Africa’s Health Systems Must Confront Climate Change as a Critical Health Crisis 19/03/2026 Anthony Ngugi In February, Cyclone Gezani devastated Toamasina, the second-largest city in Madagascar. Climate change is increasing the intensity and frequency of cyclones. Climate resilience is a key theme of the World Health Summit’s regional meeting in Nairobi 27-29 April, which is bringing leaders together to address the structural realities of health security across the continent and advance a transformative reform agenda. In some parts of Africa, like Ghana, December marked the beginning of the Harmattan season characterized by dry, dusty and cooler winds. However, over the past few years, changes in climate have interfered; temperatures are sometimes too high, whereas in different regions, there are sudden storms, and extended dry spells are becoming more frequent. These changes can be deceptive, but they are already causing grave health effects. Climate change has been far too frequently conceptualized as an environmental or economic problem, a matter that can be handled by government agencies alone. In Africa, climate shocks are already redefining the disease patterns, essential health services and the vulnerabilities of health systems. Climate change is no longer a future health threat but an escalating challenge today. The challenge that policymakers and health leaders are facing today is not only the climate change impacts on health, but also whether the African health systems in are able to absorb, adapt, and respond to the increasingly frequent and intensifying climate shocks. Increasing temperatures, extended droughts, and floods are changing the epidemiology of disease on the continent. This includes the spread of the diseases into new geographies through vectors, whereas water scarcity and flooding contribute to the regular outbreak of cholera and other waterborne diseases. In addition, heat stress exacerbates cardiovascular and respiratory health complications, especially among vulnerable groups. Exposing the fragility of health systems Government officials and relief workers wade through floodwater in Mozambique in February 2026. Health systems are grappling with the most significant effects of climate change. Floods are damaging or rendering health facilities unusable, disrupting essential medicine supplies and breaking supply chains. Climate emergencies are widening service delivery gaps by increasing the workload of already overstretched health workers. More broadly, climate change is exposing the fragility of health systems designed for stability in an increasingly dynamic environment. Many African health systems remain organized around vertical programs and short-term interventions. While these approaches have improved outcomes in specific disease areas, they are poorly suited to respond to climate-related shocks. As a result, these crises increase operational costs when core functions such as disease surveillance, emergency preparedness, infrastructure planning, and primary care are managed in silos. Climate change increases fragmentation tax – the accrued cost of fragmented systems. In the case of climate-related emergencies, this fragmentation often translates into slower responses, preventable sicknesses, and the loss of trust by the population. Integration is fundamental to resilience and requires interoperable systems and governance structures that enable flexible service delivery models, allowing rapid adaptation to changing conditions. Adaptation as an imperative Workers in Sierra Leone install a solar panel at a health clinic. Climate change adaptation is not a nice-to-have feature of health systems but an essential capability of health security. This implies a shift from the largely reactive emergency response approaches to anticipatory system design. Health systems that are climate-resilient incorporate climate risk in all their planning and investment decisions. This involves climate-proofed health infrastructure, enhancing early warning systems, responsive and adaptive supply chains, and providing health workers with the skills needed to address climate-sensitive health threats. Crucially, it also requires aligning health policy with broader national adaptation strategies to ensure health is fully integrated into climate planning. Africa’s leadership moment Despite its vulnerability to climate risks, Africa is at the forefront in developing health models that are resilient and responsive in nature. Locally led initiatives are emerging across the continent, from community-based surveillance to climate-informed primary healthcare. These approaches show that adaptation is most effective when context-specific and nationally driven. What is needed is scale, coordination, and political commitment. Climate adaptation must be integrated into health financing systems, regulatory frameworks, and regional collaboration mechanisms. This is not only about protecting populations, but also about safeguarding economic stability, institutional credibility, and long-term development trajectories. Climate change has introduced a new and increasingly fragile context for health service delivery and the process of reframing it as a health systems issue is at a critical juncture. It requires the health leaders to be front and centre in climate decision-making and climate resilience to become a performance indicator for health systems. This will also be a key issue at the upcoming WHS regional meeting hosted by the Aga Khan University in Nairobi from 27-29 April. Framing climate adaptation as a health systems strengthening pillar will help in shifting the discussion from awareness to implementation. Africa’s future depends on shifting from fragmented responses to coherent, self-reliant health systems. Our resilience in this age of disruption will be defined not by what we promise for tomorrow, but by what we do today. Professor Anthony Ngugi is Associate Dean of Research at the Aga Khan University Medical College East Africa, in Kenya and chairperson of the programme committee of the World Health Summit regional meeting. Image Credits: The Salvation Army, Bureau National de Gestion des Risques et des Catastrophes (BNGRC), WHO. Climate Change is Exacerbating Africa’s Health Challenges 19/03/2026 Kerry Cullinan Dr Yap Boum, Africa CDC’s deputy incident manager. Climate change is driving cholera cases in various African countries, particularly in Mozambique, which was hit by two tropical cyclones earlier this year that caused widespread flooding, according to Dr Yap Boum of the Africa Centres for Disease Control and Prevention. Meanwhile, two tropical cyclones in Madagascar resulted in the deaths of 600 people, the displacement of 180,000 others and the destruction of over 120,000 houses. Madagascar is one of the countries worst-affected by cyclones in Africa, and the intensity of these is increasing with climate change. Fourteen African countries have reported cholera outbreaks so far this year, with a total of 23,776 cases – and over 84% of cases are in Mozambique and the Democratic Republic of Congo (DRC). Globally, 59% of cholera cases are in Africa, but 99% of deaths are on the continent, where the case fatality rate is over 2%. The Africa CDC aims to halve this. Southern Africa has been particularly badly affected, with a seven-fold increase in cholera cases in the first six weeks of 2026 in comparison to the same time last year, according to the World Health Organization (WHO) Africa region. This has been driven largely by cases in Mozambique and Angola. Dr Marie Roseline Belizaire, WHO Africa’s emergencies director, told a recent media briefing that “the sharp rise in cholera cases in Southern Africa is a clear reminder of how climate-related shocks are intensifying public health risks”. The cyclone-related floods in Mozambique killed 270 people and displaced over 370,000 others. “This flooding has the impact first on waterborne diseases, including cholera… and also vector-borne diseases, including malaria and dengue, because the flood water provides breeding sites for mosquitoes,” Boum told a media briefing on Thursday. Angola has had two waves of cholera, said Boum. However, 54% of the population lacks access to safe drinking water, and only about 55% have adequate sanitation, he noted. “Although we can manage to stop the [cholera] wave, it will come back until people have proper access to water and sanitation.” There have been new cholera outbreaks in Rwanda and in Zimbabwe, with Zimbabwe recording a 3.2% case fatality rate, the highest rate on the continent. Meanwhile, southern Ethiopia experienced heavy rain last week that resulted in a mudslide and flooding that killed 125 people and displaced at least 10,000 others. Middle East Conflict Set to Drive Up Food and Medicine Costs, Exacerbate Hunger 18/03/2026 Elaine Ruth Fletcher Paul Molinaro, WHO head of logistics, describes short-term and long-term challenges of the war to the movement of medicines, food and fertilizer. Following Iranian missile attacks on Dubai, a major global logistics and humanitarian hub, the World Health Organization is struggling to revive the traffic of medicines and health care supplies in and around the Middle East and African regions most served by the hubs, a WHO official said on Wednesday. “We have managed to do a pharmaceutical shipment to Africa yesterday using commercial air transport, and we have started to receive inbound replenishment through alternative ports,” said Paul Molinaro, head of WHO Operations Support and Logistics, speaking at a WHO briefing on Wednesday. “And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can.” But he warned that the ripple effect of the conflict on Gulf countries like the United Arab Emirates, one of the world’s leading hubs for trade in fertiliser and pharma supplies, is only just beginning to be felt. And beyond the immediate shocks to emergency deliveries of humanitarian relief, the crisis is likely to translate into higher long term prices for fertiliser, foods and pharmaceutical supplies, hitting hard at low and middle-income regions. “When it comes to WHO, I think we’re more like the canary in the coal mine, given the vulnerability and the fragility and the conflict areas that we operate on,” said Molinaro. “And certainly there we start to feel the effects of shortages as a provider of first response, and in many cases, unfortunately, as a provider of last resort.” However, it is the mid- and short-term consequences that he is even more worried about. “The longer this goes on, I think the more we’ll be receiving an education just on how dependent some of our processes are on this part of the world,” he said. World Food Programme warns of growing hunger A UNICEF-supported mobile clinic provides healthcare to people displaced by violence in Darfur, Sudan. Supplies to Africa are now jeopardized by the war in the Middle East. His comments came in the wake of a World Food Programme report Tuesday that warned nearly 45 million more people could fall into acute food insecurity, or worse, if the current Gulf conflict does not end by the middle of the year, and if oil prices remain above $100 a barrel. “These would add to the 318 million people around the world who are already food insecure,” stated the WFP in a press release, warning that the Middle East crisis could push the number of food–insecure people to levels last seen in 2022 at the start of the Ukraine war. When the Ukraine war began, triggering a cost of living crisis, global hunger reached record levels with 349 million people impacted, WFP noted, adding that “during the 2022 period, food prices were fast to spike but slow to come down. This meant that vulnerable families already struggling with hunger were priced out of staple food items almost overnight, and for extended periods of time.” While in 2026, the conflict involves a global energy hub and not a breadbasket region, the potential impact is similar because energy and food markets are tightly correlated, the WFP warned. Fertiliser, food, and pharma trade all impacted Medical supplies being loaded onto a flight from the Dubai Humanitarian logistics hub. Molinaro’s remarks echoed similar concerns. “Something to keep an eye on is phosphates and its input into fertiliser,” he said. “Some countries are 50-60% reliant on products from this region for fertiliser and then, obviously, for medical equipment, plastics. This hasn’t necessarily been felt yet, because, again, that will take time to come through the system. “Another question we’ve been looking at is around vaccines and biologicals,” he added. “It is not necessarily an issue around the production, but certainly the Gulf region and the carriers are critical components of international logistics, particularly in air freight. “We have a lot of life sciences based in the region, and carriers dealing with time-sensitive and temperature-controlled [products].” Logistic pressures will lead to price rises, even if short-term solutions are found World Food Programme delivers meals to displaced families living in a school in in Beirut on 12 March 2026. With the development of alternative logistics routes, WHO’s capacity for delivering urgent humanitarian relief is slowly coming back online, Molinaro said. “We are working with the Dubai humanitarian hub and other partners like WP, UNICEF and the Red Crescent to consolidate our shipments. And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can. “With these kinds of systems, it takes time to reboot and to jump-start the engine, but I’m pretty confident, given the creativity we’ve shown with the humanitarian community and the different organs of the UAE that we will manage to circumvent this in the short term.” But the ongoing war pressures on logistics will inevitably lead to price rises, he warned. “Obviously you have different alternative routings. What happens there is you will get congestion, and you will get price rises,” he said. “Now I’m sure pharmaceutical companies and other medical companies have been doing in the last week or two exactly what our teams have been doing and scrambling to find out what we have at sea, what’s inbound, what our pending orders, and then trying to find solutions to that. “Certainly … wealthier, more developed countries will have a buffer, of course, least developed countries may have issues,” he concluded. Sub-Saharan Africa and Asia most vulnerable According to WFP’s analysis, countries in sub-Saharan Africa and Asia are the most vulnerable due to a reliance on food and fuel imports. Projections indicate an increase of 21% in food-insecure people for West and Central Africa and 17% for East and Southern Africa. An increase of 24% is forecast for Asia. Sudan, for example, imports around 80% of its wheat, a higher price for this staple will push more families into hunger. In Somalia, a country in the midst of severe drought, the price of some essential commodities has risen by at least 20 percent since the conflict began, according to local reports. Both are countries with high levels of food insecurity that have also experienced famine in recent years. “If this conflict continues, it will send shock waves across the globe, and families who already cannot afford their next meal will be hit the hardest,” said WFP Deputy Executive Director and Chief Operating Officer Carl Skau, who met reporters at a UN press briefing in Geneva Tuesday following a recent tour of Lebanon. “Without an adequately funded humanitarian response, it could spell catastrophe for millions already on the edge.” Growing toll of the conflict Displaced people sleep in the coastal area of Ain El Mreisseh in Beirut on 11 March 2026. In the third week of the war that began with a joint US-Israeli attack on Iran’s Islamic regime, killing the longtime Supreme Leader Ayatollah Ali Khameini, more than 1,400 civilian deaths have been reported by Iran’s government, almost 900 in Lebanon and 21 in Israel. Wednesday night, three West Bank Palestinian women were killed and 13 others wounded when an Iranian missile hit a beauty salon near the city of Hebron, busy with clients ahead of the Eid al-Fitr holiday, according to the Red Crescent and media reports. Thousands of people have also been injured across the region. Up to 3.2 million Iranians have been displaced and over 1 million people in Lebanon, according to WHO. Tens of thousands of Israelis, mainly living along the northern border with Lebanon, have also left their homes since the Lebanese Hezbollah militia, an Iranian proxy, joined in the hostilities on 2 March. Displaced Lebanese are living in overcrowded conditions in shelters, while millions of Israelis are spending hours everyday camped in parking garages, safe rooms and underground shelters to protect themselves from the more than 1,000 Iranian missiles and Hezbollah rockets fired since the war began. Israelis in Tel Aviv head to an underground parking garage Wednesday evening in response to the fifth missile alert of the last 24 hours. Crowding associated with displacement has the potential to rapidly increase health risks, WHO said. And in Syria, more than 100,000 people have recently arrived from Lebanon, a striking reverse migration after years of Syrian civil war. In Lebanon, WHO has verified 28 attacks, with 30 deaths and 25 injuries. In Iran, WHO has verified 20 attacks, with nine deaths. And in Israel, WHO has verified two attacks on health care. WHO denied, however, reports that East Jerusalem’s Al Makassad Hospital, the leading referral hospital for the Occupied West Bank had been put out of operations following a missile strike near the facility on 1 March. View this post on Instagram A post shared by Bassem Eid (@realbassemeid) Responding to a question from Health Policy Watch, a WHO spokesperson said, “According to Al-Makassed Hospital, fragments landed near the hospital and not within the premises. The incident caused fear and anxiety among staff and patients. The hospital remains fully operational, functioning at full capacity, and services have not been disrupted.” Image Credits: World Food Programme , Mohammed Jamal / UNICEF, N12 TV. Pressure Builds as Pandemic Agreement Talks Reach Final Week With Little Consensus 18/03/2026 Kerry Cullinan A previous meeting of the Intergovernmental Working Group (IGWG) that is negotiating a pathogen access and benefit-sharing (PABS) system. There are only six negotiating days left to nail down the final piece of the Pandemic Agreement, but huge areas of disagreements still exist between World Health Organization (WHO) member states. The talks, which start on Monday, are set to go until 11pm each night at the WHO headquarters in Geneva – but this may not be enough time to bridge the significant differences between member states on what the Pathogen Access and Benefit Sharing (PABS) system should look like. The PABS system is the crucial operational annex to the Pandemic Agreement adopted by the World Health Assembly (WHA) last May, and is supposed to be adopted by this May’s WHA. “Of course, there are differences between member states, but I can also see that they are closing the gaps. And we believe there will be landing zones on areas where there are still differences,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “I’m confident that the PABS could be agreed, and the agreement on PABS will also help us to start the ratification process of the pandemic agreement that was approved by the member states last May,” Tedros added. However, the latest PABS Annex text released by the Intergovernmental Working Group (IGWG) Bureau on 9 March, shows that there is little agreement so far. (Greened text shows agreement, while yellow shows significant consensus). Balancing sharing and benefiting The crux of the PABS system rests on how countries share data about pathogens with pandemic potential, the obligations on parties (including pharmaceutical manufacturers) that get access to this information, and how those who share their data benefit from any vaccines, diagnostics and therapeutics (VDTs) that are developed as a result. Aggrey Aluso, executive director of the Resilience Action Network Africa (RANA), said the world needs a legally binding PABS agreement and the “highest level of political accountability”. Without this, Aluso advocated for missing the May World Health Assemby deadline and “[taking] more time to get something that will really be transformative”. Aluso was addressing a media briefing in Brussels on Wednesday, hosted by the AIDS Healthcare Foundation (AHF) shortly after it had held a protest at the European Parliament to demand that the European nations ratify a PABS system that ensures equitable access to medicines and vaccines during health emergencies. AHF Europe head Daniel Reijer called on European countries to support a legally binding PABS system that “guarantees fair and timely access to vaccines, tests and treatments for all countries, and not only after a pandemic is officially declared, but during health emergencies as they are unfolding”. Several powerful European countries, particularly Germany and Switzerland, have advocated for voluntary sharing of any VDTs. Protecting their powerful pharmaceutical industries, they have argued that the compulsory sharing of VDTs will stifle innovation and impinge on intellectual property rights. AIDS Healthcare Foundation Europe head Daniel Reijer New obligations in latest PABS draft The latest PABS draft sets several obligations for member states sharing pathogens. PABS materials “shall” be shared “as soon as available, on a priority basis”, with one or more of the WHO Coordinated Lab Network (WCLN) laboratories of their choice. This includes uploading the pathogen sequencing information. However, while pathogen sharing is mandatory and speedy, the draft adopts less prescriptive approach to benefit-sharing – the stickiest aspect of the entire talks. Pharmaceutical manufacturers who participate in PABS are expected to donate at least 10& of their VDTs to the WHO and a further 10% “at an affordable price”. During the less serious public health emergency of international concern (PHEIC) – such as the recent mpox outbreak – manufacturers are to “implement benefit-sharing provisions, including options” regarding access to VDTs. Participating manufacturers are expected to pay an annual fee to be part of PABS. They are also expected to commit to at least two out of five options, namely: capacity-building and technical assistance; research and development cooperation;. facilitating rapid access to VDTs for public health risks; granting non-exclusive licenses to manufacturers in developing countries to produce VDTs; and finally, “other forms of technology transfer as mutually agreed”. Several other loose ends remain. African countries and the Group for Equity, a large alliance of countries from different regions, want contracts with manufacturers to be included as part of PABS – something opposed by Europe. Legally binding – or bust The Zimbabwean delegate at the WHO Intergovernmental Working Group (IGWG). Meanwhile, at the last meeting of the IGWG, the Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions all stated that they wanted a legally binding PABS system – or bust. “PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population. Zimbabwe, speaking for the Africa Group, said: “Equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.” Meanwhile, The Elders – an association of former world leaders – have urged member states to deliver a PABS Annex that is “equitable and operational from day one”. “Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. “Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation.” The Elders also called on member states to “include additional negotiating days if needed to reach consensus by the current deadline”. Running alongside the PABS negotiations, the United States is pursuing bilateral agreements with developing countries that make its health aid contingent on recipient countries agreeing to provide the US with rapid access to information about dangerous pathogens. To date, the US has signed 24 bilateral health agreements in terms of the Trump administration’s America First Global Health Strategy – their somewhat chaotic alternative challenge to the Pandemic Agreement. As further impetus for the PABS talks to succeed, The Elders called for “The multilateral architecture for pandemic preparedness and response” to be “protected as a collective endeavour”. They noted: “Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.” Progress Reducing Early Childhood Mortality Has Slowed Sharply Since 2015 18/03/2026 Elaine Ruth Fletcher Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing. Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa. The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday. Progress in reducing childhood mortality has slowed by 60% since 2015. The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. Children in fragile states and conflict zones face outsized risks of death. Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery. Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found. Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. Diarrhoeal and pneumonia remain big killers despite sharp declines Cause specific early childhood mortality declines. Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions. Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%) – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment. Child deaths heavily concentrated in a small number of regions Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme. In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. That, as compared to representing 38% of those deaths in the year 2000. Early childhood deaths are now heavily concentrated in Sub Saharan Africa. Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. “These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. Progress in even the poorest states — with political will Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps regulate the baby’s temperature and improve breathing. Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. “For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. “Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.” “One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding: “WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” Image Credits: UNICEF/FrankDejongh, WHO , UNICEF . WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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Climate Change is Exacerbating Africa’s Health Challenges 19/03/2026 Kerry Cullinan Dr Yap Boum, Africa CDC’s deputy incident manager. Climate change is driving cholera cases in various African countries, particularly in Mozambique, which was hit by two tropical cyclones earlier this year that caused widespread flooding, according to Dr Yap Boum of the Africa Centres for Disease Control and Prevention. Meanwhile, two tropical cyclones in Madagascar resulted in the deaths of 600 people, the displacement of 180,000 others and the destruction of over 120,000 houses. Madagascar is one of the countries worst-affected by cyclones in Africa, and the intensity of these is increasing with climate change. Fourteen African countries have reported cholera outbreaks so far this year, with a total of 23,776 cases – and over 84% of cases are in Mozambique and the Democratic Republic of Congo (DRC). Globally, 59% of cholera cases are in Africa, but 99% of deaths are on the continent, where the case fatality rate is over 2%. The Africa CDC aims to halve this. Southern Africa has been particularly badly affected, with a seven-fold increase in cholera cases in the first six weeks of 2026 in comparison to the same time last year, according to the World Health Organization (WHO) Africa region. This has been driven largely by cases in Mozambique and Angola. Dr Marie Roseline Belizaire, WHO Africa’s emergencies director, told a recent media briefing that “the sharp rise in cholera cases in Southern Africa is a clear reminder of how climate-related shocks are intensifying public health risks”. The cyclone-related floods in Mozambique killed 270 people and displaced over 370,000 others. “This flooding has the impact first on waterborne diseases, including cholera… and also vector-borne diseases, including malaria and dengue, because the flood water provides breeding sites for mosquitoes,” Boum told a media briefing on Thursday. Angola has had two waves of cholera, said Boum. However, 54% of the population lacks access to safe drinking water, and only about 55% have adequate sanitation, he noted. “Although we can manage to stop the [cholera] wave, it will come back until people have proper access to water and sanitation.” There have been new cholera outbreaks in Rwanda and in Zimbabwe, with Zimbabwe recording a 3.2% case fatality rate, the highest rate on the continent. Meanwhile, southern Ethiopia experienced heavy rain last week that resulted in a mudslide and flooding that killed 125 people and displaced at least 10,000 others. Middle East Conflict Set to Drive Up Food and Medicine Costs, Exacerbate Hunger 18/03/2026 Elaine Ruth Fletcher Paul Molinaro, WHO head of logistics, describes short-term and long-term challenges of the war to the movement of medicines, food and fertilizer. Following Iranian missile attacks on Dubai, a major global logistics and humanitarian hub, the World Health Organization is struggling to revive the traffic of medicines and health care supplies in and around the Middle East and African regions most served by the hubs, a WHO official said on Wednesday. “We have managed to do a pharmaceutical shipment to Africa yesterday using commercial air transport, and we have started to receive inbound replenishment through alternative ports,” said Paul Molinaro, head of WHO Operations Support and Logistics, speaking at a WHO briefing on Wednesday. “And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can.” But he warned that the ripple effect of the conflict on Gulf countries like the United Arab Emirates, one of the world’s leading hubs for trade in fertiliser and pharma supplies, is only just beginning to be felt. And beyond the immediate shocks to emergency deliveries of humanitarian relief, the crisis is likely to translate into higher long term prices for fertiliser, foods and pharmaceutical supplies, hitting hard at low and middle-income regions. “When it comes to WHO, I think we’re more like the canary in the coal mine, given the vulnerability and the fragility and the conflict areas that we operate on,” said Molinaro. “And certainly there we start to feel the effects of shortages as a provider of first response, and in many cases, unfortunately, as a provider of last resort.” However, it is the mid- and short-term consequences that he is even more worried about. “The longer this goes on, I think the more we’ll be receiving an education just on how dependent some of our processes are on this part of the world,” he said. World Food Programme warns of growing hunger A UNICEF-supported mobile clinic provides healthcare to people displaced by violence in Darfur, Sudan. Supplies to Africa are now jeopardized by the war in the Middle East. His comments came in the wake of a World Food Programme report Tuesday that warned nearly 45 million more people could fall into acute food insecurity, or worse, if the current Gulf conflict does not end by the middle of the year, and if oil prices remain above $100 a barrel. “These would add to the 318 million people around the world who are already food insecure,” stated the WFP in a press release, warning that the Middle East crisis could push the number of food–insecure people to levels last seen in 2022 at the start of the Ukraine war. When the Ukraine war began, triggering a cost of living crisis, global hunger reached record levels with 349 million people impacted, WFP noted, adding that “during the 2022 period, food prices were fast to spike but slow to come down. This meant that vulnerable families already struggling with hunger were priced out of staple food items almost overnight, and for extended periods of time.” While in 2026, the conflict involves a global energy hub and not a breadbasket region, the potential impact is similar because energy and food markets are tightly correlated, the WFP warned. Fertiliser, food, and pharma trade all impacted Medical supplies being loaded onto a flight from the Dubai Humanitarian logistics hub. Molinaro’s remarks echoed similar concerns. “Something to keep an eye on is phosphates and its input into fertiliser,” he said. “Some countries are 50-60% reliant on products from this region for fertiliser and then, obviously, for medical equipment, plastics. This hasn’t necessarily been felt yet, because, again, that will take time to come through the system. “Another question we’ve been looking at is around vaccines and biologicals,” he added. “It is not necessarily an issue around the production, but certainly the Gulf region and the carriers are critical components of international logistics, particularly in air freight. “We have a lot of life sciences based in the region, and carriers dealing with time-sensitive and temperature-controlled [products].” Logistic pressures will lead to price rises, even if short-term solutions are found World Food Programme delivers meals to displaced families living in a school in in Beirut on 12 March 2026. With the development of alternative logistics routes, WHO’s capacity for delivering urgent humanitarian relief is slowly coming back online, Molinaro said. “We are working with the Dubai humanitarian hub and other partners like WP, UNICEF and the Red Crescent to consolidate our shipments. And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can. “With these kinds of systems, it takes time to reboot and to jump-start the engine, but I’m pretty confident, given the creativity we’ve shown with the humanitarian community and the different organs of the UAE that we will manage to circumvent this in the short term.” But the ongoing war pressures on logistics will inevitably lead to price rises, he warned. “Obviously you have different alternative routings. What happens there is you will get congestion, and you will get price rises,” he said. “Now I’m sure pharmaceutical companies and other medical companies have been doing in the last week or two exactly what our teams have been doing and scrambling to find out what we have at sea, what’s inbound, what our pending orders, and then trying to find solutions to that. “Certainly … wealthier, more developed countries will have a buffer, of course, least developed countries may have issues,” he concluded. Sub-Saharan Africa and Asia most vulnerable According to WFP’s analysis, countries in sub-Saharan Africa and Asia are the most vulnerable due to a reliance on food and fuel imports. Projections indicate an increase of 21% in food-insecure people for West and Central Africa and 17% for East and Southern Africa. An increase of 24% is forecast for Asia. Sudan, for example, imports around 80% of its wheat, a higher price for this staple will push more families into hunger. In Somalia, a country in the midst of severe drought, the price of some essential commodities has risen by at least 20 percent since the conflict began, according to local reports. Both are countries with high levels of food insecurity that have also experienced famine in recent years. “If this conflict continues, it will send shock waves across the globe, and families who already cannot afford their next meal will be hit the hardest,” said WFP Deputy Executive Director and Chief Operating Officer Carl Skau, who met reporters at a UN press briefing in Geneva Tuesday following a recent tour of Lebanon. “Without an adequately funded humanitarian response, it could spell catastrophe for millions already on the edge.” Growing toll of the conflict Displaced people sleep in the coastal area of Ain El Mreisseh in Beirut on 11 March 2026. In the third week of the war that began with a joint US-Israeli attack on Iran’s Islamic regime, killing the longtime Supreme Leader Ayatollah Ali Khameini, more than 1,400 civilian deaths have been reported by Iran’s government, almost 900 in Lebanon and 21 in Israel. Wednesday night, three West Bank Palestinian women were killed and 13 others wounded when an Iranian missile hit a beauty salon near the city of Hebron, busy with clients ahead of the Eid al-Fitr holiday, according to the Red Crescent and media reports. Thousands of people have also been injured across the region. Up to 3.2 million Iranians have been displaced and over 1 million people in Lebanon, according to WHO. Tens of thousands of Israelis, mainly living along the northern border with Lebanon, have also left their homes since the Lebanese Hezbollah militia, an Iranian proxy, joined in the hostilities on 2 March. Displaced Lebanese are living in overcrowded conditions in shelters, while millions of Israelis are spending hours everyday camped in parking garages, safe rooms and underground shelters to protect themselves from the more than 1,000 Iranian missiles and Hezbollah rockets fired since the war began. Israelis in Tel Aviv head to an underground parking garage Wednesday evening in response to the fifth missile alert of the last 24 hours. Crowding associated with displacement has the potential to rapidly increase health risks, WHO said. And in Syria, more than 100,000 people have recently arrived from Lebanon, a striking reverse migration after years of Syrian civil war. In Lebanon, WHO has verified 28 attacks, with 30 deaths and 25 injuries. In Iran, WHO has verified 20 attacks, with nine deaths. And in Israel, WHO has verified two attacks on health care. WHO denied, however, reports that East Jerusalem’s Al Makassad Hospital, the leading referral hospital for the Occupied West Bank had been put out of operations following a missile strike near the facility on 1 March. View this post on Instagram A post shared by Bassem Eid (@realbassemeid) Responding to a question from Health Policy Watch, a WHO spokesperson said, “According to Al-Makassed Hospital, fragments landed near the hospital and not within the premises. The incident caused fear and anxiety among staff and patients. The hospital remains fully operational, functioning at full capacity, and services have not been disrupted.” Image Credits: World Food Programme , Mohammed Jamal / UNICEF, N12 TV. Pressure Builds as Pandemic Agreement Talks Reach Final Week With Little Consensus 18/03/2026 Kerry Cullinan A previous meeting of the Intergovernmental Working Group (IGWG) that is negotiating a pathogen access and benefit-sharing (PABS) system. There are only six negotiating days left to nail down the final piece of the Pandemic Agreement, but huge areas of disagreements still exist between World Health Organization (WHO) member states. The talks, which start on Monday, are set to go until 11pm each night at the WHO headquarters in Geneva – but this may not be enough time to bridge the significant differences between member states on what the Pathogen Access and Benefit Sharing (PABS) system should look like. The PABS system is the crucial operational annex to the Pandemic Agreement adopted by the World Health Assembly (WHA) last May, and is supposed to be adopted by this May’s WHA. “Of course, there are differences between member states, but I can also see that they are closing the gaps. And we believe there will be landing zones on areas where there are still differences,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “I’m confident that the PABS could be agreed, and the agreement on PABS will also help us to start the ratification process of the pandemic agreement that was approved by the member states last May,” Tedros added. However, the latest PABS Annex text released by the Intergovernmental Working Group (IGWG) Bureau on 9 March, shows that there is little agreement so far. (Greened text shows agreement, while yellow shows significant consensus). Balancing sharing and benefiting The crux of the PABS system rests on how countries share data about pathogens with pandemic potential, the obligations on parties (including pharmaceutical manufacturers) that get access to this information, and how those who share their data benefit from any vaccines, diagnostics and therapeutics (VDTs) that are developed as a result. Aggrey Aluso, executive director of the Resilience Action Network Africa (RANA), said the world needs a legally binding PABS agreement and the “highest level of political accountability”. Without this, Aluso advocated for missing the May World Health Assemby deadline and “[taking] more time to get something that will really be transformative”. Aluso was addressing a media briefing in Brussels on Wednesday, hosted by the AIDS Healthcare Foundation (AHF) shortly after it had held a protest at the European Parliament to demand that the European nations ratify a PABS system that ensures equitable access to medicines and vaccines during health emergencies. AHF Europe head Daniel Reijer called on European countries to support a legally binding PABS system that “guarantees fair and timely access to vaccines, tests and treatments for all countries, and not only after a pandemic is officially declared, but during health emergencies as they are unfolding”. Several powerful European countries, particularly Germany and Switzerland, have advocated for voluntary sharing of any VDTs. Protecting their powerful pharmaceutical industries, they have argued that the compulsory sharing of VDTs will stifle innovation and impinge on intellectual property rights. AIDS Healthcare Foundation Europe head Daniel Reijer New obligations in latest PABS draft The latest PABS draft sets several obligations for member states sharing pathogens. PABS materials “shall” be shared “as soon as available, on a priority basis”, with one or more of the WHO Coordinated Lab Network (WCLN) laboratories of their choice. This includes uploading the pathogen sequencing information. However, while pathogen sharing is mandatory and speedy, the draft adopts less prescriptive approach to benefit-sharing – the stickiest aspect of the entire talks. Pharmaceutical manufacturers who participate in PABS are expected to donate at least 10& of their VDTs to the WHO and a further 10% “at an affordable price”. During the less serious public health emergency of international concern (PHEIC) – such as the recent mpox outbreak – manufacturers are to “implement benefit-sharing provisions, including options” regarding access to VDTs. Participating manufacturers are expected to pay an annual fee to be part of PABS. They are also expected to commit to at least two out of five options, namely: capacity-building and technical assistance; research and development cooperation;. facilitating rapid access to VDTs for public health risks; granting non-exclusive licenses to manufacturers in developing countries to produce VDTs; and finally, “other forms of technology transfer as mutually agreed”. Several other loose ends remain. African countries and the Group for Equity, a large alliance of countries from different regions, want contracts with manufacturers to be included as part of PABS – something opposed by Europe. Legally binding – or bust The Zimbabwean delegate at the WHO Intergovernmental Working Group (IGWG). Meanwhile, at the last meeting of the IGWG, the Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions all stated that they wanted a legally binding PABS system – or bust. “PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population. Zimbabwe, speaking for the Africa Group, said: “Equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.” Meanwhile, The Elders – an association of former world leaders – have urged member states to deliver a PABS Annex that is “equitable and operational from day one”. “Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. “Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation.” The Elders also called on member states to “include additional negotiating days if needed to reach consensus by the current deadline”. Running alongside the PABS negotiations, the United States is pursuing bilateral agreements with developing countries that make its health aid contingent on recipient countries agreeing to provide the US with rapid access to information about dangerous pathogens. To date, the US has signed 24 bilateral health agreements in terms of the Trump administration’s America First Global Health Strategy – their somewhat chaotic alternative challenge to the Pandemic Agreement. As further impetus for the PABS talks to succeed, The Elders called for “The multilateral architecture for pandemic preparedness and response” to be “protected as a collective endeavour”. They noted: “Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.” Progress Reducing Early Childhood Mortality Has Slowed Sharply Since 2015 18/03/2026 Elaine Ruth Fletcher Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing. Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa. The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday. Progress in reducing childhood mortality has slowed by 60% since 2015. The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. Children in fragile states and conflict zones face outsized risks of death. Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery. Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found. Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. Diarrhoeal and pneumonia remain big killers despite sharp declines Cause specific early childhood mortality declines. Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions. Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%) – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment. Child deaths heavily concentrated in a small number of regions Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme. In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. That, as compared to representing 38% of those deaths in the year 2000. Early childhood deaths are now heavily concentrated in Sub Saharan Africa. Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. “These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. Progress in even the poorest states — with political will Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps regulate the baby’s temperature and improve breathing. Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. “For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. “Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.” “One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding: “WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” Image Credits: UNICEF/FrankDejongh, WHO , UNICEF . WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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Middle East Conflict Set to Drive Up Food and Medicine Costs, Exacerbate Hunger 18/03/2026 Elaine Ruth Fletcher Paul Molinaro, WHO head of logistics, describes short-term and long-term challenges of the war to the movement of medicines, food and fertilizer. Following Iranian missile attacks on Dubai, a major global logistics and humanitarian hub, the World Health Organization is struggling to revive the traffic of medicines and health care supplies in and around the Middle East and African regions most served by the hubs, a WHO official said on Wednesday. “We have managed to do a pharmaceutical shipment to Africa yesterday using commercial air transport, and we have started to receive inbound replenishment through alternative ports,” said Paul Molinaro, head of WHO Operations Support and Logistics, speaking at a WHO briefing on Wednesday. “And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can.” But he warned that the ripple effect of the conflict on Gulf countries like the United Arab Emirates, one of the world’s leading hubs for trade in fertiliser and pharma supplies, is only just beginning to be felt. And beyond the immediate shocks to emergency deliveries of humanitarian relief, the crisis is likely to translate into higher long term prices for fertiliser, foods and pharmaceutical supplies, hitting hard at low and middle-income regions. “When it comes to WHO, I think we’re more like the canary in the coal mine, given the vulnerability and the fragility and the conflict areas that we operate on,” said Molinaro. “And certainly there we start to feel the effects of shortages as a provider of first response, and in many cases, unfortunately, as a provider of last resort.” However, it is the mid- and short-term consequences that he is even more worried about. “The longer this goes on, I think the more we’ll be receiving an education just on how dependent some of our processes are on this part of the world,” he said. World Food Programme warns of growing hunger A UNICEF-supported mobile clinic provides healthcare to people displaced by violence in Darfur, Sudan. Supplies to Africa are now jeopardized by the war in the Middle East. His comments came in the wake of a World Food Programme report Tuesday that warned nearly 45 million more people could fall into acute food insecurity, or worse, if the current Gulf conflict does not end by the middle of the year, and if oil prices remain above $100 a barrel. “These would add to the 318 million people around the world who are already food insecure,” stated the WFP in a press release, warning that the Middle East crisis could push the number of food–insecure people to levels last seen in 2022 at the start of the Ukraine war. When the Ukraine war began, triggering a cost of living crisis, global hunger reached record levels with 349 million people impacted, WFP noted, adding that “during the 2022 period, food prices were fast to spike but slow to come down. This meant that vulnerable families already struggling with hunger were priced out of staple food items almost overnight, and for extended periods of time.” While in 2026, the conflict involves a global energy hub and not a breadbasket region, the potential impact is similar because energy and food markets are tightly correlated, the WFP warned. Fertiliser, food, and pharma trade all impacted Medical supplies being loaded onto a flight from the Dubai Humanitarian logistics hub. Molinaro’s remarks echoed similar concerns. “Something to keep an eye on is phosphates and its input into fertiliser,” he said. “Some countries are 50-60% reliant on products from this region for fertiliser and then, obviously, for medical equipment, plastics. This hasn’t necessarily been felt yet, because, again, that will take time to come through the system. “Another question we’ve been looking at is around vaccines and biologicals,” he added. “It is not necessarily an issue around the production, but certainly the Gulf region and the carriers are critical components of international logistics, particularly in air freight. “We have a lot of life sciences based in the region, and carriers dealing with time-sensitive and temperature-controlled [products].” Logistic pressures will lead to price rises, even if short-term solutions are found World Food Programme delivers meals to displaced families living in a school in in Beirut on 12 March 2026. With the development of alternative logistics routes, WHO’s capacity for delivering urgent humanitarian relief is slowly coming back online, Molinaro said. “We are working with the Dubai humanitarian hub and other partners like WP, UNICEF and the Red Crescent to consolidate our shipments. And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can. “With these kinds of systems, it takes time to reboot and to jump-start the engine, but I’m pretty confident, given the creativity we’ve shown with the humanitarian community and the different organs of the UAE that we will manage to circumvent this in the short term.” But the ongoing war pressures on logistics will inevitably lead to price rises, he warned. “Obviously you have different alternative routings. What happens there is you will get congestion, and you will get price rises,” he said. “Now I’m sure pharmaceutical companies and other medical companies have been doing in the last week or two exactly what our teams have been doing and scrambling to find out what we have at sea, what’s inbound, what our pending orders, and then trying to find solutions to that. “Certainly … wealthier, more developed countries will have a buffer, of course, least developed countries may have issues,” he concluded. Sub-Saharan Africa and Asia most vulnerable According to WFP’s analysis, countries in sub-Saharan Africa and Asia are the most vulnerable due to a reliance on food and fuel imports. Projections indicate an increase of 21% in food-insecure people for West and Central Africa and 17% for East and Southern Africa. An increase of 24% is forecast for Asia. Sudan, for example, imports around 80% of its wheat, a higher price for this staple will push more families into hunger. In Somalia, a country in the midst of severe drought, the price of some essential commodities has risen by at least 20 percent since the conflict began, according to local reports. Both are countries with high levels of food insecurity that have also experienced famine in recent years. “If this conflict continues, it will send shock waves across the globe, and families who already cannot afford their next meal will be hit the hardest,” said WFP Deputy Executive Director and Chief Operating Officer Carl Skau, who met reporters at a UN press briefing in Geneva Tuesday following a recent tour of Lebanon. “Without an adequately funded humanitarian response, it could spell catastrophe for millions already on the edge.” Growing toll of the conflict Displaced people sleep in the coastal area of Ain El Mreisseh in Beirut on 11 March 2026. In the third week of the war that began with a joint US-Israeli attack on Iran’s Islamic regime, killing the longtime Supreme Leader Ayatollah Ali Khameini, more than 1,400 civilian deaths have been reported by Iran’s government, almost 900 in Lebanon and 21 in Israel. Wednesday night, three West Bank Palestinian women were killed and 13 others wounded when an Iranian missile hit a beauty salon near the city of Hebron, busy with clients ahead of the Eid al-Fitr holiday, according to the Red Crescent and media reports. Thousands of people have also been injured across the region. Up to 3.2 million Iranians have been displaced and over 1 million people in Lebanon, according to WHO. Tens of thousands of Israelis, mainly living along the northern border with Lebanon, have also left their homes since the Lebanese Hezbollah militia, an Iranian proxy, joined in the hostilities on 2 March. Displaced Lebanese are living in overcrowded conditions in shelters, while millions of Israelis are spending hours everyday camped in parking garages, safe rooms and underground shelters to protect themselves from the more than 1,000 Iranian missiles and Hezbollah rockets fired since the war began. Israelis in Tel Aviv head to an underground parking garage Wednesday evening in response to the fifth missile alert of the last 24 hours. Crowding associated with displacement has the potential to rapidly increase health risks, WHO said. And in Syria, more than 100,000 people have recently arrived from Lebanon, a striking reverse migration after years of Syrian civil war. In Lebanon, WHO has verified 28 attacks, with 30 deaths and 25 injuries. In Iran, WHO has verified 20 attacks, with nine deaths. And in Israel, WHO has verified two attacks on health care. WHO denied, however, reports that East Jerusalem’s Al Makassad Hospital, the leading referral hospital for the Occupied West Bank had been put out of operations following a missile strike near the facility on 1 March. View this post on Instagram A post shared by Bassem Eid (@realbassemeid) Responding to a question from Health Policy Watch, a WHO spokesperson said, “According to Al-Makassed Hospital, fragments landed near the hospital and not within the premises. The incident caused fear and anxiety among staff and patients. The hospital remains fully operational, functioning at full capacity, and services have not been disrupted.” Image Credits: World Food Programme , Mohammed Jamal / UNICEF, N12 TV. Pressure Builds as Pandemic Agreement Talks Reach Final Week With Little Consensus 18/03/2026 Kerry Cullinan A previous meeting of the Intergovernmental Working Group (IGWG) that is negotiating a pathogen access and benefit-sharing (PABS) system. There are only six negotiating days left to nail down the final piece of the Pandemic Agreement, but huge areas of disagreements still exist between World Health Organization (WHO) member states. The talks, which start on Monday, are set to go until 11pm each night at the WHO headquarters in Geneva – but this may not be enough time to bridge the significant differences between member states on what the Pathogen Access and Benefit Sharing (PABS) system should look like. The PABS system is the crucial operational annex to the Pandemic Agreement adopted by the World Health Assembly (WHA) last May, and is supposed to be adopted by this May’s WHA. “Of course, there are differences between member states, but I can also see that they are closing the gaps. And we believe there will be landing zones on areas where there are still differences,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “I’m confident that the PABS could be agreed, and the agreement on PABS will also help us to start the ratification process of the pandemic agreement that was approved by the member states last May,” Tedros added. However, the latest PABS Annex text released by the Intergovernmental Working Group (IGWG) Bureau on 9 March, shows that there is little agreement so far. (Greened text shows agreement, while yellow shows significant consensus). Balancing sharing and benefiting The crux of the PABS system rests on how countries share data about pathogens with pandemic potential, the obligations on parties (including pharmaceutical manufacturers) that get access to this information, and how those who share their data benefit from any vaccines, diagnostics and therapeutics (VDTs) that are developed as a result. Aggrey Aluso, executive director of the Resilience Action Network Africa (RANA), said the world needs a legally binding PABS agreement and the “highest level of political accountability”. Without this, Aluso advocated for missing the May World Health Assemby deadline and “[taking] more time to get something that will really be transformative”. Aluso was addressing a media briefing in Brussels on Wednesday, hosted by the AIDS Healthcare Foundation (AHF) shortly after it had held a protest at the European Parliament to demand that the European nations ratify a PABS system that ensures equitable access to medicines and vaccines during health emergencies. AHF Europe head Daniel Reijer called on European countries to support a legally binding PABS system that “guarantees fair and timely access to vaccines, tests and treatments for all countries, and not only after a pandemic is officially declared, but during health emergencies as they are unfolding”. Several powerful European countries, particularly Germany and Switzerland, have advocated for voluntary sharing of any VDTs. Protecting their powerful pharmaceutical industries, they have argued that the compulsory sharing of VDTs will stifle innovation and impinge on intellectual property rights. AIDS Healthcare Foundation Europe head Daniel Reijer New obligations in latest PABS draft The latest PABS draft sets several obligations for member states sharing pathogens. PABS materials “shall” be shared “as soon as available, on a priority basis”, with one or more of the WHO Coordinated Lab Network (WCLN) laboratories of their choice. This includes uploading the pathogen sequencing information. However, while pathogen sharing is mandatory and speedy, the draft adopts less prescriptive approach to benefit-sharing – the stickiest aspect of the entire talks. Pharmaceutical manufacturers who participate in PABS are expected to donate at least 10& of their VDTs to the WHO and a further 10% “at an affordable price”. During the less serious public health emergency of international concern (PHEIC) – such as the recent mpox outbreak – manufacturers are to “implement benefit-sharing provisions, including options” regarding access to VDTs. Participating manufacturers are expected to pay an annual fee to be part of PABS. They are also expected to commit to at least two out of five options, namely: capacity-building and technical assistance; research and development cooperation;. facilitating rapid access to VDTs for public health risks; granting non-exclusive licenses to manufacturers in developing countries to produce VDTs; and finally, “other forms of technology transfer as mutually agreed”. Several other loose ends remain. African countries and the Group for Equity, a large alliance of countries from different regions, want contracts with manufacturers to be included as part of PABS – something opposed by Europe. Legally binding – or bust The Zimbabwean delegate at the WHO Intergovernmental Working Group (IGWG). Meanwhile, at the last meeting of the IGWG, the Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions all stated that they wanted a legally binding PABS system – or bust. “PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population. Zimbabwe, speaking for the Africa Group, said: “Equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.” Meanwhile, The Elders – an association of former world leaders – have urged member states to deliver a PABS Annex that is “equitable and operational from day one”. “Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. “Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation.” The Elders also called on member states to “include additional negotiating days if needed to reach consensus by the current deadline”. Running alongside the PABS negotiations, the United States is pursuing bilateral agreements with developing countries that make its health aid contingent on recipient countries agreeing to provide the US with rapid access to information about dangerous pathogens. To date, the US has signed 24 bilateral health agreements in terms of the Trump administration’s America First Global Health Strategy – their somewhat chaotic alternative challenge to the Pandemic Agreement. As further impetus for the PABS talks to succeed, The Elders called for “The multilateral architecture for pandemic preparedness and response” to be “protected as a collective endeavour”. They noted: “Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.” Progress Reducing Early Childhood Mortality Has Slowed Sharply Since 2015 18/03/2026 Elaine Ruth Fletcher Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing. Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa. The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday. Progress in reducing childhood mortality has slowed by 60% since 2015. The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. Children in fragile states and conflict zones face outsized risks of death. Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery. Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found. Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. Diarrhoeal and pneumonia remain big killers despite sharp declines Cause specific early childhood mortality declines. Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions. Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%) – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment. Child deaths heavily concentrated in a small number of regions Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme. In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. That, as compared to representing 38% of those deaths in the year 2000. Early childhood deaths are now heavily concentrated in Sub Saharan Africa. Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. “These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. Progress in even the poorest states — with political will Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps regulate the baby’s temperature and improve breathing. Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. “For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. “Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.” “One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding: “WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” Image Credits: UNICEF/FrankDejongh, WHO , UNICEF . WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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Pressure Builds as Pandemic Agreement Talks Reach Final Week With Little Consensus 18/03/2026 Kerry Cullinan A previous meeting of the Intergovernmental Working Group (IGWG) that is negotiating a pathogen access and benefit-sharing (PABS) system. There are only six negotiating days left to nail down the final piece of the Pandemic Agreement, but huge areas of disagreements still exist between World Health Organization (WHO) member states. The talks, which start on Monday, are set to go until 11pm each night at the WHO headquarters in Geneva – but this may not be enough time to bridge the significant differences between member states on what the Pathogen Access and Benefit Sharing (PABS) system should look like. The PABS system is the crucial operational annex to the Pandemic Agreement adopted by the World Health Assembly (WHA) last May, and is supposed to be adopted by this May’s WHA. “Of course, there are differences between member states, but I can also see that they are closing the gaps. And we believe there will be landing zones on areas where there are still differences,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday. “I’m confident that the PABS could be agreed, and the agreement on PABS will also help us to start the ratification process of the pandemic agreement that was approved by the member states last May,” Tedros added. However, the latest PABS Annex text released by the Intergovernmental Working Group (IGWG) Bureau on 9 March, shows that there is little agreement so far. (Greened text shows agreement, while yellow shows significant consensus). Balancing sharing and benefiting The crux of the PABS system rests on how countries share data about pathogens with pandemic potential, the obligations on parties (including pharmaceutical manufacturers) that get access to this information, and how those who share their data benefit from any vaccines, diagnostics and therapeutics (VDTs) that are developed as a result. Aggrey Aluso, executive director of the Resilience Action Network Africa (RANA), said the world needs a legally binding PABS agreement and the “highest level of political accountability”. Without this, Aluso advocated for missing the May World Health Assemby deadline and “[taking] more time to get something that will really be transformative”. Aluso was addressing a media briefing in Brussels on Wednesday, hosted by the AIDS Healthcare Foundation (AHF) shortly after it had held a protest at the European Parliament to demand that the European nations ratify a PABS system that ensures equitable access to medicines and vaccines during health emergencies. AHF Europe head Daniel Reijer called on European countries to support a legally binding PABS system that “guarantees fair and timely access to vaccines, tests and treatments for all countries, and not only after a pandemic is officially declared, but during health emergencies as they are unfolding”. Several powerful European countries, particularly Germany and Switzerland, have advocated for voluntary sharing of any VDTs. Protecting their powerful pharmaceutical industries, they have argued that the compulsory sharing of VDTs will stifle innovation and impinge on intellectual property rights. AIDS Healthcare Foundation Europe head Daniel Reijer New obligations in latest PABS draft The latest PABS draft sets several obligations for member states sharing pathogens. PABS materials “shall” be shared “as soon as available, on a priority basis”, with one or more of the WHO Coordinated Lab Network (WCLN) laboratories of their choice. This includes uploading the pathogen sequencing information. However, while pathogen sharing is mandatory and speedy, the draft adopts less prescriptive approach to benefit-sharing – the stickiest aspect of the entire talks. Pharmaceutical manufacturers who participate in PABS are expected to donate at least 10& of their VDTs to the WHO and a further 10% “at an affordable price”. During the less serious public health emergency of international concern (PHEIC) – such as the recent mpox outbreak – manufacturers are to “implement benefit-sharing provisions, including options” regarding access to VDTs. Participating manufacturers are expected to pay an annual fee to be part of PABS. They are also expected to commit to at least two out of five options, namely: capacity-building and technical assistance; research and development cooperation;. facilitating rapid access to VDTs for public health risks; granting non-exclusive licenses to manufacturers in developing countries to produce VDTs; and finally, “other forms of technology transfer as mutually agreed”. Several other loose ends remain. African countries and the Group for Equity, a large alliance of countries from different regions, want contracts with manufacturers to be included as part of PABS – something opposed by Europe. Legally binding – or bust The Zimbabwean delegate at the WHO Intergovernmental Working Group (IGWG). Meanwhile, at the last meeting of the IGWG, the Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions all stated that they wanted a legally binding PABS system – or bust. “PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population. Zimbabwe, speaking for the Africa Group, said: “Equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.” Meanwhile, The Elders – an association of former world leaders – have urged member states to deliver a PABS Annex that is “equitable and operational from day one”. “Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. “Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation.” The Elders also called on member states to “include additional negotiating days if needed to reach consensus by the current deadline”. Running alongside the PABS negotiations, the United States is pursuing bilateral agreements with developing countries that make its health aid contingent on recipient countries agreeing to provide the US with rapid access to information about dangerous pathogens. To date, the US has signed 24 bilateral health agreements in terms of the Trump administration’s America First Global Health Strategy – their somewhat chaotic alternative challenge to the Pandemic Agreement. As further impetus for the PABS talks to succeed, The Elders called for “The multilateral architecture for pandemic preparedness and response” to be “protected as a collective endeavour”. They noted: “Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.” Progress Reducing Early Childhood Mortality Has Slowed Sharply Since 2015 18/03/2026 Elaine Ruth Fletcher Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing. Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa. The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday. Progress in reducing childhood mortality has slowed by 60% since 2015. The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. Children in fragile states and conflict zones face outsized risks of death. Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery. Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found. Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. Diarrhoeal and pneumonia remain big killers despite sharp declines Cause specific early childhood mortality declines. Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions. Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%) – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment. Child deaths heavily concentrated in a small number of regions Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme. In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. That, as compared to representing 38% of those deaths in the year 2000. Early childhood deaths are now heavily concentrated in Sub Saharan Africa. Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. “These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. Progress in even the poorest states — with political will Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps regulate the baby’s temperature and improve breathing. Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. “For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. “Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.” “One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding: “WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” Image Credits: UNICEF/FrankDejongh, WHO , UNICEF . WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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Progress Reducing Early Childhood Mortality Has Slowed Sharply Since 2015 18/03/2026 Elaine Ruth Fletcher Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing. Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa. The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday. Progress in reducing childhood mortality has slowed by 60% since 2015. The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. Children in fragile states and conflict zones face outsized risks of death. Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery. Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found. Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. Diarrhoeal and pneumonia remain big killers despite sharp declines Cause specific early childhood mortality declines. Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions. Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%) – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment. Child deaths heavily concentrated in a small number of regions Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme. In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. That, as compared to representing 38% of those deaths in the year 2000. Early childhood deaths are now heavily concentrated in Sub Saharan Africa. Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. “These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. Progress in even the poorest states — with political will Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps regulate the baby’s temperature and improve breathing. Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. “For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. “Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.” “One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding: “WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” Image Credits: UNICEF/FrankDejongh, WHO , UNICEF . WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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WHO Expert Group: Step up Typhoid Vaccination in High Risk Regions, Fewer Polio Doses in Low-Risk Areas 18/03/2026 Kerry Cullinan SAGE chairperson Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization. In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk. SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair Professor Anthony Scott. “Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine. “Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two. SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings. SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”. In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott. However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.” COVID-19 vaccines for vulnerable groups Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals. “While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott. SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. SAGE also recommends one dose for pregnant women, ideally during the second trimester. However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission. “To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith. Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary Reduction in polio doses Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. “SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott. Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia. “There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed. But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”. Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says Acute resource reductions O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in national health budgets being reduced. The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said. “The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian. However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases. “This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned. Image Credits: Pakistan Polio Eradication Program . Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. 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Global Health Leaders Warn Trust in Science Is Declining 18/03/2026 Health Policy Watch Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast. Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back. Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content. “The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public. Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts. “If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.” Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines. Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial. For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back. Listen to the full conversation >> Read more about Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Global Health Is Failing on Equity, Warns South African Medical Research Council Chief 18/03/2026 Health Policy Watch Prof Ntobeko Ntusi and Dr Garry Aslanyan South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council. Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa. He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.” Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities. In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage. Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.” He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries. “The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said. For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.” Listen to the full episode >> Read more about Global Health Matters episodes on Health Policy Watch>> Image Credits: Global Health Matters. Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Wellcome Report: Aid Cuts Catalyse Global Health Reform and Regional Cooperation 18/03/2026 Felix Sassmannshausen Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform. Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday. The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation. John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust. “What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026. He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care. The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments. Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed. These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual. The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty. In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas. To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing. Driving global health reform through regional power 114 nations participated in five cross-continental dialogues to outline the global health reforms. As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks. The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines. To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems. In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments. Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals. The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors. Sovereign debt crisis threatens global health reform Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts. The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence. To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care. Global Health Infrastructure is Changing. Why Getting it Right Matters Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%. In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank. Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending. While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands. “Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process. Empowering civil society and regional cooperation The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system. Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements. Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities. “Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report. The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores. To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels. The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch. Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW. US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
US Judge Halts RFK’s Anti-Vaccine Efforts – For Now 17/03/2026 Kerry Cullinan A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule. A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal. US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women. “Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled. Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” The AAP represents over 67,000 paediatricians throughout the US. Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.” Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs. Appointment of ‘vaccine skeptics’ The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.” It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for: the appointment of vaccine skeptics to ACIP after all previous members were fired; votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines; the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine. Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports “The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported. Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”. The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies. ACIP meeting stopped The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether. ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications. However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward. An extract from the Fabrizio Ward poll on vaccines. In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp. “While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes. Image Credits: American Academy of Pediatrics, Fabrizio Ward. Posts navigation Older postsNewer posts