CSW chair Maritza Chan Valverde from Costa Rica, and UN Secretary General Antonio Guterrez at the 70th session of the commission.

The United States was isolated in its opposition to the adoption of “agreed conclusions” at the Commission on the Status of Women (CSW) on Tuesday, recording the only “no” vote at the United Nations headquarters in New York on Monday.

There were 37 votes in favour and six abstentions from Côte d’Ivoire, the Democratic Republic of Congo, Egypt, Mali, Mauritania, and Saudi Arabia. The CSW is made up of 45 elected members.

“Prior to the adoption, the representative of the United States [Dan Negrea] first proposed that its consideration be deferred, then that the text be withdrawn and then proposed eight amendments to the text,” according to a UN media release.

The US sought the removal of “controversial social issues” from the document, Devex reports. US objections included “ambiguous language promoting gender ideology”, “vague, unqualified commitments to sexual and reproductive health that can be interpreted as implying abortion rights”, and “censorship language on regulating artificial intelligence”, according to the UN media release.  

Earlier, Nigeria and Egypt called for more time to reach consensus – the usual route for UN decision-making and the only route the CSW has taken in 70 years. Pakistan later proposed voting separately on each of the US’s eight amendments.

However, CSW chair Maritza Chan Valverde from Costa Rica said that “every effort has been made to listen to delegations and to reflect the diversity of views expressed”.  

“We are convinced that the text represents the most balanced outcome achievable at this stage,” Valverde said, adding that her Bureau has decided to put the text to a vote.

Measures to address gender-based violence

UN Women director Sima Bahous and CSW chair Maritza Chan Valverde from Costa Rica

The CSW, which was established in 1946, is the main global intergovernmental body exclusively dedicated to the promotion of gender equality, and the rights and the empowerment of women. 

The theme of this year’s CSW is “ensuring and strengthening access to justice for all women and girls” by eliminating discriminatory laws, policies, and practices, as well as structural barriers to justice

The agreed conclusions “seek to create justice systems that work for everyone equally”, according to Valverde.

The proposals focus strongly on justice for survivors of gender-based violence, including integrating gender-responsive access to justice across sectors, formally recognising community justice actors, and introducing new language on digital justice and AI governance aimed at protecting women and girls.  

The text also strengthens standardised systems for gender-based violence data and promotes a whole-of-society approach that recognises civil society’s role.

Valverde stressed that hard-won progress on gender equality must not be reversed.  “We owe it to the trailblazers who charted the path for us, and to those who shall follow in our footsteps.  To our mothers, grandmothers, daughters, and sisters,” she said.

‘Epstein criminal enterprise’

President of the UN General Assembly Annalena Baerbock.

President of the UN General Assembly Annalena Baerbock told the opening of CSW that the backlash against women’s rights “feels as though we are forced to fight the same old battles again and again, battles from 80 years ago”.

Baerbock, a former German foreign minister, pointed out that she is only the fifth woman to be President of the General Assembly and that, in 80 years, a woman has never been Secretary-General. 

“If we do not address the fact that three-quarters of parliamentarians worldwide are men, and 103 countries have never had a female Head of State, then we will hardly deliver on justice.

“Women’s rights are nothing new,” she added. “They have been embedded in the DNA of this institution from the very beginning.”

“We will not stop fighting for equal representation and women’s rights… until the women of Afghanistan are free and girls worldwide are not being forced anymore to marry before they finish school; until we see justice for survivors of sexual abuse, whether it occurs at home or as part of an exploitive global sexual network as exposed in the Epstein files; where women are equally paid and represented, whether in newsrooms, in boardrooms, in governments and yes, at the helm of this institution, our United Nations,” said Baerbock.

UN Special Rapporteur on violence against women and girls, Reem Alsalem, also referred to Jeffrey Epstein, remarking that “the partial release of the information on the atrocities committed by the Epstein criminal enterprise… have been committed across the globe for decades, while flaunting nauseating levels of impunity.”

Deeply contested

Maitree Muzumdar, co-convenor of the Young Feminists’ Caucus,
Josefina Sabate, co-convenor of the Young Feminists’ Caucus,

“The decision to break consensus and proceed to a vote underscores how deeply contested commitments to gender equality, human rights and access to justice remain in this current geopolitical moment,” Maitree Muzumdar, co-convenor of the Young Feminists’ Caucus, told a media briefing on Tuesday.

“The negotiations revealed resistance by powerful states and mobilised anti-gender, anti-rights actors.”

Muzumdar, who is based in India. also criticised member states for approaching access to justice as a “technical issue rather than a political issue, focusing on procedural reforms without addressing the structural conditions that produce injustice.”

The negotiations revealed resistance by powerful states and mobilised anti-gender, anti-rights actors, 

Argentinian activist Josefina Sabate, also co-convenor of the Young Feminists’ Caucus, paid tribute to the CSW’s chair’s ability to ensure that a document was adopted.

Sabate said there has been a “real pushback in terms of gender equality policies” in Latin America following the election of conservatives in Argentina and now Chile.

Israel’s attack on Iran’s oil depot has caused massive fires, thick smoke and black acid rain.

The 12th Better Air Quality conference in Bangkok, which opens on Wednesday, is the first large climate and air quality gathering since the US and Israel attacked Iran, triggering an oil and gas-energy crisis. 

BANGKOK – The ‘Gulf War 3’ threatens to slow down climate action and the move to cleaner air. However, in the first major climate conference since the war began, experts are banking on progress thanks to market forces and the cost-benefit of countries not just sticking to the current climate and air quality ambitions but scaling these up. 

“There’s no doubt it [fighting in the Gulf] will slow progress. However, the fact is that the market forces are ultimately going to drive things. There’s only so much political will can do,” Nathan Borgford-Parnell, scientific affairs lead at the UN’s Climate and Clean Air Coalition (CCAC), told Health Policy Watch.

He was speaking on the eve of the Better Air Quality (BAQ) conference, which is being held in Bangkok from Wednesday until Friday (11-13 March), bringing together scientists, funders, think-tanks, and civil society.

“The United States is really boosting coal now. But coal energy is decreasing rapidly in the US, not because of some green policy, but because of the economics of it. Renewable energies are cheaper now. And those economics are not going to change,” Borgford-Parnell explained.

The conference is being organised by Clean Air Asia, with co-organisers CCAC, the Asian Development Bank (ADB), the United Nations Environmental Programme (UNEP) and the Economic and Social Commission for Asia and the Pacific (ESCAP). 

Cleaner solutions protect health

Bjarne Pedersen, executive director of Clean Air Asia, said that while there can be tension between environmental ambition and short-term economic pressures, this can be resolved by taking a longer-term outlook.

“Clean air solutions increasingly show that protecting health, improving productivity, and supporting economic growth can go hand in hand,” said Pedersen.

He sees the conference as an opportunity to “elevate air quality from a relatively niche environmental issue to a cross-cutting investment priority” that delivers benefits across sectors. 

Glynda Bathan-Baterina, deputy executive director of Clean Air Asia, concedes that air pollution control measures are “often seen as a cost rather than an investment”.

She lists the “positive returns on clean air investments” as “improved health, increased crop yields, more livelihoods from green industries, and greater competitiveness of cities.”

Later this year, the CCAC is expected to update its report of 25 science-based solutions, making a strong case for local and national economic benefits. However, ADB refused to comment on the issue on the grounds that it is “politically sensitive.” 

Nathan Borgford-Parnell (right), scientific affairs lead, at the UN Climate and Clean Air Coalition, and panellists at an event before the Better Air Quality meeting.

Health risks from air pollution

Over eight million deaths are attributed to air pollution annually. If there’s a silver lining, Borgford-Parnell assesses that this number could remain stable.

On the one hand, air pollution, in particular PM2.5 fine particulate matter pollution, has been decreasing because of economic forces, and countries like India and China are taking steps to reduce it, he says. 

On the other hand, the rapidly ageing global population, – particularly in the Asia-Pacific – is more susceptible to illness and premature death.

The WHO’s World Health Assembly and its Global Conference on Air Pollution and Health last year set a “voluntary target” to cut premature deaths caused by air pollution by 50% by 2040. Toxic air is linked to millions of cases of heart attacks, childhood asthma, COPD or chronic lung disease, diabetes, strokes, dementia and lung cancer. 

Air pollution’s link to diabetes and dementia is also a growing concern. It worsens the complications of diabetes, and increases the risk of people developing type 2 diabetes through mechanisms such as inflammation and oxidative stress, which can cause cell damage. 

With dementia, air pollution increases risk through similar inflammatory pathways and by damaging blood vessels. This can lead to vascular dementia and increase the likelihood of Alzheimer’s disease. The tiny particles from pollution can also directly enter the brain, potentially causing cellular damage. 

A Better Air Quality 2026 side-event.

‘Together for clear skies’

The theme for this 12th BAQ is Together for Clear Skies. But the ‘together’ part is hard to achieve. Air pollution is a transboundary issue, which means that one region or one country is often polluted by air from outside its jurisdiction. 

The World Bank points out that the governance systems across nations in the most polluted region of the world – Bangladesh, Bhutan, India, Nepal, and Pakistan – remain largely “siloed, reactive, and compliance-oriented rather than preventive”. 

Its report, A Breath of Change, documents the cross-border crisis in the northern belt of South Asia, across the plains and the Himalayan foothills, which is home to about one billion people.

Around 68% of the pollution in Nepal’s Terai region, for example, originates in other countries. Even in areas with the highest local contribution, such as Kathmandu Valley (Nepal), Uttar Pradesh (India), and Dhaka (Bangladesh), over a third of the pollution can be from other countries. 

The hosts have highlighted at least four regional agreements on air pollution control. Two for South Asia are the Malé Declaration (1998) and Thimpu Outcome (2024),  and two for South East Asia are the ASEAN Agreement and Asia-Pacific Regional Action Programme on Air Pollution (RAPAP), both adopted in 2022.

But progress, especially in South Asia, has been slow.

“Countries like the PRC (China) have shown that economic growth can be decoupled from its environmental impacts, including air pollution. In seven years, PRC was able to reduce PM2.5 pollution by more than 50%, while growing its economy,” says Bathan-Baterina. 

The hosts hope that financing discussions at the conference will demonstrate that clean air solutions can attract investment.

“Many governments already have air quality plans but face challenges in translating them into finance-able programs,” Pedersen says. 

By highlighting the economic returns and health savings associated with cleaner air, the conference aims to strengthen the case for sustained investment. Despite being closely linked, air quality and climate action are still treated by many as two separate buckets. But Pedersen points out that linking air quality initiatives to climate finance frameworks can help unlock new funding streams for cleaner air.

Image Credits: UN-CCAC., Chetan Bhattacharija .

Nobel laureate Malala Yousafzai addresses the CSW opening session.

The United Nations Commission on the Status of Women (CSW) began its 10-day session in New York on Monday, amid efforts by the United States to weaken women’s rights proposed in the draft outcome document.

The theme of the CSW, the world’s biggest global meeting on women’s rights, is “ensuring and strengthening access to justice for all women and girls.”

But the US, after initially abstaining from negotiations on the outcome document to be adopted by CSW, changed tack in the past few days and urged the removal of “controversial social issues” from the document, Devex reports.

The US wants references to climate change and a gender-responsive justice sector removed, and does not support the proposed reparations fund for survivors of violence, for example.

However, the entire purpose of the CSW’s 70th session is to chart a path to eliminating gender discriminatory laws, policies, and practices, as well as structural barriers to justice – and the outcome document due to be adopted by the end of Monday was supposed to guide this.

However, the US stance is similar to last year, when it refused to endorse the CSW’s final declaration last year, rejecting references to the UN’s Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), and dismissing gender quotas, climate policies and even the Sustainable Development Goals as “globalist overreach”.

Fewer rights

Women only have 64% of the legal rights of men, according to a report issued last week by the UN Secretary-General.

“Globally, 54% of countries lack consent-based legal definitions of rape, while 72% allow child marriage in all or some circumstances,” according to the report.

“More than 45 countries retain at least one provision in their legislation regarding nationality that discriminates on the basis of gender, and 44% of countries do not have legislation that mandates equal remuneration for work of equal value.”

Extract from the UN Secretary General’s report on the status of women.

In many countries, women’s rights are weakening. The position of women and girls who live near conflicts – 676 million in 2024 – is particularly dangerous. 

“The number of conflict-related sexual violence violations documented by the United Nations has increased by 87% in just two years,” according to the report.

Iran, Gaza and Afghanistan

Raising the plight of women and children in Iran, Gaza and Afghanistan, Nobel laureate Malala Yousafzai told the CSW opening session: “Never have I seen so many children suffering from war and violence, injured and dying at the hands of unaccountable leaders.

“I am devastated for families in Iran whose daughters left for school and did not return home, for parents in Gaza who buried their children beneath the rubble of their classrooms, for Afghan girls living under the brutal Taliban regime for nearly five years,” said Yousafzai, the Pakistani activist shot in the head as a schoolgirl for advocating for the right of girls to education.

“You will be hearing a lot this week about access to justice, but true justice does not defend the humanity of children in one place and ignore it in another,” added Yousafzai, who lived in a territory of Pakistan under Taliban rule.

“It is not selectively applied. It does not claim that our rights are dependent on where we were born or what is politically safe for the people in this room. Under international law, killing children in their classrooms is a war crime.

Nobel laureate Malala Yousafzai addresses the CSW, appealing for justice for all women and girls.

“When civilians are deprived of food, water, medicine and shelter, the law obligates states to act. Looking around the world today, we must ask ourselves why justice is a privilege.”

Yousafzai said that nowhere is the backlash against women and girls more evident than in Afghanistan: “Since the Taliban took over the country in 2021, they have controlled courts, the police, and they have used their power to abuse women and girls, preventing them from going to school or university. Women cannot go to work, leave their homes without a male chaperone, or even speak in public.”

Afghan singer Sunbul Reha also addressed the CSW opening, appealing to the UN delegates to “protect a girl’s right to an education, defend a woman’s right to speak out safely and without retaliation [and] fight to block the erosion of our progress.”

Afghan singer and student Sunbul Reha with Sima Bahous, executive director of UN Women.

Merger plan?

Country delegates may also discuss the potential merger of UN Women and UNFPA, which deals with sexual and reproductive health, first mooted by the UN Secretary-General in his plan to reform the UN, UN80.

The US has withdrawn from both bodies and defunded them, sparking a serious resource crisis.

The global feminist organisation, Fos Feminista, and other groups have opposed the merger, stressing that the two have different functions with little overlap.

For Fos Feminista, UN Women was created to “hold the entire UN system accountable for gender equality” with a mandate to ensure “gender equality is not treated as an afterthought but as a binding obligation”.

“UNFPA, meanwhile, leads on sexual and reproductive health and rights (SRHR), population data and demographic analysis, humanitarian gender-based violence coordination and reproductive health supply chains that reach women in the most fragile settings. Its work is technical, operational and often lifesaving.”

European Commissioner for Equality Hadja Lahbib addresses the press following the Commission's landmark decision on opening funds for access to safe abortions.
European Commissioner for Equality Hadja Lahbib addresses the media following the commission’s landmark decision on opening funds for access to safe abortions.

In a landmark decision, the European Commission is allowing member states to utilize existing EU funds to finance access to safe abortions. This move represents a significant shift in European reproductive health, although it stops short of providing financial certainty for women seeking essential reproductive healthcare.

“Behind every unsafe abortion is a woman forced to risk her life because she has no safe alternative, no support, and no protection,” stated European Commissioner for Equality Hadja Lahbib following the decision last week.

After intense public pressure, the EU executive branch declared that governments can voluntarily mobilize their national European Social Fund Plus (ESF+) envelopes to support safe abortion access.

These existing funds can cover medical treatments, travel, and accommodation for women seeking this life-saving care, whether they are travelling to another member state or from a rural to an urban area within their own country.

With a massive budget of €142.7 billion for the 2021-2027 period, the ESF+ traditionally supports employment initiatives, education frameworks, and severe poverty reduction programs.

Member states willing to provide this vital support will simply need to officially amend their national or regional ESF+ programmes to include safe abortion care in their health priorities.

Citizens’ initiative for safe abortions claims victory

The WHO's framework for abortion care underscores that equitable financing and a rights-based policy environment is essential to eliminating the risk of unsafe abortions.
The WHO’s framework for abortion care underscores that equitable financing and a rights-based policy environment is essential to eliminating the risk of unsafe abortions.

The Commission’s landmark decision was directly triggered by the European Citizens’ Initiative (ECI) ‘My Voice, My Choice’. This grassroots campaign gathered more than 1.2 million signatures across Europe to demand an opt-in financial mechanism that universally guarantees safe abortion access.

The campaign hailed the Commission’s acknowledgement of its core objectives as a triumph. “This is not symbolic, it is a political commitment to women’s rights,” declared Nika Kovač, the primary coordinator of the initiative.

Activists leading the campaign highlighted the grim reality that more than 20 million women in the EU currently lack access to safe abortions. This healthcare shortfall is driven by restrictive national laws and entrenched financial, procedural, and personal barriers across the bloc.

The initiative specifically aims to support vulnerable women residing in countries like Poland and Malta, where almost complete bans on abortion remain in effect.

It also highlights the plight of women in states like Italy, where despite the procedure being legal, many doctors refuse to perform the procedure based on personal beliefs, often leaving entire regions without willing providers.

According to the World Health Organization (WHO), this lack of reliable access directly leads to approximately 483,000 unsafe and potentially lethal abortions occurring in Europe every year. The WHO recognizes and approaches sexual and reproductive health and rights as fundamental human rights.

The European Commission’s public health justification aligns closely with the WHO’s comprehensive abortion care guidelines, which classify the procedure as an essential health service and urge the removal of financial barriers.

Legal boundaries in public health policy

The European Commission decided on a voluntary budget mechanism that allows member states to opt-in to using existing funds.
The European Commission decided on a voluntary budget mechanism that allows member states to opt in to using existing funds.

By relying on the existing ESF+, the Commission successfully navigated the strict boundaries of EU treaties, which designate the organization of healthcare systems primarily as a national competence.

“Health policy is a national competence and the Commission has limited room to act,” acknowledged Lahbib when explaining the legal constraints of the decision.

To respect national sovereignty, the newly approved funding pathway operates on a voluntary basis. Leading legal experts had paved the way for this intervention, arguing in an open letter that providing cross-border funding successfully respects the EU’s limited supportive competence without forcing the harmonization of national abortion laws.

The Commission must now rapidly provide member states with clear, actionable instructions on properly utilizing the existing money, the ‘My Voice, My Choice’ initiative urged.

Future funding remains in peril

Nika Kovač (fourth from right), Primary coordinator of the 'My Voice, My Choice' initiative, at a visit to the EU Commission in October.
Nika Kovač (fourth from right), Primary coordinator of the ‘My Voice, My Choice’ initiative, at a visit to the EU Commission in October.

While the ESF+ pathway offers a theoretical legislative solution, it lacks long-term financial security for reproductive healthcare. The fund relies on voluntary budgetary reallocation by member states, leaving women depending on the fluctuating political goodwill of national governments.

Fierce financial competition within the already strained ESF+ budget poses another significant barrier. Because the €142.7 billion fund was originally designed to combat structural poverty and support employment, safe abortion access will now have to compete directly against other critical social welfare programmes.

The organizers of the ‘My Voice, My Choice’ campaign have voiced their disappointment over the lack of new, dedicated financial resources. They firmly urged the Commission to establish additional funding in the near future, rather than relying solely on existing budgets.

Progressive political factions are determined to make the current compromise work while pushing for more permanent solutions.

“We will continue working to ensure that this clarification translates into structural change by promoting the effective use of available funding,” stated the liberal Renew Europe group, a fierce parliamentary supporter of the initiative.

Right is divided on reproductive rights

Margarita de la Pisa Carrión of the Patriots for Europe criticized EU financial support for abortion access.
Margarita de la Pisa Carrión of the far-right Patriots for Europe criticized EU financial support for abortion access.

The Commission’s decision comes in the midst of a global pushback against reproductive rights and abortion access in countries like Argentina and the United States.

It follows a historic vote by European legislators late last year supporting the citizens’ initiative. The December 2025 resolution secured a broad majority, primarily driven by a united front of progressive and liberal blocs.

Rollback and Resistance: The Erosion of Abortion Access in Argentina

However, this decisive majority exposed a deep geographic and ideological fracture within the centre-right European People’s Party (EPP). Already heavily divided during the initial vote, the chamber’s largest political faction has yet to establish an official stance on the Commission’s compromise, a query by Health Policy Watch confirms.

However, the Catholic Church in the European Union (COMECE) condemned the decision in an official statement, claiming: “Redirecting this financial instrument towards the financing of abortions departs from its original purpose and risks creating political friction rather than strengthening cohesion.”

Far-right political factions have also condemned the funding initiative as a massive legislative overreach and an unacceptable intervention into sovereign national affairs.

“If the Commission financially supports circumventing member states’ abortion laws, it means a fight of Europe against Europe,” argued Margarita de la Pisa Carrión from the Patriots for Europe during the December parliamentary debate. Many member parties within the far-right group oppose defining access to safe abortion as a fundamental human right.

Looking ahead to the long-term budget

Committee Chair Lina Gálvez (left) and Commissioner Hadja Lahbib (center) participate in a December 2025 hearing of the Committee on Women’s Rights and Gender Equality.
Committee Chair Lina Gálvez (left) and Commissioner Hadja Lahbib (centre) participate in a December 2025 hearing of the Committee on Women’s Rights and Gender Equality.

Now that the Commission’s decision has been finalized, liberal and progressive lawmakers are setting their sights on securing long-term financial planning for reproductive rights across the bloc.

The European Parliament’s Committee on Women’s Rights and Gender Equality is officially demanding that the EU integrates permanent abortion funding mechanisms into its future budgetary frameworks. Integrating reproductive healthcare directly into the next long-term budget, spanning from 2028 to 2034 would create a dedicated budget line that avoids draining the already burdened ESF+.

“We called on the Commission to consider without delay the budgetary implications of meeting the demands of the European citizens’ initiative,” said Lina Gálvez, committee chair and member of the centre-left Socialists and Democrats (S&D).

With debates on the next long-term budget currently heating up, dedicated funding seems unlikely.

Nonetheless, the European Commission has publicly promised comprehensive action regarding women’s rights in the very near future to build upon this political momentum.

“We will strengthen women’s health and rights across Europe, including their sexual and reproductive health and rights because this is the Europe we believe in,” promised Lahbib regarding the upcoming gender equality strategy.

Image Credits: European Union, WHO, Felix Sassmannshausen, European Union, European Union/Laurie Dieffembacq, European Union/Alexis Haulot.

Sister Miriam Chibale Mushoda RN, at the ultrasound station in the new Nakachenje Mini Hospital, Zambia – one of 108 facilities built with GE Healthcare, the Zambian Ministry of Health and NMS Infrastructure, a private Zambian firm.

As USAID programmes funding vital treatments for HIV/AIDS, malaria, maternal and child health, and other critical needs were imploding across Africa last year, a for-profit social enterprise startup geared up for its first real test.

Using medicines procurement as its lever, the Swiss-based startup Axmed called for a radical reboot of national systems — to digitize and streamline purchases, scale up pooled procurement, and drive down medicine costs.

“Has the system crumbled enough to finally compel us to rethink medicine procurement entirely? Asked Sofia Radley-Searle, Axmed COO, in a March 2025 oped.

“While deep-rooted barriers such as market fragmentation, regulatory complexity, supply chain inefficiencies, weak infrastructure, and financial constraints persist, real targeted solutions already exist,” she argued.

“Technology- enabled platforms, digital pooled procurement, data-driven forecasting, and new financing mechanisms are no longer theoretical concepts; they are active interventions reshaping healthcare systems. It is time we dared to imagine, and build, a world where fragmented, inefficient procurement cycles are replaced by digital platforms that match demand and supply in real-time, eliminating costly delays and unnecessary complexities.”

Over the past year, Axmed — a spinoff of the Gates Foundation — did just that.

Medicines delivered through the Axmed online logistics platform.

It integrated more than 5,000 essential health products in 10 therapeutic areas into a cutting-edge business-to-business (B2B) marketplace connecting healthcare buyers in low- and middle-income countries (LMICs) directly with suppliers.

Working with more than 130 commercially active procurers and suppliers, some 4.2 million patients were reached with a 35% average savings on medicines and other health products, said Alejandro Bes, Axmed General Counsel.

He was speaking at a gathering of private and public sector leaders focused on “unlocking private sector engagement” to improve health systems at the Geneva AIDEX 2025 conference, an annual global conference on humanitarian aid and development. Bes and other experts are featured in a newly published report by the Geneva Health Forum on ‘Unlocking Private Sector Engagement for more Resilient Health Systems.’  

Public-private partnerships increasingly urgent 

‘Can we imagine new forms of collaboration that support vital action … while avoiding pitfalls of conflicts of interest?’ Benoît Miribel (far left) asks panelists.

The private sector has long been deployed across the entire healthcare value chain – from the R&D and manufacture of  medicines, vaccines and medical devices, to logistics and supply chains, digital and technological solutions, workforce training, and health system management.

But how can such engagement be used more optimally to advance more robust and sustainable health facilities in a world of mounting humanitarian crises and declining donor aid? 

“Can we imagine new forms of collaboration that support vital action where resources are scarce, while avoiding the pitfalls of conflicts of interest? “ asked Benoît Miribel,  Secretary General of the Sustainable Health for All Foundation, France,who moderated the GHF session.

“Beyond financial contributions, these alliances can take many forms: technical support, joint operational projects, research and development of crisis-adapted solutions, or even the deployment of new technologies to strengthen the humanitarian response.”

“This is a reflection on the future of solidarity, at a time when finding new paths has become an essential necessity.”

Procurement: a neglected lever of access

Alejandro Bes, Axmed

Axmed, founded in 2024, identified developing country medicine procurement systems as a niche opportunity for win-wins. 

While bulk procurement has long been a practice of multilateral groups like the Global Fund, little attention has been given to practices in national marketplaces. 

In LMICs, those are often characterized by outdated, manual purchasing systems, complex regulations, and fragmented patterns of demands, driving inefficiencies and markups of 250% or more.

Axmed’s Business to Business (B2B) technology platform aggregates medicine demand across countries and presents it to manufacturing suppliers.

“In doing so, we created a viable economic model where none previously existed, reducing dependence on aid and strengthening health systems,” Bes said.

“Automation is central to our approach,” he explained. “We replace fragmented, manual systems with integrated digital solutions. We also deploy predictive technologies that assess future medicine needs based on historical consumption patterns.”

Rather than maintaining stockpiles, medicines are sourced directly from manufacturers with careful supply chain management to ensure reliable flow to partners.

“This allows us to anticipate demand, identify when medicines will be needed, and respond quickly.”

As a for-profit social enterprise, AXMED caps its markup at 10% in a market where markups of 250% are common, and redeploys 30% of profits back into the health systems it serves.

“Our objective is to reduce dependency on humanitarian aid and direct donations, and to transform existing models into more resilient, long-term systems that can sustain themselves over time,” said Bes.

Win–wins in hospital strengthening

Nakachenje Mini Hospital, Zambia – one of 108 rural facilities built through a public-private collaboration with GE Healthcare.

Large private-sector firms are also reshaping partnerships in LMICs. GE Healthcare is a flagship example.

In the past 15 years, the medical technology company — which controls about 60% of the global medical device market — has developed partnerships in more than 160 countries, with a focus on low- and middle-income settings, said Chris Bonnett, who heads its strategic projects initiatives.

“Our approach goes well beyond the delivery of medical equipment: we co-develop projects from both clinical and architectural perspectives, support implementation on the ground, and accompany our partners throughout the entire project lifecycle,” Bonnet said.

“Our ambition is to act as a long-term partner in strengthening health systems and improving access to quality care worldwide.”

The approach is a win-win because the more developed a country’s infrastructure becomes, the better equipped it is to procure and use the newest and most life-saving medical products that GE Healthcare produces. 

In Zambia, for instance, GE Healthcare worked with the UK government and partners to design and deploy deploy 108 primary healthcare centers in rural areas since 2020. The centers function as “mini-hospitals,” enabling women in some regions to access prenatal care for the first time.

“This initiative had a direct and tangible impact on maternal and child health,” said Bonnet.

“Real impact requires partnerships, shared ownership, and accountability. One of our projects in Ethiopia is a strong example of this approach. It was designed, monitored, and evaluated solely based on outcome indicators. Through close collaboration with the government, local midwives, and other partners, we succeeded in reducing neonatal mortality by 24%,” he said, citing the results of a 2018 pilot study on outcomes. 

Strengths and pitfalls of private sector engagement

Ethiopia vaccines
First doses of the AstraZeneca COVID-19 vaccine arrive in Addis Ababa, Ethiopia in March 2021. Rapid COVID vaccine development was the fruit of private-public partnerships although inequalities in rollout highlighted the importance of finding better ways to collaborate.

In its engagements, the private sector can call upon inherent resources such as: strong innovation capacity, control over industrial and production processes, operational efficiency, experience in managing complex projects and the ability to scale solutions rapidly. 

The private sector’s capacity to move quickly from design to implementation is a critical asset in emergency contexts. At the same time, there are also limitations and risks. 

For companies, the risks include financial exposure, reputational risk and staff security. For health systems, poorly coordinated engagement may result in parallel systems, increased dependency or misalignment with national health strategies. 

Conflicts of interest cannot be ignored and must be proactively managed, participants at the AIDEX event underlined. 

Key safeguards include clear governance arrangements, transparency around funding and partnerships, separation between public decision-making and commercial objectives, and alignment with priorities set by national authorities and multilateral organizations. 

These can  mitigate risks and help ensure that private-sector engagement reinforces—rather than undermines— trust in health systems. 

Mobilizing private sector know-how for emergencies

Aurélien Hubert, Foundation S

“Mobilizing private-sector expertise, resources, and operational capacity is essential if we want to respond more effectively to emergencies and support health systems in an increasingly complex global context, observed Aurélien Hubert, head of Emergency Responses and Operations at Foundation S, the philanthropic arm of Sanofi.

“The idea is to use public money more imaginatively, to unleash the potential of the private sector to achieve impact.

He described the Foundation’s role in emergency situations, such as the 2023-2024 wartime crisis in Lebanon, when his role included securing needed medicines internally while negotiating with local NGOs on the ground to organize transport.

“Everything starts with manufacturing, but production alone is not enough. Medicines must be distributed, delivered safely, and administered properly, especially in crisis settings,” Hubert observed.

“However, this process does not always succeed.”

“Failures do happen, and they can occur for many reasons. One of the most challenging situations arises when we cannot guarantee the quality of a product once it reaches the field.

A key factor is often lack of appropriate infrastructure on the ground, he added, citing the absence of cold chain equipment critical for many vaccines as well as insulin.

“Without a reliable cold chain, it is impossible to ensure that insulin can be transported and administered safely. In such cases I sometimes have to make the difficult decision to stop [deliveries].

Reliance on local NGO capacity is critical

Dozens of white tents stand outside Türkiye’s Gaziantep train station housing Turks and Syrian refugees, shortly after the February 6 2023 earthquake.

At the same time, there are moments when everything comes together, Hubert added. 

He recalled the February 2023 earthquake in southern Turkey as one such moment – when the Foundation managed to deliver DT (diphtheria and tetanus)  vaccines to extremely hard-to-reach areas within just two days.

“Vaccines were shipped from the United States to Turkey in full compliance with regulatory requirements, enabling rapid support to affected populations. This response was made possible through close collaboration with partners such as the Red Crescent, he said adding:

“These experiences highlight a key lesson: as a private-sector actor, it is essential to rely on efficient local and international NGOs capable of operating in crisis situations. Public aid alone is no longer sufficient. Collaboration is not a slogan; it is a necessity. To improve effectiveness, control costs, and maximize efficiency, all actors must work together.

Cutting edge technology emerging out of crises 

Familiy member connects safely with an Ebola-infected patient in DR Congo in 2022, thanks to the innovative “cube” developed by ALIMA with private partners.

Crises can also accelerate private-public partnerships that yield important new  innovations. The 2014-2016 Ebola crisis in West Africa offers one such example.

Together with a private-sector partner, the international medical NGO, ALIMA co-developed a major innovation: the “Cube” to protect health workers from the highly infectious and deadly virus. 

The modular medical unit was installed directly within villages, allowing Ebola patients to be isolated, protecting healthcare workers through fully transparent plastic walls, and keeping patients close to their families. 

The innovation caught on across the region, winning prizes from the African Presidential Council as well as the 2019 Global Innovation Accelerator Prize by the Bill & Melinda Gates Foundation. 

“This example reflects our core belief: by combining medical expertise, innovation, strong partnerships, and deep local engagement, we can respond effectively to health crises and contribute to the long-term strengthening of health systems,” said Alexandra Seidel-Lauer, ALIMA’s  director of development. 

ALIMA’s Cube, developed with partners in the 2014-16 West African Ebola outbreak, was deployed again in DR Congo during the 2018-19 emergency.

How USAID’s collapse fast-tracked AXMED’s rollout

Similarly, the 2025 collapse of USAID proved to be a turning point for AXMED’s new procurement model – fast-tracking its uptake.

“When USAID abruptly suspended its operations, many of our clients—who rely heavily on its support— were deeply worried, and so were we,” recalls Bes. “The question was simple: what do we do now?

The company fast-tracked deployment of its B2B system. What began as a proof of concept became a scalable model.

This year, the system is now set to expand to more than 20 LMIC countries, primarily in Africa, supported by a second $5 million Gates Foundation grant and additional investor backing.

“Ultimately, this approach allows us to move away from constant emergency response and instead build sustainable, replicable procurement models that strengthen health systems over the long term,” Bes said.

“This success demonstrates that while traditional aid approaches remain important, building resilient health systems also requires thinking differently and developing innovative solutions to address chronic challenges such as weak infrastructure, limited funding, and unreliable supply networks. This is what we aim to do: make a modest but meaningful contribution to the steady and sustainable improvement of health systems in LMICs.”

Second in a series.  See also: Innovative Finance can Strengthen Fragile Health Systems 

Image Credits: GE Healthcare , Axmed, Geneva Health Forum , Gerneva Health Forum , GE Healthcare , WHO, Geneva Health Forum , Abdulsalam Jarroud/TNH, ALIMA , Caroline Thirion/ALIMA .

Village Health Team member Fenehasi Bazimbana recording data after testing a household for malaria.

KAMPALA, Uganda – After five years of focusing on malaria prevention through Seasonal Malaria Chemoprevention (SMC) in the Karamoja region in northeastern Uganda for children under the age of five, Uganda’s Health Ministry has decided to extend the intervention to children up to the age of 10.

SMC is the intermittent administration of a curative dose of antimalarial medicine to children at high risk of severe malaria living in areas with seasonal transmission, regardless of whether they are infected with malaria. 

Since it was introduced, there has been a modest 13% reduction in malaria cases in children aged three to 59 months, according to the Uganda Ministry of Health’s National Malaria Control Division.

Uganda is one of the worst-affected countries in Africa for malaria.

Dr André-Marie Tchouatieu, senior director of medical affairs at the Medicines for Malaria Venture (MMV), described the extension of SMC to children older than five years old in Uganda as “one of the most impactful, evidence-backed strategies available to reduce the country’s malaria burden”. 

“By reducing the parasite reservoir, closing the immunity gap in older children and protecting this high-risk group, age-extended SMC could dramatically accelerate Uganda’s progress toward malaria control, and potentially elimination, in seasonal transmission zones,” said Tchouatieu.

“The combination of strong clinical evidence, WHO’s updated guidance on SMC and Uganda’s existing infrastructure makes this scale-up both feasible and urgently needed.

The first-ever joint annual meeting of the SMC Alliance and the Alliance for Malaria Prevention (AMP) was held in Kampala last week.

Lives saved

“Since SMC was introduced, many children’s lives have been saved in my region,” Lotee Paul Komol, chairperson of Kotido district, told the first-ever joint annual meeting of the SMC Alliance and the Alliance for Malaria Prevention (AMP) held in Kampala last week.

 In Africa, SMC has already been implemented at scale in 20 countries, 14 of which are in the Sahel region, according to the World Malaria Report 2025.

 “This intervention was delivered at the right time, and it has significantly reduced malaria deaths among children under five,” Komol told Health Policy Watch. 

“As leaders from Karamoja, we are extremely proud that we were prioritized and it was implemented in our region. We no longer see parents flooding health facilities with children suffering from malaria, as was once the case. SMC has put a smile on the faces of many mothers,” he said.

 In 2013, about a million children received SMC, but by 2024, this had risen to around 54 million. The success of SMC led WHO to recommend its expanded use for any child at high risk of severe malaria in Africa, irrespective of age and geography.  

In Uganda, the SMC program started in 2021 in Moroto and Kotido, with Nabilatuk serving as a control during the evaluation phase. Once the government saw that it was feasible, the program was expanded to nine districts in the Karamoja region, including Moroto, Kotido, Nakapiripirit, Amudat, Abim, Napak, Karenga and Kaabong by 2023.

Since then, some districts in Acholi and Lango regions have also met the SMC criteria, so SMC is now being expanding to 18 of its 146 districts. The Malaria Consortium is the implementing partner, with funding from GiveWell and the Global Fund.

 “When we realized that it was feasible, we mobilized resources and began to scale up,” said Dr Jane Nabakooza, a senior medical officer and technical lead for Malaria Chemoprevention and Vaccines at the Uganda Ministry of Health’s National Malaria Control Division.

Uganda is one of the three worst affected countries in Africa for malaria, recording almost 11 million cases in 2024.

Integrated approach

The Uganda SMC programme also realised that the intervention could not be delivered in isolation, so it was included in the integrated Community Case Management (iCCM) being implemented by the Village Health Teams (VHTs). These had a strong module on referral.

“SMC is not a stand-alone,” Nabakooza said. “It has to be done with other methods.” For instance, VHTs under SMC were cautioned not to dispense medicines until they established that the children had no malaria.

“If they were infected, medicines were withheld until treatment was initiated. If they had malaria signs, referral to the nearest health centre was done,” said Nabakooza. As such, the relationship between VHTs and health facilities deepened.

“If you do not plan with the VHTs, you miss a lot because they have the solutions to most of the problems and their lived experiences shape how malaria interventions succeed or fail,” she explained.

At the community level, SMC teams confirmed that households had bed nets, were using them properly, and identified children who had missed routine vaccines.

They were referred to health facilities, but many did not follow through and visit the facilities. 

“Subsequently, the SMC teamed up with vaccination teams, not only for malaria but for all childhood vaccines,” Nabakooza said.

But as the project was rolling out, weaknesses quickly became visible. VHTs could identify sick children, yet stock-outs meant they often had no medicines. Reporting was weak, and their contributions went undocumented.

“This was solved by strengthening supply chains, improving supervision, and tightening reporting systems,” said Nabakooza. 

But still, the results were not good. Data appeared weak, partly because reporting tools were not robust enough and some health workers struggled with documentation. 

Uganda’s decision to extend Seasonal Malaria Chemoprevention to older children can save many lives.

Digital dashboards

Digitisation was also introduced into SMC and staff were retrained and supplied with new tools and a robust surveillance system to identify problems and act accordingly.

Brenden Williams, co-chair of the Humanitarian and At-Risk Populations (HARP) Working Group, said national malaria programmes are leading the use of real-time digital dashboards to identify and correct registration errors mid-campaign, ensuring accurate data-driven decisions that were previously impossible with paper reporting.

Williams presented the meeting with data from national malaria programmes and partners in Burundi, Chad, Mali, Nigeria, Pakistan, Somalia, and South Sudan.

In Ghana, an electronic data system for all interventions – Insecticide Treated Nets (ITN) mass campaigns, SMC, and larviciding (killing mosquito larvae) – has been developed. All electronic community intervention data systems are in the process of being harmonised into one platform called the Ghana Malaria Interventions System (GMIS).

Moving to digital platforms generates long-term savings by reducing logistical costs and preventing over-procurement through more accurate population estimates, said Williams.

It also fosters national ownership by training local government staff to manage technical operations, reducing reliance on external support and improving the user experience for field volunteers.

But while SMC is designed for highly seasonal settings, Uganda wants to expand it beyond Karamoja’s single rainy season to regions like Lango and Acholi that have two rainy seasons and are more densely populated regions. This would mean reaching more children and lowering the cost of intervention per chil

The rationale is that children who survived malaria often carried infections that re-exposed younger children. So in 2025, SMC was extended to children aged five to 10 in Napak, Abim, Karenga and Kaabong.

While the results are still being analyzed, one outcome is already clear. “We reduced the cost per child from $4 to $1.71 over five years,” said Nabakooza.

In the Gambia, they also want to implement SMC for children up to 10 years old because they think it will enable them achieve elimination.

Peter Olumese, the World Health Organisation (WHO) technical Lead of malaria case management in the Malaria and NTD Department

But Peter Olumese, the World Health Organisation (WHO) technical Lead of malaria case management in the Malaria and NTD Department, is sceptical.

“SMC has to be done in areas where the transmission is seasonal. In most parts of Uganda, you have perennial seasons. That means transmission happens all year,” he told Health Policy Watch. 

“During the rainy season, malaria cases go up. That is not seasonal transmission. That is perennial transmission with seasonal variation, which is different from the Sahel region, where you have malaria during the months of July to October, and after that, there is little or no malaria. Even when children have a fever, you do not think about malaria. So that is where you should be doing SMC,” he said.

“Technically, speaking from a WHO perspective, [Uganda] should not be implementing this, but a country has a right to choose to do what they want to do,” he said.

The meeting also served as a shared platform for countries and implementing partners to exchange experiences, innovations and best practices, particularly in light of the revised WHO malaria guidelines and the shifting funding landscape as nations prepare for Global Fund Grant Cycle 8.

“The beauty of it is having 29 African countries and combining the two meetings.  At the end of the day, country programs here are hearing from each other and learning, plus exchanging ideas. That is one of the best things,” said Olumese.

Image Credits: UNICEF.

The US has seen record-breaking outbreaks of measles in the past year. Experts point to falling vaccination rates.

The World Health Organization (WHO) has pushed back against speculation that a critical review of the US measles elimination status was delayed until November for political reasons. Rather, the WHO said that there were strong technical reasons for postponing the review from April until November so that more data could be collected.

This came as US health officials asked an independent panel to delay its review of the country’s measles elimination status until later this year. 

The review of the measles elimination status is now set to happen after the US midterm elections, reportedly sparking concerns over political motives. However, authorities strongly insist that the extensive delay is necessary to guarantee an uncompromising and exhaustive epidemiological review of recent circulation data. 

It is essential that “all of the data, all of the evidence, all of the analysis has been done and scrupulously done,” noted Kate O’Brien, WHO director of the Department of Immunization, Vaccines, and Biologicals.

The review, which is to be led by the Pan American Health Organization (PAHO), WHO’s regional arm in the Americas, could lead to the embarrassing loss of the US status as a country that has eliminated measles, due to the multiple outbreaks that have occurred there over the past year.  

It comes at a time when PAHO, a semi-autonomous entity, is keen to retain the US as a partner – even after the US pulled out of the WHO as a global entity.

Last November, PAHO’s Measles, Rubella, and Congenital Rubella Syndrome Elimination Regional Monitoring and Re-Verification Commission resolved that Canada had lost its measles elimination status after 12 months of continuous transmission.

The US has seen record-breaking outbreaks concentrated in Texas and South Carolina in the past year, with the most recent outbreak exceeding 1,000 cases. Experts point to waning vaccination rates and community transmission.

The US achieved elimination status in 2000, marking a victory over a disease that once infected nearly every child and claimed 500 deaths per year before widespread vaccination. 

PAHO points to technical reasons for postponement

map world measles elimination status
The number of reported measles cases in the last 6 months of 2025.

The WHO carries out routine elimination verification of its member states every year, assessing whether a country had no local transmission of the same strain within the past 12 months. 

PAHO initially invited both Mexico and the US to meet in April to review their elimination statuses following recent outbreaks. Under the organization’s frameworks, the panel meets annually, but may “also convene at other times as needed to carry out its mandate.”

“The meeting date has been set to give national health authorities and national sustainability committees sufficient time to prepare comprehensive reports, including descriptions and analyses with detailed epidemiological and laboratory evidence, for review by the commission,” the announcement read.

Now, though, PAHO has said they want to “harmonize” the commission’s schedule.

The WHO defended the rationale for postponing the review: “The [status review] meeting normally takes place in the fourth quarter of the year,” said O’Brien, responding to questions during a WHO press briefing. 

“That is when the review of the evidence will take place by that committee to determine whether [countries] retain or do not retain their elimination status.”

Another reason that the meeting wasn’t held earlier was to ensure all data and analysis were completed with the necessary rigor and depth, she explained. This preparation would ensure that external committee members have every piece of information required to reach their conclusions.

US could join UK, others, in losing elimination status

measles elimination vaccines map US
The percentage of American kindergarten children who have been vaccinated against measles has declined in the past two decades.

In January, the UK, Spain, Armenia, Azerbaijan, and Uzbekistan also lost their measles elimination status after the Europe and Central Asia regional committee met to review the status.

The Region of the Americas has historically maintained the most countries to reach elimination status.

But outbreaks across the region – notably the US, Canada, and Mexico – threaten the region’s reputation as the only group that has achieved total measles elimination. 

Slipping vaccination rates in higher-income countries help explain a resurgence of infections. In the last school year, 13 US states had vaccination rates below 90%. In 2010, only six states fell below 90%, according to CDC data.

And when using the WHO’s threshold for herd immunity – 95% – only 10 states currently meet that criteria. 

Nearly 100,000 deaths a year among unvaccinated

Globally, 95,000 measles deaths occur each year, mostly among unvaccinated or under-vaccinated children under the age of five. 

Cases and deaths are mostly concentrated in low- and middle-income countries and in low-resource or conflict settings.

Yemen, Indonesia, India, Pakistan, and Angola accounted for the majority of the disease burden in 2025. 

The disease is one of the most contagious viruses that can lead to severe complications and death, according to the WHO. Vaccination, though, averted nearly 59 million deaths in the past quarter-century.

The measles virus infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body, per the WHO.

Image Credits: WHO, WHO, CDC.

Residents of Kakola–Ombaka being evacuated after their homes were flooded.

For decades, residents of Kakola-Ombaka village in Western Kenya lived through cycles of seasonal heatwaves and droughts on the shores of Lake Victoria without significant harm. 

That changed in 2019, when heavy rainfall of unprecedented intensity struck the area. The entire village and surrounding communities were inundated. The lake swelled, water levels rose steadily, banks eroded, and backflows spread across the land. Many residents were forced to flee to higher ground. 

For over a month, much of the village remained submerged. Families camped at local schools until those, too, were overtaken by water. Canoes and boats became the primary means of transport, though many residents with insufficient access to vessels continued to wade through the floodwaters on foot.

When the water eventually receded, families returned home. But the following year, the flooding returned, and then again, with increasing frequency. Historically, the area experienced a single rainy season. 

In recent years, two have become the norm — one from March to May and another from October to December. Residents have barely recovered from one episode before the next begins. Today, four camps of permanently displaced people remain in the area.

Water contaminated by pit latrines

Carren Onjala, a local community health promoter (CHP), said that almost all the pit latrines were submerged in the floods.

Many homes in this impoverished area rely on pit latrines, most of which were in a state of disrepair. When the floods came, virtually all of these were submerged. 

Carren Onjala, a local community health promoter, explained that faeces-filled stagnant water quickly became a breeding ground for snails, worms, and mosquitoes. Water and sanitation systems were seriously disrupted across the entire community.

The warmer, wetter conditions also accelerated the life cycle of parasites. The result has been a marked increase in cases of Schistosomiasis (commonly known as bilharzia) and other diseases transmitted by parasitic worms, known as helminths.

Dr Martin Mutuku, a neglected tropical disease expert from the Kenya Medical Research Institute (KEMRI), explained that rising temperatures combined with unpredictable rainfall create ideal conditions for the breeding of the snails that serve as intermediate hosts for the Schistosomiasis parasite. Many communities in Western Kenya, particularly those living along the shores of Lake Victoria, have been affected.

Children most affected

A school girl collecting water fetching water for domestic use in Kakola- Ombaka.

Schoolchildren were particularly vulnerable. Many were required to walk through floodwaters twice a day to attend school and collect water for their families, making prolonged contact with contaminated water unavoidable. 

Prisca Awuor Aende, a teacher at Nyamasao Primary School in Kakola-Ombaka village, recalled seeing children playing in stagnant water. 

Many stopped attending school altogether as a result of bilharzia infections. Younger children stayed away for fear of the rising water. Others lost their books in the floods, and academic performance across the school declined sharply.

The broader economic toll on the community has also been severe. Families have lost livestock, household goods, and property. Some have suffered damage to their homes; others have lost their land entirely, driving a rise in poverty across the area.

Neglected Tropical Diseases and climate

Neglected Tropical Diseases (NTDs) are a broad group of conditions caused by a range of pathogens, including parasites, bacteria, viruses, and fungi. 

According to the World Health Organization (WHO), more than one billion people are affected by NTDs globally, and approximately 200,000 die from them each year. 

In rural Western Kenya, the twin pressures of rising temperatures and shifting rainfall patterns are emerging as significant drivers of NTD spread, with Schistosomiasis and soil-transmitted helminths (STHs) finding new footholds as ecological changes bring parasites closer to vulnerable communities.

These climate-related risks were anticipated long before the 2019 floods. The Nyando and Kadibo sub-counties rank among the worst affected by climate change in Kisumu County, according to the county’s Special Programme and Disaster Management data. 

As early as 1966, the Kenyan government had predicted that changing weather patterns and lake flooding would place residents of Kadibo sub-county at risk. In response, the government purchased land in the Muhoroni Scheme and resettled affected communities. But after years passed without major flooding, many residents returned to their original homes and lived without incident — until 2019.

Ombaka Dispensary in Kakola –Ombaka submerged in flooded water.

The first indications that community members were suffering from bilharzia came when men and male children began presenting with swollen abdomens, an unusual symptom for their demographic. 

Those affected were taken to Ahero Sub-County Hospital, where they were diagnosed. In response, the Ministry of Health, various NGOs, UNICEF, and the Red Cross intervened with food, sanitary products, clothing, water containers, books, and medication, including Praziquantel, the primary drug used to treat Schistosomiasis.

But the delivery of these supplies was complicated by the fact that the nearby dispensary was also flooded, requiring health workers to distribute medicine and mosquito nets by boat and canoe.

Despite annual deworming programmes conducted by the Ministry of Health, re-infection rates remained high., said Maurice Murithi, the area’s Disease Surveillance Officer. 

Residents continued to wade through floodwaters to check on their submerged homes, exposing themselves repeatedly to contaminated water. The area also lacked reliable access to clean water, leaving residents with little alternative but to use what was available.

The deputy county director for special programmes, Migosi Oluoch, pointed to another contributing factor: the chronic contamination of the lake, rivers, and streams.

Waste discharged without adequate treatment from nearby industries and hotels enters the water system, creating a persistent snail habitat. When rains or lake backflows occur, this contaminated water spreads into surrounding communities, increasing exposure to both bilharzia and soil helminths.

 Mutuku highlighted structural reasons why NTDs persist despite intervention. Mass drug administration and deworming programmes are typically conducted in schools, leaving adults at home without treatment and resulting in poor overall coverage. 

Pharmaceutical companies also have limited commercial incentive to manufacture NTD drugs, as these are diseases that predominantly affect people living in poverty. This dynamic has led to a scarcity of bilharzia medication. 

Without reliable access to safe water, communities will continue to have unavoidable contact with contaminated sources. 

Flood mitigation 

Oluoch confirmed that flooding is the foremost climate-related disaster facing Kisumu County, with Kadibo among the most severely affected.

The county government has responded by opening water channels and canals to direct floodwater back towards the lake,while a Disaster Management Committee, co-chaired by the Governor and the County Commissioner, has been established to coordinate the response at the county level.

Residents of Kakola-Ombaka and the wider Kadibo and Nyando sub-counties have called for the construction of dykes, a recommendation that Oluoch supports.

He also urged the national government to accelerate the completion of the Koru-Soin Dam, which could help regulate water levels significantly.

He further proposed that vacant land rendered unusable by flooding – including the sites of former institutions such as Ombaka High School and several other abandoned settlements – be repurposed for a research centre or university.

Simultaneous actions

The situation in Kakola-Ombaka illustrates the relationship between climate change and neglected tropical diseases.

Controlling the spread of Schistosomiasis and soil helminths in Western Kenya will require action on several fronts simultaneously.

Infrastructure investment – including dams, dykes, and improved water and sanitation systems – is essential to reduce flooding and the contamination it brings. 

So too is the elimination of industrial and commercial waste entering the lake. Community-wide mass drug administration, rather than school-focused programmes alone, would improve treatment coverage. And sustained public education remains critical to equipping communities with the knowledge to protect themselves.

As Mutuku noted, vector-borne diseases that were once controlled can re-emerge whenever climate change raises temperatures and disrupts rainfall patterns. In Kakola-Ombaka, that re-emergence is already well underway

The war in Iran has paralyzed the delivery of WHO supplies from Dubai’s humanitarian hub, the world’s largest.

The US-Israeli war with Iran, which has paralyzed air travel across the Middle East, has also frozen deliveries of vital medical supplies from the world’s largest humanitarian supply hub in Dubai to conflict-wracked countries from Afghanistan to Lebanon, said the World Health Organization on Thursday. 

“Operations at WHO’s logistics hub for global health emergencies in Dubai, are currently on hold due to insecurity,” said WHO Director General Dr Tedros Adhanom Ghebreyesus at a WHO press briefing in Geneva.

WHO Director General Dr Tedros Adhanom Ghebreyesus speaks about the Iran war’s domino effect on medical supply routes throughout the region.

The airspace closures as well as restrictions on cargo traffic through the Straits of Hormuz have put the hub’s operations “temporarily on hold,” echoed Hanan Balkhy, WHO Regional Director of the Eastern Mediterranean Regional Office  (EMRO), at the briefing. 

She said that the disruption is preventing access to some $18 million in humanitarian health supplies, while another $8 million in shipments has been stranded and unable to reach the hub in Dubai. 

“More than 50 emergency supply requests from 25 countries are currently affected. And $6 million in medicines for Gaza as well as $1.6 million in polio laboratory supplies are also held up,” Balkhy said. WHO’s emergency operations across the region currently face a 70% funding gap, she added. “Without urgent financial support, essential services will cease and preventable suffering will deepen.” 

One-half of world’s humanitarian needs are in Eastern Mediterranean Region

Hanan Balkhy, WHO Director of the Eastern Mediterranean Regional Office.

The airspace and sea lane closures have had broad repercussions insofar as one-half of global humanitarian needs are concentrated in the eastern Mediterranean region – which extends from Pakistan all the way to Tunisia. 

The Dubai hub, alongside one of the world’s busiest airports, also serves as a logistics junction for WHO-supported medical supplies traveling to Africa, South-East Asia and beyond. 

“Last year, WHO’s global health emergencies logistics hub in Dubai fulfilled more than 500 emergency orders for 75 countries across all six WHO regions. However, humanitarian health supply chains are now being jeopardized,” said Balkhy.  

Deepening humanitarian crisis

The crisis comes just as WHO and other humanitarian partners are attempting to pre-position trauma supplies and essential medicines in vulnerable regions, like southern Lebanon, in preparation for potential mass casualties -as well as population displacement. 

Israel on Wednesday ordered the evacuation of some 300,000 people from southern Lebanon and on Thursday evening called for the evacuation of all of Beirut’s southern suburbs – moves that will almost certainly lead to an even wider humanitarian crisis in the region.

The Israeli  moves on Lebanon came after Iran’s ally, the Shi’ite Hizbullah militia, entered the war earlier this week pounding northern and central Israel with repeated volleys of rocket fire.

The war began last Saturday morning, when Israel and the US launched a surprise attack on Iranian military and missile sites – after negotiations to curb Iran’s nuclear ambitions and missile arsenal faltered. Iran then  sent missiles flying across the region, hitting not only Israel but Dubai’s airport, as well as military and civilian sites across the Gulf and as far away as Jordan. That has paralyzed air traffic, stranding hundreds of thousands of tourists and travelers in a widening arc of conflict.    

There are also concerns over a potential nuclear event as Israel and the United States target Iran’s nuclear facilities and Iran threatens retaliation against Israel’s nuclear facility in the Negev Desert region of Dimona, WHO’s Director General warned.  

“The threat of nuclear facilities being impacted is also concerning,” said Tedros. “Any compromise to nuclear safety could have serious public health consequences.” 

Efforts to carve out alternative supply routes

Annette Heinzelmann

As the arc of the war extends across most of the region’s air space,  WHO is exploring alternative overland supply routes as an alternative to air transport together with UNICEF and the World Food Programme, said Annette Heinzelmann – EMRO emergency director 

“We are assessing the possibility of working through our other UN logistic hubs, notably in Nairobi and in Brindisi, which are close to the region… we are also working with our logistics hub in Dakar to look into alternative shipment routes,” Heinzelmann said 

“And there is the potential of local supply sources, as well as shipments through land routes,”  she said, noting that the opportunities and barriers vary widely country by country – citing Afghanistan as an example where alternative routes of access are “highly complex.”. 

Impacts on Gaza 

Gaza tent camp amidst rain and rubble in January 2026. WHO describes progress in rehabilitation since the October 2025 cease-fire as ‘marginal.’

For Gaza, already devastated by two-years of war with Israel, the fresh conflict with Iran and Lebanon is a huge setback in an “extremely fragile situation,” she added. 

For the first few days of the war, Israel also closed key humanitarian aid corridors.  Those have since been partially reopened, “but there is really not enough humanitarian aid going in.  

“And we still do not have enough patients [able to] leave Gaza to seek medical care outside. 

Tedros described the progress in Gaza since the October cease-fire as “marginal,” saying “we need 600 trucks to cross into Gaza every single day. But currently it’s not more than 100 between 100 or 150 – and some of those tracks are actually commercial, and that doesn’t really help with humanitarian services.”

He also renewed an appeal to Israel to allow Gaza patients who can’t be treated properly in the enclave to access more specialized medical care in East Jerusalem. This, in light of the dearth of countries willing to take in the more than 10,000 Palestinians awaiting medical treatment abroad. 

“I’d like to use this opportunity to ask Israel to allow us to take patients to East Jerusalem and West Bank,” Tedros said.. 

Casualties and attacks on health facilities 

Since the war began in an early morning surprise attack by Israel and the United States on Saturday, 28 February, some 1000 people have been reportedly killed in Iran, according to the Islamic regime; 50 in Lebanon, 13 people in Israel and eleven in other countries, WHO said.

In addition, WHO has verified 13 attacks on health care in Iran and one in Lebanon, according to Balkhy, citing data culled from WHO’s  dashboard on attacks on healthcare facilities or health workers. 

The WHO dashboard, however, contains only data provided by the Islamic Regime. It has no records of the many reported regime attacks on health workers and hospitals during the month of January unrest. In that period, there were multiple, credible reports of heavily armed forces bursting into hospital emergency wards to obstruct care, arrest or kill injured patients as well as health care workers. 

Over the course of that month, the Iranian regime’s systematic killing of protestors led to an estimated 10,000 to 30,000 deaths – a death toll that the regime went to great extremes to conceal.

During the current war, members of its Islamic Revolutionary Guard Corps (IRGC)  and its affiliated Basij paramilitary volunteers, are reportedly being embedded in schools, mosques and hospitals, making them targets of attack, according to independent news reports.

KurdPa Human Rights news agency Instagram post Wednesday: Sanandaj – Forced evacuation of the Seyyed al-Shuhada private hospital and deployment of Revolutionary Guard forces.

Speaking at the WHO press briefing, Heinzelmann said that she had no information about the incursion of armed forces in health facilities. 

Reached by Health Policy Watch, a WHO spokesperson did not explain why the January attacks on health facilities by regime forces were not included in the WHO dashboard of attacks on health care. However, the spokeperson noted that the Director General had posted a remark on X about some of the reported incidents.     

Image Credits: Dubai Humanitarian , Palestinian Water Authority , Instagram/Kurdpafarsi news agency.

India’s school-based HPV vaccination initiative is a critical gateway for reaching 12 million girls with the life-saving jab to prevent cervical cancer.
India’s school-based HPV vaccination initiative is a critical gateway for reaching 12 million girls with the life-saving jab to prevent cervical cancer.

India launched the most extensive free Human Papillomavirus (HPV) vaccination initiative in history to systematically combat the rising toll of cervical cancer. This ambitious 90-day campaign aims to inoculate nearly 12 million 14-year-old girls before the preventative shot is permanently integrated into the country’s universal immunization schedule.

Indian Minister of Health Jagat Prakash Nadda addresses the WHO press briefing on the global fight against cervical cancer.
Indian Minister of Health Jagat Prakash Nadda addresses the WHO press briefing on the global fight against cervical cancer.

“India has joined the community of 160 countries in the global fight against cervical cancer,” stated India’s Minister of Health Jagat Prakash Nadda at a World Health Organization (WHO) press briefing on Thursday.

WHO Director-General Dr Tedros Adhanom Ghebreyesus commended the Indian government’s leadership and congratulated their progress toward the WHO’s ambitious 90-70-90 elimination targets. This global strategy states that by the year 2030, 90% of girls must be vaccinated, 70% of women must be screened, and 90% of women with cervical cancer or precancerous lesions must receive treatment.

HPV is a prevalent family of viruses that remains the leading cause of cervical cancer globally. Because of this direct viral link, administering the targeted HPV vaccine to young girls before they become sexually active is a highly effective clinical strategy proven to reduce cervical cancer cases by almost 90%.

With its HPV vaccination campaign, India is combating an immense localized crisis, with over 127,000 women diagnosed with the cancer annually, leading to approximately 80,000 deaths. To address this, the government has already screened 86 million women across 181,000 specialized health and wellness centres nationwide.

The massive logistics behind the immunization campaign is managed through India’s proprietary U-WIN digital platform, capturing end-to-end records of all immunizations and monitoring vaccine stocks to prevent critical supply shortages.

African leadership in global HPV vaccination rates

The WHO African region achieved a 47% first-dose HPV vaccination coverage rate for females in 2024, overtaking the European region.
The WHO African region achieved a 47% first-dose HPV vaccination coverage rate for females in 2024, overtaking the European region.

Concurrently, South Africa is drastically elevating its own historical battle against the devastating disease through high-level political intervention. A massive new national push to completely eliminate cervical cancer will be officially inaugurated by the country’s highest office in the coming weeks.

“It is no longer the minister of health who is going to launch this campaign to end cervical cancer, it will be the president himself,” confirmed South African Minister of Health Aaron Motsoaledi.

According to the WHO immunization dashboard, The African region has made spectacular strides in localized coverage, officially overtaking Europe to claim the second-highest first-dose HPV vaccination rate globally. Following setbacks in countries like Malawi, the African region’s trajectory – climbing from 9% in 2016 to 40% in 2023 and reaching 47% in 2024 – stands in stark contrast to Europe’s stagnation at 41%.

For years, the South-East Asia region hovered around a staggering 3% coverage rate for females from 2016 to 2022. The region broke double digits in 2024 by reaching 14% coverage, and India’s newly announced campaign targeting 14-year-old girls guarantees this upward trajectory will continue swiftly.

WHO Director of Immunization, Vaccines, and Biologicals Kate O'Brien speaks to major achievements in HPV immunization.
WHO Director of Immunization, Vaccines, and Biologicals Kate O’Brien speaks to major achievements in HPV immunization.

This progress is largely attributed to the transition toward simplified, single-shot immunization regimens worldwide. “It makes the way of administering a vaccine so much easier,” explained WHO Director of Immunization, Vaccines, and Biologicals, Kate O’Brien.

“We have some estimates that as a result of countries switching to the one dose schedule, something in excess of 30 million additional girls have been able to be vaccinated.”

Community-driven strategies power South Africa’s rollout

While financial constraints previously limited this life-saving intervention exclusively to public institutions, the official adoption of a single-dose regimen has fundamentally transformed the economic maths in South-Africa’s immunization efforts.

This crucial shift allows South Africa to stretch its self-funded resources and expand its protective network into private and independent schools, which serve roughly 5% of the student population.

Another key to success is South Africa’s distribution model that relies heavily on a collaborative framework between the health and basic education ministries. The ‘Integrated School Health Program’ utilizes dedicated school nurses to administer the HPV vaccine and engages with both parents and local school governing bodies.

Nothemba Simelela, adviser to the South African Minister of Health, highlights the importance of a community-driven approach.
Nothemba Simelela, adviser to the South African Minister of Health, highlights the importance of a community-driven approach.

Securing parental consent is a fundamental pillar of the rollout, with officials strategically bundling permission slips with annual school registration forms to maximize compliance.

“Some of the nurses have given us feedback that they [the girls] just join the queue because they don’t want to be left behind by their peers, and it’s quite difficult to refuse to give such young girls the vaccination,” stated Nothemba (Nono) Simelela, adviser to the South African Minister of Health.

Innovating HIV medication to tackle overlapping threats

WHO Director-General Dr Tedros Adhanom Ghebreyesus commended India's leadership in the global fight against cervical cancer.
WHO Director-General Dr Tedros Adhanom Ghebreyesus commended India’s leadership in the global fight against cervical cancer.

The underlying urgency to protect these vulnerable populations is driven by stark epidemiological realities regarding overlapping threats. Women living with HIV are six times more likely to develop cervical cancer compared to women without HIV, according to the WHO.

Recognizing that overcoming this deadly coinfection crisis requires a two-front defence, South Africa is confronting its staggering HIV burden with groundbreaking pharmaceutical developments. Just today, the state announced its intention to begin locally manufacturing Lenacapavir, a highly preventative medication.

This pharmaceutical is technically not a vaccine, but it operates as a long-acting antiretroviral injection administered every six months to high-risk individuals. In recent clinical trials, the preventative treatment has been shown to block almost all cases of HIV transmission among vulnerable demographics, Dr Tedros explained.

Global health authorities have fast-tracked the drug’s approval process to ensure equitable international distribution as quickly as possible. “It’s the first time WHO has developed pre-qualification and guidelines in parallel not in sequence to speed up equitable access to innovative new tools,” announced the WHO Director-General.

South Africa previously became the first nation in Africa to officially approve the preventative medication back in October last year. The planned massive rollout of this drug represents a fundamental shift in how the continent approaches its long-standing battle against the devastating HIV epidemic.

Image Credits: Felix Sassmannshausen, Pravin via Canva.