Brazil’s Tropical Forest Protection Fund Launches with $6.6 Billion — Will It Work? 22/11/2025 Stefan Anderson Lula’s flagship scheme has attracted only a quarter of its target funding as Indigenous groups turn from supporters to critics. Brazil’s tropical forest fund aims to be the largest global financial instrument of its kind. But as COP30 enters its final hours, $6.6 billion raised so far falls well short of its $25 billion target. Although that is still considerably more than other climate funding mechanisms, the unique structure of this fund as an interest-generating mechanism makes the target even more important. The Tropical Forest Forever Facility, Brazilian President Luiz Inácio Lula da Silva’s flagship initiative to protect the world’s tropical forests, reached $6.6 billion in pledges as COP30 entered its final hours, with Germany becoming the third nation alongside Brazil and Indonesia to commit $1 billion to the effort. The pledge was a bright moment in a day marked by an impasse over the inclusion of language on fossil fuel transition in the final COP30 agreement – something European Union continued to push for, against stiff opposition from Gulf oil producers and other petrostates, with host country Brazil also reluctant. See related story. Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ Brazil has championed forest fund since Dubai “It is symbolic that the celebration of its birth is taking place here in Belém, surrounded by sumaúmas, açaí palms, andirobas, and jacarandás,” Lula told the COP. “For the first time in history, countries of the Global South will take a leading role in a forest agenda.” The billions raised mark significant progress for the highly technical financing instrument that Lula has championed since COP28 in Dubai, set up to pay tropical forest nations for keeping trees and their surrounding forests standing rather than cutting them down, rewarding conservation with cash instead of traditional grants. But the president’s soaring language masked a fundamental problem: the fund remains well short of the $25 billion target Brazil set for government investments, designed to secure investor confidence and unlock an additional $100 billion in private financing for a total goal of $125 billion. Current funding flows to the Tropical Forest Forever Fund, according to the initiative’s website. Norway is the largest contributor by far, pledging $3 billion over ten years, nearly half the current total. France committed €500 million, while smaller pledges came from Portugal ($1 million) and the Netherlands ($5 million) to assist with technical matters pertaining to the fund’s secretariat. In effect, the entire tranche of start-up funding raised over the course of COP30 comes from just five nations, two of which, Brazil and Indonesia, are set to be major beneficiaries of the fund itself. Notably absent from the investor line-up were major economies that had previously expressed interest in supporting the fund, including China, Saudi Arabia, and the United Kingdom. The United States, viewed as another possible backer under former president Joe Biden, has reversed course under Donald Trump’s administration. UK withdrawal was a last minute blow Britain’s withdrawal came as a last-minute blow to Lula’s flagship project: the UK had been involved in designing the facility and pioneered tropical forest preservation when it hosted COP26 in Glasgow, but declined to invest on the eve of the summit due to a view in Downing Street that the effort remains in “too early a stage” to commit substantial finance, according to reporting by the Guardian. “It is telling—and concerning—that the UK, as one of the world’s richest countries, has not announced an investment to match those from less wealthy countries,” said Tanya Steele, chief executive of WWF-UK. The need for finance to protect the world’s tropical forests from the Amazon to the Congolian rainforests is urgent, despite repeated global pledges to protect them. The 2025 Forest Declaration Assessment shows that deforestation is continuing at crisis levels, with 8.1 million hectares lost in 2024 alone, 63% above the rate needed to meet 2030 targets. “At the halfway point to 2030, the world should be seeing a steep decline in deforestation. Instead, the global deforestation curve has not begun to bend,” the latest assessment found. “Financial flows are still grossly misaligned with forest goals, with harmful subsidies outweighing green subsidies by over 200 to 1.” At least 92 countries in attendance at COP30 back a separate “roadmap” to combat deforestation pushed by Lula, which Brazil had wanted to be one of the key outcomes of the summit – although it was not mentioned in the latest draft outcome text. The roadmap is supported by the EU and the Coalition for Rainforest Nations representing over 50 rainforest countries, more than the 82 nations supporting the parallel fossil fuel phase-out roadmap, according to Carbon Brief. The majority of remaining forests outside that coalition sit in Russia, Canada and the US, none of which support the roadmap in its current state. Despite the uphill battle, Lula has characterised the fund as a centrepiece of Brazil’s climate agenda. “The Tropical Forest Forever Facility will be one of the main tangible outcomes in the spirit of COP30 implementation,” he said. “In just a few years, we will begin to see the fruits of this fund. We will take pride in remembering that it was in the heart of the Amazon rainforest that we took this step together”. From carbon storage to pathogen regulation – high health stakes of forest loss Tropical forests store 15-20 years’ worth of global carbon emissions and represent roughly 30% of the planet’s carbon storage. Scientists warn that cumulative deforestation could trigger a catastrophic tipping point, converting forests to deserts. The health consequences make the degradation even more urgent as forests such as the Amazon as well as central Africa, Indonesia and elsewhere play a critical role for health in weather regulation, water storage and plant biodiversity. Sixty percent of emerging infectious diseases originate in wildlife, with nearly one-third of outbreaks linked to habitat destruction. In 1997, Indonesian forest fires drove fruit bats carrying Nipah virus into populated areas. 265 people were infected, 105 died. In 2013, a West African boy playing near a tree infested with bats displaced by deforestation became the index case for an Ebola outbreak that killed 11,000. Surveillance in deforested Amazon areas has detected Oropouche fever, a viral disease now spreading across South America, according to research published in The Lancet Infectious Diseases. Climate change compounds these threats. During the record drought of 2024, 11 million hectares burned in Brazil, blanketing cities in smoke and triggering spikes in respiratory and cardiac disease. River levels halved, stranding communities without access to health care, safe water, or food. Illegal gold mining has poisoned rivers with mercury. Each forest lost represents not just carbon released but potential medicines never discovered. Roughly 25% of modern medicines derive from rainforest plants, yet less than 1% of tropical species have been examined for pharmaceutical properties. Indigenous communities have proven to be forests’ most effective guardians, with deforestation rates significantly lower in their territories. Yet for the 30 million people living in the Amazon, including Indigenous nations, riverine communities, and urban residents, environmental degradation carries severe consequences. Unlike traditional climate funds – forest fund is built on endowment model The Tropical Forest Forever Fund’s projected investment model, according to its website. The funding shortfall matters because the TFFF isn’t designed like traditional climate funds. It’s an investment vehicle, functioning similarly to a large endowment, set up to generate “competitive market returns” and a “strong value proposition” for its backers based on a projected return of 7.5% on its assets and investments. Without sufficient capital to generate significant returns, the mathematics collapse. The concept note published by the Brazilian presidency describes it as a mechanism “to support the full range of less-marketable tropical forest ecosystem services,” designed to correct a perceived market failure: it is more profitable to chop forests down for lumber, agriculture or mining the ground beneath them than keep them standing. The facility aims to raise $25 billion from governments as “sponsor capital,” then leverage that to attract $100 billion from private investors who buy bonds. The combined $125 billion will then be invested in a global portfolio of sovereign and corporate bonds, with a particular focus on emerging market and tropical forest country bonds. In the scenario where the fund secures the full $125 billion, countries would receive approximately $4 per hectare annually for standing forest, according to World Bank calculations, provided they maintain deforestation rates below 0.5%, with heavy financial penalties applied for forest loss. Projected financial payouts to tropical forest nations under the TFFF, given full capitalization at $125 billion. The World Resources Institute noted the facility “could be the single biggest source of international finance for Indigenous peoples and local communities,” potentially funding land purchases, fighting illegal mining, and securing rights. But that depends on achieving scale the current funding makes impossible. Despite the steep financing challenges, some groups maintain the fund represents progress. WWF called it “a landmark moment for nature and climate finance.” “The TFFF is already a defining legacy of the Belém COP,” said Mauricio Voivodic, executive director of WWF-Brazil. “Not only for Brazil, but for the entire planet, especially the Global South.” Christopher Egerton-Warburton, a former Goldman Sachs banker whose London firm Lion’s Head Global Partners engineered the structure of the fund, told Global Witness success requires near-perfect execution. “The sun, the moon and stars have to all come together” for the fund to succeed, he said. The math at current funding levels The TFFF payout model, according to its website. With $6.6 billion instead of $125 billion, the fund currently holds 5% of its target. Assuming 7.5% in annual returns, a high rate of profitability that is far from guaranteed, the fund would possess roughly $495 million in annual investment income. After paying private bondholders and government sponsors their shares, approximately $213 million remains for 74 eligible tropical forest countries. That’s less than $3 million per tropical forest nation annually. The 20% earmarked for Indigenous communities amounts to about $43 million total, split among hundreds of territories across three continents. At current levels, the fund projects to pay tropical forest nations roughly 16 cents per hectare, a 96% decrease from the World Bank’s $4 projection at full capitalization. The fund’s model further relies on providing a strong financial incentive for nations currently pushing ahead with deforestation, like Bolivia, to scale back in return for money. If that money isn’t there, the incentive, and projected impact of the initiative on global deforestation rates, is weakened significantly. “Having raised only $5.6 billion from sponsoring and beneficiary countries, it is impossible to imagine that the mechanism can attract $100 billion in investment,” said the Global Forest Coalition following the launch. (Germany’s additional $1 billion commitment arrived after that analysis.) A UNEP report released ahead of COP30 found that annual forest finance alone needs to reach $300 billion by 2030, triple current levels of $84 billion. “All the calculations made by the World Bank regarding the TFFF are collapsing due to the very logic of capital they aspire to conquer: private investors only invest when profits are relatively certain,” GFC said. “Capitalism only bets on the green of dollars, not on the green of forests.” Who gets paid first? TFFF-eligible countries (deep green) and eligible biome areas within these countries (light green), including the tropical and subtropical moist broadleaf forest biome and adjacent mangrove areas. Map: Global Forest Coalition. If investments hit the target 7.5% annual return, the fund generates roughly $9.4 billion. But that money doesn’t go straight to forests, and $120 billion in assets needed to generate that return are still missing. First in line for payment are the bondholders, private investors and major financial institutions who would receive approximately $4 billion in annual returns on a combined $100 billion share in the fund. Second come the developed country government sponsors, which would collect roughly $1 billion in interest on their $25 billion seed investment. Only after investors and sponsors take their cuts does money flow to tropical forest countries. Under ideal conditions, assuming the fund hits both the $125 billion base and achieves 7.5% returns, tropical forest nations would receive approximately $4 billion annually, less than half of what the fund generates, as more than half is used to incentivize investment from wealthy nations and private capital. The facility mandates that at least 20% of payments to forest nations flow directly to Indigenous communities, meaning roughly $800 million, while $3.2 billion goes to national governments. The direct funding to Indigenous peoples and local communities is unique among global climate finance instruments, which typically channel money through national governments. The payment waterfall is explicit: investors first, forest nations and indigenous frontline communities last. The income generated by the assets held in the fund depends on successful returns on investment and global economic conditions. If a global economic downturn occurs, the entire structure could collapse. “As TFFF is an investment fund its returns cannot be guaranteed,” the fund’s framework states. “In the event that the market value drops below certain key thresholds it may be necessary to reduce the rate of payout to tropical forest nations.” Forest countries receive whatever’s left, which could be far less than the promised $4 per hectare, or nothing. Cash on delivery meets debt Over 60 low-income nations worldwide spent more on debt financing than they spend on healthcare, according to research from UK-based advocacy group Debt Justice. Unlike conventional forest finance that distributes grants directly for conservation, the facility operates what’s known as the “cash-on-delivery” model, meaning governments can spend the money received in exchange for forest preservation however they want. The money received from the fund is not required to be spent on forest protection, though governments will have to submit transparency records on how the money received from TFFF is spent. “The TFFF does not determine how tropical forest countries will use the funds awarded to them,” the concept note states. Beyond generating returns for forest conservation, the fund is also meant to channel capital from developed nations to Global South financial markets. Egerton-Warburton told Global Witness that country sponsors are “increasingly focused” on this “secondary benefit,” “over and above its benefit to the tropical forest countries.” The fund’s investment strategy raises additional concerns amid current worries of a global debt crisis, particularly in low- and lower-income nations across Africa, South America and Asia, many home to the world’s tropical forest reserves. By purchasing sovereign bonds from emerging markets and tropical forest countries, the facility is effectively buying these nations’ debt, then using returns from those bond investments to pay the countries for forest protection. Proponents note this does provide capital to Global South nations that might otherwise struggle to access international markets at favorable rates. However, critics warn the circular structure creates risks. Countries receive payments derived partly from interest on loans they themselves are servicing. With many developing nations already struggling under massive debt burdens, this arrangement could prove problematic if economic conditions deteriorate, potentially trapping forest countries in a cycle where debt payments undermine their capacity to protect forests. Greenpeace raised governance concerns in its statement following the launch: “Instead of prioritizing paying sponsors and investors first, the system should ensure equitable and timely payments to tropical forest countries and Indigenous Peoples.” Carolina Pasquali, Greenpeace Brazil’s executive director, warned of the risks inherent in the market-dependent structure: “As the Facility is dependent on the volatility of global markets, the TFFF funding and the allocation of resources by tropical forest countries must be critically scrutinized to ensure forest protection funds are stable and reliable.” Civil society and indigenous communities turn against TFFF Indigenous peoples’ representatives have shown up in force at COP30. The facility’s reception among Indigenous and forest communities has shifted dramatically since last year, tracking closely with new understanding how the financial structure actually works. Early in the design process, major conservation groups expressed enthusiasm. Brazil conducted consultations with Indigenous leaders, incorporating feedback on direct funding provisions. At the G20 Social Summit in 2024, a joint document crafted by over 2,500 civil society representatives from 91 nations endorsed the forest fund.But as the fund’s financial structures became clear, opposition mounted. More than 200 civil society organisations from Brazil, the Amazon, Asia, and Africa signed a statement strongly opposing the facility ahead of its launch last week. “The TFFF is a mechanism for privatizing forest finance,” it declared. “The TFFF mistakenly and deceptively considers deforestation a market failure that will be resolved by putting a price on ecosystem services to attract private investment. The ecological collapse caused by capitalism will not be solved with more capitalism.” Separately, the People’s Summit on the road to COP30, attended by 25,000 participants, issued a declaration categorising TFFF among “false solutions” to the climate crisis. “We oppose any false solution to the climate crisis that perpetuates harmful practices, creates unpredictable risks, and diverts attention from transformative solutions based on climate justice and the well-being of people in all biomes and ecosystems,” the declaration stated. “We warn that the TFFF, as a financial program, does not constitute an adequate response.” Header from the letter issued by over 200 civil society, indigenous and local community groups strongly opposing TFFF. The mechanism was first conceived more than 15 years ago by a World Bank executive. In 2018, the Center for Global Development circulated a proposal, which the Brazilian government adopted and presented at COP28 in Dubai. Civil society groups objected to the fund being hosted at the World Bank, a common point of contention with other similar funds to funnel capital towards developing nations like the Loss & Damage climate fund, which they view as dominated by major shareholders like the United States. “The World Bank will have significant influence over the TFFF. The wealthy countries that sponsor this mechanism will hold a majority on its board. Developing countries and civil society will have no decision-making power in the governance of the TFFF,” the statement continued. “The TFFF’s profitability is not guaranteed, and in the event of a decline in profits, payments will be made first to the fund’s managers and consultants, then to private investors, then to the sponsoring wealthy countries, and finally to the countries with tropical forests,” the civil society and indigenous community coalition said. The Global Forest Coalition questioned why Brazil and Indonesia would invest $1 billion each in an uncertain mechanism rather than “channel it directly to indigenous peoples and local communities to strengthen solutions like agroecology and promote actions to curb the expansion of deforestation, mining, and oil extraction.” Private capital out of the picture, for now UNEP’s State of FInance for Forests 2025 report found 1 in 10 dollars currently invested in forest finance comes from private sources. The fundraising strategy on which the success of TFFF depends also heavily on something that hasn’t happened: private investors committing capital. After two years of advocacy and political maneuvering, private capital remains entirely absent from the picture. The shaky government backing so far, $6.6 billion versus the promised $25 billion that would absorb first losses and shield private investors from risk, eliminates the safety margin private investors were pitched to join the initiative. The firms floated as possible major investors in the fund, including major multinational banks such as JP Morgan and private equity groups, have remained silent in recent months, with no indications of incoming investments since TFFF’s launch in Belém. Questions also surround the fund’s investment advisers. Bracebridge Capital, a Boston firm serving as one of the advisers, specializes in “high risk bets on debt from struggling economies,” according to Global Witness reporting. The firm was dubbed a “vulture fund” in 2016 for aggressively pursuing claims against Argentina after its debt default. More recently, Bracebridge has made investments far removed from conservation finance, including bailing out the Hooters restaurant chain and building cryptocurrency positions. A crowded labyrinth The launch of the Loss & Damage Fund on the opening day of COP28 in Dubai was lauded as a historic victory. Two years later, it has yet to disburse any funds. The TFFF enters a fragmented ecosystem of global development finance, from health to humanitarian aid and climate change, where even celebrated mechanisms continue to fall dramatically short of their funding targets. The Green Climate Fund, launched in 2010 and posited as the primary vehicle for channeling climate finance to developing countries, raised less than $17 billion over 15 years. The Loss & Damage Fund, celebrated as a landmark achievement of COP28 fought for by developing nations on the frontlines of the climate crisis they did little to cause for decades, has mobilized just $431 million against $724 billion annual needs. Two years after creation, it has yet to disburse any money. The Cali Fund for biodiversity, created at COP16 in Colombia with a target of $500 billion, remains empty as well. At COP29 in Baku, developed countries agreed to $300 billion annually by 2035 for climate action in developing nations. Economists estimate total climate finance requirements at $2.4 trillion annually, of which the Baku target covers around 12%. The labyrinth of overlapping funding structures, each with different governance, eligibility criteria, and reporting requirements, creates contestation and confusion about what counts toward international obligations. Whether TFFF contributions count toward the New Collective Quantified Goal remains hotly debated, especially in view of its unique mechanism in which countries that contribute stand to benefit financially from their investments. Greenpeace argued following the launch that “any contributions to the TFFF should not count towards the NCQG, nor should it divert resources already allocated.” For now, the facility enters operation with a fraction of intended resources, no private investors, and deepening skepticism from the communities it claims to serve. Experts Outline How To Strengthen Trusted Health Knowledge Worldwide 21/11/2025 Maayan Hoffman Global health knowledge is expanding faster than ever, but so are confusion and inequity over who can access trustworthy information and use it to improve their lives. In a live recorded discussion at the World Health Summit in Berlin, featured in the latest Global Health Matters podcast, Joy Phumaphi, executive secretary of the Africa Leaders Malaria Alliance, and Monica Bharel, clinical lead for public sector at Google, reflected on how health information has changed and what it will take to make it truly inclusive. Phumaphi recalled a time when there was effectively one global reference point. “Everything was recorded … by hand,” she said, and “you only had one source of information. That was the World Health Organization.” Today, she noted, “there are so many sources of information, and it’s very, very confusing… We have the rogue scientists and the rogue medical practitioners who spread disinformation.” The danger, she added, is that “the sad thing about both misinformation and disinformation is that is always mixed with a little bit of truth… What it does is that it kills people. You know, people who are not vaccinated during COVID died, and we see children who have not had their measles vaccines dying.” Bharel brought the discussion down to the level of people living on the margins, drawing on her experience caring for patients experiencing homelessness in Boston. She argued that “information is also a determinant of health,” but many people lack “the infrastructure they have to get information… the phones, the internet access, the computer access.” Both speakers stressed the need to strengthen trusted channels. Phumaphi pointed to traditional, religious and social leaders as key messengers, saying health actors “should impart the right information to these… leaders, and even perhaps to the influencers.” Digitalization and AI, they concluded, can be part of the solution. Phumaphi called them “a huge opportunity,” saying, “we can reduce poverty, we can reduce ill health… We can bring the disenfranchised into the fold so, but we have to harness this in the right way and make it available to everybody.” Bharel echoed the urgency: “We can close the gap in health equity and bring in those disenfranchised individuals… we can get people the right information at the right time, at the right level, that they can digest it, and we can do this now.” Listen to more Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Fund Raises $11.4 Billion, Including $4.6 Billion From United States 21/11/2025 Kerry Cullinan The opening of the Global Fund’s Eighth Replenishment Summit, co-hosted by South Africa and the United Kingdom, a high-level, hybrid side event convened on the margins of the G20 Leaders’ Summit. Johannesburg, South Africa, on Friday 21 November, 2025. JOHANNESBURG – The United States pledged $4.6 billion to the Global Fund during its eighth Replenishment Summit in Johannesburg on Friday – a reduction from its previous pledge of $6 billion, but also an indication that it has not abandoned all multilateral global health efforts. The Global Fund has now raised $11,4 billion of its $18 billion target for the next three years – but several key countries and groups, including France, Japan and the European Commission, have yet to pledge. South African President Cyril Ramaphosa, who co-hosted the Replenishment, said that it was a milestone at a time when multilateralism is being “sorely tested”. “Building resilient health systems, scaling up local manufacturing of medicines, diagnostics and therapeutics and securing sustainable financing are vital for the social and economic development of the people of the world who are vulnerable,” said Ramaphosa. “Without a healthy population, nations cannot prosper. It is therefore essential that we close gaps in access to medicines, diagnostics and therapeutics and financing so that every country can protect its people and achieve health equity.” South African President and Replenishment co-host Cyril Ramaphosa United Kingdom Prime Minister Keir Starmer, the other co-host, said this was the first Replenishment to be hosted by countries in the Global North and South. “Since the UK hosted the first Replenishment back in 2002, our shared investments have saved over 70 million lives across more than 100 countries, cutting the combined death rate of these diseases by almost two-thirds,” said Starmer. “Heartbreaking, malaria still kills a child under five years of age every minute, 4,000 adolescent girls and young women still contract HIV every week. TB remains the world’s single deadliest infectious disease, even though we’ve had a cure for almost a century, and the rise of antimicrobial resistance threatens some of the progress that we thought we’d managed,” he added. Starmer praised the growing investment of the private sector in the Global Fund, and the reforms in the development sector enabling countries to drive their own programmes more successfully. UK Prime Minister and Replenishment co-host Keir Starmer Announcing the US pledge via video, Jeremy Lewin, US Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, described the Global Fund as a “critical partner” in advancing his country’s new ‘American First’ strategy. The US had undergone a “rigorous review” of its multilateral commitments, and “left numerous multilateral organisations, including the WHO and Unesco, as they do not work for the American people,” Lewin noted. However, while the Trump administration views “foreign assistance as a tool of US diplomacy” and every taxpayer’s dollar is being assessed in terms of “America First”, the US is “proud of its legacy as the most generous nation in the world”, he added. “The best days of American healthcare leadership are yet ahead. The State Department recently unveiled our new ‘American First’ global health policy, which affirms our commitment to global health but enacts much-needed reforms. “The Global Fund is a critical partner in advancing our America First strategy. It has long advanced the key tenets of our approach, investing much of its resources in scaled procurement of health commodities,” said Lewin. “Under the leadership of [executive director] Peter Sands, we have every confidence that its legacy of excellence will continue,” he concluded. The US pledge is tied to a 1:2 commitment, meaning that every $1 from the US has to be matched by at least $2 from other donors. Last month, Germany announced a €1 billion pledge at the World Health Summit in Berlin (down from €1.4 billion previously). Other substantial donors include Canada, which committed CAD$1.02 billion, the Netherlands, committing €195.2 million; Norway, which committed $200 million; Italy giving €150 million; Ireland increasing its commitment to €72 million, and the Gates Foundation, which pledged $912 million. Image Credits: Global Fund. UNICEF to Relocate Most of its Geneva Jobs to Rome 21/11/2025 Geneva Solutions & Editorial team UNICEF offices in Geneva – most staff to be relocated to Rome. The United Nations Children’s Fund (UNICEF) is transferring the majority of its Geneva jobs to Rome, in the latest wave of upheaval to hit the city and longtime global health hub, as UN agencies scramble to respond to international aid cuts and save money. A UNICEF spokeperson confirmed on Friday that some 290 jobs would be transferred to the Italian capital, for cost-savings purposes, while about 70-100 posts would remain in Geneva. Meanwhile, approximately 70% of UNICEF staff in its headquarters in New York City will also be relocated to lower-cost duty stations, including Nairobi, UNICEF said in a statement earlier this week. New York City, will, however, remain UNICEF’s global headquarters, with staff levels hovering between 350-500, the spokesman confirmed on Friday. “UNICEF will continue to have a solid presence in Geneva, including through its emergency humanitarian operations, the Giga initiative (connecting every school to the internet), and some specific programme and private sector partnerships functions,” the spokeperson said. The UNICEF Giga initiative to connect every child to the internet will remain in Geneva. The agency, which protects children’s rights and provides aid in over 190 countries and territories, projects a 20% reduction in its income over the next four years compared with 2024 levels as a result of dwindling funding that began before 2025 but was catalysed by United States president Donald Trump’s drastic aid cuts after taking office in January. United States has remained a UNICEF partner, despite funding cuts Despite funding cuts to the organization, approved by Congress in July, the US has remained a partner with UNICEF both as a member state and as a key donor. UNICEF USA, a non-profit NGO is also active in fundraising for the UN agency’s global mission. The UNICEF announcement follows on reports earlier this week that the World Health Organization will shed about a quarter of its global workforce, around 2371 jobs, by next summer. Despite the dramatic cuts, the global health agency still faces a $1.05 billion budget gap for its 2026-27 biennium year. The WHO reductions follow on the January withdrawal from the organization of the US, historically the agency’s largest donor. “As you know, this year has been one of the most difficult in WHO’s history, as we have navigated a painful but necessary process of prioritization and realignment that has resulted in a significant reduction in our global workforce,” said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in a message to WHO staff, announcing the cutbacks on Monday evening. See related story: EXCLUSIVE: WHO Cutting Up to 25% of Staff by June 2026 – But ‘Shadow Workforce of Consultants’ Is Unreported Other health organisations feel the pressure Some of the city’s other leading global health agencies, including Gavi, the Vaccine Alliance, and The Global Fund to Fight Aids, Tuberculosis, and Malaria have also announced major overhauls as donors pull back on their commitments. Both groups have warned of the serious repercussions cuts will have on their work saving lives and on hard-won gains fighting infectious diseases. Gavi staff at its Geneva headquarters are understood to be anticipating a second round of redundancies after launching a transformation plan at the end of October, which announces a 33 per cent and 40 per cent reduction in full-time and non full-time roles at its secretariat over the next four years. This year, the health group has already eliminated 155 full-time jobs in Geneva after a decision to reduce its global workforce by 24 per cent. UNAIDS, meanwhile, has cut about relocated all but 19 of its 127 staff at its Geneva headquarters to Nairobia well as reducing the number of country offices from 85 to 54 and cutting about one-half of its staff worldwide to about 300. The agency’s leadership is, however, pushing back against a proposal by UN Secretary General António Guterres to shut down the agency by end 2026 as part of a UN80 reform plan. Note: Includes updates and excerpts from a 20 November article in Geneva Solutions by Kasmira Jefford. Image Credits: Shutterstock, UNICEF. Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ 21/11/2025 Chetan Bhattacharji Fire in official Blue Zone area of COP 30 disrupts discussions Thursday. A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor. And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai. Brazil itself is also expanding its exploration and production of oil. The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. Fire began in official Blue Zone pavilion COP participants flee the Blue Zone fire. The fire started Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected. Red dot in purple area of the Blue Zone denotes where the fire broke out. “The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. “But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.” Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. Fire as a metaphor for the urgency of climate action A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming. But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen. The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators. COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries. The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming. Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief . South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
Experts Outline How To Strengthen Trusted Health Knowledge Worldwide 21/11/2025 Maayan Hoffman Global health knowledge is expanding faster than ever, but so are confusion and inequity over who can access trustworthy information and use it to improve their lives. In a live recorded discussion at the World Health Summit in Berlin, featured in the latest Global Health Matters podcast, Joy Phumaphi, executive secretary of the Africa Leaders Malaria Alliance, and Monica Bharel, clinical lead for public sector at Google, reflected on how health information has changed and what it will take to make it truly inclusive. Phumaphi recalled a time when there was effectively one global reference point. “Everything was recorded … by hand,” she said, and “you only had one source of information. That was the World Health Organization.” Today, she noted, “there are so many sources of information, and it’s very, very confusing… We have the rogue scientists and the rogue medical practitioners who spread disinformation.” The danger, she added, is that “the sad thing about both misinformation and disinformation is that is always mixed with a little bit of truth… What it does is that it kills people. You know, people who are not vaccinated during COVID died, and we see children who have not had their measles vaccines dying.” Bharel brought the discussion down to the level of people living on the margins, drawing on her experience caring for patients experiencing homelessness in Boston. She argued that “information is also a determinant of health,” but many people lack “the infrastructure they have to get information… the phones, the internet access, the computer access.” Both speakers stressed the need to strengthen trusted channels. Phumaphi pointed to traditional, religious and social leaders as key messengers, saying health actors “should impart the right information to these… leaders, and even perhaps to the influencers.” Digitalization and AI, they concluded, can be part of the solution. Phumaphi called them “a huge opportunity,” saying, “we can reduce poverty, we can reduce ill health… We can bring the disenfranchised into the fold so, but we have to harness this in the right way and make it available to everybody.” Bharel echoed the urgency: “We can close the gap in health equity and bring in those disenfranchised individuals… we can get people the right information at the right time, at the right level, that they can digest it, and we can do this now.” Listen to more Global Health Matters podcasts on Health Policy Watch >> Image Credits: Global Health Matters Podcast. Global Fund Raises $11.4 Billion, Including $4.6 Billion From United States 21/11/2025 Kerry Cullinan The opening of the Global Fund’s Eighth Replenishment Summit, co-hosted by South Africa and the United Kingdom, a high-level, hybrid side event convened on the margins of the G20 Leaders’ Summit. Johannesburg, South Africa, on Friday 21 November, 2025. JOHANNESBURG – The United States pledged $4.6 billion to the Global Fund during its eighth Replenishment Summit in Johannesburg on Friday – a reduction from its previous pledge of $6 billion, but also an indication that it has not abandoned all multilateral global health efforts. The Global Fund has now raised $11,4 billion of its $18 billion target for the next three years – but several key countries and groups, including France, Japan and the European Commission, have yet to pledge. South African President Cyril Ramaphosa, who co-hosted the Replenishment, said that it was a milestone at a time when multilateralism is being “sorely tested”. “Building resilient health systems, scaling up local manufacturing of medicines, diagnostics and therapeutics and securing sustainable financing are vital for the social and economic development of the people of the world who are vulnerable,” said Ramaphosa. “Without a healthy population, nations cannot prosper. It is therefore essential that we close gaps in access to medicines, diagnostics and therapeutics and financing so that every country can protect its people and achieve health equity.” South African President and Replenishment co-host Cyril Ramaphosa United Kingdom Prime Minister Keir Starmer, the other co-host, said this was the first Replenishment to be hosted by countries in the Global North and South. “Since the UK hosted the first Replenishment back in 2002, our shared investments have saved over 70 million lives across more than 100 countries, cutting the combined death rate of these diseases by almost two-thirds,” said Starmer. “Heartbreaking, malaria still kills a child under five years of age every minute, 4,000 adolescent girls and young women still contract HIV every week. TB remains the world’s single deadliest infectious disease, even though we’ve had a cure for almost a century, and the rise of antimicrobial resistance threatens some of the progress that we thought we’d managed,” he added. Starmer praised the growing investment of the private sector in the Global Fund, and the reforms in the development sector enabling countries to drive their own programmes more successfully. UK Prime Minister and Replenishment co-host Keir Starmer Announcing the US pledge via video, Jeremy Lewin, US Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, described the Global Fund as a “critical partner” in advancing his country’s new ‘American First’ strategy. The US had undergone a “rigorous review” of its multilateral commitments, and “left numerous multilateral organisations, including the WHO and Unesco, as they do not work for the American people,” Lewin noted. However, while the Trump administration views “foreign assistance as a tool of US diplomacy” and every taxpayer’s dollar is being assessed in terms of “America First”, the US is “proud of its legacy as the most generous nation in the world”, he added. “The best days of American healthcare leadership are yet ahead. The State Department recently unveiled our new ‘American First’ global health policy, which affirms our commitment to global health but enacts much-needed reforms. “The Global Fund is a critical partner in advancing our America First strategy. It has long advanced the key tenets of our approach, investing much of its resources in scaled procurement of health commodities,” said Lewin. “Under the leadership of [executive director] Peter Sands, we have every confidence that its legacy of excellence will continue,” he concluded. The US pledge is tied to a 1:2 commitment, meaning that every $1 from the US has to be matched by at least $2 from other donors. Last month, Germany announced a €1 billion pledge at the World Health Summit in Berlin (down from €1.4 billion previously). Other substantial donors include Canada, which committed CAD$1.02 billion, the Netherlands, committing €195.2 million; Norway, which committed $200 million; Italy giving €150 million; Ireland increasing its commitment to €72 million, and the Gates Foundation, which pledged $912 million. Image Credits: Global Fund. UNICEF to Relocate Most of its Geneva Jobs to Rome 21/11/2025 Geneva Solutions & Editorial team UNICEF offices in Geneva – most staff to be relocated to Rome. The United Nations Children’s Fund (UNICEF) is transferring the majority of its Geneva jobs to Rome, in the latest wave of upheaval to hit the city and longtime global health hub, as UN agencies scramble to respond to international aid cuts and save money. A UNICEF spokeperson confirmed on Friday that some 290 jobs would be transferred to the Italian capital, for cost-savings purposes, while about 70-100 posts would remain in Geneva. Meanwhile, approximately 70% of UNICEF staff in its headquarters in New York City will also be relocated to lower-cost duty stations, including Nairobi, UNICEF said in a statement earlier this week. New York City, will, however, remain UNICEF’s global headquarters, with staff levels hovering between 350-500, the spokesman confirmed on Friday. “UNICEF will continue to have a solid presence in Geneva, including through its emergency humanitarian operations, the Giga initiative (connecting every school to the internet), and some specific programme and private sector partnerships functions,” the spokeperson said. The UNICEF Giga initiative to connect every child to the internet will remain in Geneva. The agency, which protects children’s rights and provides aid in over 190 countries and territories, projects a 20% reduction in its income over the next four years compared with 2024 levels as a result of dwindling funding that began before 2025 but was catalysed by United States president Donald Trump’s drastic aid cuts after taking office in January. United States has remained a UNICEF partner, despite funding cuts Despite funding cuts to the organization, approved by Congress in July, the US has remained a partner with UNICEF both as a member state and as a key donor. UNICEF USA, a non-profit NGO is also active in fundraising for the UN agency’s global mission. The UNICEF announcement follows on reports earlier this week that the World Health Organization will shed about a quarter of its global workforce, around 2371 jobs, by next summer. Despite the dramatic cuts, the global health agency still faces a $1.05 billion budget gap for its 2026-27 biennium year. The WHO reductions follow on the January withdrawal from the organization of the US, historically the agency’s largest donor. “As you know, this year has been one of the most difficult in WHO’s history, as we have navigated a painful but necessary process of prioritization and realignment that has resulted in a significant reduction in our global workforce,” said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in a message to WHO staff, announcing the cutbacks on Monday evening. See related story: EXCLUSIVE: WHO Cutting Up to 25% of Staff by June 2026 – But ‘Shadow Workforce of Consultants’ Is Unreported Other health organisations feel the pressure Some of the city’s other leading global health agencies, including Gavi, the Vaccine Alliance, and The Global Fund to Fight Aids, Tuberculosis, and Malaria have also announced major overhauls as donors pull back on their commitments. Both groups have warned of the serious repercussions cuts will have on their work saving lives and on hard-won gains fighting infectious diseases. Gavi staff at its Geneva headquarters are understood to be anticipating a second round of redundancies after launching a transformation plan at the end of October, which announces a 33 per cent and 40 per cent reduction in full-time and non full-time roles at its secretariat over the next four years. This year, the health group has already eliminated 155 full-time jobs in Geneva after a decision to reduce its global workforce by 24 per cent. UNAIDS, meanwhile, has cut about relocated all but 19 of its 127 staff at its Geneva headquarters to Nairobia well as reducing the number of country offices from 85 to 54 and cutting about one-half of its staff worldwide to about 300. The agency’s leadership is, however, pushing back against a proposal by UN Secretary General António Guterres to shut down the agency by end 2026 as part of a UN80 reform plan. Note: Includes updates and excerpts from a 20 November article in Geneva Solutions by Kasmira Jefford. Image Credits: Shutterstock, UNICEF. Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ 21/11/2025 Chetan Bhattacharji Fire in official Blue Zone area of COP 30 disrupts discussions Thursday. A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor. And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai. Brazil itself is also expanding its exploration and production of oil. The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. Fire began in official Blue Zone pavilion COP participants flee the Blue Zone fire. The fire started Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected. Red dot in purple area of the Blue Zone denotes where the fire broke out. “The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. “But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.” Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. Fire as a metaphor for the urgency of climate action A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming. But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen. The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators. COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries. The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming. Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief . South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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 Fund Raises $11.4 Billion, Including $4.6 Billion From United States 21/11/2025 Kerry Cullinan The opening of the Global Fund’s Eighth Replenishment Summit, co-hosted by South Africa and the United Kingdom, a high-level, hybrid side event convened on the margins of the G20 Leaders’ Summit. Johannesburg, South Africa, on Friday 21 November, 2025. JOHANNESBURG – The United States pledged $4.6 billion to the Global Fund during its eighth Replenishment Summit in Johannesburg on Friday – a reduction from its previous pledge of $6 billion, but also an indication that it has not abandoned all multilateral global health efforts. The Global Fund has now raised $11,4 billion of its $18 billion target for the next three years – but several key countries and groups, including France, Japan and the European Commission, have yet to pledge. South African President Cyril Ramaphosa, who co-hosted the Replenishment, said that it was a milestone at a time when multilateralism is being “sorely tested”. “Building resilient health systems, scaling up local manufacturing of medicines, diagnostics and therapeutics and securing sustainable financing are vital for the social and economic development of the people of the world who are vulnerable,” said Ramaphosa. “Without a healthy population, nations cannot prosper. It is therefore essential that we close gaps in access to medicines, diagnostics and therapeutics and financing so that every country can protect its people and achieve health equity.” South African President and Replenishment co-host Cyril Ramaphosa United Kingdom Prime Minister Keir Starmer, the other co-host, said this was the first Replenishment to be hosted by countries in the Global North and South. “Since the UK hosted the first Replenishment back in 2002, our shared investments have saved over 70 million lives across more than 100 countries, cutting the combined death rate of these diseases by almost two-thirds,” said Starmer. “Heartbreaking, malaria still kills a child under five years of age every minute, 4,000 adolescent girls and young women still contract HIV every week. TB remains the world’s single deadliest infectious disease, even though we’ve had a cure for almost a century, and the rise of antimicrobial resistance threatens some of the progress that we thought we’d managed,” he added. Starmer praised the growing investment of the private sector in the Global Fund, and the reforms in the development sector enabling countries to drive their own programmes more successfully. UK Prime Minister and Replenishment co-host Keir Starmer Announcing the US pledge via video, Jeremy Lewin, US Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, described the Global Fund as a “critical partner” in advancing his country’s new ‘American First’ strategy. The US had undergone a “rigorous review” of its multilateral commitments, and “left numerous multilateral organisations, including the WHO and Unesco, as they do not work for the American people,” Lewin noted. However, while the Trump administration views “foreign assistance as a tool of US diplomacy” and every taxpayer’s dollar is being assessed in terms of “America First”, the US is “proud of its legacy as the most generous nation in the world”, he added. “The best days of American healthcare leadership are yet ahead. The State Department recently unveiled our new ‘American First’ global health policy, which affirms our commitment to global health but enacts much-needed reforms. “The Global Fund is a critical partner in advancing our America First strategy. It has long advanced the key tenets of our approach, investing much of its resources in scaled procurement of health commodities,” said Lewin. “Under the leadership of [executive director] Peter Sands, we have every confidence that its legacy of excellence will continue,” he concluded. The US pledge is tied to a 1:2 commitment, meaning that every $1 from the US has to be matched by at least $2 from other donors. Last month, Germany announced a €1 billion pledge at the World Health Summit in Berlin (down from €1.4 billion previously). Other substantial donors include Canada, which committed CAD$1.02 billion, the Netherlands, committing €195.2 million; Norway, which committed $200 million; Italy giving €150 million; Ireland increasing its commitment to €72 million, and the Gates Foundation, which pledged $912 million. Image Credits: Global Fund. UNICEF to Relocate Most of its Geneva Jobs to Rome 21/11/2025 Geneva Solutions & Editorial team UNICEF offices in Geneva – most staff to be relocated to Rome. The United Nations Children’s Fund (UNICEF) is transferring the majority of its Geneva jobs to Rome, in the latest wave of upheaval to hit the city and longtime global health hub, as UN agencies scramble to respond to international aid cuts and save money. A UNICEF spokeperson confirmed on Friday that some 290 jobs would be transferred to the Italian capital, for cost-savings purposes, while about 70-100 posts would remain in Geneva. Meanwhile, approximately 70% of UNICEF staff in its headquarters in New York City will also be relocated to lower-cost duty stations, including Nairobi, UNICEF said in a statement earlier this week. New York City, will, however, remain UNICEF’s global headquarters, with staff levels hovering between 350-500, the spokesman confirmed on Friday. “UNICEF will continue to have a solid presence in Geneva, including through its emergency humanitarian operations, the Giga initiative (connecting every school to the internet), and some specific programme and private sector partnerships functions,” the spokeperson said. The UNICEF Giga initiative to connect every child to the internet will remain in Geneva. The agency, which protects children’s rights and provides aid in over 190 countries and territories, projects a 20% reduction in its income over the next four years compared with 2024 levels as a result of dwindling funding that began before 2025 but was catalysed by United States president Donald Trump’s drastic aid cuts after taking office in January. United States has remained a UNICEF partner, despite funding cuts Despite funding cuts to the organization, approved by Congress in July, the US has remained a partner with UNICEF both as a member state and as a key donor. UNICEF USA, a non-profit NGO is also active in fundraising for the UN agency’s global mission. The UNICEF announcement follows on reports earlier this week that the World Health Organization will shed about a quarter of its global workforce, around 2371 jobs, by next summer. Despite the dramatic cuts, the global health agency still faces a $1.05 billion budget gap for its 2026-27 biennium year. The WHO reductions follow on the January withdrawal from the organization of the US, historically the agency’s largest donor. “As you know, this year has been one of the most difficult in WHO’s history, as we have navigated a painful but necessary process of prioritization and realignment that has resulted in a significant reduction in our global workforce,” said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in a message to WHO staff, announcing the cutbacks on Monday evening. See related story: EXCLUSIVE: WHO Cutting Up to 25% of Staff by June 2026 – But ‘Shadow Workforce of Consultants’ Is Unreported Other health organisations feel the pressure Some of the city’s other leading global health agencies, including Gavi, the Vaccine Alliance, and The Global Fund to Fight Aids, Tuberculosis, and Malaria have also announced major overhauls as donors pull back on their commitments. Both groups have warned of the serious repercussions cuts will have on their work saving lives and on hard-won gains fighting infectious diseases. Gavi staff at its Geneva headquarters are understood to be anticipating a second round of redundancies after launching a transformation plan at the end of October, which announces a 33 per cent and 40 per cent reduction in full-time and non full-time roles at its secretariat over the next four years. This year, the health group has already eliminated 155 full-time jobs in Geneva after a decision to reduce its global workforce by 24 per cent. UNAIDS, meanwhile, has cut about relocated all but 19 of its 127 staff at its Geneva headquarters to Nairobia well as reducing the number of country offices from 85 to 54 and cutting about one-half of its staff worldwide to about 300. The agency’s leadership is, however, pushing back against a proposal by UN Secretary General António Guterres to shut down the agency by end 2026 as part of a UN80 reform plan. Note: Includes updates and excerpts from a 20 November article in Geneva Solutions by Kasmira Jefford. Image Credits: Shutterstock, UNICEF. Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ 21/11/2025 Chetan Bhattacharji Fire in official Blue Zone area of COP 30 disrupts discussions Thursday. A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor. And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai. Brazil itself is also expanding its exploration and production of oil. The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. Fire began in official Blue Zone pavilion COP participants flee the Blue Zone fire. The fire started Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected. Red dot in purple area of the Blue Zone denotes where the fire broke out. “The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. “But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.” Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. Fire as a metaphor for the urgency of climate action A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming. But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen. The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators. COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries. The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming. Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief . South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
UNICEF to Relocate Most of its Geneva Jobs to Rome 21/11/2025 Geneva Solutions & Editorial team UNICEF offices in Geneva – most staff to be relocated to Rome. The United Nations Children’s Fund (UNICEF) is transferring the majority of its Geneva jobs to Rome, in the latest wave of upheaval to hit the city and longtime global health hub, as UN agencies scramble to respond to international aid cuts and save money. A UNICEF spokeperson confirmed on Friday that some 290 jobs would be transferred to the Italian capital, for cost-savings purposes, while about 70-100 posts would remain in Geneva. Meanwhile, approximately 70% of UNICEF staff in its headquarters in New York City will also be relocated to lower-cost duty stations, including Nairobi, UNICEF said in a statement earlier this week. New York City, will, however, remain UNICEF’s global headquarters, with staff levels hovering between 350-500, the spokesman confirmed on Friday. “UNICEF will continue to have a solid presence in Geneva, including through its emergency humanitarian operations, the Giga initiative (connecting every school to the internet), and some specific programme and private sector partnerships functions,” the spokeperson said. The UNICEF Giga initiative to connect every child to the internet will remain in Geneva. The agency, which protects children’s rights and provides aid in over 190 countries and territories, projects a 20% reduction in its income over the next four years compared with 2024 levels as a result of dwindling funding that began before 2025 but was catalysed by United States president Donald Trump’s drastic aid cuts after taking office in January. United States has remained a UNICEF partner, despite funding cuts Despite funding cuts to the organization, approved by Congress in July, the US has remained a partner with UNICEF both as a member state and as a key donor. UNICEF USA, a non-profit NGO is also active in fundraising for the UN agency’s global mission. The UNICEF announcement follows on reports earlier this week that the World Health Organization will shed about a quarter of its global workforce, around 2371 jobs, by next summer. Despite the dramatic cuts, the global health agency still faces a $1.05 billion budget gap for its 2026-27 biennium year. The WHO reductions follow on the January withdrawal from the organization of the US, historically the agency’s largest donor. “As you know, this year has been one of the most difficult in WHO’s history, as we have navigated a painful but necessary process of prioritization and realignment that has resulted in a significant reduction in our global workforce,” said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in a message to WHO staff, announcing the cutbacks on Monday evening. See related story: EXCLUSIVE: WHO Cutting Up to 25% of Staff by June 2026 – But ‘Shadow Workforce of Consultants’ Is Unreported Other health organisations feel the pressure Some of the city’s other leading global health agencies, including Gavi, the Vaccine Alliance, and The Global Fund to Fight Aids, Tuberculosis, and Malaria have also announced major overhauls as donors pull back on their commitments. Both groups have warned of the serious repercussions cuts will have on their work saving lives and on hard-won gains fighting infectious diseases. Gavi staff at its Geneva headquarters are understood to be anticipating a second round of redundancies after launching a transformation plan at the end of October, which announces a 33 per cent and 40 per cent reduction in full-time and non full-time roles at its secretariat over the next four years. This year, the health group has already eliminated 155 full-time jobs in Geneva after a decision to reduce its global workforce by 24 per cent. UNAIDS, meanwhile, has cut about relocated all but 19 of its 127 staff at its Geneva headquarters to Nairobia well as reducing the number of country offices from 85 to 54 and cutting about one-half of its staff worldwide to about 300. The agency’s leadership is, however, pushing back against a proposal by UN Secretary General António Guterres to shut down the agency by end 2026 as part of a UN80 reform plan. Note: Includes updates and excerpts from a 20 November article in Geneva Solutions by Kasmira Jefford. Image Credits: Shutterstock, UNICEF. Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ 21/11/2025 Chetan Bhattacharji Fire in official Blue Zone area of COP 30 disrupts discussions Thursday. A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor. And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai. Brazil itself is also expanding its exploration and production of oil. The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. Fire began in official Blue Zone pavilion COP participants flee the Blue Zone fire. The fire started Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected. Red dot in purple area of the Blue Zone denotes where the fire broke out. “The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. “But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.” Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. Fire as a metaphor for the urgency of climate action A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming. But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen. The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators. COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries. The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming. Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief . South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
Fire Hits COP30 Climate Talks in Crucial Juncture in Debate over Fossil Fuel ‘Transition’ 21/11/2025 Chetan Bhattacharji Fire in official Blue Zone area of COP 30 disrupts discussions Thursday. A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor. And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai. Brazil itself is also expanding its exploration and production of oil. The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. Fire began in official Blue Zone pavilion COP participants flee the Blue Zone fire. The fire started Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected. Red dot in purple area of the Blue Zone denotes where the fire broke out. “The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. “But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.” Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. Fire as a metaphor for the urgency of climate action A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming. But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen. The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators. COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries. The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming. Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief . South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
South Africa May Be Excluded From Future US Grants for HIV Amid Political Row 21/11/2025 Kerry Cullinan South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate. The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries. While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation. “The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch. A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”. “The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026. The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson. “The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.” In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”. “Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia. The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe. Largest HIV+ population A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services. Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world. In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January. In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026. Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”. The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. All 2026 lenacapvir stock bought Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections. The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission. The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”. But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday. “Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI). “By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added. Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia. The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections. The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. ‘Insulting’ The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator. “Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela. However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses. “We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund. “We are working out between ourselves exactly who will distribute and procure for which country,” Smith added. Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”. US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya. Political decisions Citing the US Executive Order against South Africa, the advocacy groups say that the US has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”. Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim. “In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note. Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”. “Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add. This story has been updated to include the US State Department’s comment. Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead. Global Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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 Fund Seeks $14 Billion at Replenishment Summit – With Progress Against HIV, TB and Malaria at Risk 20/11/2025 Kerry Cullinan Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment. JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria. The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus. “We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday. “We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries. South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%. The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV. Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday. “No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said. “Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.” Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras. Saving 70 million lives The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025. Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted. While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent. In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years. Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period. In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.” Malaria ‘way off target’ Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling. “Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease. “Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023. Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8% “Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025. “The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.” President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.” HIV resurgence? “There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment. “We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.” Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease. “Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025. It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. Private sector contributions While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002. “The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates. The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.” The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics. John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation. Unlike countries, which give unrestricted funds, private donors can earmark their contributions. Image Credits: Tommy Trenchard/ Global Fund, Global Fund. Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
Investing in the Global Fund is Smart Economics, Not Charity 20/11/2025 Duma Gideon Boko Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund. As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK. At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa. Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. Communities, businesses, and leaders are stepping up. But, we cannot succeed in ending malaria alone. If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP. Children’s lives at risk The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost. We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes. Malaria is not just a health issue. It is an economic brake on our prosperity. Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines. Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030. But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect. Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel? We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children. We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now. Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University. Image Credits: Ben Moldenhauer/MMV, Global Fund. European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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.
European Commission Moves to Ease AI Rules as WHO Warns of Patient Risks due to Regulatory Vacuum 19/11/2025 Felix Sassmannshausen There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging. Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. “The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe. The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide. The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy. WHO warning collides with EU deregulation moves EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels. In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states. But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”. ‘Our DNA could be used to train the AI systems of big companies’ Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”. Ella Jakubowska, EDRi “According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe. “Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object. European Commission also aims to postpone rollout of new AI rules specific to medical devices In another move that worries patient advocates, the Commission also has proposed postponing the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical procedures. The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority. European Union AI Act, which came into force in 2024. Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe. The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament. Lack of liability rules puts patients at risk Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place. The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges. In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments. Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it. Other critical ethical concerns highlighted include the lack of safeguards around data privacy. Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs. A deepening digital divide in regulation as well The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems. In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system. Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement for medical devices is also preserved even in the looser regulatory measures of the EU’s “Digital Omnibus” proposal. By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service. Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”. WHO calls for strengthening funding and cross-border harmonisation Private sector investments are concentrated in wealthier regions. With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights. To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance. The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability. “We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.” Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region. One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. 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
One in Three Women Globally Has Faced Intimate Partner or Sexual Violence During their Lifetime 19/11/2025 Disha Shetty Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates. Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies. In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said. “Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found. “Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said. While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable. For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found. Non-partner violence affects a large number of women globally. While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide. “We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha. Widespread, lifelong and intergenerational risks Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control. The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older. “The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing. Violence against women prevalence estimates, 2023. Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression. In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research. “Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. See related story: How Intimate Partner Violence Affects Children Funding cuts make solving the global problem a challenge Avni Amin, Unit Head for Rights and Equality across the Life course at WHO. While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%. Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining. Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women. The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID. Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need. “In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap. A call for action — and accountability Violence against women starts early and affects both young and old. While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said. The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls. Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area. This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021. “These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar. The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November. “Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros. Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023. Posts navigation Older postsNewer posts