Algeria, speaking for the Africa Plus Group.

Two largely opposing proposals for a pathogen access and benefit-sharing (PABS) system – the last outstanding piece of the World Health Organization’s (WHO) Pandemic Agreement – were tabled during the seventh round of negotiations, which ended on Friday.

Africa consolidated behind a “federated” model, while the European Union and its developed-country allies backed a “hybrid” model.

The PABS annex aims to set out how dangerous pathogens are shared (access) during public health emergencies and how to share any medical products (benefits) produced as a result of manufacturers getting access to this information.

Speaking at the close of talks, WHO Director General Dr Tedros Adhanom Ghebreyesus said that at the start of the week, “access and benefit-sharing started feeling like two sides of an argument” but by the end of the week “more of us now start to see them again as two halves of one promise”.

“That shift matters, even where the text hasn’t fully caught up to it yet,” said Tedros. “I will not pretend the remaining issues are small. Real gaps remain, and they deserve the same seriousness in the next session that they have received in this one.”

Tedros also reported that “many members” had told him this week that finalising the annex this year is possible “so let’s continue to aim for that”.

Regional nodes in a ‘federated’ system

Algeria, speaking for the WHO Africa region plus Egypt, Somalia, and Sudan (the Africa Plus Group), described the “federated” model as “architecture built around sovereign national and regional nodes, interconnected through a WHO-hosted metadata index and catalogue with unique, persistent identifiers, ensuring end-to-end traceability of biological materials and pathogen sequence information”.

This means that every party getting access to pathogen information could be tracked throughout the system.

“It conditions access on binding benefit-sharing commitments at the point of use, and treats digital sequence information and physical materials with parity,” said Algeria at the closing session.

In other words, parties that want access to pathogen material will need to sign contracts that commit them to sharing any benefits.

Algeria’s representative added that African capitals were still consulting on the design features that will “give practical effect to the federated model”, and hoped to return to the negotiating table “with firm compositions and concrete textual proposals”.

‘Dilute access conditionalities’

In apparent criticism of the EU’s “hybrid” model, Algeria added that the federated model “offers a more balanced and sustainable approach than models that rely on centralised infrastructures, dilute access conditionalities, or leave open parallel channels that may perpetuate the status quo that failed during COVID”.

Algeria also called for further work on “the treatment of derivatives, including scientific products developed from pathogen sequence information shared through the PABS system, and on intellectual property to ensure that benefit sharing obligations cannot be circumvented through downstream innovation”. Countries that share biological materials and pathogen sequence information “must receive fair, equitable, predictable, and tangible benefits consistent with Article 12 [of the Pandemic Agreement]. 

“Implementation must be accompanied by adequate financial, technical, and capacity-building support for developing countries, particularly for national laboratories and for laboratories participating in the WHO-Coordinated Laboratory Network (WCLN).”

The UK’s Matthew Harpur chaired his final IGWG meeting this week.

The European Union finally put a proposed “hybrid model” to the Intergovernmental Working Group (IGWG) that is conducting the talks, although the proposal has been discussed for several months.

The “hybrid” proposal consists of a mix of mandatory and voluntary measures for sharing pathogen information and benefits that flow from this information.

It envisages both a global WHO-controlled PABS system working through the WCLN with some benefit-sharing commitments, and national processes where countries can share pathogen material with groups and laboratories outside the formal PABS system according to mutually agreed terms.

Leadership changes

Australian diplomat Madeleine Heywood is stepping back as vice-chair of IGWG after five years of negotiating on the Pandemic Agreement.

When the IGWG convenes again from 14–19 September, several key members will no longer be part of the process – including co-chair Matthew Harpur of the UK and vice-chairs Madeleine Heywood (Australia) and Dr Hanan Al Kuwari (Qatar).

Heywood told the meeting that her baby had been six months old when the pandemic agreements talks had started and was now five-and-a-half years old.

“There aren’t many left now here who were in this room, masked and distanced, when we started this process,” said Heywood.

“Every one of us knows why we’re here, and how important it is to complete the pandemic agreement and get it into force. 

“When we have breakthroughs, it’s because we understand each other. So what I wanted to ask you is to please talk to each other, listen to each other, and please ask yourself, and ask yourself often, because this process is always evolving: ‘What more can I be doing towards a common understanding in this room to find common ground? Who can I reach out to? What conversations can I be initiating?”

Budget shortfalls and political pressures threaten Unitaid's independent market-shaping global health mandate.
Budget shortfalls and political pressures threaten Unitaid’s unique market-shaping mandate in the fight against HIV/AIDS, tuberculosis (TB), malaria, and cervical cancer.

Unitaid is quietly searching for its next leader behind closed doors amidst growing demands for transparency. Whoever takes the helm of the market-shaping agency will inherit an organisation that faces acute financial shortfalls and mounting pressure for institutional reform. As Unitaid celebrates its 20th anniversary, severe cuts to the agency’s funding threaten to disrupt the downstream rollout of its market-shaping breakthroughs. Founding member France emphasises its continued support, with French Minister Éléonore Caroit assuring Health Policy Watch that this commitment remains steadfast. 

The search for the next executive director of Unitaid, conducted entirely behind closed doors, represents another watershed moment in global health amid a period of unprecedented financial contraction, geopolitical ruptures, and calls to fundamentally overhaul the global health architecture.

Within the global health ecosystem, the agency has a unique function in pre-shaping markets by clearing intellectual property barriers and negotiating early access agreements to de-risk innovations – for example, by securing $40-a-year generic pricing for the HIV prevention injection lenacapavir and helping to develop flavoured HIV and TB medicines for children.

“Put simply, Unitaid’s comparative advantage is identifying and addressing the bottlenecks that stand between innovation and impact,” explained a Unitaid spokesperson. “We can invest early, test delivery approaches, generate evidence and help create the conditions for scale.”

After clearing initial market barriers, heavyweight procurement entities such as Gavi and the Global Fund to Fight AIDS, Tuberculosis and Malaria step in.

To execute this mission, the Geneva-based agency operates with about 110 employees and an annual investment budget of $300 million, totalling a $1.5 billion commitment through 2027. Alongside private philanthropy, its budget relies overwhelmingly on public funding from core donor governments, including France, the United Kingdom (UK), Brazil, Chile, Japan, Norway, the Republic of Korea, and Spain.

Unitaid executive director recruitment remains strictly confidential

Recruitment process behind closed doors: the Global Health Campus is home to the world's leading global health organisations such as Unitaid and the Global Fund.
Recruitment process behind closed doors: the Global Health Campus is home to the world’s leading global health organisations such as Unitaid and the Global Fund.

Despite the massive flow of public funds, the nomination process remains strictly confidential, with a Unitaid spokesperson telling Health Policy Watch that “an announcement will be made in due course once the recruitment process has been completed”.

Unlike the formal public election process of its host, the WHO, Unitaid conducts its transition as a standard executive recruitment without public vision statements or candidate forums. Applications closed in March, and an internal selection panel is currently evaluating contenders behind closed doors.

The final decision rests with an exclusive voting bloc that includes Unitaid’s founders – France, Brazil, Chile, Norway, and the UK – along with seats for the African Union, the Republic of Korea, Spain, civil society networks, and foundations. The board seeks to select the new leader by consensus and only resorts to a two-thirds majority vote if an agreement cannot be reached. Following its recommendation, the WHO Director-General then merely executes the final appointment.

Critics recently warned that conducting secret leadership transitions at organisations like Unitaid, which are heavily dependent on public funding, prevents the global health community from being involved in the future of the institutions designed to serve them. This undermines their legitimacy, especially when development aid and global health spending face massive cuts and fierce political opposition.

A history rooted in ‘solidarity taxes’

Hosted in Paris, French diplomat and EB Chair Anne-Claire Amprou leads Unitaid through critical funding crossroads and the ED recruitment process.
Hosted in Paris, French diplomat and board chair Anne-Claire Amprou (centre) leads Unitaid through critical funding crossroads and the ED recruitment process.

Unitaid was established in 2006 by France, Brazil, Chile, Norway, and the UK as a collaborative initiative hosted by the WHO. As the primary architect, France became the agency’s dominant donor, contributing more than $2 billion, which accounts for roughly 56% of the organisation’s overall funding since its inception.

Heavily championed by former French President Jacques Chirac, the agency was built on an “innovative financing” model powered by the world’s first solidarity tax on airline tickets and financial transactions, rather than relying solely on traditional official development assistance.

The United States has not contributed to Unitaid, preferring instead to channel funds through its own bilateral assistance programmes, such as the US President’s Emergency Plan for AIDS Relief (PEPFAR).

Established in 2003, PEPFAR has been the US government’s flagship bilateral global health initiative and has invested over $100 billion to combat the HIV/AIDS epidemic and saved over 26 million lives.

According to global health experts, this bilateral approach gave Washington much greater control over its global health spending. Meanwhile, independent researchers have warned that recent US funding freezes have severely disrupted frontline PEPFAR HIV testing and prevention services.

The lack of direct US funding insulates Unitaid’s core budget from Washington, but the agency remains vulnerable to global political shifts because it relies heavily on buyers like the Global Fund to purchase and deploy its innovations at scale. Consequently, Unitaid’s executive board and the agency’s 2025 internal analysis warn that US aid cuts and shrinking global health financing threaten the downstream rollout of its market-shaping breakthroughs, placing half its scale-up products at heightened risk.

Massive financial shortfalls

Facing a major shortfall, Unitaid forecasts raising less than half of its $300 million target.
Facing a major shortfall, Unitaid forecasts raising less than half of its $300 million target.

However, Unitaid’s unique role as global health pathfinder is currently under pressure from an overall trend of massive ODA and global health budget cuts.

“Resources are becoming more constrained, countries are under increasing pressure, and expectations of what the global health system must deliver continue to grow,” said Unitaid executive director Philippe Duneton in a social media post marking the agency’s 20th anniversary in July.

The agency has raised just $696 million towards its five-year goal of $1.5 billion, according to the civil society delegation to Unitaid’s executive board. At its July board meeting, Unitaid forecast that it will raise just $140 million this year – less than half of its $300 million target – as major donors like France and the United Kingdom have slashed their contributions.

French Minister Éléonore Caroit pledges continued diplomatic and financial support for Unitaid's market-shaping mission.
French Minister Éléonore Caroit pledges continued diplomatic and financial support for Unitaid’s market-shaping mission.

Responding to the budget cuts, French Minister Delegate for Foreign Affairs, in charge of international partnerships, Éléonore Caroit, told Health Policy Watch that “notwithstanding the re-budgeting prompted by constitutional issues around earmarked tax revenues, France remains Unitaid’s leading partner”.

The “constitutional issues” cited by Caroit stem from a 2021 French law that restricts the use of pre-allocated taxes. To comply with this legal restriction, the 2025 and 2026 finance bills formally abolished the Solidarity Fund for Development, completely diverting the €738 million generated by these innovative taxes into the country’s general government budget.

Despite the cuts, France remains Unitaid’s top contributor, both annually and historically, committing at least €150 million over 2026 to 2028.

“Beyond funding, France provides political and diplomatic backing, including support for Unitaid’s strategy to diversify its resource base,” the Minister added.

“The decline in health funding is happening against the backdrop of a broader drop in ODA overall. It in no way calls into question either the importance of Unitaid’s mission or its comparative advantage,” Caroit concluded.

Pressure to consolidate – but no mergers

Financial pressure to consolidate will likely also impact Unitaid's mandate to advance cervical cancer screening and treatment, like here in the Philippines.
Financial pressure to consolidate will likely also impact Unitaid’s mandate to advance cervical cancer screening and treatment, like here in the Philippines.

The World Health Organization (WHO), and organisations like Gavi and the Global Fund, also face mounting pressure to consolidate their operations as donor governments are increasingly questioning whether separate secretariats are necessary to manage different stages of the medical supply chain.

The push for consolidation has already triggered unprecedented structural reviews among the largest players. The Global Fund and Gavi recently formed a joint task force to explore structural and non-structural options to increase efficiency.

In the face of political pressure, Unitaid defends its distinct operational territory, insisting that the system emerging from reforms must remain “fit for purpose” with an adequate focus on “access to innovation” as a core function.

“Unitaid and Global Fund have a well-defined division of labour included in their MOU that is limited to the scope of diseases and health challenges that the Global Fund seeks to address,” the agency explains.

Echoing this defence, Caroit noted that “Unitaid has an ‘end-to-end’ mandate – identifying, coordinating, and funding the interventions that make efficient, low-cost rollout possible – which then allows the Global Fund and Gavi to take those solutions to scale”.

Unitaid’s work and that of these other bodies is therefore complementary, not duplicative, she argued.

“Merging these entities and their mandates would risk a loss of specificity and expertise, an excessive concentration of missions in one place, and ultimately, less impact for the people who need it most,” Caroit warned.

Global health architecture reform hits political roadblocks

French Minister Éléonore Caroit champions country health sovereignty and equitable access at the Lyon Summit.
French Minister Éléonore Caroit champions global health architecture reform, country health sovereignty and equitable access at this year’s Lyon Summit.

Caroit emphasised that “France is a leading voice for global health reform, grounded in concrete steps designed by and for countries according to their own priorities,” specifically pointing to this year’s Lyon Declaration at the One Health summit under the French G7 presidency.

Adopted in April by dozens of states and organisations, this declaration outlines an urgent need to adapt the fragmented global health architecture by shifting towards country health sovereignty, inclusive governance, and equitable access to innovations.

However, during the 79th World Health Assembly (WHA) in May, the adopted mandate for global health architecture reform explicitly ruled out recommendations for specific mergers or consolidations.

“On this specific point, the decision to rule out mergers was a mandate adopted collectively at WHA79, not a position France arrived at on its own,” the Minister explained. According to Caroit, the priority right now is to focus on coordinating and aligning funding streams for greater impact.

“Unitaid is also strengthening its impact through direct partnerships and co-financing arrangements with the countries where it operates, which themselves roll out these products within their health systems, as well as with regional players such as Africa CDC and the African Medicines Agency, to open up new avenues for deployment,” she concluded.

The stakes of the leadership race

Whoever emerges victorious from the opaque Unitaid nomination process will inherit an agency at a critical crossroads. The new Executive Director must navigate fierce debates over architectural reform while proving that Unitaid’s upstream market interventions still warrant dedicated donor funding.

If member states demand deeper structural integration, the incoming leader will need to orchestrate a graceful streamlining of the agency, while remaining fit for purpose. They must accomplish this while managing an increasingly volatile funding landscape dominated by retreating Western donors and restrictive bilateral agreements.

Ultimately, the next Unitaid leader will define whether the agency remains an independent market-shaping powerhouse or is gradually absorbed into a consolidated global health system.

WHA79 Must Make Universal Health Coverage the Compass for Global Health Architecture Reform

Image Credits: Unitaid, Guilhem Vellut via flickr, Unitaid, Felix Sassmannshausen/HPW, Gouvernement de France, Unitaid/Jhpiego, WHO/Laurent Cipriani .

Global health and the fight against malaria require more leadership from Germany, reflecting the countries' growing responsibilities, according to Sascha van Beek.
Global health and the fight against malaria require more leadership from Germany, reflecting the countries’ growing responsibilities, according to Sascha van Beek.

Editor’s note: As the Global Fund Executive Director nomination process progresses behind closed, reports by Health Policy Watch and The Lancet have revealed a few of the names said to be shortlisted, including high-profile candidates from the United States and Botswana. Meanwhile a German contender was reportedly sidelined. In this article, Sascha van Beek, a leading global health actor in Germany’s Bundestag (Parliament) and a nurse by training, explains why Germany, a major global health donor and host to world-class scientific research, also needs a seat at the table. 

Sascha van Beek
Sascha van Beek

                                    ___

For decades, Germany has been a quiet giant in global health – offering support financially and with expertise in the background, while letting others take the steering wheel. With global realities changing, this role must evolve.

However, the recent Health Policy Watch report on the ongoing selection process for the next Executive Director of the Global Fund highlights how Germany consistently falls short of its potential when it comes to securing leadership positions in global health.

Germany’s overly cautious strategy

This is not due to a lack of expertise or credibility. Germany enjoys an excellent international reputation, is home to world-class scientific institutions, and has been a reliable partner in global health for decades. It is therefore all the more difficult to understand why we continue to leave this potential untapped when it comes to international leadership.

It is not an isolated case, but the result of an overly cautious personnel strategy pursued over many years. Germany has too rarely prepared candidates strategically for senior global positions, has done too little to raise their international profile, and has often failed to articulate its ambitions. If we want to help shape international policy, we must also be willing to assume leadership responsibilities within these organisations.

The German government now has the opportunity to change course. Germany needs a far more active, confident, and strategic approach to international appointments. Strong German candidates should be identified early, supported across government, and promoted internationally. Not out of national prestige, but because international organisations can benefit from German expertise, reliability, and experience.

Germany already has internationally recognised institutions such as the Robert Koch Institute, Charité, the University of Berlin medical school and hospital, and the Bernhard Nocht Institute for Tropical Medicine. Their expertise has been instrumental in initiatives ranging from polio eradication to epidemic preparedness and outbreak response over many years.

Demanding transparency in global health

Critics demand more transparency and accountability rather than opaque leadership elections.
The Global Health Campus, home to the Global Fund and others. Critics demand more transparency and accountability rather than opaque leadership elections.

At the same time, the current debate raises fundamental questions about the governance of the Global Fund itself. Reports of procedural irregularities and a lack of transparency in the selection process must be fully clarified. The appointment of the Executive Director of one of the world’s most important global health institutions cannot be conducted through a process that leaves major stakeholders with unanswered questions. The Global Fund is responsible for millions of lives worldwide; its leadership cannot be decided behind closed doors.

The Global Fund has faced criticism over its Executive Director selection process before. Similar concerns were raised in 2017, leading to a restart of the process. Those lessons should have resulted in lasting reforms. Such procedural missteps must not be repeated. If the reported concerns about the current process are confirmed, the selection procedure should be repeated under revised rules that ensure full transparency, fairness and confidence among all stakeholders.

Trust must be earned, not claimed

Leadership aspirations must always go hand in hand with responsibility. If the United States wishes to play a leading role in global health again, this should be welcomed in principle. However, this requires a renewed and lasting commitment to the global health architecture. Those who have stepped back from international responsibility and contributed to uncertainty should first rebuild trust before seeking leadership positions.

Germany should draw the right conclusions from this debate. Our ambition must be not only to support global health through our expertise and financial contributions, but also to help shape it politically and through leadership. A country that has long been among the largest contributors should also have the ambition to help shape global health governance through its people.

Accountability to taxpayer money

Germany remains firmly committed to the Global Fund. There should be no doubt about our continued support for this unique partnership. 

But as a member of the German Bundestag who strongly advocates for these public expenditures, I am facing a difficult reality. It is becoming nearly impossible to justify sending billions of taxpayer Euros to an organisation that cannot transparently explain how its leadership is chosen. 

At a time when many donor countries are debating whether to channel resources through bilateral programmes or multilateral institutions, the Global Fund should do everything possible to strengthen confidence in its governance. Opaque leadership selection processes do not strengthen multilateralism. They undermine the trust on which it depends.

See related story:

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

Image Credits: WHO, Sascha van Beek/Niclas Brosthaus, Global Fund/Vincent Becker.

DRC Health Minister Dr Samuel Roger Kamba (right) meets health workers at Bunia General Reference Hospital after inaugurating a new Ebola treatment facilities over the weekend.

Two months after the Democratic Republic of Congo (DRC) declared an outbreak of Ebola Bundibugyo, the outbreak is “continuing to outpace the response” – and with 2,073 people infected and 796 dead, this is the fastest outbreak ever, World Health Organization (WHO) Director General Dr Tedros Adhanon Ghebreyesus told a media briefing on Thursday.

“Intense transmission in the province of Ituri remains our biggest concern,” added Tedros. “More than 80% of new cases are being detected outside known contact lists, showing that transmission chains are still being missed. About two-thirds of deaths are occurring in communities among people who never receive care in a health facility.”

It took 10 months for the 2018-2019 Ebola outbreak in DRC to reach 2,000 confirmed cases, said Tedros,  adding that “active armed conflict is hampering access to the affected areas and hindering the response”.

Reporting that another treatment centre in Bunia had been attacked on Wednesday, Tedros once again appealed for international support to make up the $400 million-plus shortfall needed to mount a sufficient response. 

“This is not charity. It’s an investment in national security,” Tedros stressed.

Care in health facilities, not communities

Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme.

Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme, said that the primary focus across all the outbreak-affected areas “is getting cases into care”. 

Over 60% of deaths are happening in communities, which means that people were likely to have been sick and infectious for weeks before their deaths – and were only diagnosed with Bundibugyo because health officials are taking swabs from dead people shortly before burials, Ihekweazu explained.

“Your chances of survival are three to four times higher when you come into care. We have, at the moment, a case fatality ratio of about 30 to 40%. If you look at those that come into care, it’s about 10 to 15%. If you look at those that die in the community, it’s about 60 to 70%,” he added.

To encourage people to seek care in health facilities, the DRC government is offering free healthcare for all diseases to everyone presenting to hospitals and clinics in the outbreak-affected areas, he added.

Ihekweazu, who recently returned from the epicentre of the outbreak, said the situation was being met by “an incredibly committed set of healthcare workers going out every single day to provide care”.

“We are facing a very difficult situation, no doubt about that. It is not out of control, but we need to work very hard and consistently into the next few weeks and months to get ahead of this. This will be a marathon.”

First vaccine safety trial starts

On Monday, the world’s first Phase I Bundibugyo ebolavirus vaccine trial was launched by the Oxford Vaccine Group (OVG) in Oxford in the United Kingdom.

Fifty healthy adults aged 18–55 years are being recruited for the trial, which will assess the safety and immune response of the ChAdOx1 BDBV vaccine. 

“In the coming weeks, and following regulatory review for trial commencement, participants will then be vaccinated and attend follow-up visits in Oxford,” the OVG said in a statement.

The vaccine uses the same viral vector platform as the Oxford/AstraZeneca COVID-19 vaccine. Meanwhile, the Serum Institute of India (SII) has manufactured and stockpiled approximately 620,000 doses of the vaccine candidate to support the rapid launch of the study and progression of the vaccine candidate into clinical evaluation.

The trial is funded by the Coalition for Epidemic Preparedness Innovations (CEPI) as part of its $8.6 million programme to advance the development of Bundibugyo vaccines. 

At the beginning of July, a trial of two antivirals started patient enrolment in the DRC. 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.  

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. 

Image Credits: DRC Department of Health.

Ordinary Venezuelans took the lead in the aftermath of the earthquakes.

In the days that followed the earthquakes that struck Venezuela on 24 June, La Guaira, the worst-hit city, went silent. Any noise could be a sign of life, so people remained alert, listening carefully, even as entire communities took to the streets. 

“People took matters into their own hands and started looking for their friends and families,” a La Guaira sociologist who asked not to be identified told Health Policy Watch. That moment, she said, sparked “an incredible wave of solidarity.” 

But solidarity wasn’t the sole catalyst. “There was no hope that the government would mobilize resources,” said the sociologist.

According to her, Venezuelans’ perception is that resources are scarce and institutions don’t act with the necessary speed. Each community that responded autonomously did so because the population knew it was unassisted, she observed.

She believes the outcomes of the earthquake response proved them right: “People themselves had to search for relatives, renting equipment and engineering materials to help break through the concrete and recover the bodies.”

Government’s inadequate response

Interim president Delcy Rodriguez (centre) addresses journalists about her government’s earthquake response.

Following the tremors, almost 200 buildings collapsed, leaving over 17.000 displaced and 4,490 dead. While the official number of missing people hasn’t been released, the United Nations estimates that it approaches 50,000. 

The government’s response has been criticized by residents and international observers for delays, missing centralized information, and a lack of heavy machinery that could have saved lives. 

Venezuela’s interim president, Delcy Rodriguez, denied the claims during a press conference, where she also affirmed that the criticism was politically motivated. 

Rodriguez told journalists that institutions acted immediately, mobilizing international cooperation and deploying thousands of agents. 

But sources on the ground told Health Policy Watch a different story. What they witnessed was the presence of armed personnel who, for the most part, didn’t engage in rescue efforts. 

“You could see scenes of desperate people rescuing their own relatives while police officers stood on the sidelines, doing little or nothing to help,” one source said. 

Civil society took the lead

The first 72 hours after such an event are crucial for rescue. From day one, civil society led the efforts. They were the ones going through the rubble, sometimes with their bare hands. 

The lack of information created an obstacle for volunteer first responders. Citizens answered by creating collaborative platforms to gather information, map affected buildings and list missing people.

“Civil society didn’t passively wait for all decisions to come from the government,” said Mariangelli Álvarez, founder of terremotovenezuela.com, one such platform. 

Álvarez said that making sense of what was happening was the first step, but that as the response evolved, information alone wasn’t enough. Amidst a crisis that changed every day, she said the platform’s purpose now is “to identify necessities, give orientation to families, and connect resources.” 

Most importantly, Álvarez said, it is to make sure the people of La Guaira won’t be abandoned once public attention fades. 

A crisis on top of a crisis

PAHO regional director Jarbas Barbosa.

Even before the earthquakes, Venezuela was already suffering from a grave humanitarian crisis. Over the past decade, inflation, shortage of food and medicine, and increasing violence across the country forced 7.6 million people to seek refuge abroad, in what is considered to be the largest exodus in the continent’s recent history. 

According to a UN report, before June 2026, almost eight million Venezuelans already needed some sort of humanitarian assistance.

Venezuela’s healthcare system, now operating under extreme pressure, was also not doing well before the earthquakes.

According to the World Health Organization (WHO), hospitals lacked 37% of emergency supplies as of September 2024, while a 2024 report from the National Hospital Survey found an almost 60% gap in surgical capacity. 

Since the earthquakes, structural damage to health facilities, the high number of injured people, backlogged surgeries, and the shortage of personnel and medical supplies threaten hospitals’ ability to continue operating. 

International aid

For José Miguel Rodriguez, Association of Volunteers in International Service (AVSI) Country Representative in Venezuela, the government’s biggest achievement in its earthquake response has been the openness to international aid. 

“There have obviously been some unfortunate instances of restrictions,” Rodriguez told Health Policy Watch. “But overall there has been openness to the entry of aid and personnel.”

Countries like Brazil, Chile and China have donated medicine, vaccines, water purifiers and generators, while Spain has set up a field hospital in Caracas dedicated to primary healthcare. 

The international response is being coordinated by the WHO’s regional office, the Pan American Health Organization (PAHO), alongside Venezuelan national authorities. 

PAHO regional director Jarbas Barbosa told a recent press briefing that the organization’s response has focused on three immediate priorities: “Saving lives, maintaining the continuity of essential health services, and preventing additional health risks in the coming weeks.” 

PAHO has deployed specialized teams, delivered six metric tons of emergency health supplies from a strategic reserve in Panama, and launched a $24 million emergency appeal to support the first six months of the health response and early recovery. 

New phase of the response

According to Barbosa, as the initial increase in trauma cases has begun to stabilize, the response is entering a new phase. 

“The priority now is not only to keep health facilities open, but to ensure safe and timely access to essential health services,” he said, stressing the importance of continued care for people with chronic and non-communicable diseases.  

Barbosa said that, after an earthquake, the greatest risks tend to arise from interruptions to health services, access to drinking water, sanitation and vaccination. 

This is particularly concerning for the over 17.000 displaced people housed in 87 transitional camps, where overcrowding and poor sanitary conditions increase the risks of disease outbreaks. 

In the coming weeks, Barbosa said the response must prioritize re-establishing access to primary health care, safe water, sanitation, epidemiological surveillance and vaccine coverage, which was already below required levels in the country. 

But according to the sociologist from La Guaira, people in the camps report that very few resources are being distributed and there is little information about the camps’ management. 

Recovery and reconstruction

Now that rescue efforts has ceased, Venezuela is focusing on reconstruction.

The focus has shifted from rescue to reconstruction, according to terremotovenezuela.com’s Alvarez, but the emotional and social recovery “will take far longer than the initial emergency.”

Besides structural damage and physical injuries, Venezuela will have to address a mental health crisis. 

“Thousands of people have suffered losses, displacement, and uncertainty,” said Barbosa. “Mental health is also an urgent priority after a tragedy of this magnitude.”

PAHO’s director stressed that recovery must go beyond a simple return to what existed before. “It must be an opportunity to build back stronger, safer, more resilient, and better prepare health services for future emergencies,” he said.

That, however, will be particularly hard given the country’s uncertain political future. Six months ago, the United States captured Venezuela’s president, Nicolás Maduro, and has imprisoned him in the US.

The 180 days of Rodriguez’s interim presidency expired in the first week of July, and there is no timetable for new elections so far.

However, the US controls Venezuela’s finances, with US Secretary of State Marco Rubio setting conditions on what that money can be spent on, and by whom, according to a recent report by The New York Times.

With no clear plan for the future, the sociologist said, suffering is even greater: “There is a sense of grief over the loss of institutions, which deepens Venezuela’s humanitarian crisis in every respect.”

Image Credits: Toposdigitales .

The risk of dementia can be reduced by addressing tobacco and alcohol consumption , lack of physical exercise and social isolation.

Up to 45% of the risk of dementia can be prevented or delayed by addressing tobacco and alcohol use, social isolation, physical inactivity, air pollution and noncommunicable diseases (NCDs), including high blood pressure and diabetes, according to the World Health Organization (WHO).

The global health body released updated guidelines on reducing the risk of cognitive decline and dementia this week, providing countries with evidence-based recommendations to help prevent or delay the onset of dementia across the life course.

Brain diseases cause dementia, which affects memory, thinking and the ability to function. More than 57 million people live with dementia worldwide and nearly 10 million people get newly diagnosed every year. Alzheimer disease is the most common form of dementia and is estimated to account for 60–70% of cases.

“We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries now have clear, evidence-based recommendations they can put into practice immediately to protect people’s cognitive health.”

WHO’s new guidelines reflect the latest evidence and innovations in dementia risk reduction providing proven interventions that can effectively lower dementia risk through early awareness and timely action. 

They provide consolidated recommendations on addressing unhealthy behaviours, managing medical conditions, and reducing exposure to environmental factors that may contribute to cognitive decline and dementia.

The guidelines recommend several healthy behaviours and lifestyle interventions to reduce dementia risk, including cognitive training and cognitive stimulation and engagement in social activities for adults with normal cognition or mild cognitive impairment.

The updated advice also includes interventions that reduce risk of NCDs, including increasing physical activity, stopping tobacco use, reducing alcohol consumption, adopting a healthy diet, and a new recommendation to reduce exposure to air pollution.

Management of hypertension, diabetes, and high cholesterol can also help reduce dementia risk. Further, hearing aids may be offered as part of risk-reduction strategies.

 

Image Credits: WHO/A. Loke.

A child receiving a vaccination. Global immunization efforts are off track to meet the 2030 targets.

Nearly 90% of infants globally received at least one dose of a diphtheria, tetanus and pertussis (DTP) vaccine in 2025, while around one-third of girls globally received at least one dose of Human Papillomavirus (HPV) vaccine, which protects against cervical cancer.

This is according to the annual World Health Organization (WHO)-UNICEF Estimates of National Immunization Coverage (WUENIC) released on Wednesday, based on data from 195 countries and territories.

The number of children who have not received a single dose of vaccine ever, called zero-dose children, fell by 750,000 compared to the previous year.

But most countries are off track to meet the Immunization Agenda 2030, which requires them to reduce the number of zero-dose children by 50% compared to 2019 levels.

“Countries with significant improvement in their zero dose numbers include Sudan, India, Brazil, Ethiopia, and Mexico, who have made commendable progress,” said Dr Ephrem  Lemango, UNICEF’s global head of immunization.

However, 13.5 million children were still without any vaccinations, and experts warned that the impact of funding shortfalls for Gavi, the global vaccine alliance, will only show up in the data in the coming years. There is also a rising cohort of drop-outs.

Nigeria, the Democratic Republic of Congo and Yemen have the highest numbers of zero-dose children, while the countries with the highest prevalence of zero-dose children are in Yemen, Papua New Guinea and Venezuela.

“Every child, whether born into wealth or poverty, peace or conflict, deserves the life-giving protection that vaccines provide. Immunization is one of the most cost-effective, most equitable, and most reliable interventions for protecting children’s health and well-being,” said WHO Director General Dr Tedros Adhanom Ghebreyesus.

Also read: GAVI Vaccine Alliance Secures More than $9 Billion from Donors – Despite US Ambush at Pledging Event

Challenges for immunization efforts

Countries with the largest number of zero-dose children are a mix of ones with structural issues, conflict and a large growing population.

Immunization efforts are being challenged by several issues including rapidly growing populations, conflict, and structural and governance issues.

Drop-outs are another challenge. Globally, 7.3 million infants are estimated to have received their first DTP dose but dropped out before receiving their first measles dose.

This drop-out rate contributed to stalled measles coverage, with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). A vaccination rate of 95% is required to maintain community immunity, and 57 countries reported large or disruptive measles outbreaks in 2025.

“We think that that is clearly related in some settings to false information, misinformation that is provided around measles vaccination, and this is of very significant concern because, as we know, measles is probably one of the most infectious viruses and is causing deaths in children around the world,” said Dr Kate O’Brien, WHO director of immunization, vaccines and biologicals.

The Americas and South-East Asia have fully recovered since COVID-19 and improved their performance, with the latter now the highest-performing region, compared to their 2019 baselines.

While Africa, the Eastern Mediterranean, and Europe saw gains last year, their coverage remains below pre-pandemic levels. In contrast, the Western Pacific experienced a decline, leaving it the region furthest below its 2019 baseline.

“Immunization programs in the least wealthy countries of the world are often closing vaccination gaps faster than wealthier ones, while also protecting what they already have achieved and continuing to do more,” Lemango said.

India, Sudan and South Africa – a story of gains and losses 

Countries with the largest number of zero-dose children are a mix of ones with structural issues, conflict and a large growing population.

The reduction in zero-dose children is largely due to gains made by countries like Sudan, India and Brazil in very different circumstances.

While India, with its 1.4 billion people, has the largest population in the world, Sudan has managed to keep its gains despite conflict.

“Sudan shows what is possible when access is improved, even during conflicts. It gained about 35 points on the first dose of DTP and 22 points on measles. This is the largest single country improvement anywhere in the world we are reporting this year,” Lemango said.

But South Africa, which was doing well, has seen backsliding, as has Bangladesh.

“South Africa again has had a pretty strong program, and in recent years has had more challenges with their program from a structural perspective, and mostly from a fiscal perspective,” said O’Brien.

“Now we’re seeing some of the effects of the financial constraints that South Africa has in terms of a weakening program, and that’s showing up through weakening coverage,” she added.

Looming threat of funding shortfall

US President Donald Trump dismantled the USAID – United States’ primary aid agency in early 2025, sending most global development agencies scrambling for funds.

However, the 2025 data represent a snapshot of where global immunization stood before the funding cuts, driven largely by the US.

Around 85% of the drop in zero-dose children occurred in Gavi-supported countries, which also accounted for 95% of girls vaccinated against HPV

Last year, Gavi was only able to secure $9 billion out of its $11.9 billion goal – largely because the US refused to support it, with US Health Secretary Robert F Kennedy Jr. announcing that his country was halting support for the alliance until it could “re-earn” the public trust.

Gavi said its ability to survey outbreaks has been impacted by its funding shortage, and it is already having to make some hard choices.

“We believe that 600,000 lives that could have been saved will be impacted by this right-sizing and trying to fit to the wallet that we have,” said Thabani Maphosa, Gavi’s chief country delivery officer.

Meanwhile, O’Brien warned that more backsliding could lie ahead: “We don’t think that the impact of those funding cuts is showing up yet fully in the 2025 data. Our concerns are very much for what’s happening in programs in 2026 and what is yet to come.”

Reacting to the report, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)’s Laetitia Bigger said that “routine childhood vaccination remains one of public health’s greatest success stories”.

“Today’s report highlights the potential of new vaccines to transform health outcomes – such as the expansion of HPV vaccination – but also serves as a reminder that too many children still remain unprotected against life-threatening diseases,” said Bigger, IFPMA’s director of vaccines policy.

“To respond to this challenge, governments and international organisations should invest in strong health systems and continue to prioritise the introduction of new vaccines.”

Image Credits: UNICEF, WHO and UNICEF , The White House.

The Africa Clean Air Forum 2026 opened this week in Pretoria.

PRETORIA, South Africa – Participants from 47 African nations are meeting at the Africa Clean Air Forum this week as part of a continental drive to address the air pollution health crisis. 

The forum, convened by the Africa Clean Air Network (AfriCAN), is in its fourth year, and this is the first time it is being held in southern Africa. 

The theme of the four-day forum is “investment case for clean air and healthy cities”, and participants have been sharing evidence-driven clean air actions, discussing sustainable funding and promoting cross-border knowledge sharing.

It follows the first G20 resolution on clean air, which was proposed by South Africa last year. Advocates are now focusing on what the continent requires to improve air quality, especially as it faces development challenges and a growing population. 

Opening the conference, Bernice Swarts, South Africa’s Deputy Minister of  Forestry, Fisheries and the Environment, said that her country’s presidency of the G20 last year created an opportunity to elevate air quality as a strategic development priority. 

This resulted in the G20’s air pollution resolution, which recognised that poor air quality is a cause of premature mortality, and the importance of open and reliable air quality data. However, the resolution also noted that sharing 

The resolution also commits G20 countries to supporting “international collaboration to combat transboundary air pollution”.

But in an interview with Health Policy Watch, Swarts asked: “What are we talking about when we say we are going to work together? It must not just be broad and blank. It must be specific so that it talks to outcomes that we want to achieve and will add value to the air quality that we are going to have.” 

However, apart from Swarts, the forum was not attended by any Cabinet Ministers or senior politicians, and focused on the work by scientists, city and provincial officials, and policy experts. 

South African Deputy Minister Bernice Swarts opened the forum.

Changing tradition for cleaner air 

Africa’s population is projected to grow from about 1.5 billion now to about 2.5 billion by 2050. The median age is 19 today, but by 2073, the number of young Africans under 25 is likely to surpass Asia. 

Development will have to pick up pace to meet the needs of the population, but the challenge is to do that without the air pollution that has typically accompanied rapid development. 

That challenge is most noticeable at the grassroots level. Xoli Fuyani from Black Girls Rising, a South African non-profit, described how she couldn’t breathe in a traditional mud hut when a fire was lit for tea. Her hosts seemed unconcerned, saying that is how their grandmothers cooked. 

“How long can we accept this as normal?” Fuyani says. 

“Any transformation begins when communities see themselves as innovators and not just beneficiaries,” said Fuyani, calling for local communities to be made partners in air quality management. 

Indoor air pollution from biomass cooking fuels remains one of sub-Saharan Africa’s most persistent yet under-prioritized public health emergencies. 

South-South cooperation

Although the focus is on Africa, South-South cooperation between all developing countries is one of the core themes. 

Rebecca Garland from the University of Pretoria cautioned against relying on the Global North’s support, including for funding, as the North often had a different agenda.

Sharifah Buzeki, executive director of the Kampala Capital City Authority in Uganda, provided a direct example of South-South collaboration. 

Officials from Dhaka, Bangladesh’s capital and one of the world’s most polluted cities, visited to see Kampala’s progress in air quality management, said Buzeki. 

She explained that Kampala’s response rested on hyperlocal monitoring, live public data access via a mobile app and website, and an awareness campaign on digital screens in the city. 

A research team from the Kenyan capital of Nairobi explained how the city went from just two low-cost air pollution monitors to about 130 in four years, leading to impact on the ground. 

“Analysts have been able to map out trends in pollution. For example, it peaks between six and nine in the morning and evening. probably because of traffic and household habits. But the extensive data across Nairobi has meant enforcement can be tracked,” explained one of the researchers.

“We can now translate this into action on the ground. We are able to inspect. We are able to carry out our compliance and enforcement in various sectors within the city.”

The researchers showed the data from low-cost sensors at about 40 schools from January to May. All of them were above the WHO’s safe guideline of 5 micrograms/cubic metre of PM2.5, the fine particulate pollutant.

This is the annual conference’s fourth edition, and the largest with over 530 participants. The large number of participants this year demonstrates “a great continental movement,” says Tunde Ajayi of the Lagos State Environmental Protection Agency and Africa Clean Air Network. 

“Clean air is not a luxury. It is a prerequisite for healthy people, for thriving economies and sustainable development. The investments we make today will determine the quality of life of generations to come,” said Ajayi.

From left to right: Dalila Hamou (WIPO), Dr Alain Labrique (WHO), and Bilel Jamoussi (ITU) hold the newly launched joint strategic guidelines at the Artificial Intelligence for Good Global Summit in Geneva.
From left to right: Dalila Hamou (WIPO), lain Labrique (WHO), and Bilel Jamoussi (ITU) hold the newly launched joint strategic guidelines at the AI for Good Global Summit in Geneva.

As artificial intelligence drives rapid health innovations, global guardrails, equitable data, and local capacity are needed to ensure equitable progress. To address this, a landmark framework launched by three United Nations agencies lays out a strategic roadmap for innovators. Meanwhile, health leaders emphasise that lower-income regions must become co-creators of future innovations.

New guidelines for the use of artificial intelligence lay out a roadmap for health innovators to navigate complex intellectual property, data governance, and regulatory pathways. The landmark framework, co-authored by experts from the World Health Organization (WHO), the International Telecommunication Union (ITU), and the World Intellectual Property Organization (WIPO), was presented at the “AI for Good” Global Summit in Geneva last week.

“This collaboration between these three organisations brings our expertise together and shows how we can have a collaboration in this very important field,” said Dalila Hamou, director of the external relations division at WIPO, at the Summit.

The joint initiative arrives as technological innovation accelerates, with the number of new generative artificial intelligence patents published over the last two years topping the total from the entire preceding decade. For instance, AI-assisted liquid biopsy tests can now predictively detect multiple cancers at stage one – when survival rates reach up to 92% – long before physical symptoms manifest.

At the same time, critics warn that the rapid deployment of unregulated advanced algorithms increases risks and may end up amplifying existing health disparities and deepening social exclusion.

“The few exceptions when technology actually had an equitable positive impact in society was when equity was included by design,” said Ricardo Baptista Leite, CEO of HealthAI, in an interview with Health Policy Watch during the summit, echoing the need for guardrails.

Embedding equity in the artificial intelligence life cycle

An equitable IP framework uses field-of-use licensing and tiered cloud access to bridge global disparities.
An equitable IP framework for AI should apply field-of-use licensing and tiered cloud access to mitigate global disparities, advocates say.

Fundamentally, the joint framework, which is entirely non-biding, recommends a mixed intellectual property system for new AI tools. It guides developers in strategically combining patents for technical methods with trade secrets for proprietary datasets, ensuring commercial viability – while also building trust through careful adherence to quality assurance, safety monitoring and patient privacy.

But to actively embed equity into the innovation life cycle, the joint framework also champions access models such as differential pricing and field-of-use licensing. These mechanisms allow patent holders to serve profitable commercial markets while partnering with domestic manufacturers in the Global South for vital technology transfers.

Specifically, field-of-use licensing allows patent holders to legally differentiate their intellectual property rights by geography or therapeutic application. This means a developer can maintain exclusive, highly profitable sales in the Global North while simultaneously licensing the identical algorithm to a domestic partner in a lower-income region.

Similarly, differential pricing leverages flexible delivery methods, such as cloud-based architectures, to offer tiered access to artificial intelligence services. This mechanism ensures that resource-constrained health systems pay reduced, subsidised fees for vital diagnostic tools, while the same technology generates premium commercial revenue in wealthier markets.

Since the international guidelines lack the binding enforcement mechanisms needed to standardise protections globally, voluntary frameworks must be actively translated into enforceable national regulations, the 2025 HealthAI Global Landscape Report stresses.

Fiscal pressure drives new collaborations

From left to right: Catherine Cheney (Devex), Alex Aliper (Insilico Medicine), Leslie Yeh (Google.org), Rita Rhayem (Gavi), and John Fairhurst (Global Fund) participate in a panel discussion at the AI for Good Global Summit in Geneva.
From left to right: Catherine Cheney (Devex), Alex Aliper (Insilico Medicine), Leslie Yeh (Google.org), Rita Rhayem (Gavi), and John Fairhurst (Global Fund) participate in a panel discussion at the AI for Good Global Summit in Geneva.

The urgency to implement these global standards is driven by the fast-changing face of the technologies as well as severe economic pressures, which are prompting health systems to leverage largely unregulated artificial intelligence tools for rapid efficiency gains and/or to reach underserved populations.

“We can’t expect every country to suddenly find money in this current fiscal context that they’ve not had for the last 10 years,” said John Fairhurst, head of private sector engagement at the Global Fund to Fight AIDS, Tuberculosis and Malaria, during a panel discussion with Gavi the Vaccine Alliance, and Google.org at last week’s AI for Good summit in Geneva. He noted that AI offers a pathway forward because “what countries are looking for is efficiencies. They’re looking for the ability to drive greater impact from every dollar that they spend.”

One breakthrough innovation highlighted at the summit pairs acoustic analysis with machine learning to detect tuberculosis directly from the sound of a patient’s cough. This tool, currently still in pilot stages, can be scaled up rapidly over basic mobile networks to identify people infected with TB earlier in the infection cycle.

“It’s a disease where we miss something like 3.6 to 4 million people a year, and those people go on to infect more people,” added Fairhurst.

This tool is part of a wider strategic partnership between The Global Fund and Google.org, the corporate social responsibility arm of Google, highlighting the advantages of public-private sector collaborations in a fast-developing AI landscape.

“Rather than focusing on a singular or point-to-point partnership, we try to bring together the cross-functional players [and] the cross-sector players,” said Leslie Yeh, director of scientific progress for Google.org. She explained that by treating health challenges as interconnected systems, partners can share learnings “so that we can get towards this accelerated outcome together and […] not leave anyone behind.”

Empowering local health capacity

Joyce Nabende, AI lab head, Makerere University (Uganda).
Joyce Nabende, AI lab head, Makerere University (Uganda).

To effectively serve resource-limited settings and build local health capacities, developers must also design digital health tools capable of working entirely offline or with limited power and internet data access.

“If you think about low or limited settings that we come from, then you have to ensure that you have models that can work, for example, offline or with devices that are limited,” emphasised Joyce Nabende, head of the artificial intelligence lab at Makerere University in Uganda.

Innovators are currently working to make new technologies accessible by deploying AI diagnostic tools directly onto portable phones and other devices. For example, healthcare providers in parts of rural Africa can use offline, AI-assisted ultrasound tools to triage pregnancy risks, so that only the most at-risk cases travel to distant specialist centres.

Beyond hardware adaptations, international tech researchers and leaders like Nabende stress that true empowerment requires cultivating technological expertise directly where the medical challenges occur. This strategic shift involves transferring more advanced digital capabilities into the Global South.

Bridging the data equity divide

A 3D rendering of a neural network representing artificial intelligence.
To ensure the rapid deployment of artificial intelligence does not amplify existing disparities, digital health innovations must actively embed equity by design.

Another problem involves deploying algorithms in low- and middle-income countries without representative foundational data, which currently risks perpetuating systemic health disparities. Hidden biases within imported models can trigger inappropriate clinical triaging and inadvertently cause severe patient harm.

“When we import models, they’re often trained on usually high-income countries, populations that don’t represent the target populations where these tools are meant to be deployed,” said Alain Labrique, director of data, digital health, analytics and AI at the WHO, during a panel discussion.

Approximately 90% of global genomic data currently belongs to people of European descent, dangerously skewing the efficacy of predictive tools for diverse global populations, warned Alireza Haghighi, director of the Harvard International Center for Genetic Disease, during the summit.

Consequently, governments in the Global South demand an active role as co-creators of medical AI technologies that have to undergo rigorous local validation before clinical deployment.

“Africa must not be only a market for digital health solutions,” said Habiba Mizouni, representing the Tunisian Ministry of Health, during a keynote speech at the summit. She asserted that the continent must become a producer of ethical and context-specific health AI, not merely a consumer of imported digital solutions.

To actively support this transition, the newly launched guidelines champion access models that enable the adaptation of algorithms to local disease patterns and require developers to share performance data across diverse populations to ensure algorithmic non-discrimination.

Addressing regulatory fragmentation

A major issue hindering these equitable advances is regulatory fragmentation, which prevents emerging developers from safely scaling their life-saving tools.

HealthAI CEO Ricardo Baptista Leite.
HealthAI CEO Ricardo Baptista Leite.

“Small and medium enterprises don’t stand a chance if they have to deal with different regulatory environments in every country they go to,” said HealthAI’s Leite. The Geneva-based global non-profit agency supports governments in building regulatory ecosystems to responsibly assess and scale these AI technologies.

To construct this infrastructure, the agency is building a Global Regulatory Network (GRN) that recently expanded to include Zambia, the Philippines, and Brazil. While artificial intelligence powerhouses like the United States and China remain outside formal GRN membership, they actively engage through broader communities of practice to prevent geopolitical fracturing, Leite explained.

To align internationally fragmented systems, the network is currently developing a global early warning system for post-market monitoring of new digital tools and devices. This shared platform will allow international regulators to instantly detect and communicate adverse algorithmic events, ensuring patient safety while building long-term societal trust in adaptive technologies, echoing the goals of the joint UN guidelines.

Build trust to keep innovation at pace

A robotic hand reaching into a digital network on a blue background, symbolising artificial intelligence.
Joint guidelines by WIPO, ITU and WHO set intellectual property standards and innovation guardrails.

As long as the regulatory landscape remains fragmented, both developers and patients are ultimately penalised by delayed access to life-saving medical diagnostics, the UN agencies state. The new framework directly addresses this systemic friction by proposing common intellectual property strategies and technical standards.

“Standards create trust. Without standards, innovation remains isolated. With standards, innovation becomes scalable and sustainable,” concluded Tunisian representative Mizouni.

Ultimately, the enthusiasm that greeted the new WHO, ITU, and WIPO joint report signals a readiness to govern digital health. If international guardrails support collaborative momentum and trust, the current wave of technological innovation could successfully reduce global health inequities and scale the life-saving tuberculosis and cancer breakthroughs presented in Geneva.

However, to translate these frameworks into reality, international regulators and national governments must accelerate to match the rapid pace of the technology itself. Building this regulatory legitimacy is the only way to ensure patient safety and global adoption because, as HealthAI CEO Leite emphasised, “Innovation will move at the speed of trust”.

Echoing HealthAI’s collaborative mission, Dr Hans Henri Kluge, WHO Regional Director for Europe, reinforced this urgency during a global conference in Lisbon starting on Wednesday where the WHO brought 37 countries together to establish AI governance.

Urging leaders to regulate artificial intelligence in health “before the gaps become irreversible”, Kluge stressed: “The future of AI in health won’t be decided by algorithms. It will be decided by the frameworks we build now, the partnerships we forge, and the political will we bring to making sure this technology serves everyone – not just the countries and communities wealthy enough to shape it on their own terms”.

See related story:

An Equitable Pandemic Agreement is a Global Public Good

Image Credits: Tara Winstead via Pexels, Felix Sassmannshausen/HPW, Google DeepMind via Pexels, HealthAI .

Experts urging a youth social media restriction insist children cannot resist deliberately addictive platforms on their own.
Lawmakers urging a phased youth social media restriction insist children cannot resist deliberately addictive platforms on their own.

The European Commission is preparing more robust youth social media restrictions to protect children from addictive algorithms, following urgent expert warnings and landmark court rulings. But unlike the blanket digital bans imposed in countries such as Australia on everyone under the age of 16, restrictions would be eased gradually as children grow older.

As countries increasingly move toward youth social media restrictions, an EU expert panel recommends the bloc enforce a “phased and gradual” digital childhood. The experts advise no independent access for children under 13, followed by a graduated transition into autonomy where “safety-by-design” is the default standard.

European Commission president Ursula von der Leyen expressed support for this approach, relying on Eurobarometer data showing widespread public concern. According to the study, 63% of Europeans want EU rules restricting children’s access to social platforms by age, either through an outright prohibition or delayed access.

“The platforms have a duty of care towards their users, especially the most vulnerable among them,” said von der Leyen, reacting to the panel recommendation.

This autumn, the Commission plans to propose new legislation to the European Parliament that would adopt the scheme for staggered, age-appropriate access.

Members of the European Parliament signalled broad support for the Commission’s regulatory push. However, some key lawmakers are demanding even stricter measures, such as raising the minimum digital access age to 15 years and mandating a non-addictive “youth mode”.

Science supports youth social media restriction

From left to right, Professor Jörg Fegert, Ursula von der Leyen and Dr Maria Melchior present recommendations.
From left to right, Professor Jörg Fegert, Ursula von der Leyen and Dr Maria Melchior present recommendations.

The regulatory push aims to dismantle engagement-maximising business models that prioritise profit over the physical and mental health of vulnerable children. The EU expert panel insists that tech providers must retain primary responsibility for platform safety, rather than shifting the burden of protection onto parents or the minors themselves.

The authors of the report underlying the recommendations, Dr Maria Melchior, Research Director at the French National Institute of Health and Medical Research (INSERM), and Professor Jörg Fegert, Medical Director of Child and Adolescent Psychiatry at the Ulm University Hospital (Germany), highlight a critical neurobiological mismatch during adolescence. Children have highly active emotional and reward systems, which overpower the still-developing prefrontal cortex responsible for impulse control. Because of this imbalance, minors are especially vulnerable to platforms optimised for immediate gratification and continuous external stimulation

Based on emerging research from the UNESCO international ethics committee, neuroscientists highlight that these digital environments exploit the developing adolescent brain by merging fundamental social drives with powerful algorithmic reward systems.

According to experts, platforms intentionally condition reward systems through infinite scrolling and variable feedback, directly manipulating the ventral striatum.

While evidence of digital harm continues to mount, scientists acknowledge that establishing a definitive causal link remains a subject of ongoing debate. Researchers warn that tech giants restricting data access forces independent academics to rely heavily on correlative studies, making exact behavioural impacts difficult to prove.

EU fines and civil liability for addictive algorithms

Driven by deteriorating youth mental health, countries including Germany, France, and Spain are also actively proposing domestic access restrictions for minors. However, media law experts point to the EU’s responsibility under the Digital Services Act (DSA).

Only just last week, the European Commission issued a preliminary ruling that found Meta in breach of the Digital Services Act for its addictive design of Instagram and Facebook. If the decision is confirmed following a response from Meta, the Commission could issue a non-compliance decision, which can trigger large fines – up to 6% of the total worldwide annual turnover of the provider.

Earlier this year, US courts in California and New Mexico ordered social media companies to pay millions in damages for creating addictive products that juries determined had caused users’ depression and anxiety, in the California case, and in the New Mexico ruling, failed to safeguard users of its apps from child predators

As global efforts intensify to enforce youth social media restrictions, the burden seems to be shifting toward tech companies to prove their digital environments are safe before accessing vulnerable populations.

 

Image Credits: Kampus Production via Pexels, European Union.