Alekuwodo market in Osogbo is now noticeably cleaner because of the efforts of locals.

OSOGBO, Nigeria – A few years back, when the bustling Alekuwodo market in Osogbo in Osun State quietened down at night, the chaos of the day lingered. Crushed tomatoes, discarded papers, plastic wrappers, bean husks, watermelon rinds and other fruit scraps turned the market square into a suffocating mess. As the sun set, the stench would rise — a grim reminder of the day’s waste.

Ruth Adelakun, 57, acknowledges that she was part of the problem. As a locust bean seller, she set up her roadside stall under a tarpaulin umbrella to shield herself from the heat. The sweltering weather meant she drank plenty of water out of plastic sachets.

“I can drink at least five sachets a day,” she admitted, waving an empty plastic wrapper. “I used to drop them anywhere because I didn’t know it harmed the environment.”

But the harm is real. “Dirty environments breed disease-causing microorganisms,” explained Dr Mahmud Abubakar from Federal Teaching Hospital in Kebbi State.

“Air pollution increases respiratory infections, while contaminated water can cause cholera, diarrhoea, and even bladder cancer.”

Struggling with waste

Nigeria ranks in the bottom 30 countries globally for waste management — ranked 152nd out of 180 in the  Environmental Performance Index  2024 compiled by the Yale Center for Environmental Law and Policy, with a dismal score of 12.7.

Mayokun Iyaomolere, environmentalist and executive director of the environmental group, Plogging Club, warns that this negligent approach to waste fuels climate change.

“Waste ends up in landfills, releasing carbon dioxide and other harmful gases. These emissions contribute to extreme weather events like flooding, heatwaves, and droughts,” he said.

The impact of climate change is already severe, with Nigeria ranked 158th out of 182 countries for climate vulnerability.

By September 2024, flooding had affected 31 states, displaced over 641,000 people, and claimed 285 lives, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA).

Meanwhile, rising heat levels have led to deadly heatwaves in the southwest with average temperatures of 50C last February, crippling food security and worsening Nigeria’s hunger crisis  — with the Global Hunger Index scoring the nation 110th out of 120 countries, signalling serious food insecurity.

Local hero on a mission

‘Spider-Man’ Olaunlokun Johnathan speaks to school students about litter.

Nigeria generates  0.51 kg of municipal solid waste per capita every day , amounting to an overall daily generation of 75.6 million kg, according to the World Bank. This ends up at  landfills and causes carbon emissions.

Amid this crisis, one man decided to act. Olaunlokun Johnathan, 45, doesn’t have a formal environmental science degree — he simply loves clean surroundings. In 2004, he began advocating for a litter-free Nigeria, undeterred by insults or indifference.

“Our people are part of the problem — even the regulators don’t take their jobs seriously,” he said, frustrated. “They care more about their salaries, and there aren’t enough waste-collection vehicles.”

Determined, Johnathan cleans the streets of Osogbo three times a week, picking up litter wherever he goes. Dressed in a polo shirt or orange jacket, with cotton gloves and worn-out shoes, he tirelessly works to change minds.

In 2021, Johnathan took his mission to the next level — dressing up like Spider-Man. His costume caught people’s attention, helping him spread his message to schools, markets, motor parks, and religious centers across states like Osun, Kaduna, Ogun, Oyo, and Lagos.

He taught schoolchildren to use trash bins, urged market vendors to tidy up their stalls, and showed drivers how to keep motor parks clean. Slowly but surely, his persistence paid off.

Shift in mindset

Ruth Adelakun, a locust bean seller, admits that she used to litter the market.

Meanwhile, Adelakun is now a changed woman. She keeps a sack for her waste and disposes of it properly every evening.

“I keep my trash here and empty it into the big government bin,” she said proudly.

Usman Zakariyya, a 25-year-old bean seller, also adjusted his habits after hearing Johnathan speak.

“Before, I used to leave the chaff blown out here without worrying about packing up in the evening before going home but now any time I finish the blowing I sweep and pack up them instantly,” said Zakariyya.

“When people get conscious of their environment and no longer litter, it is a window of opportunity for them to adjust to other behaviors that ultimately have environmental impact,” Iyaomolere told Health Policy Watch.

Uphill battle

Olaunlokun Johnathan cleaning the streets of Osogbo in Nigeria.

Despite his successes, Johnathan faces many challenges. People mock him, while government grants are restricted to younger advocates aged 18 to 30, leaving him without crucial funding.

“Some people thought I was mad,” he confessed. “I’ve thought of quitting, but the community needs change.”

However, today Alekuwodo market is noticeably cleaner. People pack their waste neatly, and traders sweep up as soon as they spot Johnathan.

“You won’t find trash carelessly thrown around here anymore,” he said, smiling as he waved to a watermelon seller tidying his stall.

“Sweep it clean!” he called out, his voice echoing through the square as he walked off to continue his mission — a living reminder that one determined person can inspire an entire community to change.

Image Credits: Abdullahi Jimoh.

Clean air light show and exhibits bedeck a heavily trafficked street outside of the Cartagena Convention Center hosting WHO’s Second Conference on Air Pollution and Health.

CARTAGENA, Colombia – A tour bus emits a cloud of black diesel smoke in front of Cartagena’s glittering white conference center. It is a vivid reminder that from the hottest tourist destinations to the slums of Latin America, Asia and Africa, nine out of ten people on the planet breathe dangerously unhealthy levels of air pollution every day. Thanks to air pollution, millions fall ill every year with a range of respiratory and cardiovascular diseases as well as cancers, leading to at least seven million deaths each year. 

On Tuesday, the Colombian coastal city will host the second WHO Air Pollution and Health conference 25-27 March, where global leaders are poised to call for an ambitious goal of cutting deaths from air pollution by 50% in 2040.

“Clean air is not a privilege; it is a human right,” says Dr Maria Neira who heads WHO’s work on climate, environment and health.

Indeed, air pollution is the biggest environmental risk to human health – risks that altogether account for some 25% of premature deaths every year –  as well as a major contributor to climate change, according not only to WHO, but also the world’s leading climate scientists. 

Solutions largely require political will

Delhi’s winter smog routinely reaches air quality ratings exceeding 50 times the level deemed safe by the WHO.

But unlike some other disease challenges, there are ready, affordable, solutions that largely require political will to implement. Neira has a ready list of WHO’s top priorities for the conference at her fingertips: 

“We need to work together urgently to scale up transitioning from coal-fired power to renewable energy,” she says, while also. “expanding public and sustainable transport, establishing low-emission zones in cities and promoting clean energy for cooking, and solar power in healthcare facilities.” 

Even so, cutting emissions enough to halve deaths from air pollution within just 15 years is a highly ambitious goal.The challenges to attainment are particularly daunting given not only the current trajectory of fossil fuel emissions – but also rollbacks to environmental and climate commitments by trend setters like the United States. 

Even so, the fact that WHO has been able to muster significant member state support for such a commitment represents a milestone in a battle to raise awareness about a health threat from fine particulates and other air pollution components that scientists first defined in the mid-1990s, and that WHO member states only formally embraced in a 2015 World Health Assembly Resolution.

And while ambitious, this year’s conference goal also provides a clear target for countries to aim for – after the WHO’s inaugural Conference on Air Pollution and Health failed to do so. 

“The science is as clear as our skies must be. We will take action to stop toxic air from polluting our health,” declared Neira in a statement to Health Policy Watch. 

Health community rallies around air pollution

As another reflection of growing awareness, nearly 50 million health professionals, patients, advocates, and individuals signed a call ahead of this week’s conference for urgent action to reduce air pollution. 

Signatories included more than 47 million health professionals, patients, representatives of civil society organizations, and individuals – from organizations such as the World Medical Association, NCD Alliance, and the World Heart Federation. 

“Forty-seven million people from the health community have issued a clarion call for urgent, bold, science-driven action on air pollution, and their voices must be heard,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in a press statement ahead of the three-day conference event. 

“At the second WHO Conference on Air Pollution and Health in Cartagena, we hope to see concrete commitments from countries to implement those tools and save lives.”

Even so, Tedros himself will not be attending the three-day conference – a last minute cancellation perhaps reflective of the continuing budget and political woes faced by WHO in Geneva.

Among the more than 700 participants, however, are ministers of health, deputy ministers and other high level health officials from China, India, Colombia, Vietnam, and El-Salvador. A number of mayors from cities such as  London, Santiago, Quebec, as well as leaders in civil society, will be in attendance. 

Other UN-affiliated agencies, such as the World Bank, the World Meteorological Organization and the UN Environment Programme, as well as philanthropies such as Wellcome and the Clean Air Fund, are co-sponsoring as well as supporting sessions on topics ranging from finance to “super pollutants” – that warm the planet as well as polluting the air.  

Notably, no US government officials will be attending the conference – reflecting the Trump Administration’s recent decision to withdraw from WHO and as well as from multilateral global climate and environmental efforts where the US was previously a leader.

International cooperation fraught with uncertainty

The Cartagena conference comes at a time of tumultuous international relations and cuts to environmental and climate action. 

New US President Donald Trump, in particular, not only renounced the 2015 Paris Climate Accord but he has cancelled US participation and funding for clean energy development in Africa and beyond. At home, his administration has also issued a record number of orders rolling back domestic environmental regulations that limited toxic air pollution. (see related story)

https://healthpolicy-watch.news/epa-plans-to-roll-back-dozens-of-regulations-threatening-americas-health-environmental-health-experts-warn/

Historically, the US Environmental Protection Agency (EPA), National Atmospheric and Oceanic Administration (NOAA), and National Aeronautics and Space Administration (NASA) were global leaders in much of the air pollution space, participating on WHO, WMO and UNEP scientific panels. In this year’s conference, their voices will be strangely still. 

However, American academics from institutions such as Columbia University, the University of Colorado and University of California at Berkeley will still be in attendance, as will civil society groups such as the Environmental Defense Fund, Healthcare Without Harm, Client Earth and others. 

Despite the gaps, conference organizers hope the decades of research and expanding body of evidence around air pollution’s health impacts will spur individual countries to make strong national commitments to reducing air pollution – in line with the 50% by 2040 goal etched by WHO and its  “BreatheLife” awareness-raising campaign. 

Low- and middle income countries in Asia and Africa, struggling with a huge and still growing burden of air pollution-related diseases, can also be inspired by success stories on controlling air pollution in not only North America and Europe, but also in emerging economies of Latin America, and elsewhere. 

Countries that are unable to pledge to halve air pollution deaths within just 15 years will also be encouraged to make commitments to reducing pollution’s impacts more incrementally to at least meet one of WHO’s “interim air quality” goals, on the path to cleaner air.  

Air pollution quality table
The WHO’s air quality targets.

Countries also may pledge to act in specific sectors, such as the transport sector, through better monitoring and tighter regulatory oversight, or through new clean energy investments, for example. 

“While the challenge is immense, progress is possible. Many cities and countries have significantly improved air quality by enforcing stricter pollution limits,” said Neira. 

Expanding knowledge around health impacts

In the two days leading up to Thursday’s session on high level policy commitments, the conference will feature dozens of technical sessions on the latest science.

These will cover air pollution sources and their measurement – from household air pollution to wildfires and fracking; solutions for cities and polluting sectors such as transport and for reducing emissions from health sector facilities – and its environmental footprint more broadly. 

Notably, a widening array of health conditions have now been linked to air pollution exposure beyond the “traditional” diseases of respiratory illnesses, cardiovascular diseases and cancers.

More recent research has shed light on a growing set of linkages between high air pollution levels and health at all stages of life – from adverse birth outcomes to dementia and mental health. 

“Besides years of living with laboured breath, punctuated by asthma attacks, or clouded by cataracts, mounting evidence links air pollution to various health outcomes like low birth weight, diabetes, cognitive impairment, and mental health impacts,” said Neira.

“The evidence is indisputable.” 

Health sector’s role

A key point of cross-cutting focus will be the health sector – how health policy officials and healthcare professionals – can play a meaningful role in an issue oft-perceived largely through an “environmental” lens. 

The conference also will:

  • Take stock of global progress since the start of the 2015 Sustainable Development Goals (SDGs)
  • Showcase health, climate, gender and equity co-benefits of air pollution and energy action 
  • Harness climate and development finance to tackle air pollution and ensure a just energy transition.
  • Leverage health arguments to drive country cooperation and financial commitments.

Cultural hype to build awareness 

Cartagena 2025 conference air pollution
Air pollution simulators in “pollution pods” being set up prior to the conference.

Amid the technical panels and commitments, the conference will host a range of  interactive and cultural events open to the public on the broad esplanade that graces Cartagena’s seaside Conference Center.

Beginning on Wednesday, renowned Brazilian street artist Eduardo Kobra will develop and exhibit a large-scale mural dedicated to global environment and climate concerns on the esplanade. 

British British artist Michael Pinsky will invite public participants to an immersive air pollution experience in his “pollution pods” which will simulate different types of air pollution and sources for visitors to the dome shaped pods. 

Each pod will mimic a different type of pollutant, and its sensory discomforts, highlighting the urgency of addressing toxic air sources, Pinsky said.  

Conference participants as well as members of the public will also be able to test their lung and heart health through booths operated by the European Respiratory Society, World Heart Federation, and European Lung Foundation. 

On Monday, the eve of the conference, early bird arrivals can opt to join a six kilometer cycling tour of the city or a four kilometer run/walk – illustrating the importance of clean air to healthy, active lifestyles.

During the event, sponsored by the global non-profit Cityzens, participants will be equipped with personal sensors to get a sense of their own particulate matter exposure while exercising – beginning at 6 am before the city’s temperatures rise above 30°C. 

It’s hoped that the cultural and activities hype will bring the dangers of air pollution down to a more personal and motivational level, Neira said. 

Image Credits: E.Fletcher/Health Policy Watch, Fletcher/Health Policy Watch, Raunaq Chopra/ Climate Outreach, WHO, S. Samantaroy/HPW.

Saima Wazed, Director of WHO’s South East Asia Regional Office (SEARO) with Dr Tedros Adhanom Ghebreyesus, WHO-Director General, during her swearing in ceremony in January 2024

Bangladesh’s Anti Corruption Comission  (ACC) has filed two cases against Saima Wazed, director of WHO’s South East Asia Regional Office (SEARO), for fraud, forgery and misuse of power in connection with her campaign to become the WHO’s top official in the South East Asia region.

The charges against Wazed, who took office as Regional Director in January 2024 following her election by SEARO member states, are the culmination of an ACC investigation that began in January 2025, as reported by Health Policy Watch.

Her  2023 election campaign was shadowed by charges that her influential mother, former Bangladesh Prime Minister Sheikh Hasina, had used her influence to gain her daughter’s election to the post – only a few months before widespread protests prompted Hasina’s resignation and flight from the country in 2024.

According to the formal charges that now have been filed against Wazed, she is alleged to have provided false information about her academic record, during her campaign for RD, violating Section 468 of the Bangladesh Penal Code (forgery for the purpose of cheating); and Section 471 (forging a document).  The ACC alleges she misrepresented her qualifications—claiming an honorary role at Bangabandhu Sheikh Mujib Medical University, which the university disputes—to secure her WHO position. The charges were detailed to media Thursday by ACC Deputy Director Akhtarul Islam,

Wazed is also accused of having misused her power and influence to collect about $2.8 million from various banks for the Shuchona Foundation, which she formerly headed.  The ACC case did not provide complete details on how the money was then used. Those charges include: allegations of fraud and misuse of power under Sections 420 (cheating and dishonestly inducing delivery of property); , as well as Section 5(2) of the Prevention of Corruption Act of 1947.

Asked to comment on whether the Bengali government investigation of Wazed would trigger any WHO investigation of the RD and the alleged campaign misdeeds, WHO did not respond.

Charges follow other cases against high level WHO officials

Dr Takeshi Kasai, Director for WHO’s Western Pacific Region at an April 2021 COVID press conference – he was ousted from his position in 2023.

The legal action against Wazed is the latest in a series of scandals that have implicated senior leadership in WHO – at a time when it is also under unprecedented financial pressure, due to the United States’ January 2025 announcement that it intends to withdraw from the global health organization.

In March 2023,  member states in WHO’s Western Pacific Region voted to oust WPRO Regional Director  Takeshi Kasai, following allegations of abusive behaviour and financial mismanagement. His exit after an internal probe reflected a serious crisis of governance in one of the six regional offices upon which the global health agency depends to fulfil critical missions in countries.

During the period of the investigation and ouster, Dr. Temo Waqanivalu, a senior WHO official from Fiji, emerged as a potential candidate to replace Kasai as RD of the WPRO office.

However, Waqanivalu’s candidacy unravelled when he was accused of harassing Dr. Rosie James, a young UK health professional, at the October 2022 World Health Summit in Berlin. The investigation concluded with Waqanivalu’s dismissal from WHO in April 2023 –  as the Organization tried to step up its responses to sexual harassment and abuse allegations by staffers as well as recipients of WHO aid against powerful WHO officials.

Role of WHO Regional office leadership – under scrutiny

The role and position of WHO’s Regional Office leadership could become all the more important as the agency comes under under increased pressure  to improve efficiency, transparency and overall performance in the wake of the announced United States withdrawal  – the agency’s largest financial backer.

Reinforcing the leadership and prowess of the agency’s six regional and 152 country offices was core to the “transformation” initiative launched by WHO Director Genera Tedros Adhanom Ghebreyesus in July 2017, just after he took office.

Now facing a financial crisis, shifting more staff, as well as some core areas of expertise, to WHO regional centers and country offices could also serve as an inportant cost-saving measure since generous “post adjustments” based on location, are usually much lower for international staff in regions than in Geneva’s headquarters.

At the same time, to fill any enhanced role and mission, WHO’s regional offices need leadership acting professionally and above any single set of vested interests.

In the case of the South East Asia Regional Office, the charges filed against the RD, represent yet another setback in that “Transformation” journey.

WHO’s budget under the knife

Sources: WHO bi-annual HR reports, and UN salary scales, in comparison to proportion of costs attributable to entitlements and benefits. Note: Costs of P6 positions, while comparable to D1, are included in the P- category, not D category.

This year, WHO already faces a $175 million budget shortfall in 2025 as hoped-for US and other donor funds have so far failed to materialize, and an even more severe crisis in 2026 when the US withdrawal formally takes effect, and its mandatory dues of about $130 million annually cease altogether.

That’s despite reducing its 2026-2027  bi-annual budget to $4.9 billion – nearly $2 billion less than the $6.83 billion budget for the organization in 2024-25.

In a press conference on Monday, WHO Director General Dr Tedros Adhanom Ghebreyesus and other senior WHO officials described the grim impacts on WHO’s global health operations faced as a result of the loss of US contributions – representing about 15% of WHO’s annual budget. Programmes ranging from TB and malaria control to measles surveillance and humanitarian response face severe cutbacks, the officials warned.

At the same time, WHO still has not issued any response to the 10 March Health Policy Watch report detailing the bloated ranks and costs of its most senior management – with senior director positions having nearly doubled since 2017 – and costs for just 215 of WHO’s most senior staff approaching $100 million.

EXCLUSIVE: Number of WHO Senior Directors Nearly Doubled since 2017, Costs Approach $100 million

 

Image Credits: X/Saima Wazed, WHO.

A nurse tests a woman for tuberculosis.

A Phase 3 trial for the tuberculosis vaccine known as M72/AS01E is running a year ahead of schedule and has already recruited 90% of the 20,000 people it needs, according to Dr Alemnew Dagnew, who leads its clinical development.

The vaccine aims to prevent adolescents and adults already infected with latent TB from developing pulmonary TB. In countries with high TB burden, vast numbers of people have latent TB, which means that they are infected with the TB bacteria but not symptomatic or infectious. People with latent TB do not generally develop TB disease unless their immune systems are compromised.

The trial scientists initially thought it would take two years to recruit all the study participants at the 54 trial sites spread across South Africa, Kenya, Zambia, Malawi and Indonesia.

“We started the trial last year in March, and we have already enrolled more than 90% of the participants, which is huge progress, and we are hoping to have full enrollment in the coming weeks,” Alemnew told Health Policy Watch this week. “It’s one year ahead of our projection.”

Alemnew works for the Gates Medical Research Institute (Gates MRI), which is sponsoring the trial, while funding comes from the Gates Foundation and Wellcome Trust.

The sites were chosen because they are in communities where there is a high TB incidence and because of the countries’ capability to conduct clinical research, said Alemnew.

Dr Alemnew Dagnew

Efficacy of 50% in Phase 2b trial

A Phase 2b trial of the vaccine found that it was 50% effective in blocking latent TB from becoming pulmonary TB. This would not have been efficacious enough to persist with a costly Phase 3 trial for many other diseases. But because of the enormous global burden of TB, 50% efficacy will save millions of lives.

“If we think about the population level, the impact is going to be huge,” said Alemnew.

“If I can throw in some numbers, the World Health Organisation (WHO) estimates that, over 25 years, a vaccine with 50% efficacy for protecting adolescents and adults could save 8.5 million lives, prevent 76 million new TB cases and save $41.5 billion for TB-affected households.”

Currently, the only available TB vaccine is BCG, which is given to newborn babies. It was first administered to humans in 1921 and no new vaccines have been developed despite TB being one of the world’s most deadly infectious diseases.

While the BCG vaccine “works well in preventing severe forms of childhood TB, its efficacy against prevention of preliminary TB in adolescents and adults is insignificant,” notes Alemnew.

Of the 20,000 participants – aged from 15 to 44 – 18,000 will be infected with TB, 1000 participants will be non-TB infected and 1000 will be people living with HIV.

The trial will stop once 110 people have developed pulmonary TB, he adds – by which time scientists enough data will have been generated to analyse the vaccine’s efficacy.

Tech transfer

First developed by GSK, the M72/AS01E vaccine is made up of a fusion of two TB antigens combined with an adjuvant (AS0) to boost the body’s immune response.

Trial participants will get two doses of the vaccine or a placebo 28 days’ apart, with telephonic follow-up every two months and a clinic visit every six months until the trial is over.

GSK developed the vaccine over many years, and published the results of its Phase 2b results in the New England Journal of Medicine (NEJM) in 2018 and 2019. Gates MRI then stepped in to license the vaccine candidate.

“GSK continues to provide the adjuvant component for clinical trials, and will also for the commercial product [if the Phase 3 trial is successful]. They have also been working with us to have technology transfer to manufacture the antigen component,” said Alemnew.

Personal mission

Alemnew was born and raised in Ethiopia, where he also trained as a physician and practised medicine.

“One of the most one of the common health conditions that I used to manage was TB, so have seen the devastating impact of TB on patients, their families and also the communities,” he said.

“TB affects people of poor socio-economic status. If a family member gets sick with TB, then they would have to stop working. If that family member is the only source of income, the whole family will be in a bad situation. 

“Developing a vaccine like the one which I’m currently working on, [if successful] is going to be like a gift to the community that I came from.

 “So for me, it’s a great honour and privilege to work on this important vaccine. It’s going to motivate not only those of us who are working on this vaccine, but the whole TB research community.”

Image Credits: Socios en Salud , Bryce Vickmark.

Without proper guidance, fasting can lead to dangerous fluctuations in blood sugar levels.

ALEXANDRIA, Egypt – As the sun sets over Alexandria, the scent of simmering Molokhia fills the air, mingling with the voices of street vendors calling out their final sales before Ramadan fasting ends for the day.

Long tables offer festive dishes of lamb with grilled meats, dates, lentil soup and rice, beloved traditions passed down through generations. Yet this plenty poses a chronic health risk – because many Egyptian adults live with diabetes.

In Irbid, Jordan, a similar scene unfolds. Families sit down to enjoy Mansaf, Jordan’s rich national dish of lamb, alongside plates of fresh vegetables, pickles, yoghurt, and warm Shrak bread.

Again, the celebrations pose dietary changes as well as possible medication issues, with many disadvantaged Muslims choosing holiday food purchases over insulin. In many other nations, providing insulin without holiday interruptions or unfair pricing is a challenge.

Ramadan is not just about fasting – it is about community, generosity, and celebration. But amid the joy and indulgence, people with diabetes face a difficult puzzle: how to balance their health with the deep-rooted traditions.

Fasting and blood sugar

Without proper guidance, fasting can lead to dangerous fluctuations in blood sugar levels, dehydration, and cardiovascular complications. These lead to serious illness and death, but also disability with job loss and further demands on health budgets.

Pre-Ramadan nutrition education is a public health necessity. Scaling up structured, culturally relevant diabetes education programs can empower Muslims worldwide to observe Ramadan safely while maintaining their health.

While the global rise in diabetes prevalence is well known, fasting during Ramadan presents unique challenges from Zamboanga to Tangier. Across diverse Muslim communities – whether in majority-Muslim nations or as minorities worldwide – growing diabetic populations need knowledge to fast safely.

In Egypt and Jordan, pre-Ramadan nutrition education has emerged as a policy-driven intervention that empowers individuals with diabetes to make informed dietary and lifestyle choices while fasting. By integrating structured education into national healthcare systems, policymakers can ensure that diabetes patients receive the guidance they need to observe Ramadan safely.

The new interface between social media and telehealth is showing promise in providing culturally sensitive education about diabetes. Starting before the holiday and continuing to measure results months later, researchers have found ways to help patients complete Ramadan with greater knowledge and more stable blood sugar levels.

Ramadan also poses challenges in terms of medication access and distribution, raising a major public health concern in a nation where nearly 15% of adults live with type 2 diabetes. Across all regions, individuals with diabetes face significant risks, including hypoglycemia, hyperglycemia, dehydration, and cardiovascular complications if not properly managed.

Bridging the gap between faith and health

Fasting from dawn to sunset disrupts the typical dietary and medication routines of individuals with diabetes. Without proper guidance, some consume high-sugar, high-fat meals at iftar, leading to post-fasting hyperglycemia, while others experience dangerously low blood sugar throughout the day. Irregular medication use further complicates diabetes management, making fasting particularly risky for those on insulin or glucose-lowering therapies.

Despite medical concerns, fasting is a strong religious and cultural obligation for Muslims – but most lack accessible fasting and dietary guidance, increasing their vulnerability to complications.

Equipping patients with practical and culturally relevant guidance can help with diabetes management during fasting periods.

The International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance have long recommended personalized strategies including meal planning, medication adjustments, and frequent glucose monitoring to mitigate risks. Yet these strategies remain rare, inconsistent and underdeveloped across healthcare systems.

Nutrition education in diabetes management

Nutrition is central to diabetes management, and education programs tailored to Ramadan fasting have shown significant benefits.

Patients who receive structured guidance before Ramadan learn how different foods affect blood sugar and adjust meal choices accordingly. This enables them to reduce their risk of complications such as hypoglycemia and cardiovascular issues.

Improved medication adherence and modified dosages can be undertaken safely under medical supervision.

These interventions enable people with diabetes to sustain healthier habits beyond Ramadan, promoting long-term diabetes control.

Studies from Egypt, Jordan, and Pakistan show that individuals who participate in pre-Ramadan nutrition education programs experience improved glycemic control and lower rates of diabetes-related complications.

By equipping patients with practical, culturally relevant guidance, these programs have the potential to transform diabetes management during fasting periods.

Scaling pre-Ramadan education through policy

Despite its benefits, pre-Ramadan diabetes education is not widely institutionalized. To bridge this gap, policymakers must integrate structured education programs into primary healthcare systems.

If pre-Ramadan education is mandated in healthcare settings, primary care providers could offer structured guidance for diabetes patients who intend to fast.

Public health campaigns need to provide accessible, culturally relevant materials that address common misconceptions and promote balanced eating. Mobile health (mHealth) applications and telemedicine services can extend the reach of diabetes education, providing real-time support to fasting individuals.

Physicians, dietitians, and community health workers should be equipped with specialized training on Ramadan-focused diabetes management.

National media campaigns should highlight the importance of pre-Ramadan preparation and safe fasting practices.

The UK and Canada have begun integrating Ramadan-focused diabetes education into their broader public health initiatives, providing models that can be adapted in other regions with large fasting populations.

Holiday Training Pays Health Dividends 

Pre-Ramadan nutrition education is more than a clinical intervention – it is a public health necessity. By embedding structured, culturally sensitive diabetes education into care systems, governments protect both fasting individuals and health budgets without undermining religious practices.

Tight health budgets and rising diabetes rates require policy-driven education strategies to reduce illness and deaths. These simple preventive programs can improve the quality of life worldwide for nearly two billion Muslims. The time to act is now—because no one should have to choose between their faith and their health.

Naqaa Alomari is a Jordanian health educator and nutritionist working in Egypt on diabetes. Work experience at the Diabetes and Diabetic Foot Center and as a Saudi government health specialist deepened her focus on health policy needs. Her research merging new media with Ramadan education is forthcoming. She compared US and Taiwan school lunch programs for a global health and development thesis at Taipei Medical University.

Image Credits: Unsplash, Unsplash.

Depletion of world’s glaciers that are also its water towers threatens water supply to hundreds of millions downstream.

Many glaciers in western Canada, the United States, Scandinavia, Central Europe, the Caucasus, New Zealand and the tropics will not survive the 21st century – and this will have a “dramatic impact” on mountain communities and hundreds of millions of people who depend on water that originates from these glaciers.

These are the key findings of the latest reports from the United Nations (UN) agency World Meteorological Organization (WMO), and the Zurich-based glacier monitoring agency World Glacier Monitoring Service (WGMS).

Glaciers are among the key indicators of the health of our planet, and some of the world’s largest rivers including the Ganga, Brahmaputra, Indus, and Yangtze, originate from the glaciers.

But those glaciers are now rapidly retreating.

“WMO’s State of the Global Climate 2024 report confirmed that from 2022-2024, we saw the largest three-year loss of glaciers on record. Seven of the ten most negative mass balance years have occurred since 2016,” said WMO Secretary-General Celeste Saulo.

“Preservation of glaciers is a not just an environmental, economic and societal necessity. It’s a matter of survival.”

Since 1975, the world’s glaciers have lost 9,000 billion tonnes of ice or an ice block the size of Germany, with a thickness of 25 meters. This has pushed the sea levels up by 25 mm.

See related story: The Year 2024 Was Warmest-Ever on Record – Temperature Rise Likely Exceeded 1.5°C

Melting glaciers are putting food security at risk

Distribution of glaciers around the world.

The 2024 data shows that, for the third consecutive year, all the glaciers around the world had lost mass.

The rate of melting of glaciers is directly linked to the rising global temperatures, Stefan Uhlenbrock, Director of Water and Cryosphere department at the WMO said.

As 2024 was the warmest year on record, temperatures are expected to continue to rise, and Uhlenbrock warned the changes this will cause will be dramatic.

“Globally, in the interconnected economy, it’s everyone around the world who’s indirectly impacted from these dramatic changes. It’s putting at risk the water supplies. It’s putting at risk food security, energy security, as well as the ecosystem services that water resources and other resources provide. But you shouldn’t also forget the social, the cultural as well as the spiritual values glaciers have,” he said during a press conference.

The reports were released to mark the first World Day for Glaciers on March 21 this year, and sound alarm that the accelerating glacier melt risks unleashing cascading impacts on economies, ecosystems and communities.

Source of 70% of world’s freshwater under threat

There are approximately 275,000 glaciers around the world that cover roughly 700,000 km² or the equivalent of twice the size of Germany. These exclude the continental-sized ice sheets of Greenland and Antarctica.

The glaciers are in high mountain regions often referred to as the world’s water towers as glaciers are the source of about 70% of the world’s freshwater reserves.

In the short-term, increased glacier melting increases the risk of natural hazards such as floods for those living downstream. But in the long-term, they threaten the water security of people as the rivers that the glaciers feed risk running dry. In dry and hot seasons in some areas, glacier runoff is often the only water available.

“Hotspots of water availability from glaciers are Central Asia and the central Andes, where glaciers in the hottest and driest months are often the only water resource,” Dr Michael Zemp, Director of the WGMS said during the press conference. WGMS has been coordinating glacier monitoring for over 130 years now.

Glacier melt contributes to sea-level rise

Annual global glacier mass changes from 1976 to 2024 in gigatons. The shades of blue refer to years the glaciers increased in mass while the shades of red refer to the years the glaciers lost mass.

The new findings complement a recent study published in the journal Nature in February, which found that between 2000 and 2023, glaciers lost 5% of their remaining ice.

From 2000 to 2023 alone, the global glacier mass loss totals 273 billion tonnes of ice every year, according to the reports. This amounts to 6,552 billion tonnes over 24 years or what the entire global population currently consumes in 30 years (assuming three litres per person per day).

Regionally, the loss of glacier ice ranges from 2% in the Antarctic and subantarctic islands to almost 40% in Central Europe.
This melting ice is currently the second-largest contributor to global sea-level rise, after the warming of the ocean.

During this period, glacier melt contributed 18 mm to global sea-level rise. “This might not sound much, but it has a big impact: every millimeter sea-level rise exposes an additional 200,000 to 300,000 people to annual flooding,” says Zemp.

Based on a compilation of worldwide observations, the WGMS estimates that glaciers (separate from the continental ice sheets in Greenland and Antarctica) have lost a total of more than 9,000 billion tonnes since records began in 1975.

The changes in global glaciers since 1975 in gigatons (Gt).

“If you take the example of Germany, it would be an ice block of the size of Germany, with a thickness of 25 meters. That is the ice that we lost since 1975 from glaciers,” Zemp said. “This is about 25 millimetres of sea level rise, or currently, a bit more than one millimetre each year,” he said.

The Greenland ice sheet is also melting while the Antarctic ice sheet is not contributing “so much” to the rising water levels at the moment. But as the temperatures continue to rise that will change.

“For the next decades, the glaciers are the drivers for the sea level rise. When we talk about the next centuries, it’s the ice sheets that we have to worry about,” Zemp said.

Preservation of glaciers is a necessity

The 2024 hydrological year, calculated from 1 October 2023 to 30 September 2024, saw the fourth-highest glacier mass loss on record. It was also the third year in a row during which all 19 glacier regions in the world experienced a net mass loss.

This loss was relatively moderate in regions like the Canadian Arctic and the Greenland periphery but glaciers in Scandinavia, Svalbard (Norwegian archipelago) and North Asia experienced their largest annual mass loss on record.

“I just want to want to stress that preserving glaciers is not only an environmental imperative, it’s really a survival strategy,” said WMO’s Uhlenbrock.

He pointed to the 2022 heatwave in Europe when the heat caused the Swiss Alps to lose 10% of its ice in two years.

“This was also the year when it was so hot that several nuclear power plants in France had to be shut down because of the lack of cooling water. It was such a dry and hot time that there were energy supply problems,” he said.

“We need to advance through better observation systems, through better forecasts and better early-warning systems for the planet and the people. Only then we can protect our water supplies, the livelihoods of people, as well as ecosystems for future generation,” he said.

The way forward is to limit the global emissions of greenhouse gases, experts said, adding that there are no other viable long-term measures.

This year is being marked as the International Year of Glaciers’ Preservation by the United Nations (UN). Global leaders, policymakers, scientists and civil society members will attend a UN high-level event in Paris and New York on March 20 and 21 to address the crucial role of glaciers in the climate system and water availability.

Image Credits: WMO, World Glacier Monitoring Service (WGMS), C3S/ECMWF/WGMS.

Witkoppen Clinic’s HIV services in Johannesburg was one of many African clinics receiving PEPFAR funds via USAID.

Two to four million additional Africans are likely to die annually as a result of the shock aid cuts by the United States and other key donors, according to Dr Jean Kaseya, who heads the Africa Centre for Disease Control and Prevention.

Kaseya heads to Washington next week to coincide with the end of US Congress’s reauthorisation of the US President’s Emergency Plan for AIDS Relief (PEPFAR) on 25 March.

Numerous PEPFAR projects have already been terminated in the past two months by Trump appointee Elon Musk’s Department of Government Efficiency (DOGE) and it is unclear what the Republican-dominated Congress envisages for the plan.

Kaseya said he planned to meet members of the Trump administration, PEPFAR officials and Members of Congress next week in a bid to restore US aid.

“It is a disaster,” Kaseya told a media briefing on Thursday, disclosing that some African countries relied on “external assistance” for 80% of their HIV and malaria responses.

‘Overnight, everything is gone’

“Overnight, everything is gone,” he said, noting that 30% of Africa’s health expenditure comes from official development assistance (ODA) – yet there had been a 70% cut in ODA this year from $81 billion to $25 billion.

Aside from the gutting of virtually all the US Agency for International Development (USAID) grants, major European donors have also cut ODA.

Earlier in the week, the World Health Organisation (WHO) reported that Kenya, Lesotho, South Sudan, Burkina Faso and Nigeria would run out of antiretroviral medicine for HIV within the next few months as a result of USAID cuts.

WHO Director-General Dr Tedros Adhanom Gebreyesus said that while the aid withdrawal was the right of the US administration it “has a responsibility to ensure that, if it withdraws direct funding for countries, it is done in an orderly and humane way to allow them to find alternative sources of funding.”

Kaseya reported that he has been travelling the breadth of the continent and internationally to secure three key pillars of support for health on the continent: increased domestic funding, “innovative financing” for outbreaks and “blended financing”.

Africa CDC is pursuing three sources of funds to address the enormous gap left by the US withdrawal of aid.

The aid cut will “reverse two decades of health achievements in maternal, child health and infectious diseases”, warned Kaseya, adding that entire health systems “could collapse”.

Alongside the cuts is a surge in disease outbreaks – up 41% in the past two years.

The African health response is also hampered by countries’ debt servicing burden and dependence on imported medical countermeasures, said Kaseya.

Africa CDC projects an additional 39 million people will be pushed into poverty as part of the ODA cuts. The calculations are based on CDC modelling.

Kaseya has held several briefings with health ministers and African Union leaders to address the crisis, particularly focusing on alternative sources of funding.

Only two of the 55 member states – Botswana and Rwanda – spend 15% of their GDP on health – something that African states pledged to do in the Abuja Declaration back in 2001.

Only 16 countries have national health financing plans.

Kaseya said the Africa CDC is also trying to ensure that the health sector access to some of the $95 billion contributions made by the diaspora, including possibility via taxes.

With blended finance, Kaseya said private sector investment is needed “mostly in local manufacturing, electrification of health centres, connectivity, digital health and supply chain infrastructure”.

Mpox plateaus – but fall in testing is to blame

While mpox cases appear to have plateaued, this is due to challenges related to testing – particularly in the Democratic Republic of Congo (DRC) – rather than the disease being controlled, said Kaseya.

Conflict in eastern DRC and the loss of USAID funding that was covering the transportation of mpox samples to laboratories have led to a 16% drop in testing in the DRC over the past week alone. Less than a quarter of suspected cases were tested. Meanwhile, the turnaround time for testing has increased in many regions due to transport problems.

Image Credits: International AIDS Society, Witkoppen Clinic.

The method used in carcass sampling utilizes the knowledge and experience gained during previous outbreaks and the samplers work in pairs and in wearing personal protective equipment

The proposed pandemic agreement being negotiated at the World Health Organization (WHO) represents a critical opportunity for the global community to prevent future pandemics – including through coordinated multi-sectoral surveillance across human, animal, and environmental health data. As WHO member states gather in closed meetings over the next few week, three experts in wildlife health policy and research present field-based evidence that such a surveillance approach is critical to prevent pandemics.

The next pandemic is not a matter of if, but when, unless strong action is taken. The world remains highly vulnerable to outbreaks of zoonotic diseases that jump from animals to humans due to increasing urbanization, deforestation, and globalized travel.

As the world scrambles to strengthen pandemic prevention, preparedness, and response, the proposed pandemic agreement being negotiated at the WHO represents a critical opportunity for the global community to prevent future pandemics. 

Central to this effort is Article 4 of the draft Pandemic Agreement , which calls for countries to develop plans for coordinated multi-sectoral surveillance across human, animal, and environmental health data. While some countries express concerns about feasibility, such surveillance is not only necessary but entirely achievable with the right global commitment.

Multi-sectoral surveillance takes a One Health approach that recognizes the interdependence of human, animal, and environmental health. Given that the majority of emerging infectious diseases originate in animals, particularly wildlife, this type of surveillance is essential to prevent future pandemics.

In practice, it involves human health workers, veterinarians, environmental scientists, empowered citizens, and others on the spillover frontlines working together to detect early warning signs of potential pathogen emergence and outbreaks.

Lessons from Republic of Congo 

Dr. Alain Ondzie leading educational outreach on Ebola at a village in northern Republic of Congo

The Republic of Congo (RoC) provides a compelling example of effective multisectoral surveillance. Following devastating Ebola virus outbreaks that took thousands of lives and threatened great ape populations, a collaborative effort between wildlife experts and the Congolese Ministry of Health established a low-cost wildlife mortality reporting network covering 50,000 km².

This system serves as an early warning mechanism for potential Ebola virus outbreaks, which have historically been linked to infected wildlife and consumption of animal carcasses, especially in the Congo Basin. 

The program demonstrates how resource-efficient surveillance can function in challenging settings. Local personnel were trained in safe specimen collection protocols, and geographically distributed bases were equipped with sampling kits.

Critically, the system established in-country diagnostic capabilities for Ebola virus testing, reducing turnaround time from months to hours. The program not only monitored wildlife mortality but also provided educational outreach to over 6,600 people in rural northern RoC. That outreach aimed to encourage behavioral changes to reduce human activities that lead to pathogen spillover.

 This initiative represents the essential elements of multi-sectoral surveillance: cross-sector collaboration, community engagement, strategic resource allocation, and rapid diagnostic capabilities.

While the RoC has not experienced an Ebola epidemic since 2005, this surveillance system has detected anthrax in carcasses and continues to function as an early warning mechanism in a high-risk region, protecting both human communities and the country’s globally significant great ape populations.

Carcass sampling a great ape in the Republic of Congo.

Southeast Asia’s wildlife surveillance

Similarly, the WCS initiative WildHealthNet in Southeast Asia has shown how national wildlife health surveillance programs can be built on partnerships with local governments, existing resources, and targeted technical support.

Such wildlife health surveillance programs were first to detect African Swine Fever, a devastating domestic pig disease, in free-ranging wildlife in Laos, Cambodia and Vietnam, and identified biosecurity breaches that contributed to its spread. 

The network also identified a significant transnational outbreak of Highly Pathogenic Avian Influenza (HPAI) in multi-use wetlands, rapidly informing public and livestock health partners to limit onward transmission to domestic animals and humans.

The governments of Lao PDR and Cambodia have now formally adopted legislation codifying the network’s reporting structures and standard operating protocols. Building on this regional progress, WCS has expanded WildHealthNet to additional regions and is helping lead a global community of practice (Wildlife Health Intelligence Network-WHIN).

Some countries with large animal populations are concerned that multi sectoral surveillance, particularly an obligation to identify settings and activities where humans and animals interact, would be onerous and not implementable due to resource limitations and coordination challenges.

Developing countries also worry that institutions, companies, and other countries could profit from the data they share. Meanwhile, developed countries are keen to include multisectoral surveillance so that outbreaks can be detected and mitigated as soon as possible.

Coordination, data-sharing and sovereignty

Coordination between health, animal, and environmental sectors presents challenges, but establishing clear communication protocols, creating joint task forces, and standardizing data-sharing procedures can streamline collaboration. Emerging One Health governance platforms help formalize these mechanisms, ensuring smoother cross-sectoral cooperation.

Regarding data-sharing concerns, the proposed WHO agreement can establish frameworks that protect data sovereignty while enabling critical information exchange. Tiered data sharing – where non-sensitive data is shared widely, while sensitive data remains under member State control – can balance sovereignty with global health security.

Technology significantly reduces the burden of cross-sectoral surveillance. Digital platforms, mobile data collection, and analytics facilitate real-time surveillance without excessive cost and present additional savings through adoption and scaling of common tools.

The RoC initiative demonstrates that even with limited resources, establishing strategic diagnostic capabilities can dramatically reduce response times. Low-cost technologies, like instant messaging groups, can ensure effective communication and surveillance even in low-resource settings.

Those sampling dead wild animals now wear full personal protective equipment.

The cost-benefit case 

The economic benefits of investing in multi-sectoral surveillance far outweigh the costs. The COVID-19 pandemic cost the global economy trillions of dollars (and millions of deaths), while preventative measures would have been exponentially cheaper.

Early detection and containment of future zoonotic threats could prevent not only countless lives lost but also devastating economic consequences. Ebola outbreaks can run from the millions to tens-of-billions for the 2014 West Africa outbreak. The RoC’s surveillance system represents a modest investment compared to the potential costs of another Ebola epidemic.

The draft pandemic agreement, through its Article 4, has the potential to make multi-sector surveillance both achievable and sustainable by facilitating international cooperation, channeling resources, fostering capacity-building, and ensuring standardized protocols. It can empower governance frameworks that formalize multi-sectoral surveillance while safeguarding national sovereignty. 

The stakes are simply too high to exclude coordinated multi sectoral surveillance from the agreement. The perceived challenges are not insurmountable; they are challenges the global community is well-equipped to solve. A world without catastrophic pandemics is within reach, but only if we dare to work together. The time for action is now.

 

Sarah Olson is director of health research for the health program at the Wildlife Conservation Society (WCS). She provides leadership and research support to field veterinarians and conservation staff around the world. Her research with WCS has focused on frontline wildlife conservation and One Health challenges, including the wildlife trade and emerging infectious diseases, Ebola virus in great apes and bats, avian influenza in wild birds, and white-nose syndrome in North American bats. She is currently focused on understanding and mitigating wildlife health and zoonotic disease threats  and helping grow sustainable and effective wildlife health surveillance systems.

Manoly Sisavanh is  the WCS Deputy Country Director for Laos Program. She leads the policy dialogue with government in the areas of environmental policy on protected areas, forest and wetland management, supervises counter-wildlife trafficking and One Health programs, and oversees office operations. 

Dr Michel Masozera is WCS director of policy and institutional partnerships for Africa. He is an experienced professional in the field of biodiversity conservation, protected areas management and sustainable development. He received the National Geographic/Buffet Award for Leadership in African Conservation in 2004 for his role in the creation of Nyungwe Forest National Park, one of the largest remaining mountain forests in Rwanda.  

 

Image Credits: Sebastien Assoignons/ Wildlife Conservation Society, Sarah Olson/ Wildlife Conservation Society, Wildlife Conservation Society Congo, Wildlife Conservation Society.

Record warming has led to cascading impacts, such as a higher rate of glacier melting and ocean warming, which threaten fisheries and freshwater supplies.

The past ten years (2015-2024) were the ten warmest years on record, individually and collectively, according to the State of the Global Climate 2024 report released on 19 March.

The year 2024 was also the warmest year in the 175-year observational record of temperature tracking, according to the United Nations’ agency World Meteorological Organization (WMO), in the annual report.

And it was the first calendar year during which average temperatures were “likely” more than 1.5°C above the pre-industrial era (1850-1900) baseline, WMO experts said at a press conference on the report’s findings on Tuesday.

They use the term “likely” due to a highly technical scientific debate over what exactly may be considered the pre-industrial temperature baseline.

2024 was likely the warmest year on record and an estimated 1.55°C above the pre-industrial average, with a margin of error of ±0.13 C.

Key climate indicators worsening

Key climate indicators have worsened and some of the consequences are irreversible over hundreds if not thousands of years, said, Chris Hewitt, WMO’s Director of Climate Services at Tuesday’s press briefing.

“The climate has always been changing, if we look back at the distant past, then these rates of change are pretty high and not very welcome,” he said.

Among those, atmospheric concentrations of the greenhouse gas (GHG), carbon dioxide (CO2), are now at the highest levels it has been in the last 800,000 years.

The largest three-year loss of glacier mass on record also occurred over the past three years. This has pushed up the rate of sea level rise which has doubled since satellite measurements began.

In 2024, extreme weather events like tropical cyclones, floods, droughts, and other hazards led to the highest-ever number of people displaced in the past 16 years. Those events also contributed to worsening food crises and caused massive economic losses.

“While a single year above 1.5°C of warming does not indicate that the long-term temperature goals of the Paris Agreement are out of reach, it is a wake-up call that we are increasing the risks to our lives, economies and to the planet,” said WMO Secretary-General Celeste Saulo in a press statement.

See related story: Many of the World’s Glaciers Will Not Survive This Century With Dire Consequences for Hundreds of Millions

Rising planetary distress

Record temperatures extended over a wide area.

Rising heat is also affecting the integrity of the world’s oceans, critical habitats for fish, upon which around 16% of the world’s population depends as a key source of protein, with each of the past eight years having set a new record for ocean heat content.

“Our planet is issuing more distress signals — but this report shows that limiting long-term global temperature rise to 1.5°C is still possible. Leaders must step up to make it happen — seizing the benefits of cheap, clean renewables for their people and economies  —  with new National climate plans due this year,” United Nations Secretary-General António Guterres said in a press statement.

Right now, the contrary is happening in the world’s largest economy and second-largest GHG emitter, the United States.  The US government has fired key scientists affiliated with the National Oceanic and Atmospheric Administration (NOAA), which monitors oceans and temperatures; removed key climate data and pollution references from websites; abolished climate-related Environmental Protection Agency pollution regulations, rescinded incentives for clean energy production.

See related story: US EPA Rollback of Dozens of Air, Water and Chemical Pollution Regulations Threatens America’s Health, Experts Warn

In the case of the 2024 report, data was not affected, WMO experts at the conference said. But they did not elaborate on the extent to which scientific collaborations with US government scientists were still continuing.

“So, in the world of meteorology, whether in climates and oceanography, we exchange and share data and science and knowledge. So that would apply to any country and the US is clearly one of the world leaders in the field of climate. So, we certainly value the engagement in collaboration with us scientists and US organizations,” Hewitt said.

Scientists also stressed that the WMO report relies on multiple datasets, including, but not limited to data provided by NOAA.

Long-term warming hasn’t yet exceeded 1.5°C

While the average temperature in 2024 may have been above 1.5°C, the average over the past several decades was estimated at 1.34-1.41°C above the 1850-1900 baseline, the scientists said. Effectively, this means that the 1.5°C limit set out in the 2015 UN Paris Agreement, hasn’t yet been formally breached.

The record global temperatures seen in 2023 and broken in 2024 were also due to the ongoing rise in GHG emissions, coupled with a shift from a cooling La Niña to warming El Niño event, the report said.

Several other factors may have contributed to the unexpectedly unusual temperature jumps, including changes in the solar cycle, a massive volcanic eruption and a decrease in cooling aerosols, according to the report.

A WMO team of international experts is working to ensure even more reliable tracking of long-term global temperature changes, in collaboration with the Intergovernmental Panel on Climate Change (IPCC) – the UN body set up to assess science related to climate change.

Why oceans are warming faster

Annual global ocean heat content down to 2000 m depth for the period 1960–2024.

Around 90% of the energy trapped by GHGs in the earth’s system is absorbed by the oceans. The rate of ocean warming over the past two decades, 2005-2024, is more than twice that in the period 1960-2005.

“The ocean is warming, and it’s a continued warming, and in 2024 we observed ocean heat content which reached the highest levels in a 65-year observational record,” Karina von Schuckmann, an oceanographer at Mercator Ocean in France said during the press conference.

“Data for 2024 show that oceans continued to warm, and sea levels continued to rise. The frozen parts of Earth’s surface, known as the cryosphere, are melting at an alarming rate: glaciers continue to retreat, and Antarctic sea ice reached its second-lowest extent ever recorded. Meanwhile, extreme weather continues to have devastating consequences around the world,” said Saulo of WMO.

The 18 lowest Arctic sea-ice extents on record were all in the past 18 years.

Cascading impacts of extreme weather events

In 2024 extreme weather events worsened around the world.

Meanwhile, extreme weather driven by rising temperatures, such as cyclones, forest fires and floods, displaced over 100,000 people, the highest number since 2008, and destroyed homes, critical infrastructure, forests, farmland and biodiversity.

The compounded effect of various shocks, such as intensifying conflict, drought and high domestic food prices drove worsening food crises in 18 countries globally by mid-2024, the WMO report said.

Tropical cyclones were responsible for many of the highest-impact events of 2024. Tropical cyclone Chido on 14 December 2024 caused casualties and economic losses in the French Indian Ocean island of Mayotte, Mozambique and Malawi.

But high displacement numbers are not all bad, experts stressed.

“Early warning systems, when they’re effective, say, for a tropical storm, can often mean that people have moved out of an area and may be counted amongst displaced people,” explained John Kennedy, co-chair of WMO’s expert team on Climate Monitoring and Assessment.

“So rather than seeing casualties, we see people being moved to safer areas.”

Ocean warming will continue until the end of the century, even in low-carbon scenarios

Real-time data from specific locations show that levels of the three main GHGs – carbon dioxide, as well as methane and nitrous oxide – already at the highest levels in the last 800,000 years – continued to increase in 2024.

Gases like carbon dioxide remain in the atmosphere for generations, trapping heat.

Ocean warming leads to the degradation of marine ecosystems, biodiversity loss, and reduction of the ocean’s ability to act as a carbon sink. It fuels tropical storms and contributes to sea-level rise. Ocean warming is even more irreversible – on centennial to millennial time scales.

Climate projections thus show that ocean warming will continue for at least the rest of the 21st century, even for low-carbon emission scenarios.

Along with the urgent need to reduce GHG emissions, experts stressed on the need to strengthen early warning systems for countries.

Investments in weather, water and climate services are more important than ever to meet the challenges and build safer, more resilient communities, Saulo stressed.

“Only half of all countries worldwide have adequate early warning systems. This must change,” said Saulo.

Image Credits: WMO, WMO , WMO.

WHO head of immunisation Dr Kate O’Brien and Dr Joachim Hombach, WHO senior health advisor and SAGE Executive Secretary

Cuts to global immunisation budgets are hitting measles vaccine coverage, disease surveillance, laboratory networks and outbreak response the hardest, according to the Strategic Advisory Group of Experts on Immunization (SAGE).

SAGE, which advises the World Health Organization (WHO) on immunisation, issued the warning at a media briefing on Tuesday after its four-day biannual meeting.

It warned that the recent cuts by the Trump administration in the United States create a risk of further backsliding in immunisations “just when countries are recovering from the impact of the COVID-19 pandemic”. 

“The number of zero dose children, meaning those children that have not received any vaccines, have increased, even though the big [post-COVID] catch-up has helped,” SAGE chair Dr Hanna Nohynek told the media briefing.

Dr Kate O’Brien, WHO’s head of immunisation, said that vaccines have saved at least 154 million lives over the past 50 years, “and 60% of those lives saved were attributable to the measles vaccine”. 

Measles labs shutdown

However, WHO’s global measles and rubella network of more than 700 laboratories, funded solely by the US, faces “imminent shutdown”, WHO Director-General Dr Tedros Ahhanom Ghebreyesus told a media briefing on Monday. 

The collapse of the network, called Gremlin, would mean that outbreaks would not be detected – either at all or not rapidly, said O’Brien.

“Measles is one of the most infectious viruses, and it can have serious consequences, including infections of the brain, of the lung, pneumonia and  encephalitis,” she noted.

“The purpose of detecting [measles outbreaks] rapidly is to stamp them out at source as quickly as possible and to respond,” said O’Brien. 

She warned that measles was already surging, with 57 countries having outbreaks last year, in comparison to 35 countries in the two prior years. 

“Without that lab network and the epidemiologists, scientists and public health workers that are part of that response, we will certainly see many, many more outbreaks, many, many more deaths and many, many more cases,” said O’Brien.

Gremlin costs $8million a year, which O’Brien described as a “best buy” investment to save lives. It had been funded by the US Centers for Disease Prevention (CDC) not the US Agency for International Development (USAID).

The major theme of the four-day meeting was the “very high concern” of SAGE members of the impact of the funds cut on the “eradication, elimination and control of diseases”, added O’Brien.

Polio transmission

SAGE is “highly concerned” about the continued transmission of wild poliovirus in Pakistan and Afghanistan and the circulation of vaccine-derived poliovirus type 2 and its expansion into new areas, including European countries.

SAGE also reviewed updated evidence and concluded that a polio vaccination schedule with a minimum of three vaccine doses of the inactivated poliovirus (IPV), starting at six weeks of age or later is adequate, without the need for a scheduled IPV booster dose (4th dose). 

SAGE reaffirmed that three doses of pneumococcal conjugate vaccines (PCVs) is the most effective way to prevent childhood pneumococcal disease. 

SAGE noted that PCV10 by the Serum Institute of India had recently received WHO-prequalified for the immunization of infants, joining PCV10 (GlaxoSmithKline) and PCV13 (Pfizer).

It also recommended varicella vaccines, using a two-dose schedule with a minimum four-week interval between doses, for children in populations where varicella is an important public health problem. 

Varicella vaccination could also be introduced for special populations, such as immunocompromised people, those living with well-controlled HIV infection and health workers in areas where they 

SAGE also received a report from the global vaccine platform, Gavi. Highlights include that Gavi’s HPV vaccine initiative is on track to immunise 86 million girls by the end of the year,  while significant progress has been made in rolling out malaria vaccines.

Gavi will invest $800 million in polio vaccines this year and $5.6 million to address mpox.

Gavi aims to launch a new strategy in 2026 that will focus on introducing new vaccines, strengthening country programmes, and reducing zero-dose children.