A WHO health worker administers an oral cholera vaccine to residents in Sudan during a mass camapign in July 2025.

The Democratic Republic of Congo (DRC) has seen a 30% increase in cholera cases over the past week, largely as a result of flooding and conflict, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

Deaths have almost doubled, with 124 people dying in the past week in comparison to 65 deaths the previous week.

Vaccination against cholera is at a low 7%, in part due to the inaccessibility of areas and the lack of vaccines, according to Professor Yap Boum, Africa CDC’s deputy head of mpox.

Meanwhile, cholera cases in Sudan have dropped by 43% and by 12% in South Sudan, which has also managed to vaccinate 72% of people at risk.

The World Health Organization’s (WHO) Eastern Mediterranean Region reports that the decline in cholera cases in Sudan’s Khartoum State follows “a 10-day vaccination campaign that reached more than 2.24 million people – achieving 96% coverage – in 12 hot spots in 5 at-risk localities”.

“Together with response measures such as case management, surveillance, risk communication and community engagement, and improvements in access to safe water, sanitation and hygiene, the campaign contributed to a sustained fall in the number of new cases,” according to WHO EMRO in a media release this week.

The year-long cholera outbreak in Sudan has infected 87,219 people and caused 2260 deaths, according to WHO EMRO.

“The outbreak is fueled by displacement, lack of access to safe water, sanitation and hygiene caused by the breakdown of water supply systems, and limited amounts of medical supplies for the management of cases,” said WHO EMRO, adding that drone attacks on power and water system infrastructure had “severely compromised access to safe water and adequate health care”.

But cholera “will not be solved from a medical perspective, but only through a multi-sectoral approach” that includes access to clean water, Boum stressed.

He added that the continent had already experienced 44 “high-risk” health events this year (in comparison to 72 for the entire 2024).

“We have to get used to the challenge of answering to diverse outbreaks at the same time, but also at a time where the resources are more and more limited, reminding us of the need to be efficient,” said Boum.

Mpox cases fall

Mpox cases continue to fall across Africa, with almost three-quarters of cases in the DRC, Uganda and Sierra Leone.

However, Boum said that several people infected with mpox died as a result of being infected with other diseases at the same time,  most notably measles.

“This has re-emphasised the decision that we’ve taken to focus on integration [of disease control and prevention],” he added.

Ethiopia has used its polio vaccination campaign to also screen for mpox, reaching more than 22 million people, which “is a very good example of leadership and integration”, said Boum.

Mpox testing coverage has also improved, reaching 55,5% of suspected cases in the past week in comparison to 39% in previous weeks.

Boum also reported that, in the past week, the African Union has signed a Memorandum of Understanding (MOU) with the United Arab Emirates (UAE) to “strengthen health systems and expand healthcare access across Africa”. 

This was formalised during the African Union Mid-Year Coordination Meeting (AUMYCM) in Malabo, Equatorial Guinea. The agreement aims to enhance public health security, improve emergency response, and foster a healthier future for Africa

Image Credits: WHO EMRO.

Climate change also added 41 days of dangerous heat in 2024, according to a report jointly produced by the team at World Weather Attribution (WWA) and Climate Central.

After 2024 became the warmest year on record, with temperatures rising 1.5 °C above pre-industrial levels for the first time ever, humanity is “moving into the unknown,” said Andy Haines, professor of environmental change and public health at the London School of Hygiene & Tropical Medicine.

Andy Haines
Andy Haines, London School of Hygiene and Tropical Medicine.

“We are now above the Paris Agreement’s preferred target of 1.5° Celsius [above pre-industrial levels), and six of the nine planetary boundaries have already been transgressed,” Haines said, speaking in late May at an event on the margins of the World Health Assembly.

“These environmental thresholds interact in ways we don’t fully understand, meaning we will encounter surprises, nonlinear changes, and tipping points with irreversible consequences in human lifetimes.”

The nine planetary boundaries are a scientific guideline that outlines the safe limits of Earth’s natural systems. They mark the thresholds that humanity shouldn’t cross if it wants to avoid lasting harm to the environment and serious risks to human well-being.

Crossing these boundaries—such as climate change, biodiversity loss, and others—could lead to sudden or irreversible shifts in the Earth’s systems.

A framework linking planetary boundaries and human health outcomes.
A framework linking planetary boundaries and human health outcomes.

Just six weeks on, his words seem all the more prescient, given the unprecedented flooding in Texas and unbearable heat waves seen since in Europe. Meanwhile, the World Meteorological Organization (WMO) has forecast that last year’s record heat levels will continue for the next five years, exceeding the 1.5°C threshold yet again at least once.

Rare moment of constructive dialogue amidst geopolitical tensions

Wildfire in western United States. Rich as well as poor countries across the world are seeing Increased flooding, heatwaves and wildfires as a result of climate change.

Haines’ stark warning opened a unique gathering of about 100 climate and health experts from around the world. The session on “Climate Change and Health, Adaptation and Resilience in a Changing World, at the Geneva Health Forum’s 2025 conference, offered a rare moment of constructive dialogue amid rising geopolitical tensions.

As Haines and other participants underlined, climate change is having a cumulative series of impacts going far beyond heatwaves, and it must be treated as an environmental or economic crisis, as well as a defining human health emergency.

Haines also cautioned that efforts to adapt to climate change – an emphasis in many low- and middle-income countries that lack resources to transition to clean and renewable energy sources – will not be enough to avert disaster.

“We can’t adapt our way out of this crisis. We have to do both—adaptation and mitigation—in an integrated way,” Haines stressed.

He highlighted that decisions made now will shape the health futures of generations. “Children born in 2020 will experience drastically different lifetimes than those born in the 1960s,” Haines said. “About 90% of them are expected to live their lives exposed to extreme climate conditions, especially heat.”

Planetary boundaries

In the past, climate change was traditionally seen through the lens of rising heat and more extreme weather, including storms. But today, there is a growing understanding of how warmer temperatures are stressing other ecosystems essential to human life on this earth. And at the same time, as more of those planetary boundaries are breached, these also exacerbate the effects of climate change.

Planetary boundaries
Planetary boundaries

The nine planetary boundaries are climate change, ocean acidification, stratospheric ozone depletion, biogeochemical flows in the nitrogen cycle, excess global freshwater use, land system change, the erosion of biosphere integrity, chemical pollution, and atmospheric aerosol loading. They were first identified in 2009 by a team of 28 international researchers.

“Planetary health is bigger than climate change,” Haines stressed. “So, we’re actually facing multiple planetary level threats. Six of the nine planetary boundaries have been exceeded, have been transgressed, and these planetary boundaries interact in all sorts of complex ways we don’t fully understand.”

Adaptation vs mitigation

Hospital in Rwanda. More climate resilient roofs, ventilation and energy systems can both adapt to, and mitigate, climate change.

Climate adaptation involves taking action to prepare for and adjust to the current and future impacts of climate change. In contrast, climate mitigation refers to efforts to reduce or prevent greenhouse gas emissions from human activities, thereby slowing or reversing the effects of global warming.

Countries most vulnerable to climate impacts prioritize adaptation, while major emitters focus on mitigation.

“It’s often true to say that we tend to put adaptation and mitigation in separate boxes. I want to argue that we need to do both in an integrated way,” Haines said.

“We shouldn’t pose one against the other. We shouldn’t say, ‘Well, we’re going to adapt, so we don’t need to mitigate. We’re going to mitigate so we don’t need to adapt.’ That’s not true. We can’t adapt our way out of this crisis. We have to do both,” he continued.

Haines noted that while many adaptation strategies may seem intuitive, they must still be evaluated for long-term impact. For example, installing air conditioning to deal with heat might appear helpful, but it releases hot air outdoors and increases fossil fuel consumption.

“So, we’ll then have to move towards passive ventilation – green roofs, green space in cities,” Haines said.

“But even when we’re thinking about cities and nature, we need to be careful which trees we choose. So if you choose some very allergenic trees, you make health problems worse,” Haines said.

He added that adaptation must not be oversimplified: “We need to have better science, better understanding, and a more nuanced approach to adaptation.

“Implementation science is not given the respect it deserves in academia,” Haines said. “But understanding what happens when we apply interventions at scale is critical. Do we get the co-benefits we expect? Do we inadvertently harm people?”

Other challenges of adaptation – nutrition and health services

Jessica Kronsdadt, Planetary Health Alliance.

Similar questions arise when considering how to adapt to shifting food systems, said Jessica Kronstadt of the Planetary Health Alliance at Johns Hopkins University.

“How do food systems change because of different concentrations of CO₂ in the environment, because of changing precipitation?” she asked.

“What are the implications of the loss of pollinators and other biodiversity loss?” Kronstadt continued. “What are the implications of pollution, and how does this affect aquaculture? So again, as we think about adaptation, what are all the environmental changes we’re adapting to, and what are all the health impacts?”

Good nutrition is central to climate resilience as well as health equity, added Sandro Demaio, Director of the WHO’s Western Pacific Regional Office, who described how countries in his region are actively working to ensure that healthy food remains accessible to all in a warming world.

A traditional vegetable market in the Maldives. Traditional markets provide access to healthy, fresh foods that play critical roles in feeding individuals and households globally.

Across Asia “there is such an incredibly rich food culture that we should be proud of, and we should hold on to, including the indigenous food knowledge across the region,” Demaio said.

At the same time, in isolated Pacific Island states, climate change poses severe risks to food systems and other vital health infrastructure, he noted.

In many Pacific Island countries, for instance, around 60% of health services are located within half a kilometer of the ocean, and are increasingly threatened by rising sea levels and extreme weather.

Better assessment of adaptation measures

For Yonhee Kim of the Department of Global Environmental Health at the University of Tokyo, the key concern is more effective assessment of adaptation measures.

“There are many ideas, and there are many interventions,” she said. However, leaders must evaluate which strategies best suit particular settings and contexts.

“We need to think about the real-world setting,” Kim emphasized.

She also pointed out that while there is growing evidence about the physical impacts of adaptation strategies, there is still insufficient research on their effects on mental health. For instance, one typical response to urban heat is establishing cooling centers, but psychological barriers may prevent some individuals from utilizing them.

“We need to think of what we might overlook, and we may need to consider the kinds of unique characteristics that individuals with mental health conditions may have,” Kim said.

Cultural values and human behavior are primary drivers of environmental change and will ultimately shape how countries approach adaptation and mitigation, she pointed out.

“What are the values that we need to both try to prevent some of the changes, to begin with, but also make sure we’re adapting?” Kronstadt asked.

On the road to COP30 in Brazil

Vanke Dean and former WHO Director General Margaret Chan

The WHA session took place ahead of a long lineup of summer and autumn climate events climaxing in the United Nations Climate Conference in Belém, Brazil in November (COP 30).

“We need to go further, faster, and fairer,” said UN Climate Change Executive Secretary Simon Stiell at the close of the intersessional Climate meetings in Bonn on 27 June, where delegations from around the world made only incremental progress on a range of thorny issues, from the weak-kneed national climate commitments to a new goal on climate finance.

That followed an event earlier in June, where the WHO’s European Regional office launched the Pan-European Commission on Climate and Health (PECCH) – to tackle the growing threat climate change poses to public health.

This week, a Global Climate and Health Summit hosted by the Physiological Society and supported by Wellcome is taking place in London.

Anh Vu, of the UK’s National Centre for Social Research, talks about research on the increased impacts of heat on outdoor workers in Viet Nam, at the Global Climate and Health Summit this week in London.

That is to be followed by the more policy-focused Global Conference on Climate and Health, 29-31 July, in Brasília, Brazil, hosted by the Government of Brazil, the World Health Organization, and the Pan American Health Organization (PAHO).

The Brasília conference hopes to come up with a set of concrete inputs to the draft Belém Health Action Plan as well as a strategy for promoting health as a “core pillar of climate action” at COP30, taking place in Belém, 10-21 November.

And on 1-2 November, just ahead of COP30, Beijing’s Vanke School of Public Health will commemorate the 10th anniversary of the Paris Agreement at its World Health Forum, with the theme : Climate Change & Health: Responsibility, Governance, and a Shared Future for Mankind,” notes Vanke Dean, Margaret Chan, former WHO Director General (2006-2017), who moderated the WHA side event in May.

“The scientists’ discussion about ‘planetary limits’ is real,” Chan said, who, in her remarks  stressed the urgency of equipping younger generations to tackle climate-related health threats, and noted a Vanke School initiative to develop a Chinese edition of a textbook on planetary health limits.

Speaking later with Health Policy Watch, Chan recalled how she was “initiated very early on about climate and health issues,” when she first first joined WHO in 2003 as the Director of the Department of Public Health and Environment, which was synthesizing at the time, the early research on the issue. In 2008, as a new WHO Director General, Chan presided over the passage of the first World Health Assembly Resolution on Climate Change and Health.

Europe and Asia are both heat hotspots

In 2024 Europe saw climate impacts ranging from heatwaves to wildfires.

While nearly half of humanity already lives in areas highly susceptible to climate change weather extremes, a third of the world’s heat-related deaths occur in the European Region – with an estimated 100,000 heat-related deaths in 35 European countries in 2022-23 alone, according to WHO.

Asia, meanwhile, is warming at twice the rate as the rest of the world, according to another recent WMO report; glaciers that feed vital freshwater reserves used during the dry season also are melting faster.

In 2023, the Lancet Countdown report found that global deaths from heat exposure have surged by 65% since the early 2000s, from around 188,000 annually to 310,000 in the 2020s.

The Intergovernmental Panel on Climate Change’s medium emissions scenario, which predicts 2.4°C warming by 2100, projects that between a million and 1.7 million additional temperature-related deaths will occur annually by the end of the century.

The health argument: A longstanding refrain still ignored

Maria Neira, WHO’s Climate, Environment and Health Department.

“Health can be the most powerful argument for climate action. Health is the argument for climate change,” said Dr Maria Neira, director of WHO’s Department of Climate, Environment and Health, at the May event.

Her remarks are a longstanding WHO refrain that come amid growing scientific consensus that climate change is “the greatest 21st-century health threat,” according to a recent analysis in the BMJ, which called for more focused local data and funding for climate and health priorities.

“Substantial and growing evidence shows its harmful effects on health through various pathways, including heat stress, drought, and shifting infectious disease patterns,” wrote the authors from Australia, Norway and Denmark, echoing remarks by Haines and others at the GHF conference.

Neira said that reducing climate pollutants would also reduce air pollution, which now causes as many as seven million premature deaths each year.

“Everybody should understand that they are not just negotiating with the percentage of emissions of greenhouse gases. They are negotiating with our lives because the decisions they are going to take will have an impact on how many cases of asthma, lung cancer, and cardiovascular diseases we are going to have.”

“What we are seeing are politicians, with the best intentions, treating climate change as if it were an economic or an environmental issue,” Neira added.

Cunrui Huang, Vanke School, talks about collaboration across sectors.

Cunrui Huang of the Vanke School of Public Health at Tsinghua University in China echoed Neira’s message, emphasizing the need to prioritize people and public health in climate action.

He said climate change multiplies health risks and stressed the importance of strengthening cross-sector partnerships, particularly between the environment, health, and energy sectors.

“We need to bring health to the center of climate discussions, and we need to break the silos of health, energy, environment,” Huang said. “We need to work together.”

Linking adaptation and mitigation seamlessly

Hospital in Johannesburg, South Africa decked with solar panels to support clean energy supply in the health sector.

One area where such cross-sector partnerships can foster more seamless adaptation and mitigation strategies is in the health sector itself, said Neira.

She pointed to the Alliance for Transformative Action on Climate and Health (ATACH). The initiative focuses on two primary goals. The first involves decarbonising health systems, which account for around 5% of global emissions. The second involves bolstering health systems’ resilience and response to extreme weather and climate-related events through channels ranging from early warning systems to better health services coverage for climate-sensitive diseases.

ATACH already has membership from 94 member states, which have set goals for their health systems in line with local needs and capacities.

“As the health professionals, we can decarbonize our own health system, of course, keeping with the top quality of care,” Neira said. “We can also reduce the amount of plastics and the amount of procurements.”

Leveraging renewable energy is a key component of the initiative, she said, leading to more accessible and affordable electricity for clinics in remote and rural areas of Africa and Asia – while also putting them on a low-carbon trajectory.

At the same time, designing the physical infrastructure of clinics to better withstand heat and storms, can simultaneously make them more resilient and more energy-efficient.

“We are solarizing as many healthcare facilities around the world as possible,” said Neira.

‘Sponge’ cities to combat urban heat impacts

(On left): John S Ji of China’s Vanke School of Public Health.

Urban planning is yet another domain where the use of integrated adaptation and mitigation strategies can bolster the health and climate resilience of a city’s residents, Neira added.

More urban green spaces not only reduce climate impacts, but can improve mental health, ease traffic congestion, and encourage more active lifestyles, in turn reducing the burden of non-communicable diseases and their associated conditions.

John S Ji of China’s Vanke School of Public Health at Beijing’s Tsinghua University pointed to the tensions that have arisen in traditional forms of urbanization between climate, health and development goals.

For example, in many developing countries, including China, urbanization has been associated with longer life expectancy due to better access to health services.

“Is urbanization causing longer life expectancy?” Ji asked. “Maybe, but at the same time, it’s causing the urban heat island effect,” he explained, referring to the phenomenon where large expanses of urban asphalt heat up cities more than around their periphery.

“In downtown centers, the temperature can be up to 5° C higher as compared to rural areas. So the urban heat island is an issue.”

To address this, some communities have implemented a “sponge city” concept, which enables the coexistence of water, green spaces, and dense urban development.

Central Park, New York City: Green spaces can mitigate urban heat island impacts – although design features need to consider local factors like vector borne disease habitats.

“But how do we implement this effectively?” Ji asked. “How do we do it without vector-borne diseases, such as mosquitoes, and also allergies from certain choices of trees? These could be major issues going forward.”
China leads ‘climate health literacy’

Despite the growing impacts on daily life of heat and extreme weather, the general public remains poorly informed about the relationship between climate and health, said Jian Zhou of the Institute of Energy, Environment and Economy at Tsinghua University.

“I think it is the critical moment and essential for us to set up something that we label as the climate health literacy,” Zhou said.

China’s leadership in climate and health education

Vanke School of Public Health, Tsinghua University, China.

Under the guidance of Chan, who has continued to carry forward the climate message ever since leaving WHO in 2017, the Vanke School of Public Health, which is part of Tsinghua University, has launched a new climate and health literacy initiative.

The programme features two core courses on climate and health run by the Global University Alliance, which recruits students from around the world for a six-month program. After completing the courses, students return to their universities and local communities to share their knowledge with peers.

In 2024, the program reached students from more than 400 universities in 79 countries.

Vanke’s World Health Forum in November will meanwhile bring together international organizations as well as government officials, academic experts, and industry leaders from around the world, Chan told Health Policy Watch. “This forum, directly addresses the growing health risks posed by escalating climate crises, aiming to promote the deep integration of emission reduction targets and population health benefits. It will also contribute to the implementation of the Paris Agreement and advancing the United Nations Sustainable Development Goals (SDGs).

“Global climate governance has entered a critical stage of deepening global cooperation and collaboration,” Chan said, adding “Climate change has become the most pressing global challenge of the 21st century.”

–Elaine Ruth Fletcher contributed reporting and editing to this story

Image Credits: WMO, Maayan Hoffman, London School of Hygiene and Tropical Medicine, Daria Devyatkina/Flickr, Stockholm Resilience Centre, WHO/Bill & Melinda Gates Foundation, GHF, WHO/V. Gupta-Smith, E Fletcher, Health Policy Watch, European State of the Climate 2024 report, Health Care Without Harm , Sergio Calleja/Flickr , Vanke School of Public Health .

Protesters demonstrating against global funding cuts during the opening ceremony of IAS 2025, the 13th International AIDS Society Conference on HIV Science, in Kigali.

KIGALI – Relief swept through delegates at the International AIDS Society (IAS) conference in Kigali, Rwanda, as news broke that the US Senate had moved to shield the President’s Emergency Plan for AIDS Relief (PEPFAR) from proposed budget cuts.

Late Tuesday, the US Senate  agreed to exempt the flagship HIV program from a planned $400 million reduction, which had been included in a $9.4 billion rescission package put forward by President Donald Trump.

The rescission package seeks to claw back federal funds from various programs, including approximately $900 million in global health allocations.

While the full package still awaits a final vote in both chambers of Congress, and amendments may yet emerge, the bipartisan removal of the PEPFAR cut marks a significant policy reversal. Under US budget law, Congress had 45 days to reappropriate the allocations, and that window closes on Friday (18 July).

IAS President-Elect Kenneth Ngure and Prof Linda-Gail Bekker

“This is the best news ever,” said Professor Linda-Gail Bekker, former IAS president and director of the Desmond Tutu HIV Centre in South Africa.

“I’ve said this before, and I’m going to say it again, PEPFAR is the most important and consequential contribution to public health, certainly in my lifetime, and probably ever. That it is not going away in its entirety is a victory for all who’ve advocated for it.”

Bekker also thanked “every single person who’s advocated for this, and every person who will ensure that we see it go through and that it does not end until we get to a point where we can safely transition to a sustainable plan”.

PEPFAR’s impact over the past 20 years.

Since the US global funding freeze from 20 January when Trump assumed the presidency, disruptions in service delivery have been reported across globally, and most severely in Africa, including interruptions in HIV testing, treatment distribution, and prevention programs.

These disruptions have placed millions of lives at risk, particularly in countries heavily dependent on US-supported HIV infrastructure.

Carolyn Amole, Clinton Health Access Initiative vice-president for HIV, hepatitis and TB, said that the ripple effects of PEPFAR’s funding disruptions had extended to commodities procurement, and essential systems, such as human resources, supply chains, and data infrastructure, undermining service delivery and overall program performance.

Modeling estimates suggest that, without intervention, up to 11 million new HIV infections and three million additional deaths could occur globally in the next five years.

Questions about PEPFAR’s future still remains

While the Senate’s move was met with applause, experts cautioned that broader risks remain.

Jirair Ratevosian, PEPFAR’s chief-of-staff under President Joe Biden, told an IAS press briefing that the US administration had yet to justify the rationale for these cuts, raising concerns about the politicization of budgetary decisions.

The Trump administration had claimed that PEPFAR funds were being spent in Russia, an assertion that was disproved as no allocations have been made to Russia since 2012. This clarification was instrumental in building bipartisan support for PEPFAR’s protection.

Still, the future of the program remains uncertain. With PEPFAR now under the US State Department, decisions on implementation will be shaped by the PEPFAR Scientific Advisory Board and other external advisors. Updated frameworks are expected to guide how and where services are delivered, though details remain limited.

“Unfortunately, it’s not over,” Ratevosian said. “We have to take today’s victory, celebrate, and then wake up tomorrow ready to keep fighting.”

“Global advocacy played a crucial role in persuading US lawmakers to protect this vital programme, reminding them that decisions about PEPFAR shape the health and futures of people around the world,” said IAS President Beatriz Grinsztejn.

But Grinsztejn warned that “uncertainty remains, with ongoing threats to global health funding. We must stay vigilant.”

People at Luyengo Clinic in Eswatini wait for services. PEPFAR funded 80% of the clinic’s cost, and US cuts threatened the HIV treatment of 3,000 people.

Ratevosian also viewed the crisis as a chance to rethink how countries prepare for shocks. “This wake-up call has forced us to build resilience and sustainability,” he said, urging governments to take ownership of their HIV responses and expand domestic funding mechanisms.

“We don’t know who will be in power next year. We can’t leave national health programs at the mercy of external political changes.”

He also called for greater transparency in transitions: “There must be a planned phase-out—not a chaotic drop-off. The uncertainty of this crisis was part of the harm.”

Despite the Senate’s decision, gaps remain, particularly in areas supported by National Insitutes of Health (NIH), Centers for Disease Control and Preventin (CDC), and other US agencies.

“The PEPFAR money will only cover certain things. There are still huge holes due to earlier account freezes. We must continue to push for full restoration, not just of PEPFAR, but of the broader global health apparatus.”

Bekker also called for change: “We can’t go back to how things were. We need to recalibrate based on what’s most effective now, country by country.”

IAS President-Elect Kenneth Ngure added that conversations on long-term sustainability must still continue:  “PEPFAR is a lifeline for communities across Africa. But we must also strengthen domestic investment and reduce dependence on donors.”

He warned that while PEPFAR may be protected for now, future rescission packages, delayed disbursements, or reprogrammed funds remain plausible threats. Advocacy, he stressed, must continue to be relentless and grounded in evidence. “We must showcase the science and the human impact—again and again.”

Image Credits: Jean Bizimana/ IAS, PEPFAR, UNAIDS.

Most coal-fired power plants in India are now exempt from installing technology to reduce sulphur dioxide emissions.

NEW DELHI – On 11 July, the Indian government changed its own rules, exempting most coal-fired power plants from installing technology to reduce sulphur dioxide (SO2) emissions. 

This reverses a key environmental policy launched in 2015 to cut SO2 emissions. It means that about 78% of India’s 537 or so thermal power plant units do not have to install machinery to reduce SO2 emissions called Flue Gas Desulfurization systems (FDGs).

India is the largest SO2 emitter, mostly from such plants. The gas is an air pollutant linked to respiratory disorders and other health impacts, as well as ecological impacts such as acid rain. 

While the move has been questioned by experts, the government has hit back by denying that it is reversing the policy.

In an X post, India’s environment ministry described criticism of the change as a “gross misinterpretation”, adding: “The revised sulphur dioxide emission policy is not a rollback” and that it remains “fully committed” to science-based air quality management:

Referring to an unnamed media report, the ministry added that it is “not aligned with empirical evidence, exaggerates the health and air quality impacts of sulphur dioxide, and underestimates the trade-offs of large-scale FGD implementation.”

However, the near-total reversal of the policy “weakens pollution control efforts and endangers public health,” according to the Centre for Science and Environment, an environmental think tank.

The new policy divides the thermal power plants into three categories. Of the 537 units which were supposed to get FGDs, now only 65 units (12%) must have these in category A. 

In the case of a further 66 units, category B,  officials will determine on a case-by-case basis whether they need to install FGDs . The remaining 406 units, category C,  are now exempted. 

This categorisation can be problematic. Similar pollution sources now have “different” environmental standards within India, points out an editorial in The Hindu newspaper. When the emission cuts were ordered in 2015, there was no such differentiation. All coal-fired power plants had to implement it. 

Herein, researchers point out, lies another significant dilution. Of the 36 coal-fired power units around Delhi, many have been shut down in the past during peak pollution times. However, 22 of them are now exempt from installing FGDs. 

 

Delays, postponement and now reversal

In 2015, shortly after the landmark Paris Conference on climate, India ordered all thermal power plants to reduce their sulphur dioxide emissions within two years. This was to be mainly done by installing FGD units in old and new plants. 

The policy’s clear goal was to curb air pollution. In 2014, Delhi replaced Beijing as the world’s most polluted city, a shock to many in India. 

But within two years, the pushback from India’s power ministry and various power firms began. Then the reasons ranged from the likelihood of increased costs to consumers, cost effectiveness as there were few FGD vendors in India, and, after 2020, disruption due to the COVID-19 pandemic. 

The highest costs for implementation would be borne by privately owned plants (over 45%), followed by state-owned (32%), and centrally-owned plants (24%), a study at the time estimated. 

The ten years of delays, postponements and finally the reversal of 2015 policy.

Government’s rationale for reversal

The decision has been a long time in coming. Over the past year and more, government-backed institutes of science have produced reports contending that there is no “notable” difference in ambient air SO2 concentrations between cities which have thermal power plants (TPPs) with the emission-reducing FGDs, and those cities where TPPs don’t have this. 

The rationale includes that most of the coal used has low sulphur content, that SO2 emissions are well within Indian air quality standards because of mandatory height of smokestacks (220 metres) and “Indian climatic conditions,” and that acid rain was not a significant issue.

By numbers: Lives and money

The government says sulphates (what SO2 turns into in the atmosphere) contribute only 0.96% to 5.21% of PM 2.5 in cities near TPPs. However, researchers point out that this approach is selective at best both in terms of the number of cities covered and the time period for the testing. 

“As highlighted, the estimated 5% sulfate contribution, derived from data in 18 non-attainment cities, may not fully represent the national air quality scenario. Limitations such as the short three-month sampling period and exclusion of rural areas suggest the need for broader, year-round assessments to inform effective policy,” points out Dr Manoj Kumar, analyst at Centre for Research on Energy and Clean Air (CREA).

Other studies have shown that pollution from burning coal can contribute between 15% to 20% of India’s PM2.5. 

If FGDs are installed in all coal-fired power plants throughout the country, this could reduce PM2.5 by 8%, says a paper by authors from Harvard and IIT Hyderabad. This would significantly reduce the gap between India’s annual PM2.5 average of 50.6 micrograms/m3 last year and the national acceptable standard of 40. The study estimates that near the coal-fired power plants, PM2.5 pollution would be reduced by 7-28%, and potentially avoid 48,000 premature deaths. 

FGD benefits are worth four times the investment

Since the environment ministry says it has weighed fresh scientific evidence versus the economics of imposing standards, it is useful to look at the numbers. 

Installing FGDs across the country would cost over INR 2,540 billion ($29,5 billion), the government has stated. But doing so would benefit India by an estimated INR 9,622 billion ($112 billion). This means for every rupee invested, the benefit could be about INR 3.79, a return of almost four times. 

Over 90% of that is from preventing premature deaths by 2030. Ironically, this was in a 2018 study, by Bengaluru-based CSTEP, done on the premise that the rollout, not rollback – would be done by this year 2025!

Benefits to India’s GDP after a full rollout of FGD are approximately $18.1–$604 billion per year, which is equivalent to ~ 0.44 to 10% of India’s GDP, according to the IIT-Hyderabad and Harvard study. 

However, the ministry posted that the July 11 decision reversing the requirement weighs the “disproportionate resource and environmental costs of indiscriminate FGD mandates.” 

SO2 emissions: India up 50%, China down 75%

Since the early 2000s, China has reduced its SO2 emissions by 75%, whereas India’s emissions grew by 50% during the same time, according to NASA analysis. This has been attributed to strict policies and pollution control measures by Beijing. 

Source: Newslaundry, Centre for Research on Clean Energy and Air (CREA)

SO2 is not typically a greenhouse gas. On the contrary, it can block some of the sunlight and cause a cooling effect. But this is a short-term outcome and blurs the effects of rising global warming. However, this was cited by India’s Power Minister, Manohar Lal Khattar. 

“The sulphate aerosols from these coal plants aren’t to the extent that they affect human health…it is less than 5%. On the contrary, it is necessary that some of it remain in the atmosphere. If it is too less, it can increase warming,” Khattar said.

While the environment ministry did not echo this in its rebuttal post on X, it described the new regulation as climate coherent. One of the government’s arguments has been that FGD technology would increase carbon emissions. However, researchers say this is marginal, benefits outweigh the climate cost, and that this amount would anyway be exceeded by India’s increasing coal consumption. 

Image Credits: Ella Ivanescu/ Unsplash.

PAHO director Jarbas Barbosa da Silva (centre).

Massive economic losses are ahead for South America if it fails to address non-communicable diseases, according to a report launched on Tuesday by the Pan American Health Organization (PAHO).

“Between 2020 and 2050, non-communicable diseases (NCDs) and mental health conditions are projected to cost South America more than $7.3 trillion in lost productivity and healthcare spending that is primarily due to premature deaths, disability and reduced workforce participation,” PAHO director Jarbas Barbosa da Silva told a media briefing.

“To put it in perspective, that is equivalent to the entire annual GDP of Latin America and the Caribbean lost to preventable and treatable conditions.”

To reach these figures, Harvard University researchers developed an analytical model over the period 2020–2050 in 10 South American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. 

The report projects “massive economic losses for countries ranging from $88 billion in Uruguay to $3.7 trillion in Brazil”, said Barbosa, who described this as a “alarm bell situation”. 

“This is not just another health crisis. The escalated burden of NCDs and mental health conditions has become an economic emergency, perhaps the worst economic disaster in health, and people living with cardiovascular diseases, cancer, diabetes and chronic respiratory conditions are at the heart of this storm.”

Nearly six million people died of NCDs in the region in 2021, with 40% of deaths in people under the age of 70. Cardiovascular diseases and cancer accounted for more than half of those deaths. 

Barbosa blamed the increase on NCDs on ageing and risk factors including tobacco use, unhealthy diets, lack of physical activity, harmful alcohol use and pollution.

Around 60% of adults in the region are overweight in comparison to the global average of 43.5%. Diabetes is rising, and an estimated 43 million people do not have access to the treatment they need, said Barbosa. 

Thirty-nine percent of the energy in the region is generated from fossil fuels, which has increased air pollution. In 2020, exposure to harmful outdoor air particulate matter (PM2.5) such as from exposure to biomass smoke, resulted in approximately 37 000 deaths in South America.

Harvard’s Professor David Bloom said that policy makers in South America and beyond have, in many cases, tended to undervalue health.

The report is aimed at “helping economics ministers make grounded and judicious decisions about health sector budgets”, said Bloom.

The report encourages policymakers to take urgent action, including “prevention, universal health care, long-term care reform, the overhauling of healthcare systems, more rigorous health technology assessment and innovation, and responsive healthcare policy”.

Aitano Valentina (4 years) receives her DPT and Polio vaccination at the Roosevelt Children’s Hospital for Infectious Diseases and Rehabilitation in Guatemala City.

The global childhood vaccination rate in 2024 held steady with 85% of infants and children receiving three doses of the vaccine for diphtheria, pertussis and tetanus (DPT), used as a global benchmark for immunization rates overall.  However large, continued gaps in coverage are propelling outbreaks, including the highest rate of measles cases since 2019. 

“In 2024 85% of infants around the world, about 109 million infants received three doses of the core vaccine, the DTP-containing vaccine that is the global marker for routine childhood immunization coverage,” said WHO’s Katherine O’Brien, head of Immunizations, Vaccines and Biologicals. She spoke to reporters just ahead of Tuesday’s publication of 2024 data on global vaccination rates by WHO and UNICEF, the UN children’s organization.  

The data, considered the most comprehensive in the world, tracks rates of childhood vaccination against 16 major diseases across 195 countries.

WHO’s Katherine O’Brien.

“There’s both progress and pressing challenges in the data from 2024,” O’Brien said, noting that in absolute numbers 1 million more children received basic vaccinations in 2024, as compared to 2023.

“At the same time, the latest estimates highlights a really concerning trajectory,” she added.  “The world is currently off track for the SDG [2030 Sustainable Development Goal target] to halve the number of ‘zero dose’ children and achieve at least 90% global immunization coverage. 

“In 2024 nearly 20 million children missed at least one dose of DTP, and of these 20 million children, 14.3 million never received even a single dose of any vaccine.”  And the number of zero dose children still remains higher than the years just before the COVID-19 pandemic.

Hit a stubborn glass ceiling 

Zero dose children by region. Numbers are still higher than pre-pandemic 2019. Regional designations are as per UNICEF definitions, e.g.: East Asia and Pacific; Europe and Central Asia; Eastern Europe and Central Asia; Western Europe; Latin America and Caribbean; Middle East and North Africa; Regional Office for Southern Africa; West and Central Africa.

“We’ve hit this very stubborn glass ceiling, and breaking through that glass to protect more children against vaccine-preventable diseases is becoming more difficult,” she stressed. 

Wars are a key reason for persistent under-vaccination in key parts of the world. 

“Conflicts throughout the world are eroding immunization progress. Children living in one of 26 countries affected by fragility, conflict or humanitarian emergencies are three times more likely to be unvaccinated compared to children who live in stable countries,” O’Brien said. 

“In fact, half of all children unvaccinated in the world live in these fragile, vulnerable and conflict countries, while two-thirds of [other] countries in the world have maintained at least 90% coverage of core vaccines in the past five years, which is great news. 

DPT 3 coverage, the benchmark indicator for vaccine coverage. 110 countries had coverage at 90% or higher, but 22 countries had coverage below 70%, accounting for 17% of the world’s infants.

However, even in politically stable countries, there are some “emerging signs of slippage, and in other countries, stalling of vaccine coverage,” O’Brien noted, saying that “even the smallest drops in immunization coverage as measured at the country level, can have devastating consequences. It opens the door to deadly disease outbreaks and puts even more pressure on health systems that are already stretched.”

Along with conflicts, vaccine disinformation is another factor at play, playing on parents’ fears about their children’s health and well-being.  And that can fuel vaccine hesitancy, raising dangerous pockets of under-vaccination to the level of a national threat.

“We don’t have a way to quantify what fraction of people who aren’t vaccinated at a global level are making those choices because of incorrect information that they’re receiving,” O’Brien said. “But what we do know is that this information is scaling very fast. around social media channels, it’s influencing people the use of social media is highly influential on what people believe, and yet the most influential factor is the advice from an individual’s local medical practitioner

Measles as a case in point 

Ephrem Lemango, UNICEF

The rising number of measles outbreaks, and people infected in the United States and worldwide is one case in point, said UNICEF’s Ephrem Lemango in the briefing. 

It typifies the paradox: on the one hand global immunization rates can improve, while persistent pockets of under-vaccination still generate consequences.

“The first dose of measles containing vaccine coverage this year rose to about 84% in 2024 which is a little higher than what we had in 2023 and due to this improvement, an estimated additional 1.7 million children had measles vaccination,” he said, attributing the progress to improved measles vaccine rates in Africa, the Americas and South East Asia. 

Coverage for a second dose of measles vaccine also increased to 76%, above 74% in 2023 – reflecting the rebound from the setbacks of the COVID-19 pandemic. 

“But these gains are not keeping up with the level needed to stop outbreaks, and that is why you keep on hearing there are an increasing number of outbreaks in different countries,” said Lemango, noting that you need a 95% measles vaccine coverage to protect communities entirely against the spread of the highly contagious virus.

In 2024, about 20 million children missed their first measles dose while another 12 million children didn’t get their second dose – leaving about 30 million children globally still vulnerable to  measles infections.

“Over half of these children are in the African region and in countries affected by conflict and fragility, such as Sudan, Yemen and Afghanistan,” he pointed out. 

But there are also uncovered pockets in countries like the United States, whose national vaccine rates appear to be high otherwise. 

World sees highest rate of measles cases since 2019

Measles coverage with at least one vaccine dose in 2024.

“This immunity gap resulted in about 360,000 confirmed measles cases be reported in 2024 which is the highest we have seen since 2019 as a global community,” Lemango said. 

“Immunization efforts face distinct challenges across different contexts, and this could range from access to acceptance-related challenges,” Lemango said.

“Challenges like fewer health facilities, workforce shortage, vaccine stock outs and difficulty to reach remote communities are leaving millions of children unprotected. These barriers are especially acute in conflict effects or displacement settings.

“But in high-income countries, decreased acceptance or even slight vaccine hesitancy driven by misinformation or distrust in institutions tend to cause the resurgence of vaccine preventable diseases like measles. And the result is that children are left vulnerable to vaccine-preventable diseases across countries.”

Added O’Brien, some 60 countries have had large or disruptive measles outbreaks over the past 12 months. 

“Contrast that with just 24 months ago, when the number around the world was only 32 countries,” she said, noting that some countries are still experiencing a backlash in vaccine hesitancy that is a legacy of the COVID pandemic.

“What we see now are the impacts from the pandemic and from the inability at this point for countries around the world to really get in and fill those immunity gaps,” O’Brien said. “And part of the threat is mis- and disinformation – anything that’s done that discourages parents from believing and knowing, in fact, that vaccines are safe and effective.”

Funding cuts further threaten progress 

Thabani Maphosa, director of country programmes at Gavi, The Vaccine Alliance.

Global progress is also under threat from the massive cuts by the United States in assistance for  vaccine rollout and vaccine surveillance. Those are related to the Trump Administration’s January withdrawal from the World Health Organization, followed by the dismantling of USAID and deep budget cuts in the National Institutes of Health and the US Centers for Disease Control, among other institutions. 

“Progress is under threat by growing funding cuts, particularly for immunization services and disease surveillance,” observed Lemango. “Our ability to respond to [measles] outbreaks in nearly 50 countries has been disrupted. 

On a brighter note, the 25 June replenishment drive for Gavi, the Vaccine Alliance, raised more than $9 billion out of Gavi’s $11.2 billion five-year goal. And that was despite the US withdrawal of support for the initiative founded 25 years ago by the Bill and Melinda Gates Foundation.  

“In 2024 Gavi supported lower income countries to vaccinate more children than ever before –  against more diseases than at any point in history,” declared Thabani Maphosa, Gavi’s managing director of country programmes. That is not just a statistic. It is a testament to the resilience and determination of countries. They are also committing record amounts of domestic financing to immunization.

“Countries like Mali, DR Congo, Rwanda and Ethiopia made major strikes, helping Africa recover immunization coverage to pre pandemic levels, even as birth rates were rising, coverage across all vaccines – with significant gains in protecting against polio, measles, pneumonia, rotavirus, yellow fever and cervical cancer,” he said.  

The HPV vaccine that protects against most forms of cervical cancer, is a particular success story, he noted:

“Nearly 60 million girls are now protected against cervical cancer, and more were protected in 2024 than in  the previous decade. This progress, following on from a strategic investment in 2022, puts Gavi on track to reach 86 million girls by the end of 2025.”  See related story: 

Malawi Acts to Overcome COVID-era Setbacks in HPV Vaccination

 

Image Credits: UNICEF 2024 , WHO/UNICEF 2025.

Sand and dust storms affect about 330 million people across 150 countries in 2024.

In 2024, sand and dust storms affected 330 million people across 150 countries taking a toll on health and economies, according to a new report by the World Meteorological Organization (WMO).

While the annual mean dust surface concentrations was slightly lower in 2024 when compared to 2023, there were big regional variations. In the most affected areas, the surface dust concentration in 2024 was higher than the long-term 1981-2010 average.

WMO estimates that between 2018–2022 around 3.8 billion people or nearly half the world’s population were exposed to dust levels exceeding World Health Organization’s (WHO) annual safety threshold for PM10.

“Sand and dust storms do not just mean dirty windows and hazy skies. They harm the health and quality of life of millions of people and cost many millions of dollars through disruption to air and ground transport, agriculture and solar energy production,” WMO Secretary-General Celeste Saulo said.

Overall, dust storms are worsened by poor land and water management, including urban sprawl and deforestation, which removes vital ground cover in arid or semi-arid areas, as well as drought. With climate change exerting pressure on all of these areas, WMO has underlined the need to improve monitoring, forecast and early warnings.

Increasing exposure trends

Difference in average population-weighted days when exposure to desert dust was higher than 45 μg/m3, comparing 2018–22 with 2003–07. On average, more people were exposed to sand and dust storms between 2018–22 than between 2003–07.

WMO estimates that every year, around 2,000 million tons of sand and dust enters the atmosphere –  equivalent to 307 Great Pyramids of Giza. Over 80% of this originates from the North African and Middle Eastern deserts, and can be transported across continents and oceans.

While much of this is a natural process, poor water and land management, drought and environmental degradation are increasingly to blame.

A new sand and dust storm indicator developed by WMO and the WHO shows that 3.8 billion people were exposed to dust levels exceeding WHO’s annual safety threshold for PM10 between 2018–2022. This represents a 31% increase from 2.9 billion people during 2003–2007.

This exposure varied widely from only a few days in relatively unaffected areas to more than 87% of days – equivalent to over 1,600 days in five years – in the most dust-prone regions of the world, including Africa’s Sahara, and Asia’s Gobi and Taklamakan Deserts.

Health impacts of sand and dust storms

Sand and dust storms contribute directly to air pollution, even in areas far from the source.

Health impacts of sand and dust include respiratory and cardiovascular issues.

However, sand and dust particles from natural sources tend to be larger than the PM2.5 particles produced by combustion and industrial sources, which penetrate deeper into the lungs and into the cardiovascular system, causing impacts such as hypertension and cancer, as well as respiratory impacts.

Even so, natural dust sources may also carry with them dust from industrial sources such as urban construction and dust kicked up by road traffic, which may include benzene and diesel components as well as tire wear and tear. In addition, there are significant threats to health when mineral dust, including a range of toxic compounds, is lifted from ploughed or bare fields. And this can occur in temperate or even humid climates, according to the WHO.

Apart from this, there are the socio-economic impacts. For instance, Iraq, Kuwait, Qatar, and the Arabian Peninsula were struck by an exceptional winter dust storm in December 2024. It led to widespread flight cancellations, school closures, and the postponement of public events.

“This Bulletin shows how health risks and economic costs are rising – and how investments in dust early warnings and mitigation and control would reap large returns,” Saulo said. “This is why sand and dust storms are one of the priorities of the Early Warnings for All initiative,” she added.

The WMO Sand and Dust Storm Warning Advisory and Assessment System coordinates international sand and dust research and has operational regional centres.

Geographical distribution of sand and dust storms

Dust storms in 2024 relative to the 1981–2010 mean. The image shows the geographical distribution of dust storms and their intensity.

For 2024, the central African nation of Chad saw the highest annual average dust concentrations. Chad is home to the Bodélé Depression, a mountain-rimmed valley, which is one of the key dust emission sources of the Sahara desert.

In the southern hemisphere, annual average dust concentrations were highest in parts of central Australia and the west coast of South Africa.

In 2024, sand and dust concentrations were lower than what they normally are in many of the main source areas but higher in areas where the dust blowed to. The transatlantic transport of African dust invaded the parts of Caribbean Sea region.

The regions that are most vulnerable to long-range transport of dust are: the northern tropical Atlantic Ocean between West Africa and the Caribbean; South America; the Mediterranean Sea; the Arabian Sea; the Bay of Bengal; central-eastern China.

Economic costs of sand and dust storms

While the global economic costs of sand and dust storms are not clear there are some country-level estimates. In the US alone, dust storms and related wind erosion cost an estimated $154 billion in 2017 – more than a fourfold increase over the 1995 estimate, according to one brand-new study, published in Nature in January.

The analysis included costs to households, crops, wind and solar energy production, as well as excesss mortality from fine dust exposure, health costs due to Valley fever, and transport. The true cost of dust was much higher, since reliable national-scale evaluations of many of dust’s other economic impacts (for example, on human morbidity, the hydrological cycle, aviation and rangeland agriculture) were not available, said the study’s authors, affiliated with the University of Texas and Virginia’s George Mason Universityy.

WMO, a UN agency, has been assessing sand and dust storms since 2007. The UN has declared the 2025-2034 as ‘Decade on Combating Sand and Dust Storms.’

Image Credits: WMO, The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action, Chris Ison/WHO, China Meteorological Administration (CMA) & WMO.

Saima Wazed, daughter of deposed Bangladesh leader Sheikh Hasina, sworn in as Director of WHO’s South East Asia Region in February 2024.

Saima Wazed, the World Health Organization’s (WHO) controversial regional director for the South East Asia Regional Office (SEARO), was placed on leave Friday (11 July) – four months after Bangladesh’s Anti Corruption Commission  (ACC) filed two cases against her for fraud, forgery and misuse of power.

WHO Director General Dr Tedros Adhanom Ghebreyesus notified staff in a brief internal email that Wazed would be on leave from Friday and that former WHO Assistant Director-General Dr Catharina Boehme for External Relations would “serve as the Officer in Charge” in Wazed’s place. Boehme will arrive at the SEARO office in New Delhi on Tuesday, 15 July, Tedros added. No date was given for Wazed’s return to her position.

Some of the charges against Wazed, daughter of Bangladesh’s former Prime Minister Sheikh Hasina who fled the country last August after protests, stem from her bid to be appointed regional director.

Wazed was elected to the position by SEARO member states in November 2023, but her campaign was shadowed by claims that her influential mother used her influence to ensure her daughter’s position. Following the confirmation of her appointment by the WHO Executive Board, WHO Director Dr Tedros Adhanom Ghebreyesus formally appointed her to the position in February 2024. Only a few months later, widespread protests prompted Hasina’s resignation and flight from the country on 5 August.

In January 2025, the ACC launched an investigation into claims that she had forged documents during her campaign to become WHO regional director and misused funds collected for a foundation that she previously headed, as previously reported by Health Policy Watch.

According to formal charges filed by the ACC in March, Wazed is alleged to have provided false information about her academic record during her campaign for regional director, violating Section 468 of the Bangladesh Penal Code (forgery for the purpose of cheating) and Section 471 (forging a document).  

The ACC also alleges she misrepresented her qualifications by claiming an honorary role at Bangabandhu Sheikh Mujib Medical University, which the university disputes, to secure her WHO position. The charges were detailed  by ACC Deputy Director Akhtarul Islam.

Wazed is also accused of having misused her power and influence to collect about $2.8 million from various banks for the Shuchona Foundation, which she used to head.  

The ACC case did not provide complete details on how the money was then used. But it said that charges include: allegations of fraud and misuse of power under Sections 420 (cheating and dishonestly inducing delivery of property); as well as Section 5(2) of the Prevention of Corruption Act of 1947.

After the charges were set out, a warrant was issued for Wazed’s arrest in Bangladesh. As a result, the WHO office in Bangladesh has reportedly refused to work with her as RD, while Wazed has been unable to travel to other countries in the South-East Asia Region.

Boehme was appointed as ADG in charge of External Relations and Governance in 2023, but she was not named to any role in Tedros’ shake-up of his  leadership team, in May, which also reduced their numbers from 11 to 6.

While the reductions were supposed to save WHO funds, a number of other members of WHO’s senior leadership may have remained on in the agency’s payroll without any clear role – raising criticisms from rank-and-file staff.  Except for ADGs such as Mike Ryan who publicly announced his retirement, or Samira Asma, who left the Organization to take another position, there has so far been no clear public accounting of the positions of other remaining senior managers. In Boehme’s LinkedIn account, for instance, she still refers to herself as a WHO ADG.

*Additional reporting by Elaine Ruth Fletcher.  Updated 14.07.2025 with corrected attribution to Boehme as a former WHO ADG.  

Image Credits: WHO.

Intergovernmental Working Group (IGWG) co-chairs the UK’s Dr Mathew Harpur and Brazil’s Ambassador Tovar da Silva Nunes.

Intense negotiations lie ahead for World Health Organisation (WHO) member states to conclude the missing part of the Pandemic Agreement, after a brief respite since the agreement was adopted by the World Health Assembly in May.

A new body, the Intergovernmental Working Group (IGWG), met for the first time this week, and chose Brazil’s Ambassador Tovar da Silva Nunes and the UK’s Dr Mathew Harpur as co-chairs.

The IGWG also adopted a tight schedule to achieve its key task: negotiating an annex to the pandemic agreement on a pathogen access and benefit sharing (PABS) system. This system will set out how information about pathogens with pandemic potential is shared in a safe, transparent and accountable manner, and how those who share information will benefit from products that are developed as a result.

Member states have until 10 August to submit proposals on what they want to see in the annex, which will flesh out Article 12 of the agreement. 

According to Article 12,  the IGWG needs to develop provisions to govern the PABS System, “including definitions of pathogens with pandemic potential and PABS materials and sequence information, modalities, legal nature, terms and conditions, and operational dimensions”.

Aside from the PABS system annex, the IGWG will also prepare the ground for the Conference of the Parties that will govern the pandemic agreement, and the terms of reference for a coordinating financial mechanism, which will help defend countries against outbreaks and pandemics.

September meetings

An informal IGWG meeting is planned for 12 September, with the next formal meeting from 15-19 September.

The IGWG Bureau, the administrative body overseeing the talks, is also compiling a list of experts to assist with negotiations. These will also be circulated to member states.

Experts are essential for this part of the talks, which are complex given that the annex will need to harmonise with several international agreements covering intellectual property and trade, as well as the Nagoya Protocol, which determines how to share the benefits arising from the utilisation of genetic resources fairly and equitably.

Dr Mike Ryan addresses the IGWG meeting, his final pandemic negotiations meeting before he leaves WHO in September.

Speaking at the conclusion of the first IGWG meeting, WHO outgoing Assistant Director-General Dr Mike Ryan described the annex as the “core” and “engine house” of the pandemic agreement.

“You are beginning a really important process with difficult miles ahead diplomatically,” said Ryan, who revealed that the meeting was his last on the pandemic agreement negotiations as he leaves the WHO in September.

“You are constructing a platform that will save countless lives,” said Ryan, who added that he had “huge hope” that the talks would succeed – although member states will have to “go at it” to conclude by April 2026 in time for the World Health Assembly.

Earlier in the week, the Pandemic Action Network (PAN) and partners urged the IGWG negotiators to “keep up momentum and adopt a PABS Annex at the next World Health Assembly”.

They described the annex as critical “to advance equitable access to outbreak and pandemic medical countermeasures, and an essential step to advance the promise and potential of the pandemic agreement”.

They urged negotiators to bring in experts from public health and environmental, align early on priority themes and core structure, and tackle the toughest issues first.

“We appreciate the idea of a structured template to gather proposed texts, and stress that strategically timed meetings and well-used informal and intra-sessional opportunities will be essential to achieve a May 2026 deadline,” said the group in a press statement released by PAN, the Panel for a Global Public Health Convention, Spark Street Advisors and Helen Clark, co-chair of The Independent Panel for Pandemic Preparedness and Response.

Sugary drinks are significant drivers of obesity and diabetes.

At the 2025 Club World Cup, the world’s most celebrated footballers – from global icons to rising stars – are showcasing their elite athleticism and passion for the game. 

But as stars like Lionel Messi take center stage, there is one name that doesn’t belong anywhere near the pitch: Coca-Cola.  

Coca-Cola has partnered with global football body FIFA since 1978 and has been a ubiquitous presence at this year’s Club World Cup. FIFA’s football tournaments are a premier platform for showcasing health and fitness, while Coke is the largest global manufacturer of soft drinks, a top driver of the world’s twin epidemics: obesity and diabetes. Coca-Cola should not be sharing the spotlight with football players and using their achievements to “sportswash” away soda’s harms. 

It’s easy to see why not. Four of the five brands under Coke’s umbrella contain high levels of added sugar or artificial sweeteners. A single 20 oz bottle of Minute Maid Lemonade contains 67 grams of added sugar, over 100% of what a typical adult should consume in a day.

Liquid sugar is especially damaging. It causes dental caries, weight gain and increases many health risks. Our bodies don’t respond to liquid calories the same way as food calories: they do not make us feel full, leading us to consume more. 

Additionally, there’s increasing scientific evidence to suggest sugar is addictive: it affects the brain in a manner similar to cocaine and can lead to increasing intake, withdrawal and cravings.

The health harms of sugary drinks start young. Big Soda companies hook kids on their products through pervasive marketing tactics used in schools, during kids’ sports and on screens. As a result, over half of American children consume sugary drinks daily. And because dietary behaviors set in childhood track into adulthood, these early preferences set kids up for lifetimes of unhealthy eating. 

PepsiCo and Coca-Cola are amongst the worst plastic polluters in the world.

Big Soda also devastates our environment. Along with PepsiCo, Coke is one of the largest plastic polluters in the world. According to the University of California, per liter, soda uses 27 times more water and produces 11 times more greenhouse gas emissions than the equivalent amount of tap water.  

Yet, Big Soda has tried to frame itself as “part of the solution.” For decades, it’s promoted physical activity as a solution to obesity, ignoring data that it’s nearly impossible to out-exercise a bad diet. Beverage companies have interfered with scientific research and professional nutritional organizations, obfuscating the true health impacts of their products. And by positioning themselves as “helpful,” they have actively fought against public policies to reduce sugary drink consumption.

Along with “sports” and “health washing,” Big Soda employs “greenwashing,” or framing damaging products as helping, not harming, the environment. At the 2024 Olympic Games, where Coca-Cola was a leading sponsor, the soda giant claimed to be an environmental champion by halving the number of plastic bottles used at previous Olympics.

 While seemingly offering nine million drinks in reuseable, returnable eco-cups, 75% of these drinks came from plastic bottles poured into eco-cups. At best, this type of “greenwashing” is misleading to consumers and at worst, threatens to exacerbate the pollution crisis.

These companies also use emotion to push product sales. Coke’s 2022 World Cup advertisement featured people from around the world celebrating amid a flurry of confetti, which outwardly has nothing to do with soda. Coke chose to capitalize on the emotions the World Cup incites: hope, joy and a sense of social connection that is increasingly rare. It profits from this emotional appeal by selling us products that are harmful for our health and planet. 

Football is bigger than ever. The 2022 FIFA World Cup drew a cumulative audience of over 5 billion, with the final alone watched by 1.5 million people. With this massive reach comes increased responsibility to engage in ethical, transparent practices that don’t cause health and environmental harm. If we expect our athletes to play fair, so should FIFA. 

But the tide is turning. The Kick Big Soda Out of Sport campaign, led by global health advocates and organizations, is mounting an opposition to Big Soda’s sports sponsorships. As the 2025 Club World Cup games are being played across the U.S., the Kick Big Soda Out movement is demanding FIFA end its partnership with Coca-Cola. Over 350,000 people, alongside 97 health and environmental organizations have already pledged their support. 

The spotlight isn’t only on the players—it’s on FIFA too. Will it continue to hijack the global stage for profit, or will it take a stand for the health of fans, players and the planet? 

The facts are clear. It’s time to ban Big Soda in sport. 

Lindsey Smith Taillie, PhD, is an associate professor in the Department of Nutrition at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill. She is a nutrition epidemiologist focused on designing and evaluating healthy food policies.

 

Image Credits: Vital Strategies.