats on the board’s 34-member roster, with 10 members rotating out in 2026 and 10 new ones taking their place.

EB will select three DG candidates

So why does any of this matter? The countries entering the Executive Board in 2026 will screen the Director General (DG) candidates and narrow the field to three finalists before the full WHA makes its final call in 2027.

That process begins this year. Any serious candidate already knows it. As Health Policy Watch reported in February, those with their eye on the top job are already touring capitals, working the conference circuit, and calling in favors – with exactly the countries now taking their seats on this board.

They still need the golden ticket: a formal nomination from their own Ministry of Foreign Affairs, and that clock starts the moment Tedros issues his call for candidates, anticipated later this month.

The question is whether the incoming countries will have the mettle to reverse the damage done to the organization, or whether they will simply provide fresh cover for an institution that is at risk – budget-wise and politically – before a new DG even gets the chance to restore some credibility.

China in the new EB line-up

So who do we have? Up first is the Western Pacific Region (WPRO). At the 76th session of the WPRO, held behind closed doors in Nadi, Fiji, in October 2025, member states made a little-publicized decision to nominate China to WHA 2026, replacing Australia, whose term expires next month.

The closed-door nature of the proceedings suggests this was contentious, a reading reinforced by the chair’s report, which notes that the equitable distribution of seats within WPRO will be revisited for a final decision sometime in 2026.

What exactly happened in that room? The context matters. Former WPRO Regional Director Takeshi Kasai was terminated following allegations of misconduct, leaving the region reeling and lacking leadership.

One could reasonably assume that both Indonesia, which recently and controversially opted to depart WHO’s South East Asia Region (SEARO) for WPRO, and New Zealand, had their own ambitions for a board seat.

The internal turmoil is likely to have done little to smooth the path to consensus on China’s nomination.

China described the US withdrawal from the WHO as a lack of leadership at the WHO Executive Board in February.

European region

Then we head to the European Region, where Georgia and the United Kingdom have been allocated Executive Board seats beginning May 2026. Yes, the UK is still in WHO’s far-flung European Region of 53 member states, which extends from Iceland eastward to the Russian Federation and Central Asian republics. The UK and Georgia will replace Switzerland and Ukraine whose terms end this month.

You really have to read the fine print to find this, and scratch around in Georgian news to confirm it. The UK’s inclusion is unsurprising. Based on Resolution EUR/RC53/R1, permanent members of the UN Security Council within the European Region are entitled to Executive Board membership for three out of every six years.

France, on the same basis, is already confirmed to follow in 2027. Worth noting too that Ukraine loses its board seat while its medical facilities and civilian infrastructure continue to be bombed by Russia, a detail that speaks for itself. Reports indicate that Russia stood as a competing candidate for the seat ultimately won by Georgia, meaning it was not afforded the same rotating privileges extended to the United Kingdom and France.

African and Eastern Mediterranean Regions

Over in the African Region, four out, four in: Cote d’Ivoire, Guinea, Mozambique, and South Sudan replace Togo, Cameroon, Comoros, and Lesotho respectively, with Cote d’Ivoire also tapped to serve as Vice-Chair of the Executive Board from the 159th session onwards.

From the Eastern Mediterranean Region (EMRO), Qatar completes its term at the close of the 79th World Health Assembly in 2026, with Kuwait set to take its seat through to May 2029.

Question marks in South East Asia and Americas

All four regions – Africa, EMRO, EURO and WPRO – have now published their nominations, though they are buried deep inside the archives of WHO’s never-ending pile of papers.

Two question marks remain. First, who will replace the Democratic People’s Republic of Korea (DPRK) from SEARO? Given the region’s smaller size, the list of viable candidates is short. Replacing one pariah with another in the form of Myanmar seems unlikely. The Maldives has limited diplomatic capacity. That leaves India, Sri Lanka, or Bangladesh, given Nepal and Thailand still have time left on their existing terms.

If India is paying attention, and it almost certainly is, it may well calculate that with China joining the board, it cannot afford to remain aloof. The cold diplomatic war between the two countries, and their competing claims to the title of pharmacy of the world, gives India every reason to want influence over an organization that can directly shape that designation.

Second, the Americas. With Barbados going out, logic suggests another Caribbean nation could come in, but no reporting has yet confirmed a nomination. Jamaica or Trinidad and Tobago would both have the diplomatic capacity to make a push and represent the region credibly. And notably, the United States will not be at the table, given their recent exit from the WHO.

The board that emerges from Geneva in May will be imperfect. Based on historical precedent, including the DPRK being confirmed to the board three years ago despite its status as a global health pariah, it is hard to see any of the proposed names being rejected.

That said, several of the countries to be represented have human rights records that would raise eyebrows anywhere else. But they will help decide who leads WHO through its most consequential period in a generation. The world will be watching. One can only hope they set politics aside and do what the role demands: govern.

Following WHA 2026, the Executive Board is expected to be composed of the following Member States:

Staying on (continuing terms):

AFRO: Cabo Verde (2025-2028), Central African Republic (2025-2028), Zimbabwe (2024-2027)
AMRO/ PAHO: Chile (2024-2027), Costa Rica (2024-2027), El Salvador (2025-2028), Haiti (2025-2028), Panama (2025-2028)
SEARO: Nepal (2025-2028), Thailand (2024-2027)
EURO: Bulgaria (2024-2027), Israel (2024-2027), Norway (2024-2027), Poland (2024-2027), Serbia (2025-2028), Spain (2025-2028)
EMRO: Egypt (2025-2028), Lebanon (2024-2027), Saudi Arabia (2025-2028), Somalia (2024-2027)
WPRO: Brunei Darussalam (2024-2027), Japan (2025-2028), Republic of Korea (2024-2027), Solomon Islands (2025-2028)

Rotating in from May 2026:

AFRO: Cote d’Ivoire, Guinea, Mozambique, South Sudan
AMRO: TBC (replacing Barbados)
SEARO: TBC (replacing DPRK)
EURO: United Kingdom, Georgia (replacing Switzerland, Ukraine)
EMRO: Kuwait (replacing Qatar)
WPRO: China (replacing Australia).

Image Credits: WHO/X.

Growing Body of Evidence Links Air Pollution and Diabetes, But More Research is Needed

09/04/2026 Disha Shetty

Exposure to air pollution, particularly in the long term, is associated with an increased risk of diabetes.

Air pollution increases the risk of diabetes, particularly when exposure is long-term, according to emerging evidence.

A 2025 study from China involving 18,606 middle-aged and elderly adults found that long-term exposure to air pollution – both indoor and outdoor – significantly increased their risk of metabolic disorders like diabetes.

“This national cohort study shows that outdoor air pollution -– particularly PM1, PM2.5, and their chemical components – is an important environmental factor contributing to GMDs [glycolipid metabolic disorders],” according to the study, published in the World Journal of Diabetes.

Long-term exposure results in higher toxicity than short-term exposure.

This is one of a series of studies on the association between diabetes and air pollution produced in the past decade.

But researchers need to factor in several variables that could affect the results, such as sugar consumption, genetics and socio-economic conditions, Arindam Roy, climate science advisor at the Clean Air Fund, told Health Policy Watch.

“It’s difficult in terms of getting the data right, because you need to have a substantial amount of air quality monitors, or by any means, you need air quality information at a very high resolution. You also need health information at a very high resolution,” Roy said.

A 2022 study published in The Lancet concluded that, “in 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure.”

While type 1 diabetes is an autoimmune condition where the body attacks the insulin-producing cells, type 2 diabetes is influenced by environmental factors, diet and exercise.

Solid fuel not linked to higher diabetes risk

Using solid fuels does worsen indoor air pollution, but research does not show any association with metabolic disorders like diabetes.

The 2025 study from China looked at air pollution as a result of various particle sizes ranging from PM1, PM2.5 and PM10. It studied the health impact over a five-year (long-term) and one-year (short-term) period.

Researchers found that while any kind of exposure to air pollution increases the risk of developing diabetes, the impact of long-term exposure was strongest.

The terms short-term and long-term are not very well defined, but short-term usually refers to episodic high exposure around events like wildfire or a season of high exposure. Long-term duration is usually measured in a timeline of years.

The use of solid fuels for cooking, which is known to push up indoor air pollution, did not appear to increase the risk of developing diabetes in the China study.

The researchers concluded that the lack of any association with air pollution from solid fuels and metabolic disorders like diabetes “underscores the urgent need for targeted interventions to improve outdoor air quality and reduce metabolic risks at the population level.”

This result is also in line with another four-year multi-country trial, the Household Air Pollution Intervention Network (HAPIN), which studied 3,200 households in Guatemala, India, Peru, and Rwanda. Study participants switched from cooking on solid stoves to LPG but did not see any significant health gains – a result that surprised the study’s researchers.

Also read: Switching from Biomass to LPG Failed to Show Health Gains in Four-Country Study of Household Air Pollution

Lack of adequate ground monitors is getting in the way

A 2022 study from Denmark that studied 1.9 million people found that exposure to all air pollutants was associated with a higher risk of diabetes.

Studying the health impacts of air pollution requires two sets of data – one on air pollution, and the other on health. Currently, very few countries have both these datasets at hand.

Air pollution data requires better monitoring on the ground using ground monitors.

“We do have satellite-based or modelled air quality data, which are very high resolution, like one kilometre or so. But again, you need ground-based monitors to validate the data in those particular areas to give you more confidence in your research,” Roy said.

Sharing health data is also often fraught with ethical challenges, apart from the fact that institutions in many countries might not even have them in digital format. Then there is the issue of both health and environmental researchers working in silos.

Evidence is lagging in most parts of the world

High-quality evidence on air pollution’s impact on health is available only in some countries and regions, such as the US, UK, and Europe.

“China is one example of a country where AQ (air quality) data has been improved during the recent past. There are other countries as well where accessibility has improved,” Roy said.

Africa in particular, and much of the developing world in general, suffers from the lack of evidence, researchers told HPW.

“The monitoring is not nationwide. A lot of the monitoring is centered in urban areas, and especially in the capital cities. Most of this monitoring is not national government activities,” said Gordon Dakuu, a Ghana-based analyst with Clean Air Fund.

“These are mostly project-based initiatives using Low-Cost Air Quality Sensors with a few Reference Grid monitoring. So, in Kenya, it is just Nairobi. In South Africa, it is Johannesburg, then when you come to Ghana, [it] is just Accra.”

The US administration’s cuts to the budget of its Environmental Protection Agency (EPA) have further disrupted air quality monitoring in several global locations.

Currently, the awareness of the air pollution-diabetes connection is also low.

“We tried engaging [people] on how air pollution can lead to some of these conditions. And you see, people’s perception of the linkages between air pollution and diabetes is still very weird,” Dakuu said.

“They think diabetes has to do with eating sugar, especially white sugar. So, I think there is still a lot for us to do as far as public health sensitization of people is concerned about the risk factors.”

Image Credits: isensusa/Unsplash, hailegebrael Berhanu/Unsplash.

Trump Administration Nominates USDA Official to Lead World Food Programme

09/04/2026 Sophia Samantaroy

Thousands of Somalis escaping drought and conflict have been arriving every month in sprawling settlements on the outskirts of towns, like this one in Baidoa, south-central Somalia, pictured in August 2022. The World Food Programme is the largest humanitarian organisation operating in the country.

The Trump administration has put forward Luke J Lindberg, the US Department of Agriculture trade and foreign agricultural affairs under secretary, as its pick for executive director of the United Nations World Food Programme (WFP).

Lindberg would succeed Cindy McCain, who announced her resignation in October due to health issues.

“Throughout his career, Under Secretary Lindberg has demonstrated the strategic vision, geopolitical insight, and focus on accountability that are necessary to lead WFP in delivering emergency food assistance,” the State Department said in its media note.

The WFP, founded in 1961, is the largest humanitarian organization in the world, offering emergency food relief, direct cash assistance, and technical and development assistance.

The programme is overseen by an executive director, who is appointed jointly by the UN Secretary General, and the Food and Agricultural Organization (FAO) Director-General.

The US is the single largest WFP donor, and has chosen its executive director for each five-year term since 1992. Under the first Trump Administration, WFP head David Beasly, the former South Carolina governor, oversaw the agency raising $55 billion in funding and a Nobel Peace Prize.

From trade to aid

USAID and WFP channelled American-grown food to countries in need.

Prior to serving as USDA under secretary, Lindberg founded South Dakota Trade, an association that assists Midwestern businesses in accessing international markets. Lindberg has also held roles at the Export-Import Bank of the United States, where he served as chief of staff and chief strategy officer; and at Sanford World Clinic, a Sioux Falls-based health system.

Lindberg is also a fellow at the America First Policy Institute, a conservative think tank founded by Trump administration officials in 2021, and a member of the Council on Foreign Relations.

The State Department pointed to Lindberg’s experience overseeing the McGovern-Dole Food for Education Program, Food for Progress program, and the Food for Peace program as demonstrating “proven operational excellence at the scale required for WFP leadership.”

World Food Programme in crisis

The prolonged conflict in Sudan is hindering key humanitarian aid, including the World Food Programme’s work.

Lindberg’s nomination comes at a fraught time for the UN agency. Under the second Trump administration, WFP saw its funding slashed in half following the shuttering of the US Agency for International Development (USAID).

The loss of $2.6 billion in US funding triggered the layoff of a third of its staff – and a surge in malnutrition in some of the most fragile humanitarian states.

WFP has issued emergency appeals to aid Sudanese refugees, Afghan families, and Ukrainians – some of the 103 million people supported by the agency in 2023.

The war in the Middle East further complicates WFP’s mission of providing life-saving aid. “If this conflict continues, it will send shockwaves across the globe, and families who already cannot afford their next meal will be hit the hardest,” said Carl Skau, WFP deputy executive director and chief operating officer in a press statement. “Without an adequately funded humanitarian response, it could spell catastrophe for millions already on the edge.”

“The more consequential question is whether Trump’s pick will rebuild WFP’s lifesaving mission, or continue dismantling an enterprise awarded the Nobel Peace Prize just six years ago,” wrote Sam Vigersky, an international affairs fellow at the Council on Foreign Relations in a March opinion piece. “Humanitarian aid is no longer billed as a needs-based charity, but an explicit lever of statecraft.”

Vigersky argued that the UN Secretary General is likely to green-light Trump’s pick, given the tense status of US-UN relations and the US stake in its financing.

With the State Department and USDA now channelling money back into the WFP, it remains to be seen whether WFP under Lindberg’s leadership will recover its funding and its impact.

The State Department reiterated its stance: “Our support for Luke J Lindberg’s candidacy demonstrates the U.S. commitment to keeping the WFP focused on its core mission: feeding those in need.”

Image Credits: Mercy Corp/ TNH, WFP/Abubakar Garelnabei.