In February 2026, Germany’s governing coalition parties CDU and SPD have aligned to push for a social media ban for minors.
Germany’s governing coalition parties CDU and SPD under Chancellor Friedrich Merz (bottom right) back a social media ban for minors.

Following the lead of Australia, France, and Spain, Germany’s governing parties have found common ground on a proposal to ban social media for children. But as politicians prepare strict age restrictions, experts warn that significant legal roadblocks and data protection concerns could stall the legislation.

At a recent party conference in Stuttgart, the centre-right Christian Democratic Union (CDU) voted to push for a ban on social media for children under 14. To enforce the restriction, the proposal suggests heavy fines for platforms that fail to maintain robust age-verification systems.

Days earlier, the Social Democratic Party (SPD) tabled a similar proposal for a complete ban up to age 14. For adolescents up to 16, the party is demanding a mandatory “youth version” of platforms, stripped of addictive algorithms, infinite scrolling, and intrusive push notifications.

These domestic efforts mirror a global legal crackdown on “addictive by design” features, headlined by Australia becoming the first country to enforce a national ban for children.

This pressure is mounting on multiple fronts. While Meta defends itself against charges in Los Angeles, the EU is simultaneously investigating TikTok under its Digital Services Act (DSA) for similar allegations of addictive design.

Experts warn of addictive online platforms

Professor Christian Montag, a researcher in cognitive and brain sciences at the University of Macau, warns that specific social media features are designed to manipulate the reward systems of the developing brain.
Professor Christian Montag asserts that social media features are designed to manipulate the developing brain.

Proponents of a ban point to skyrocketing screen time and the deterioration of youth mental health as the primary problems to be solved.

Professor Christian Montag, a researcher in cognitive and brain sciences at the University of Macau (China), confirms that specific platform features are designed to manipulate the brain.

“If one gets many likes for their own post compared to few likes, this relatively clearly triggers the reward system of the brain, including the ventral striatum,” which can explain habit formation.

The ventral striatum, including the nucleus accumbens, is a key brain region for reward processing, motivation, and emotional regulation.

Montag identifies a bouquet of interconnected issues affecting minors online, pointing to the debates around the “displacement hypothesis,” which suggests the sheer volume of time extracted by the platforms’ data-driven business models leaves children with too little time for crucial developmental experiences, such as physical play outdoors or offline social interaction.

Furthermore, minors are regularly exposed to age-inappropriate content, cyberbullying that scales far beyond the school yard, and algorithmic feeds that promote unrealistic beauty ideals. The latter correlate with body dissatisfaction and eating disorders, Montag says.

However, researchers face a major difficulty in proving definitive causality due to many cross-sectional studies in the field and because tech giants have largely closed off data access since the Cambridge Analytica scandal, preventing independent scientists from testing how specific algorithmic designs affect user behaviour.

The company Cambridge Analytica had harvested private data of 87 million Facebook users without consent.

Pushing ahead: Australia, Spain, and France

Data from Australia justifying the ban shows 96% of minors are active online, with 71% exposed to harmful content and 1 in 7 experiencing grooming.
Data from Australia justifying the ban shows 96% of minors are active online, with 71% exposed to harmful content and 1 in 7 experiencing grooming.

Germany’s announcement comes after Australia enacted the world’s first ban in December 2025, prohibiting children under 16 from holding accounts on 10 major platforms, including TikTok, Instagram, X, YouTube, and Snapchat.

The Australian government justified the ban with alarming survey data: 96% of children aged 10-15 used social media, and 71% had been exposed to harmful content, including violent material and content promoting suicide. Alarmingly, one in seven children reported experiencing grooming-type behaviour from adults or older teens.

Under the Australian model, tech giants face massive fines of up to AUS$49.5 million for serious or repeated failures to keep children off their platforms, as the BBC reported.

The early days of the ban, however, revealed significant workarounds, with teenagers rapidly turning to virtual private networks (VPNs) and using fake birthdays to bypass local restrictions.

While experts claim it is too early to determine the effectiveness of the Australian regulations, other countries are pursuing similar measures.

The Spanish government has drafted a law to ban access for minors under 16, demanding effective age verification systems. Going further, Spanish Prime Minister Pedro Sanchez recently announced plans to hold tech CEOs criminally liable for failing to remove illegal content and to turn algorithmic manipulation into a new criminal offence.

In France, a parliamentary enquiry has recommended banning children under 15 from social media and introducing a social media “curfew” for 15- to 18-year-olds, restricting them from accessing or using social media platforms during specific hours of the day, such as late at night.

Spain to Restrict Social Media Access as Evidence Mounts of Health Harms for Children

 

European Union regulation slows national ambition

Media law expert Stephan Dreyer warns that the EU’s Digital Services Act creates significant legal roadblocks for national social media bans in Europe.
Dr Stephan Dreyer cautions that EU regulation forms a legal roadblock for national laws.

Despite the political fervour in Berlin, Paris and Madrid, national legislatures in Europe face a massive legal roadblock: Under the EU’s Digital Services Act (DSA), platform regulation is harmonised across the continent.

Stephan Dreyer, a media law expert from the Leibniz Institute for Media Research in Hamburg (Germany), points to the complexities of the actual legal frameworks: “European regulations are fully harmonising and contain no opening clauses for national laws. The individual member states cannot enact national regulations addressed to the same recipients with the same protective purpose.”

Simply put, Germany cannot pass a law ordering TikTok or Meta to ban under-14-year-olds from their platforms. Any national attempt to do so would be legally inapplicable because it contradicts higher-ranking European law. To bypass the DSA, a state would have to pass laws that target parents or criminalise the children themselves, alternatives Dreyer considers highly undesirable.

The European Commission has cautioned member states against overstepping their legal boundaries. Placing additional regulatory obligations directly on platforms is a “clear no-go,” according to a Commission spokesperson.

As the regulatory power lies with the EU, the Commission is planning a new initiative by summer. It is expected that the upcoming European “Digital Fairness Act” may introduce minimum age limits and age verification requirements for specific services at the EU level, potentially enforcing age checks at the App Store rather than on the platforms themselves.

Additionally, the current EU-level investigation into TikTok proves the bloc already has the legal tools to force platforms to change their addictive designs, rendering legally precarious national bans largely unnecessary.

Assuming that leading politicians know this, the national announcements from Germany, France, and Spain are more likely to be strategic posturing: “These are attempts to rush ahead to create facts to increase the pressure on Brussels,” Dreyer explains.

Data protection concerns form major hurdle to strict bans

Experts highlight significant hurdles in verifying age, ranging from privacy-intrusive biometric scanning and high-risk ID uploads to the proposed EU Digital Identity Wallet.
Implementation hurdles range from biometric scanning and high-risk ID uploads to the proposed EU Digital Identity Wallet.

Even if a national ban were legally viable, enforcing it is currently a privacy nightmare, Professor Anja Lehmann, IT security expert at the Hasso-Plattner Institute Potsdam (Germany), warns. Existing age verification methods, such as submitting ID photos or using AI to estimate age from face and voice scans, force users to surrender excessive personal data.

Further, while there can be secure, privacy-preserving solutions like the EUDI Wallet, which allows anonymous age verification, teenagers can still bypass these systems.

“If age verification is only mandatory in certain countries, you can always use a VPN to trick the service into thinking you are in a country where there is currently no mandatory age verification,” Lehmann explains.

Regulating platform design instead of bans

IT security expert Professor Anja Lehmann warns that current age verification methods often require users to surrender excessive personal data.
Current age verification methods are privacy-intrusive, warns Professor Anja Lehmann.

Instead of strict bans, experts advocate for a different alternative: regulating the platforms’ design rather than banning the users. As the DSA already mandates a high level of privacy and safety for minors, the existing legislation could be used to force platforms to offer age-appropriate environments by disabling endless scrolling, autoplaying videos, and hyper-personalized feeds.

According to research, the effects of social media depend heavily on whether a child is passively scrolling or actively engaging. Additionally, experts point out that social media is a vital communication tool for youth to manage relationships, making strict bans a Draconian limitation on their societal participation.

IT security expert Lehmann echoes this sentiment, arguing that banning children from social media treats the symptom while rewarding tech companies with a fresh trove of identity data.

“I would strongly advocate tackling the fundamental problem, namely that we have algorithms and systems that are currently very harmful not only to children but to the whole of society,” she concludes.

Image Credits: Deutscher Bundestag/Thomas Imo, Christian Montag, Felix Sassmannshausen, Stephan Dreyer, Anja Lehmann.

An operating room at Okhmatdyt Children’s Hospital in Kyiv lies in ruins following a missile strike on July 8, 2024. In 2025, the WHO reported a nearly 20% increase in attacks on healthcare facilities, workers, and transport compared to previous years.
An operating room at a Children’s Hospital in Kyiv lies in ruins following a missile strike in 2024. The WHO reported a massive increase in attacks on healthcare facilities in 2025.

As the war in Ukraine grinds into its fifth year, the systematic destruction of healthcare infrastructure is accelerating, with strikes targeting hospitals, ambulances, and medical workers surging by nearly 20 percent in 2025 compared to the previous year, according to a statement by the World Health Organization Europe region (WHO/EURO) released on Tuesday.

The cumulative toll since the February 2022 invasion now stands at a staggering 2,881 verified attacks. The violence reached a peak in the third quarter of last year, when 184 strikes over a three-month span killed a dozen people and wounded 110 patients and staff.

Compounding the crisis, shelling hitting medical warehouses tripled, crippling the critical supply chains needed to keep the remaining facilities functioning.

Strikes on civilian infrastructure, combined with repeated failures of the national power grid during subzero winter temperatures, have increasingly disrupted the delivery of essential health services.

“Behind every one of these system breakdowns are families, elderly residents, and health care workers who must keep saving lives while their own homes are without heat, water, or electricity,” stated Jarno Habicht, the WHO Representative to Ukraine.

“The burnout after four years of war is immense, and the demand for health care has never been higher.”

An escalating medical and mental health crisis

A WHO-established modular clinic in the Kharkiv region, in April 2025. As the war in Ukraine enters its fifth year, these modular units have become essential for maintaining primary health services,
As the war in Ukraine enters its fifth year, modular clinic have become essential for maintaining primary health services,

According to the UN’s humanitarian coordinator in Ukraine, Matthias Schmale, 2025 stands as the deadliest year for civilians since the onset of the full-scale invasion. The bloodshed escalated sharply, with fatalities surging by more than 30 percent compared to the previous year. In a single 12-month span, at least 2,500 civilians were killed and another 12,000 were left wounded.

Beyond the blast zones, a quieter but equally lethal health crisis is ravaging the population. The stress of perpetual conflict has driven cardiovascular disease to alarming levels, leaving one in four Ukrainians battling dangerously high blood pressure.

Treating these conditions is becoming nearly impossible, with eight out of ten people reporting they cannot get the medications they need. In frontline towns, residents are effectively cut off by shuttered pharmacies and active combat, while across the country, skyrocketing prices have put life-saving drugs out of reach for the vast majority.

The psychological scars are equally profound, with the WHO estimating that nearly half the country is grappling with mental health issues, and 72 percent reporting recent battles with anxiety or depression.

“Four years of war have created a serious health crisis in Ukraine,” Hans Kluge, the WHO Regional Director for Europe, underscored the gravity of the situation in a press statement on Monday.

Ukrainian children bear a large share of the war’s burden, facing immense trauma and being deprived of normalcy and education. And out of an estimated 20,000 children abducted and taken to the Russian Federation, only about 2,000 have been safely returned to their families, Philip LeClerc, the UNHCR Regional Director for Europe and Refugee Regional Coordinator for Ukraine explained.

Displaced persons face immense psychological toll

Displaced women and children rest at a transit centre in Lviv’s central train station in March 2022. Currently, 3.6 million people remain internally displaced, with nearly half the population facing mental health concerns.
Displaced women and children rest at a transit centre in Lviv in March 2022 – millions of Ukrainians remain displaced.

The war has triggered immense and sustained human displacement. Currently, 3.6 million people remain internally displaced within Ukraine. Internationally, 5.9 million refugees have sought safety abroad, with 5.7 million remaining in Europe.

A significant challenge involves addressing the profound psychological toll, as mental health issues are growing among the displaced populations.

To properly support these groups, host countries must ensure access to critical psychological and legal aid, which is necessary to help refugees remain self-reliant and supported, UNHCR Regional Director for Europe Philip LeClerc demanded.

As Ukraine’s severely damaged health infrastructure cannot currently absorb or adequately care for highly vulnerable individuals, the UN urges host states to allow displaced vulnerable individuals to continue benefiting from national healthcare services for an extended period.

WHO calls for funds to secure access to healthcare

A crane lowers an industrial-grade generator at a WHO logistics hub in January 2026. Part of a strategic surge to protect Ukraine’s health system, these units were dispatched to hospitals in Kyiv and Odesa to ensure uninterrupted medical services.
A crane lowers an industrial-grade generator at a logistics hub in January 2026, used to ensure uninterrupted medical services.

To protect healthcare in Ukraine, the WHO launched its 2026 Humanitarian Appeal in February, urgently requesting $42 million.

These critical funds would secure access to healthcare for approximately 700,000 vulnerable individuals, prioritizing emergency trauma care, expanding primary health services in frontline zones, and facilitating safe medical evacuations, WHO stated in its appeal.

The international medical humanitarian organization Médecins Sans Frontières (MSF) also highlighted the impossible conditions facing their work: due to extreme insecurity, MSF has been forced to abandon seven hospitals and over 40 medical locations since 2022, the organization stated in statement released via social media.

In response, they expanded their mobile clinics, doubling consultations to 9,500 in 2025 to reach displaced civilians sheltering in freezing facilities.

EU reaffirms solidarity in joint statement

Marking the fourth anniversary of the full-scale invasion, EU leaders reaffirmed its commitment to support Ukraine’s military and humanitarian recovery.
Marking the fourth anniversary of the invasion, EU leaders reaffirmed their commitment to support Ukraine.

Marking the grim four-year anniversary of the invasion, the European Union’s top leadership issued a blistering condemnation of Moscow’s warfare strategy, accusing Russian forces of deliberately freezing out civilians by targeting energy grids, hospitals, and schools.

Reaffirming their position as Kyiv’s most crucial financial backer, the EU unveiled a massive €90 billion lifeline for 2026 and 2027. Recognizing the immediate battlefield realities, two-thirds of that package (€60 billion) has been exclusively earmarked to bolster Ukraine’s military arsenal. “Our goal is a comprehensive, just and lasting peace for Ukraine, based on the principles of the UN Charter and international law,” the joint statement declared.

The financial blueprint for rebuilding the battered nation is staggering. A newly released joint assessment by the UN, the World Bank, and the European Union pegs the cost of a ten-year recovery at a colossal $590 billion – a price tag three times the size of Ukraine’s entire economic output last year.

Yet, UN officials caution that true recovery cannot be measured solely in money. Addressing reporters, Schmale emphasized that any path forward must prioritize human repair, specifically through reintegrating an estimated one million war veterans, paving the way for refugees to safely come home, and drastically expanding women’s participation in the workforce – alongside the restoration of the healthcare system.

Image Credits: WHO, WHO, WHO/Marta Soszynska , WHO, European Union/Claudio Centonze.

Ipas aims to prevent 30% of unsafe abortions in 10 countries by 2040.

The US based reproductive rights organisation Ipas has secured a substantial grant from The Audacious Project to expand global access to abortion and contraception.

The full amount has not been disclosed as Ipas is still negotiating with the donor. 

“Every year, 35 million people end pregnancies using unsafe methods, amounting to one unsafe abortion every second of every day, with life-altering and often fatal consequences for women, girls, and their families,” said Ipas in a statement on Tuesday.

“Our vision is to prevent 16.3 million unsafe abortions and 22.6 million unintended pregnancies and to avert 39,000 maternal deaths by 2032, reducing unsafe abortion by 30% in 10 high-need countries across Sub-Saharan Africa, Asia and Latin America by 2040.” 

But achieving this vision requires substantial resources, Ipas director in the Democratic Republic of Congo (DRC), Dr Jean-Claude Mulunda, told Health Policy Watch.

“A total investment of $350 million is required to reduce unsafe abortion by 30% across 10 countries, including six in sub-Saharan Africa region,” said Mulunda.

While an initial commitment has been secured from Audacious, “discussions with several donors are still underway, and we expect to have a clear picture soon of the exact level of funding that will be made available”, he added.

Priority countries

The organisation will focus on Côte d’Ivoire, DRC, Ethiopia, Kenya, Nigeria and Zambia, as well as Bangladesh, India, Pakistan and Mexico. 

Mulunga acknowledged that several of these countries have restrictions on access to abortion.

Some countries allow abortion when a woman’s life is in danger, but healthcare providers are unsure of when and how they can help, he added.

“Ipas works with partners, with government, with the health system, to clarify through guidance so it’s easy for health providers to identify when they can provide those services,” he explained.

“The abortion ecosystem needs to shift, but we don’t wait for everything to change. We try to leverage every single positive step to transform it as quickly as possible into tangible services for women, because that is the only way for us to protect women’s lives.”

Focus activities

Ipas will focus on three activities in Africa. 

“The first involves strengthening the health system to deliver high quality of abortion care to women, while looking at diversifying pathways to care,” said Mulunga.

This includes not only improving facility-level care, but also the possibility to train pharmacists to provide information and the abortion pill to women who can self- manage their abortion .

“The second level will be around advancing laws, policies and political will to support sexual reproductive health and rights, including the right for safe abortion,” Mulunga added.

The third focus will be on “reducing stigma, strengthening referral pathways, and building a movement that will support the advocacy,” he said.

This will involve partnering with civil society organisations to enable them to support abortion advocacy, information on where women can get pills and services, and social support.

“We are honoured to be part of this inspiring Audacious Project 2025 cohort,” said Ipas CEO Anu Kumar.

“We know access to abortion and contraception leads to immense benefits to individuals, families, communities, and even countries. We want every woman and girl, no matter where they live, to have healthy, prosperous lives.”

Audacious is a collaborative donor platform that includes ELMA Philanthropies, MacKenzie Scott, Melinda French Gates’ Pivotal Ventures, Netflix co-founder Reed Hastings and his wife, Patty Quillin, and the Skoll Foundation.

Image Credits: Center for Reproductive Rights.

Kenyan nurse Everlyne Esige examines an expectant mother. Access to medicine for maternal conditions has plunged in some counties.

Kenyans’ access to a range of health products – including HIV treatment, maternal medicine, and contraceptives – plunged in three counties last year, largely as a result of the closure of the US Agency for International Development (USAID).

In contrast, Zambia showed “modest improvements” in certain areas, particularly maternal health – largely thanks to a 30% increase in domestic financing for medicines and medical supplies.

This is according to new research from the Solutions for Supporting Healthy Adolescents and Rights Protection (SHARP) Project, which compared the availability, affordability, and frequency of stockouts for 50 commodities in Kenya’s Mandera, Isiolo, and Marsabit counties and Zambia between 2022 and 2025.

In Kenya, there was a “significant deterioration” in access, including “chronic stockouts of potentially life-saving medicines, in some cases lasting several months”, according to the researchers.

‘Near collapse’ of HIV treatment

In Kenya’s largely rural Mandera County, HIV treatment availability is at a “near-collapse”, with the average for all HIV treatment at 1,5%. Three of the seven antiretroviral (ARV) medicines available in 2022 were completely unavailable in 2025, in both public and private sector health facilities. However, ARV access in 2022 was also very low in the county, averaging at around 4.5%.

People on ARV treatment run a high risk of drug resistance if they stop their medication.

In Mandera, which borders Somalia and Ethiopia, only 1.8% of women use modern contraceptions, and the fertility rate (7.7%) is double the country’s average.

While the availability of all family planning commodities was “critically low”, there had been an improvement over 2022. Availability of the most common oral contraceptive pill had increased from 17% to 25.7% of facilities, while male condoms were found in 31.4% of facilities – a substantial increase from 13.3% in 2022. 

The availability of antiretroviral medicine has virtually collapsed in Mandera County, Kenya.

Dire shortage of maternal medicine

In Isiolo County, a dry region in the east, the availability of magnesium sulphate for the management of pre-eclampsia in pregnancy fell from 35.7% in 2022 to 15.4% in 2025.

The availability of male condoms and some oral contraceptives dropped sharply from over 80% to just 38.5%. 

There were also prolonged stockouts of two medicines to treat sexually transmitted infections (STI), namely benzathine benzylpenicillin and ceftriaxone  – lasting up to 218 days.

In Marsabit County, in the north bordering Ethiopia, there was a “dramatic decline” in the availability of life-saving maternal health commodities. For example, the availability of oxytocin, the gold standard for preventing haemorrhaging, dropped from 51.9% 2022 to just 14.3% in 2025. 

Kenya has a relatively high maternal mortality rate of 355 deaths per 100,000 births.

‘Post-USAID crisis’

To compile the report, data collectors from Health Action International (HAI) and Access to Medicines Platform Kenya (AMPK) visited 86 health facilities in 2022 and 91 health facilities in 2025 from the public, private and faith-based sectors in the three counties.

They surveyed the availability, stockouts and patient prices of 50 medicines and other products. These included family planning products, maternal health medicines, STI treatment, ARVs, HIV tests, and menstrual health products. 

Aside from county variations, researchers report that adolescents’ unmet need for family planning is as high as 34%: “Without access to condoms and self-test kits, we are facing a ‘triple threat’ of unintended pregnancy, STIs, and HIV.”

AMPK executive director Dorothy Okemo said that the results “suggest that Kenya experienced a post-USAID transition crisis.” 

“USAID had previously bridged the gap for high-cost sexual and reproductive health (SRH) commodities [and] their absence created a vacuum that the public sector has failed to fill,” said Okemo.

She added that the “lack of a robust, state-funded contingency plan following the devastating cuts has effectively privatised SRH access, with the public sector left unable to serve the vulnerable communities that traditionally rely on it.”

Zambia mitigates effects with investment

In contrast, similar research by HAI with Medicines Access and Research Platform (MedRAP) across public, private, and faith-based facilities in Zambia showed “modest improvements” in certain areas, particularly maternal health. 

Teams of data collectors visited 133 Zambian health facilities in 2022 and 105 in 2025 from the public, private and faith-based sectors. 

While there were fewer stockouts in 2025 than 2022, shortages of STI treatments and “the vast majority of HIV/AIDS commodities fell between 2022 and 2025.” 

“While changes in donor funding have also affected Zambia, a 30% increase in domestic financing for medicines and medical supplies has helped cushion the impact of reduced external support, particularly from the United States,” the research notes.

Sustainable domestic finance

“The findings of these reports highlight the fragility of access to essential SRH commodities and underscore the urgent need for sustainable domestic financing in the long term,” the report notes. 

“But without the support of donor countries and other stakeholders, vulnerable communities, especially women and adolescents, risk losing access to potentially life-saving health services.”

The European Union funded the research. Many EU members have also cut their aid budgets, including for HIV.

Image Credits: Brian Otieno /Global Fund.

cosmetics beauty products PFAS
A study published in Environment & Health identified dozens of chemicals linked to cancer and reproductive harm in hair extensions. The study follows others that have revealed hidden toxics in beauty products. Yet the US remains ‘far behind’ in regulating toxic chemicals in cosmetics.

Everyday beauty and hair products on drugstore and supermarket shelves can contain chemicals known to be harmful to human health. Ingredients like PTFE, phthalates, parabens, and parfum hide in make up, shampoo, and other products – and have been linked to cancers, reproductive harm, and endocrine disruption. 

Yet cosmetics and hair products in the US are “largely regulated” and subject to an “increasingly outdated set of federal cosmetics laws,” said Congressional Representative Jan Schakowsky (IL-9), in a statement to Health Policy Watch.

Schakowsky and several other US lawmakers are spearheading stricter standards and regulations of cosmetics and beauty products. A Bill introduced at the start of the Congressional session aims to give consumers “peace of mind” about the products they buy.

“Today, the US only bans or restricts 11 chemicals compared to the European Union, which bans nearly 1,700 chemicals that are known or suspected to cause cancer, genetic mutation, reproductive harm, or birth defects. The US has a lot of catching up to do,” said Schakowsky, who sits as a ranking member of the Commerce, Manufacturing, and Trade House subcommittee. 

The push for safer cosmetics – and the lack of federal oversight – has led a half dozen states to create their own legislation. California’s Toxic-Free Cosmetics Act bans 24 chemicals from cosmetics sold in the state, including mercury, formaldehyde, 13 PFAS chemicals, and several parabens and phthalates. 

Although states have created a patchwork set of chemical bans, advocates like the Breast Cancer Prevention Partners hope to see laws to bolster the Food and Drug Administration’s ability to regulate cosmetics.

“We all deserve access to personal care and beauty products that are free from cancer-causing and other harmful chemicals, no matter where we live, work, or shop,” the advocacy and research group said. 

“Fewer than 10% of breast cancer cases are due to family history,” the group said. 

Instead, it’s often chemicals in our environment that increase the risk of certain cancers, according to another breast cancer research organization, Silent Spring Institute, a Boston-based research non-profit.

‘Largely unregulated’

cosmetics beauty products exposure pathway
Exposure to chemicals in beauty products – like PFAS and fragrances – can occur through ingestion, inhalation, and absorption.

Four years ago, the US had updated its federal regulation of cosmetics for the first time in 84 years. Congress enacted the Modernization of Cosmetics Regulations Act of 2022 (MoCRA) to authorize the FDA to regulate fragrance allergen labeling, standardize testing methods for detecting asbestos and talc-containing products, ensure Good Manufacturing Practice requirements for cosmetics factories, and publish assessments of PFAS in cosmetics.

However, “there is still work to be done,” said Schakowsky. “While MoCRA significantly increased FDA’s oversight, we still must prioritize banning toxic chemicals linked to hormone disruption, cancer and other health problems once and for all.”

She also noted the need to “provide full ingredient transparency for consumers and manufacturers; and protect the health of women of color and salon workers, who are among the most highly exposed to toxic chemicals because of the products marketed to them or commonly found in their workplaces.”

The lack of transparency in ingredients in the US has meant that states, rather than the federal government, have picked up the slack in regulating cosmetics.

In addition to California’s Toxic-Free Cosmetics Act, the state also banned an entire class of PFAS from being added to cosmetics. These chemicals are added to improve consistency and texture in products like shampoos and foundations. 

Exposure to the PFAS in these products can happen through ingesting lipsticks, absorption of mascara through tear ducts or lotion through the skin, and inhalation or spray on products and powders, according to a University of Notre Dame study.

The researchers found that the ingredient lists of most products tested “did not disclose the presence of fluorinated compounds”, exposing a gap in US labeling laws.

“We must focus on transparency and ingredient disclosure,” said Schakowsky. “The FDA needs to require disclosure of ingredients and additional safety information between entities in the cosmetic industry supply chain. Consumers deserve to know that the products that they are using on themselves and their kids are safe and what exactly is in them.”

Hair extensions ‘laden’ with chemicals 

black hair chemicals cosmetics
“This is an industry that has long overlooked the health of Black women, who should not have to choose between cultural expression, convenience, and their health,” said lead author Dr Elissia Franklin.

The average American woman will use 13 personal care products a day. Teenage girls use, on average,17 products. The gap between men and women is shrinking; men now use 11 products daily, which is double the figure of two decades ago.  

But the toxicity of these products, especially in hair extensions, has been largely unexplored. 

Researchers at Silent Spring Institute examined 43 common hair extension products for a range of toxic chemicals in a recently published study. 

Their analysis revealed that weaves, wigs, and other products are laden with flame retardants, phthalates, pesticides, styrene, tetrachloroethane, and organotins – chemicals linked to cancer, hormone disruption, developmental problems, and effects on the immune system. 

“While prior reports have found some chemicals of concern in hair extensions, there’s still much we don’t know about their overall chemical makeup. We wanted to get a better picture of the extent of the problem,” said lead author Dr Elissia Franklin, an analytical chemist and research scientist at Silent Spring Institute, in a press statement

“This is an industry that has long overlooked the health of Black women, who should not have to choose between cultural expression, convenience, and their health.”

“[C]ompanies rarely disclose the chemicals used to achieve these properties, leaving consumers in the dark about the health risks from prolonged wear,” Franklin said. 

Fibers made from synthetic materials or even human hair are often treated with these chemicals to make them waterproof or antimicrobial. But woven onto wearers’ heads, they sit on the scalp and neck for extended periods of time. Franklin’s team used a non-targeted analysis to screen these samples and a combination of gas chromatography and high-resolution mass spectrometry to detect the toxic chemicals. 

The authors noted that all but two of the 43 samples contained hazardous chemicals, with nearly 10% harboring organotins – a compound typically used to heat stabilize PVC. 

For Silent Spring, the finding that 17 chemicals related to breast cancer were found in more than 80% of the products tests, were especially poignant, as the group was founded to focus on breast cancer prevention through uncovering the links between everyday chemicals and women’s health. 

A global market – and unequal exposure

black women cosmetics chemicals
Use of cosmetics and hair products is expected to grow globally as products become more affordable and accessible.

Worn for convenience, cultural, and personal reasons, hair extensions are now a global market projected to surpass $14 billion in 2028. The US leads in global imports. However, other regions, including Africa, are expected to start to make up a larger part of the market share.

The globalization of hair products – from sourcing in India to chemical treatment in China – has also meant an increase in everyday exposure for millions of women.

More than 70% of Black women reported wearing hair extensions at least once in the past year, according to a University of California Berkeley study. Less than 10% of women of other racial and ethnic groups use these products, meaning that the burden of exposure is unequal. 

Beyond hair products, Silent Spring notes that “studies show women of color face higher exposures to toxic chemicals relative to White women, regardless of socioeconomic status.

“Black women and children also have increased rates of hormone-mediated health conditions. For example, in the United States, Black women have higher rates of diabetes, experience earlier menarche, more prevalent fibroids, and more aggressive forms of breast and endometrial cancers.”

Schakowsky also underscored this disparity. Part of her bill package funds research, education and outreach, and the development of safer chemicals to protect the health of women of color and salon workers – and requires the FDA to regulate the safety of synthetic braids, which can contain toxic chemicals.

Professional salon workers and communities of color bear a disproportionate burden of toxic exposures because of where they work, the products they work with, and the toxic products marketed to them,” she said.

And while the package was introduced last year to little traction, Schakowsky and her team are still optimistic that clean cosmetics have plenty of supporters in Congress.

“I strongly believe consumers should not have to wait another 84 years to get the cosmetic safety protections they want and deserve,” Schakowsky said.

Image Credits: S. Samantaroy/HPW, Whitehead et al, Unsplash, Unsplash.

The American Academy of Pediatrics (AAP) is contesting the CDC’s reduction in routine vaccines, warning that it will endanger babies.

The US Health and Human Services (HHS) has cancelled this week’s meeting of its Advisory Committee on Immunization Practices (ACIP) amid a court challenge to the committee’s composition and decisions, led by the American Academy of Pediatrics (AAP).

Meanwhile, the long-delayed Senate panel confirmation hearing for US President Donald Trump’s nominee for Surgeon General, Casey Means, convenes on Wednesday (25 February). Means, a 38-year-old wellness influencer who has linked vaccines to autism, was nominated on the advice of HHS Secretary Robert F Kennedy Jr, according to Trump

Her brother, Calley Means, co-founder of an online wellness sales platform, is Kennedy’s special advisor. The Means siblings co-authored a book called Good Energy, in which they argue that all chronic conditions are caused by metabolic dysfunction linked to lifestyle.

Since Kennedy took office last February, he has consistently chipped away at vaccines’ credibility and access.

Last June, Kennedy fired all 17 members of ACIP, which advises the US Centers for Disease Control and Prevention (CDC) on immunisation, and appointed several vaccine sceptics in their place.

In early January, the CDC announced that vaccines for Hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19 would no longer be routinely recommended but “remain on the schedule based on shared clinical decision-making”.

The AAP has issued its own routine child and adolescent vaccine schedule, endorsed by 12 other national health organisations, which retains as routine the vaccines that the CDC no longer recommends.

In the past, the AAP partnered with the CDC to present a unified set of vaccine recommendations, but says that “recent changes to the CDC immunisation schedule depart from longstanding medical evidence and no longer offer the optimal way to prevent illnesses in children.”

“AAP recommends immunisations that have been designed to teach the immune system to recognize and resist serious diseases,” said Dr Sean O’Leary, chair of the AAP Committee on Infectious Diseases. “They are carefully tested and monitored over time. The pacing and combination of vaccines are based on what we know about when your child’s immune system is ready to learn and respond best.”

The US has seen a resurgence in measles cases in the past year, fueled by misinformation and falling vaccination coverage. South Carolina has reported nearly 1,000 cases since October.

Casey Means, Trump’s nominee for Surgeon General, being interviewed on the Joe Rogan show.

Kennedy’s ‘arbitrary and capricious actions’

Last week, the AAP, American Public Health Association (APHA), American College of Physicians, Infectious Diseases Society of America and several other US medical organisations applied for a preliminary injunction to block the CDC’s changes to federal vaccine recommendations and to stop the ACIP meeting.

In their court papers, the bodies accuse Kennedy of “arbitrary and capricious actions” that “sow confusion and undermine public health, purposefully disregard and contravene required process, and ignore decades of established science.”

Judge Brian Murphy of the US District Court of Massachusetts has yet to rule on the application, which he heard on 13 February. But in the meantime, the ACIP meeting, which was due to start on Wednesday, has been called off.

But the decision to cancel the ACIP meeting, which removes the urgency for the judge to rule, may simply have been taken because the HHS failed to announce the meeting on the Federal Register within seven days and post an agenda, as required by law.

Kennedy’s former organisation, the Children’s Health Defense (CHD), also issued an urgent court application last week to join the case as a defendant, alongside Kennedy and the HHS. Murphy has yet to decide on CHD’s application.

CHD is routinely involved in opposing vaccinations, erroneously claiming on its website that “countless peer-reviewed observational studies show unvaccinated populations consistently have fewer chronic health conditions than vaccinated peers.”

Dr Susan Monarez, the former CDC director nominated by the Republican Party, who was fired by Kennedy after 29 days.

The next court hearing about the injunction is on 4 March. The case is part of a series of AAP-led court actions aimed at preserving federal vaccine recommendations, which started last July after HHS removed COVID-19 vaccines for children and pregnant women. The court papers have since been amended to include a challenge to Kennedy’s firing of all 17 ACIP members and the January changes to routine childhood vaccination.

Meanwhile, Kennedy ally Dr Jay Bhattacharya, currently head of the National Institutes of Health, has also been appointed  as acting CDC director. Bhattacharya can only serve until late March as federal law requires the US president to nominate a replacement within 210 days of HHS firing the previous director, Susan Monarez, which took place in late August.

After her firing, Monarez and Dr Debra Houry, the CDC’s former Chief Medical Officer, told a Senate health committee hearing that Kennedy is driving an agenda based on ideology not science, and he had tried to reduce the CDC to a rubber stamp.

Since Kennedy took over HHS, thousands of people working in the CDC, NIH and other government health bodies have been fired. The Trump administration has also dismantled major global health 

A snapshot of some of the changes to the CDC’s budget under the current Trump administration. Some functions have moved to the newly formed Administration for Healthy America (AHA). 

In response, several organisations have been formed to contest the views and actions of Kennedy and his allies. These include Stand up for Science, which was formed to oppose political interference in science, secure and expand funding for science and safeguard equal opportunities for all people to become scientists. It is leading a call to impeach and remove Kennedy. 

Fired CDC workers – estimated to number over 4,000 – have formed the National Public Health Coalition to champion health causes that are no longer supported in the current CDC, and monitor the health cuts via the CDC Data Project.

Image Credits: CDC/ Unsplash, CDC Data Project.

At the London School of Economics, postgraduate students are using board games to model climate-health policy trade-offs, guided by game designer Matteo Menapace.

“If we redirect healthcare funding to climate infrastructure, cholera spikes in the Sundarbans,” one student warns, tracking disease markers across the board. “Dengue and malaria already rise with every flood.”

“But without climate investment, there are no jobs and no resilience infrastructure,” another counters, shifting resource tokens. “How do vulnerable populations survive the next cyclone?”

A third student traces the health inequality index as it dips. “When heatwaves hit and crops fail, who carries the mortality burden? It’s always the most vulnerable.”

The group pauses, recalculating their moves. “And the next generation inherits whatever system we design,” someone says. “If we don’t build health equity now – clean air, water, healthcare – there may be no future left to protect.”

The exchange could easily be mistaken for high-stakes negotiations at a global climate summit. Instead, it is unfolding on a winter afternoon inside a postgraduate classroom at the London School of Economics, a 130-year-old UK public university long associated with shaping global debates on economics and public policy. 

The stakes feel real because the students are not analysing someone else’s decisions; they are designing their own board game, forced to confront the same impossible trade-offs faced by climate and health policymakers.

Around them, cards, tokens, and wooden markers lie scattered across the table. At the centre sits a health index, quietly tracking which populations retain access to care, and which are pushed into vulnerability as climate shocks mount.

Games for Change

Before designing their own games, students were introduced to Daybreak, a climate-action board game now used as a teaching tool at LSE, and one that has won major recognition, including Best Board or Tabletop Game for Impact at the 2024 Games for Change Awards. 

The game emerged from co-creators Matteo Menapace and Matt Leacock’s attempt to grapple with the climate crisis. “I wanted to make sense of it,” Menapace says. “And I wanted to do something about it.” 

Unlike competitive games, Daybreak is fully cooperative: players either succeed together or fail together. Each player represents a world region–Europe, the United States, China, or the Majority World across Africa, Latin America, and Asia, and works towards a shared goal called “Drawdown”, the point at which more carbon is removed from the atmosphere than emitted. 

To get there, players must cut emissions, invest in infrastructure and ecosystems, and prevent communities from sliding into crisis. If global temperatures cross 2.0°C, or any region collapses under repeated shocks, everyone loses.

As a game designer, Menapace felt constrained by climate communication that cast people as passive observers. “In a game, you put players in the driving seat,” he says. “You give them agency to make choices–and those choices shape the system.”

For students in LSE’s Health Policy programme, the lesson runs deeper: every climate decision is also a health decision. Although Daybreak does not explicitly track health indicators, students quickly recognise the consequences embedded in each crisis. 

Rising emissions translate into deadly heatwaves, triggering heatstroke and cardiovascular deaths. Floods do not simply displace communities; the “Communities in Crisis” markers stand in for cholera outbreaks, waterborne disease, and health systems pushed to breaking point.

Immersive teaching

Students design their own games for assessment, tracking how choices on emissions, infrastructure, and jobs translate into disease outbreaks, inequality, and survival.

These insights form the foundation of Health Equity, Climate Change and the Common Good, a module led by health economist Professor Miqdad Asaria. After months of collaboration with Menapace, the course was introduced in the 2024–25 academic year, with Daybreak at its core. 

Its development, however, began much earlier, unfolding over several years of brainstorming, identifying key readings, piloting methods through workshops, and navigating internal academic processes. The module continues to evolve, shaped by ongoing student feedback.

“We use immersive teaching methods across LSE, including simulations, theatre, and games,” Asaria says. “But I think this is the only course at the School where students are challenged to design their own games.”

That distinction is deliberate. Conventional policy education typically trains students to work within existing frameworks–analysing trade-offs, optimising outcomes, and implementing established solutions. 

By contrast, this module asks students to interrogate those frameworks and, where necessary, redesign them. Asaria describes the course as an exercise in “bold, imaginative thinking”, explaining that the game helps students grasp both the constraints imposed by policy rules and the power that comes with being able to change them.

The curriculum tightly integrates theory and practice. Seminars on political economy, climate science, geoengineering, and public health provide the conceptual foundations. 

Weekly workshops translate those ideas into playable systems. The course actively engages students with the world beyond the classroom–sending them to art galleries to explore protest art, or participating in gift exchanges to understand the gift economy. 

Students first play Daybreak to understand its mechanics, before hacking and remaking it to reflect their own policy priorities. 

“It is amazing to see the creative links they’ve been making,” Asaria says.

Refreshing approach

The approach has also drawn attention from outside LSE. Professor Tim Doran, a health policy expert at the University of York who visited one of the workshops, praised the pedagogical innovation. 

“In the AI era, educators need to keep innovating–this approach is refreshing,” he observed. “It forces students to actively engage their minds and apply knowledge in real time through tangible problem-solving. You can’t AI your way through building a functional game system–you have to think. In the coming years, colleges will need more innovative modules like this.”

Asaria describes the games students design and play as “playable policy models”– not simplifications, but intentional alternatives to conventional policy modelling. Rather than relying on “complex mathematics and computer programming”, he explains, the games allow students to work through the full range of intended and unintended consequences that policy decisions set in motion. 

By lowering the technical barrier, the approach redirects students’ “time and intellectual energy” away from building models and towards grappling with the political, ethical, and distributive questions that policies inevitably raise. Crucially, it opens the classroom to genuine interdisciplinary collaboration. 

Students from “very diverse academic perspectives”, Asaria says, can explore difficult policy problems together–allowing clinicians, economists, and social scientists to test ideas side by side. The result is a learning space where expertise is shared rather than siloed, and technical skill no longer acts as a gatekeeper to policy imagination.

Turning health crises into playable policy

One of the groups is designing a game set in West Bengal, one of India’s most climate-vulnerable states.

The module’s summative assessment asks students to design a board game that models climate and health together, with health equity and the common good at its centre. 

“This assessment requires students to see the whole course as a complex system, with ideas feeding back off each other,” Asaria explains. Unlike traditional exams, he adds, “doing the assessment is very much part of the learning process.”

In practice, students translate policy choices into game mechanics–using cards, scores, thresholds, and crisis events to simulate how decisions ripple through health systems and societies over time. That shift is deliberate. 

“This authorial leap is crucial,” Asaria says, “because it conveys that there is hope, and that students have agency.”

The resulting games take diverse forms. Some use Health Quality Indices to track access to care and disease burden; others incorporate quality-adjusted life years (QALYs) or happiness indices, forcing players to weigh quality of life against climate and economic decisions. Several games model how climate anxiety, displacement, and trauma accumulate across generations.

“Over the course of the module, students begin to understand that health and wellbeing are what truly matter,” Asaria reflects. “They also recognise a key failure in policymaking, that we prioritise progress using metrics with little intrinsic value.”

The process also gives students hands-on experience of real-world policymaking, where sustainability must be negotiated across competing interests. As they design their games, students are required to grapple with the tensions between corporate actors, activist movements, and research evidence–mirroring the messy politics through which climate and health policies are actually made.

One group, Bonum Commune, is designing a game set in West Bengal, one of India’s most climate-vulnerable states. Rather than focusing only on emissions or disease outcomes, the game makes ideology itself playable, forcing participants to negotiate climate and health policy from positions shaped by capitalism, welfare, environmental justice, and collective care. 

The aim is to show how power, values, and historical inequality determine which policies become possible, long before technical solutions are even considered.

For Sounak Das, a student from another group, which focuses on India, Pakistan, and Bangladesh, the exercise made those connections unavoidable. “This module showed me how climate collapse intersects with historical inequality and public health,” he says.

“Our game demonstrated that survival depends on crossing health thresholds–reducing disease burden and maintaining healthcare capacity–while navigating cooperation dilemmas. The key lesson was clear: equity isn’t a moral luxury, but a strategic condition for resilience.”

Beyond the university door

Game designer Matteo Menapace guides students in designing games that rehearse what the future could be.

Nearly two years went into developing Daybreak, shaped through conversations with climate scientists and humanitarian experts. Crucial feedback came from the Red Cross Red Crescent Climate Centre.

“We were focusing too much on decarbonisation,” Menapace recalls. “They helped us realise that mitigation alone isn’t enough. You also have to build resilience and protect people.”

Menapace’s work with games extends well beyond LSE. He also collaborates with the UK government’s Policy Lab, where games are used as tools for policy design rather than entertainment. 

In these workshops, policymakers, researchers, and affected communities come together to experience how a system works, critique its failures, and “hack” it by changing the rules. In one project, a co-designed game brought fishermen, scientists, and officials into the same room, helping shape discussions that fed into fisheries policy decisions.

Menapace believes this approach could be especially powerful in low- and middle-income countries, where climate impacts are acute and communities are often excluded from policymaking. 

Simplified, low-cost games can help people understand complex issues–and adapt them to reflect lived realities. He is also developing Dawn, a shorter, more accessible companion to Daybreak focused on zero emissions. “Net zero can create complacency,” he says.

The game ends. Students assess who survived and who didn’t. For Asaria, this moment is where learning happens, tracing the line from policy to mortality, from choices to consequences.

In a world facing health shocks and widening inequality, a board game in London is rehearsing the future. Not as it is, but as it might still be redesigned.

 

 

Image Credits: Miqdad Asaria, Abhishek Chakraborty/ Unsplash.

NIH director Jay Bhattacharya
Dr Jay Bhattacharya, seen here testifying before the Senate Health Committee, will now also serve as acting director of the CDC.

Dr Jay Bhattacharya, the director of the National Institutes of Health, will take on an additional role in the Administration of US President Donald Trump as acting director of the Centers for Disease Control and Prevention (CDC), long seen as a leading reference point for public health policy not only in the US but worldwide. 

Bhattacharya succeeds Dr Jim O’Neill, a science and tech investor who has been acting CDC director since August 2025.  O’Neill, who lacks any medical or research experience, is now being tapped to oversee the National Sciences Foundation in what critics described as a “musical chairs leadership shakeup for science agencies.

Bhattacharya, meanwhile, will lead both NIH and CDC until President Trump appoints a permanent director for the latter – reflecting the tightening grip of a small coterie of Health Secretary Robert F Kennedy Jr and Trump confidantes around the leading US health policy, science and research institutions.

A permanent appointee to head the CDC would require Senate confirmation. Susan Monarez, the first Senate-confirmed CDC director under the Trump administration, led the agency briefly in 2025, before being ousted by Kennedy Jr just 29 days into her tenure.

In Senate testimony about her firing, Monarez told the Senate Health Committee members that she refused Kennedy’s requests to “replace evidence with ideology,” in pre-approving vaccine recommendation changes and in firing career public health officials.

Musical Chairs: Jim O’Neill (center) sworn in as Deputy HHS Secretary in June, 2025. In August he became Acting CDC Director. Now he is to lead the National Science Foundation.

Bhattacharya will have to balance managing the nation’s premier biomedical agency headquartered in Bethesda, Maryland, with running the federal public health agency, in Atlanta, Georgia. But the geographic distance is not the only challenge the incoming director faces.

Now positioned to reduce US vaccine schedules

The CDC vaccine advisory committee, also hand-picked by Kennedy, has made clear that its recommendations aim to reduce the number of shots American children should get, with the committee’s most recent recommendations dropping six common vaccines. The changes made good on Kennedy’s promises to reverse decades of US vaccine policy. 

As CDC’s acting director, hand-picked by Kennedy and a close ally, Bhattacharya is positioned to oversee further rollbacks in vaccine schedules, although the NIH director has stated he does support vaccinations for major childhood diseases. 

“The measles epidemic [is] best solved by parents vaccinating their children for measles,” he said during a Senate hearing in early February. The US has seen a resurgence in measles cases in the past year, fueled by misinformation and falling vaccination coverage. South Carolina reported nearly a thousand cases since October.

Along with the festering vaccine debate, the CDC has also seen mass layoffs as well as closures of departments that monitor infectious disease trends, support mental health, and manage tobacco and substance use prevention. 

Kennedy and his team claim that they have acted to reduce what they term “bureaucratic bloat” and conflicts of interest in the nation’s medical agencies. But some critics, including Dr James Alwine, speaking on behalf of  the alliance ‘Defend Public Health’,  argue that the movement championed by Kennedy is a new form of conflict of interest. 

“They promote ‘Medical Freedom,’ which is simply underwriting the largely unregulated multi-billion dollar wellness industry,” Alwine , an emeritus professor of cancer biologist at the University of Pennsylvania, said in a statement to Health Policy Watch.

“And the negative results of [this] movement are appearing as vaccine hesitancy rises, with increased cases of measles, whooping cough, flu, tetanus, mumps, and more. Children are suffering and dying.”

COVID-19 contrarian

HPV vaccine
Vaccine policy has been at the center of the Trump Administration’s public health controversy.

Bhattacharya rose to prominence during the COVID-19 pandemic as an outspoken critic of the US management of the pandemic – particularly state-mandated shutdowns, as well as CDC  recommendations regarding vaccination and public use of masks.  A Stanford economist and physician, Bhattacharya co-wrote the Great Barrington Declaration, which argued for minimal COVID restrictions to boost ‘natural’ herd immunity.

The declaration was embraced by the Trump Administration and conservative news outlets. But critics pointed out that achieving herd immunity for COVID-19 without vaccines is both unethical and improbable. 

Bhattacharya will have to contend with an agency gutted of its top leadership after conflicts with Secretary Kennedy over vaccine recommendations. 

“I resigned because CDC leaders were reduced to rubber stamps, supporting policies not based in science and putting American lives at risk,” said Dr Debra Houry, a career CDC official and former CDC Chief Medical Officer, during Senate testimony on her resignation in September 2025.

“Secretary Kennedy censored CDC science, politicized its processes, and stripped leaders of independence.”

Image Credits: C-SPAN, HHS Photo by Amy Rossetti, National Cancer Institute on Unsplash.

Speakers at the panel on extreme heat and the future of outdoor work at Mumbai Climate Week. First from right is Dr Radhika Khosla, Associate Professor at the University of Oxford, and fourth from right is Dr Soumya Swaminathan, former WHO chief scientist.

MUMBAI, India – Air pollution and heat are much worse together for human health than each of them alone, said Dr Soumya Swaminathan, former chief scientist at the World Health Organization, speaking at this week’s Mumbai Climate Week (MCW).

Heat and air pollution were among the key regional priorities during the three-day event that brought global climate conversations to a climate-vulnerable region.

“There is work done in California which shows that on the days when you have the highest heat and high air pollution, the deaths which occur on those days are three times more than when you have either heat or high air pollution,” Swaminathan said at a session on extreme heat and outdoor labour.

In South East Asia, climate change is leading to more extreme heatwaves, and the region’s very high levels of air pollution exacerbate related health impacts, worsening cardiovascular and respiratory symptoms, and increasing premature mortality. Swaminathan stressed, however, the need for more research on the synergies.

Bringing climate conversation to the global south

Mumbai is one of the few cities in the global south to host a climate week.
Shishir Joshi, Project Mumbai.

Mumbai’s Climate Week, which ended on Thursday, was the first of its kind to be staged in South East Asia. Modelled after more well-established events in New York City and London, it was organised by the local non-profit Project Mumbai, in collaboration with several dozen Indian and international partners. Those included well-known philanthropies such as the Clinton Global Initiative, as well as other finance, industry, UN agencies. The Climate Group, which organises the New York climate week was also a partner.

The goal was to bring climate dialogue that often happens in the developed world to the global south, and provide a platform to diverse voices across India and other developing countries, said Shishir Joshi, CEO and founder of Project Mumbai speaking to Health Policy Watch ahead of the event.

The organizers selected Mumbai due to its position as India’s financial capital, its range of urban challenges, and its active civil society. The densely populated urban metropolis of over 18 million people is struggling with extreme heat, rainfall, flooding as well as worsening air quality.

The event received the support of the Indian government and the regional Maharashtra government. The latter launched its ‘Be Cool’ initiative to scale up cooling solutions across the state’s cities, supported by the United Nations Environment Programme (UNEP).

The week revealed “the strength of a collaborative, philanthropic effort for change,” Joshi said, but added that the week was also a platform for, “citizen-led action … While deep dive conversations on the three thematic areas are the primary focus of the climate week, our effort is also to ensure that citizens feel they do have a voice and a voice which can be heard.”

Attention given to heat’s impact on workers

Outdoor workers are often exposed to a disproportionate amount of heat.

Roughly half of India’s workforce, or an estimated 231.5 million workers are outdoor workers, according to one recent analysis. They labour in agricultural fields, at construction sites, in markets, and as delivery workers in urban areas.

These workers are increasingly on the front lines of rising heat and air pollution, among other climate extremes.

Yet related health impacts may go unnoticed for a long time. “A lot of them experience chronic exhaustion, kidney stress, and declining productivity before there is a medical emergency. That means the true burden of heat still remains quite invisible,” said Dr Radhika Khosla, an associate professor at the University of Oxford, who also appeared on the panel on outdoor workers.

Nearly 62% of India’s female workers are employed in agriculture and are thus by extension, primarily outdoor workers.

Of those women not engaged in agriculture, about 40% are home-based workers, mostly engaged in artisanal food production and sewing or textile work. And they are also at risk, said Renana Jhabvala, President of SEWA Bharat, a national federation of informal women workers.

“Their homes’ roofs are usually aluminum sheets, and the temperatures are almost 8-10° C higher than what it is outside,” she said, adding that the related impacts on health and productivity are also often invisible.

Experts said what is needed is to scale up cheap and locally available solutions like cooling paints, low-cost roofs that don’t overheat, increasing green cover and shade across cities, along with access to public water dispensers and toilets.

Workers applying reflective paint to a roof in South Africa.

Global North players made their presence felt

Former US Secretary of State Hillary Clinton.

An occupational health insurance initiative being piloted by the Clinton Global Initiative (CGI) demonstrates another approach. The insurance scheme provides compensation for lost work days due to heat. So far, some 500,000 have been enrolled in India, said former US Secretary of State Hillary Clinton, who discussed the initiative during a fireside chat at the MCW.

“We are very focused on climate, health and women, and that combination is important, because women are on the front lines of climate change,” Clinton said. “Women, especially in the Global South, and obviously here in India, are very often working outdoors and now in extreme heat. India will be the model for the rest of the global south because of this CGI commitment.”

Finance remains an issue

Yet, typically it is women workers, and women climate advocates, who find it harder to access finance for available climate solutions, Clinton observed.

Speakers at the session on climate finance expressed optimism about India’s prospects. In the centre in black is Clarisa De Franco of Allied Climate Partners.

Unlocking finance more broadly was another key theme at the sessions, taking place in India’s financial capital with major international banks such as HSBC, British International Investment, IDFC First, and others partnering both in the event and its panels.

What is really needed is more “blended finance” – e.g. combination of public and private investments in climate projects – because neither the public nor the private sector can meet all of the looming needs on its own, said Clarisa De Franco, of Allied Climate Partners, a philanthropy that mobilizes investments for climate projects in the Global South.

But the panelists also expressed optimism for India’s prospects of mobilizing more climate investment as the region is regarded as an attractive option for international investment overall.

Image Credits: Unsplash/Previn Samuel, By arrangement, Mario Spencer/Unsplash, HABVIA , By Arrangement.

Air pollution worsens a range of serious mental health disorders, according to the latest research.

Breathing in air with high levels of pollution worsens a range of serious mental health conditions, such as schizophrenia, depression, and anxiety disorders, according to emerging research.

A 2026 study, published in the journal Environmental Research, reviewed 25 existing studies on air pollution’s impact on anxiety disorders and found that while long-term exposure is the most dangerous, even short-term exposures worsen anxiety disorders.

The finer the air pollutants, the higher the danger, according to a 2023 study published in Environment International involving over 1.7 million people in Rome, Italy.

“Long-term exposure to ambient air pollution, especially fine and ultra-fine particles, was associated with increased risks of schizophrenia spectrum disorder, depression, and anxiety disorders,” the 2023 study found.

Currently, nearly 99% of the world’s population breathes in air exceeding the World Health Organization’s (WHO) clean air guidelines.

While air pollution’s impact on depression is reasonably well known, more is being understood about its impact on other mental health disorders. Research on a link between air pollution and bipolar disorder has currently produced mixed results.

“A growing evidence base links exposure to air pollution to a variety of mental health disorders, including anxiety, depression, and schizophrenia, as well as risk for suicide. Evidence also points towards the risk being higher for more disadvantaged communities,” said Pallavi Pant, an environmental health scientist at Health Effects Institute (HEI).

Pant cautioned that this area of research is currently limited but very active.

Also read: More Evidence That Air Pollution is Linked to Higher Risk of Dementia

Air pollution’s role in worsening mental health disorders

Air pollution has been linked to a large number of dementia deaths in research.

Air pollution kills an estimated 8.1 million people every year, according to the State of Global Air Report 2024, which is brought out annually by HEI in collaboration with the Institute for Health Metrics and Evaluation’s (IHME) Global Burden of Disease project.

The links between high levels of air pollution and higher rates of dementia and other cognitive impairment, post-partum depression, and even schizophrenia relapse were established by a study in World Psychiatry published in 2024.

“Higher levels of specific air pollutants were associated with a higher risk of dementia or cognitive impairment, cognitive disorders, post-partum depression (class II), and schizophrenia relapse,” according to the 2024 study, which looked at 32 existing global studies on air pollution and mental health disorders.

Higher temperatures also affect mental health. “Temperature increase was associated with an increase in suicidal behaviour, suicide or mental disorders-related mortality; and hospital access due to suicidal behaviour or mental disorders, or mental disorders only,” the 2024 study noted.

“What happens when high temperatures and poor air quality intersect? That is an area that remains understudied, Pant said.

The biological mechanisms of how air pollution affects mental health disorders are still not well understood, “but evidence points towards inflammation playing an active role,” Pant explained.

“Some studies also indicate greater risks for children and adolescents- exposure during critical windows of development, including development of the brain, can increase the risk of psychiatric disorders,” she added.

Also read: Air Pollution ‘Kills a Child Every Minute’

Disadvantaged communities hit hardest

Most of the air pollution deaths are in low- and middle-income countries.

A report released last year by the US non-profit advocacy group, Physicians for Social Responsibility Pennsylvania, looked at the role physicians can play in low-income neighbourhoods where air pollution levels tend to be worse, and the mental and emotional toll on communities is high.

“Physicians can work as advocates for their patients’ health. They can use their influence as trusted professionals to promote policies that will decrease air pollution and increase access to mental health resources,” said Laura Dagley, a nurse who wrote the report.

“We have learned from research that air pollution itself has physiological impacts on the brain and other organs in the body, but what I learned from my time working with these communities is the mental health implications from the erosion of their sense of place and home,” Dagley added.

 “Many felt they were living in sacrifice zones, or that their lives were not considered important enough by industry or politicians to care about the health impacts.”

Such communities often also tend to have poorer access to resources.

Limited research from the global south

Nearly 99% of the world breathes in polluted air. World’s most polluted countries are in Africa and Asia.

The world’s most polluted countries are in the developing world, particularly in Asia and Africa, but evidence about the health impact is sparse from these regions.

Most studies are from high-income countries in North America, Western Europe, and increasingly, from China and other Asian countries. Studies from Africa and South Asia are still relatively scarce, Pant said.

Dagley said that physicians can also play a role in filling this data gap: “A lot of the research we have showing mental health impacts has come from medical records, combined with air pollution data.”

Image Credits: Unsplash, State of the Global Air report 2025, IQAir.