As WHO Debates Global AI Regulation, States Clash Over ‘Data Sovereignty’ 05/02/2026 Felix Sassmannshausen Hans Kluge, WHO Regional Director for Europe, warns that digital tools and AI may widen health gaps without proper governance and trust. A stark debate over who owns the data in the future of AI and digital health emerged at the World Health Organization (WHO) Executive Board on Wednesday. Low and middle-income countries warned that the rapid deployment of new technologies risks accelerating data extraction and increasing inequality, cautioning that – without strict AI governance, sustainable financing and equitable guardrails – the implementation of AI in health systems would compromise “data sovereignty”. The debate centred on a WHO report outlining the framework for a digital transformation strategy spanning 2028 to 2033. Highlighting the profound shifts driven by AI and genomics, the report notes that many member states remain paralysed by “fragmented systems with limited interoperability.” And it warns that without reliable, representative data, AI risks amplifying biases and inefficiencies. “Innovation alone is not enough,” stated Hans Kluge, WHO Regional Director for Europe. “Without skills, governance and trust, digital tools widen gaps instead of closing them.” Kluge also warned that “the risk of a new digital divide is real”. Based on the deliberations, the Secretariat will continue its technical work on the strategy. To this end, the WHO has established a tripartite collaboration with the International Telecommunication Union and the World Intellectual Property Organization. The board also decided to move forward on consultations to strengthen the global health workforce code, while the fight against substandard medicines moves to a new operational phase under an approved work plan. Closing the rift in AI regulation The representative from Cameroon, speaking for the African Region, shifted the focus from technical standards to ownership at the WHO Executive Board session on Wednesday. Regarding AI and digital health, a regulatory rift is opening as high-income regions press forward. While the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) have established guiding principles on AI, a formal global standard remains elusive. The European Union, represented by Bulgaria, argued that health data and information systems are the “essential foundation”, calling for the WHO to lead harmonisation efforts. These ought to focus on autonomy, safety, well-being of patients and health care professionals. Israel supported this, proposing “regulatory sandboxes” to test technologies safely while integrating economic considerations. However, the African Region and other LMICs shifted the focus from technical standards to ownership. Cameroon, speaking for the region, called for rigorous ethical governance. The prevailing fear is that international companies will harvest data from the Global South to train AI models or develop products that are then sold back for profit. Barbados reinforced this, rejecting the model of “donor-funded surveys”. The delegate argued that health data must be treated as a “national asset” under local control. Positioning the country as a “living laboratory” for digital innovation, Barbados demanded sustainable financing models to advance universal health coverage rather than short-term extraction. Rich nations urged to ‘pay up’ for imported health talent Zimbabwe’s representative calls for co-investment from rich nations to address the crisis of health worker migration. The board also confronted the escalating crisis of health worker migration, reviewing new data confirming that active recruitment from nations with fragile health systems is intensifying ‘brain drain’ to plug staffing gaps in the Global North. Zimbabwe, speaking for the African Region, issued a sharp rebuke of current practices. “Targeted recruitment continues to strain our fragile health systems,” the delegate warned. The region demanded that development banks and donor agencies move beyond rhetoric to “co-invest” in the education and retention of the workforce in source countries. Pakistan amplified this, arguing that while the principle of co-investment is recognised, there is currently a lack of “binding commitment to deliver it”. The United Kingdom, a major destination country, maintained that the Global Code of Practice remains “central to ethical international recruitment.” However, the UK acknowledged the need for clearer guidance on safeguards and supported a process to refine the Code’s application. To bridge this divide, the Secretariat, and member states agreed to launch informal consultations to draft a decision for the World Health Assembly in May. The talks will focus on specific additions to the Code, such as co-investment mechanisms and protections for care workers. Debate on ‘scourge’ of substandard medicines ongoing The WHO is intensifying surveillance of medical products following a deadly spike in contaminated products containing toxic chemicals like cough syrups. On a last item, the board confronted the lethal proliferation of substandard and falsified medical products, a crisis described by delegates as a critical threat to both public health and economic security. The WHO’s surveillance system has recorded over 10,000 suspect products since 2013, with the Secretariat highlighting a recent, deadly spike in contaminated medical products containing diethylene glycol, like cough syrups. Togo, speaking for the African Region, characterised the issue as a “scourge,” exacerbated by open borders and informal markets. The region called for “innovative financing” to support regulatory authorities in resource-poor settings, where the risk of infiltration into public supply chains remains high. Ukraine shifted the focus to modern distribution channels, warning of the specific threat posed by “unregulated online sales.” The delegate urged the WHO to help secure supply chains for high-risk excipients – inactive ingredients often implicated in contamination cases. The International Pharmaceutical Federation backed these concerns, emphasising that the workforce must be trained to detect fakes before they reach patients. “Protecting patients requires safeguarding the quality of medicines,” the Federation argued. To close the detection gap, the Board noted the urgent need to roll out market surveillance technologies, specifically the Epione reporting tool, to track suspect products in real-time. The Secretariat will now develop the draft global strategy for 2028 to 2033, which is scheduled for submission to the board at its 160th session in January 2027 before final consideration by the 80th World Health Assembly. Image Credits: Felix Sassmannshausen, WHO/Christopher Black , Pexels/Towfiqu barbhuiya. Tedros Expresses Confidence That Pandemic Talks Will Meet ‘Absolute Deadline’ 05/02/2026 Kerry Cullinan WHO Diector-General Dr Tedros and IGWG co-chair Matthew Harpur (right) World Health Organization (WHO) Director General expressed confidence that member states would agree on the last outstanding part of the Pandemic Agreement by the “absolute deadline” of May at the body’s Executive Board meeting on Wednesday. “This year’s World Health Assembly [in May] must receive a text that member states can consider and act upon. There is no scope for delay because the next pandemic will not wait,” Tedros urged. But questions by Pakistan, part of the Group for Equity negotiating bloc in the negotiations, indicated a lack of agreement on several key issues relating to how pathogens should be shared. Member states only have two more weeks of formal negotiations before the deadline – with the next round starting on Monday. However, the talks are also affected by WHO budget cuts which have limited their access to translators. Countries are hammering out a Pathogen Access and Benefit-Sharing (PABS) system, deciding on how materials and sequence information from pathogens with pandemic potential can be shared fast and fairly – and how countries sharing this information can also benefit from any products that are developed as a result. The Group for Equity and Africa Region want draft contracts to be included as part of the deal to set out the terms for those who want access to pathogen information – for example, pharmaceutical companies in order to make vaccines, therapeutics and diagnostic tests. The Pakistan delegate said that the two groups – representing 80% of the world’s population – had come up with a standard material transfer agreement based on other international agreements, and a draft contract for digital sequence information. “We have had only one informal discussion on the draft contracts,” said Pakistan, urging those in charge of the process to organise more consultation on the contracts. “In order to complete the exercise, to have full legal clarity and certainty we would like to have a pandemic agreement with draft contracts.” Three key areas for talks Matthew Harpur, co-chair of the Intergovernmental Working Group (IGWG) overseeing the negotiations, outlined the three key areas for the talks. “Firstly, we have the scope and objectives and the use of terms,” said Harpur, who added that by last meeting, “it was really good to see some progress”. “Secondly, we have the implementation and the operation of the PABS system,” he added. This includes the issue of “equal footing” – namely, that rapid access to pathogens information and how the benefits deriving from this sharing are of equal importance. “How do we how do we swiftly share that information that keeps us all safer and but how do we also ensure equity,” said Harpur, adding that issues such as monetary contributions had to be agreed on to ensure equity. The third part is “governance and enforcement”. “You can have the best words on paper, but if they’re not enforceable, if they don’t work in practice, it is meaningless,” said Harpur. “So how do we ensure an effective governance system, with the advisory group, the role of the [Conference of the Parties] and, of course, the role of the Secretariat.” The next IGWG meeting runs from 9-14 February. Wild Poliovirus Transmission Persists in Afghanistan and Pakistan 05/02/2026 Arsalan Bukhari Polio cases are falling, but persistent transmission in Afghanistan and Pakistan, vaccine-derived outbreaks elsewhere, and funding gaps keep global eradication at risk. Polio remains a public health emergency of international concern despite a continued decline in case numbers, according to the World Health Organization’s (WHO) Director-General report presented to the Executive Board. The report warns that progress toward eradication remains fragile. Some 38 cases of wild poliovirus type 1 had been reported globally by 22 October 2025, down from 62 during the same period in 2024. All cases occurred in Afghanistan and Pakistan, the only two countries where wild poliovirus remains endemic. Environmental sampling has continued to detect the virus beyond core transmission areas, including during the low-transmission season, suggesting silent spread even where no clinical cases are immediately visible. Transmission concentrated in endemic reservoirs WPV1 cases in Pakistan and Afghanistan Wild poliovirus type 1 persists in a small number of reservoirs, particularly in southern Afghanistan, and the southern area of Khyber Pakhtunkhwa in Pakistan, the report notes. In Afghanistan, operational and communication strategies are being adjusted to improve coverage. Supplementary immunization improved markedly in the eastern region in early 2025, contributing to reductions in transmission. Vaccination teams continue to use site-to-site approaches in the south, supported by transit posts and advocacy for house-to-house vaccination to reach missed children. Pakistan is implementing the Polio National Emergency Action Plan 2024–2025 with a phased strategy aimed at restoring an emergency posture, closing operational gaps and sustaining high immunity. While high-level political commitment and intensified supervision have improved performance, subprovincial variation persists in parts of Khyber Pakhtunkhwa, Quetta and Karachi. Both countries are applying risk-categorization models to identify and reach migrants, mobile groups and other missed children, while strengthening coordination along virus corridors and addressing surveillance gaps. Microplanning, targeted campaigns, fractional-dose inactivated poliovirus vaccine and expanded subnational surveillance are part of these efforts. The Global Polio Eradication Initiative (GPEI), which leads implementation with national authorities, says its 2026 Action Plan will prioritize the low-transmission season to interrupt remaining chains of spread and close immunity gaps among persistently under-immunized populations. Vaccine-derived poliovirus outbreaks in low-coverage areas Vaccine-derived polio persists in low-coverage regions, with cases across 13 countries and new detections signalling ongoing cross-border spread. Beyond the two endemic countries, circulating vaccine-derived poliovirus remains a persistent challenge where routine immunization coverage is weak. WHO reported 151 cases of circulating vaccine-derived poliovirus type 2 across 13 countries as of late October 2025, compared with 182 cases across 16 countries a year earlier. Despite the decline, transmission continues in northern Nigeria, the Lake Chad Basin, the Horn of Africa, particularly south and central Somalia, Ethiopia and Yemen. Health experts say these outbreaks occur when weakened strains of the oral polio vaccine circulate for prolonged periods among under-immunized children, allowing the virus to mutate and spread. Some countries have recorded progress. Madagascar’s outbreak of circulating vaccine-derived poliovirus type 1 was declared closed in May 2025. In the Democratic Republic of the Congo, cases have fallen sharply in recent years following targeted responses, dropping to a single case in 2025. Limited detections of circulating vaccine-derived poliovirus type 3 were reported in Guinea, Cameroon and Chad, with outbreak responses underway. New environmental detections, including in Papua New Guinea and several European countries, underscore the risk of international spread through travel, population movement and surveillance gaps. Vaccination tools and integration expand Polio efforts are shifting toward new vaccines and integrated routine immunization to reach zero-dose children and strengthen health systems. While the standard oral polio vaccine remains the primary tool in eradication efforts, new products include the expanded use of the novel oral polio vaccine type 2 and combination formulations. With support from Gavi, the vaccine alliance, Senegal and Mauritania became the first countries to introduce the hexavalent vaccine into routine immunization schedules this year. WHO partners are also emphasising the integration of polio activities into broader health services. Coordination between GPEI, the Essential Programme on Immunization and Gavi has been strengthened to reach zero-dose children with multiple vaccines and to align polio assets with routine immunization systems. Addressing the Executive Board, a Gavi representative urged countries to promote integrated approaches to reaching zero-dose and under-vaccinated children with life-saving vaccination and primary health care, particularly in humanitarian and complex emergency settings, and to accelerate the transition of polio programme infrastructure into national systems to ensure long-term resilience. Humanitarian pressures complicate delivery In the Eastern Mediterranean Region, which includes both the endemic countries, ongoing crises continue to strain health services. Regional Director Hanan Balkhi told the board that the region carries nearly half of the world’s humanitarian burden and accounted for 40% of attacks on health care last year. She said WHO responded to 62 outbreaks in 2025 and delivered supplies to crisis settings, including Gaza and Sudan, but funding cuts have reduced the regional health emergency workforce by about half. Millions of treatments are now at risk, while clinic closures in Afghanistan and disruptions in Sudan have limited access to essential services. Cross-border collaboration between Pakistan and Afghanistan continues, supported by regional oversight and diplomatic engagement, to sustain polio eradication activities. Although the Polio Eradication Strategy has been extended through 2029, financing remains a constraint. Donors have pledged $ 4.7 billion of the $ 6.9 billion required, leaving a $ 2.2 billion shortfall. The Director-General’s report cautions that sustained political commitment, stronger routine immunization systems and adequate resources will be essential to interrupt remaining transmission and secure a lasting polio-free world. Image Credits: GPEI, RAJA IMRAN BAHADR / Unsplash.. Ukraine Features in WHO Emergencies Debate as Peace Talks Resume in Abu Dhabi 04/02/2026 Elaine Ruth Fletcher Ukraine: Russia is systematically attacking healthcare. Ukraine and its front-line allies unleashed a storm of criticism over Russia’s relentless attacks on Ukraine’s energy and health infrastructure in WHO’s Executive Board meeting Wednesday – condemning the Russian Federation for “weaponizing winter to make cities go dark, hospitals fail and civilians suffer.” “Russia is systematically attacking healthcare and the civilian lifelines it depends on,” said Ukraine’s delegate to the EB. “….But hospitals are no target, and a maternity ward is not a battlefield,” he added, noting that as of January 2026, more than 2500 attacks on health care workers and facilities had been verified in Ukraine since the war began in February 2022. Ukraine’s remarks were echoed in another joint statement by 40 other allied nations, led by Bulgaria and other European front-line states but also including Canada, Australia and Japan. Together, as well as individually, a long list of member states denounced the prolonged crisis in Ukraine, and its impacts on public health, mental health and women’s health services, in particular. Attacks on energy are an attack on health systems: Bulgaria. “While Ukraine continues to tirelessly work for peace, Russia continues its aggression and is even intensifying its deliberate attacks on the civilian population and infrastructure, violating international law,” said Bulgaria in its joint statement. “We commend WHO’s efforts in maintaining and strengthening the health system in Ukraine under these extremely challenging and dangerous circumstances.” Russia – debate is a ‘negative backdrop’ to peace talks Russia, meanwhile, said that the bitter criticism provided a ‘negative backdrop’ to the second round of US-brokered negotiations that began Wednesday in Abu Dhabi between the warring nations. “A few hours ago in Abu Dhabi, once again, we saw trilateral negotiations that began. They involved Russia, the US and Ukraine. But the EB discussions create “a very negative backdrop to those negotiations,” the Russian Federation delegate charged. “This clearly demonstrates that there is a wish on the part of some to drag out this war.” Russia also protested the annual Member State practice of producing a separate WHO report devoted to the Ukraine conflict since the war began in 2022. That’s distinct from the combined treatment of most other health emergencies, Russia noted. “It is not clear what criteria were used to cluster all health emergencies the world into a single group, whereas item 20 [the war in Ukraine] is worthy of a standalone discussion,” said the Russian delegate. “The regular specific discussion on this should take place on the basis of the work of the WHO standing committee on health emergencies.” His remarks made no reference to the other exception – the occupied Palestinian territories – which has been the focus of two annual WHO reports to member states, since the Israel-Hamas war began in 2023. Iran conflict another political subtext Israel calls for a report on WHO’s response to the bloody protests in Iran. In a discussion officially focused on Ukraine, debate also veered into other geopolitical fracture points, including the Gaza humanitarian crisis, Taiwan and the recent Iranian civil uprising – triggering fierce exchanges between Iran, Pakistan and Israel, as well as between China and allies of Taiwan. At the outset of Wednesday’s discussions, Israel’s EB delegate called for the WHO to produce a detailed report for the May World Health Assembly on the bloody protests in Iran, and specifically “the organization’s activities in support of medical care for those affected by the recent events – including access to emergency health services and treatment of the injured.” According to Iranian opposition accounts, regime members invaded hospitals to arrest or execute injured protestors. And some three dozen medical professionals who treated protestors have reportedly been detained. Iranian opposition media has put the overall death toll from the January protests at over 36,000 people, ten times the 3,117 fatalities reported by the regime. A recent Wall Street Journal article, meanwhile, cited a death toll of at least 10,000. Last week, WHO Director General Dr Tedros Adhanom Ghebreyesus issued his first social media message on the disturbances – although that came several weeks after the protests had peaked. I am deeply concerned by multiple reports of health personnel and medical facilities in Iran being impacted by the recent insecurity, and prevented from delivering their essential services to people requiring care. In recent days, there have been reports of health workers… — Tedros Adhanom Ghebreyesus (@DrTedros) January 29, 2026 Pakistan – standing “in solidarity with Iran” Iran protests Israeli initiative, supported by allies in regiong. Iran’s humanitarian crisis, however, has also become entangled by the broader geopolitical situation in the region – with critics and allies of the regime lined up accordingly. And the debate at the EB was no exception. Israel’s call to WHO for a report was therefore immediately reubuffed by Pakistan and others in the region as a political maneuver aiming to deflect attention from Israel’s record in Gaza – where where two years of war have reduced the enclave to rubble and intermittent attacks continue despite a cease-fire declared last October. “This is a clear attempt to abuse this forum for political point scoring and to divert attention from the catastrophic consequences of Israel’s own conduct in the occupied Palestinian territory and across the Arab region,” said Pakistan, speaking on behalf of the 57-member Organization of Islamic Cooperation (OIC). Pakistan rebuffs calls for a report on Iran. “The OIC stands in solidarity with Iran against these politicized accusations and calls on who to reject Israel’s malicious proposal and any attempt to instrumentalize the organization for narrow political purposes.” Added Egypt, asking WHO to detail its response to Iran’s recent civil uprising would not be “in line with the technical aspect of the [WHO] reports. We must adopt unified criteria that are applicable to all. Therefore, we would like to ask the secretary to make sure that the reports are purely technical.” In just the past 24 hours Israeli airstrikes and shelling of alleged Hamas targets have led to the deaths of some 21 Gazans, including several children, added Palestine’s representative to the EB, citing media reports. Meanwhile, European member states that have recently been critical of Iran’s human rights abuses, as well as of Israel’s, remained largely aloof. Africa and other developing regions appeal for more attention to health emergencies in their corner But the headline-grabbing flashpoints in Europe and the Middle East, should not be allowed to obscure health emergencies elsewhere in the world, other member states emphasized, a theme underlined by WHO’s broader reporting on health emergencies. Africa, for instance, faces crises including infectious disease outbreaks such as mpox, climate-linked drought, foods and food insecurity, and conflicts that have displaced millions of people, driving disease, hunger and sexual abuse. Long-burning conflicts include the Sudan crisis, driven by UAE-backed RSF rebels, and a civil war in eastern DR Congo, led by Rwanda-backed M-23 fighters, who have taken over the regional capital of Goma. “The African region knows through experience that humanitarian crises as well as the massive displacement of populations weaken health care systems,” said the delegate from Comoros, speaking on behalf of 47 African member states. “They worsen inequalities and threaten the progress that has been made towards universal health coverage. Even so, “health crises that are linked to conflicts that should not draw attention away from other global health emergencies, especially such as those in Africa, recurring epidemics, climate change as well as food insecurity,” she stressed. But against the backdrop of the United States’ withdrawal from the global health agency “the African region would like to rereaffirm its commitment to work with the WHO, as well as all member states, to make sure that health remains a fundamental right that is protected everywhere at all times,” the Comoros delegate added. “We call on reinforced international cooperation. We call on unwavering solidarity as well as concerted action so that no one is left behind.” $9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Tedros Expresses Confidence That Pandemic Talks Will Meet ‘Absolute Deadline’ 05/02/2026 Kerry Cullinan WHO Diector-General Dr Tedros and IGWG co-chair Matthew Harpur (right) World Health Organization (WHO) Director General expressed confidence that member states would agree on the last outstanding part of the Pandemic Agreement by the “absolute deadline” of May at the body’s Executive Board meeting on Wednesday. “This year’s World Health Assembly [in May] must receive a text that member states can consider and act upon. There is no scope for delay because the next pandemic will not wait,” Tedros urged. But questions by Pakistan, part of the Group for Equity negotiating bloc in the negotiations, indicated a lack of agreement on several key issues relating to how pathogens should be shared. Member states only have two more weeks of formal negotiations before the deadline – with the next round starting on Monday. However, the talks are also affected by WHO budget cuts which have limited their access to translators. Countries are hammering out a Pathogen Access and Benefit-Sharing (PABS) system, deciding on how materials and sequence information from pathogens with pandemic potential can be shared fast and fairly – and how countries sharing this information can also benefit from any products that are developed as a result. The Group for Equity and Africa Region want draft contracts to be included as part of the deal to set out the terms for those who want access to pathogen information – for example, pharmaceutical companies in order to make vaccines, therapeutics and diagnostic tests. The Pakistan delegate said that the two groups – representing 80% of the world’s population – had come up with a standard material transfer agreement based on other international agreements, and a draft contract for digital sequence information. “We have had only one informal discussion on the draft contracts,” said Pakistan, urging those in charge of the process to organise more consultation on the contracts. “In order to complete the exercise, to have full legal clarity and certainty we would like to have a pandemic agreement with draft contracts.” Three key areas for talks Matthew Harpur, co-chair of the Intergovernmental Working Group (IGWG) overseeing the negotiations, outlined the three key areas for the talks. “Firstly, we have the scope and objectives and the use of terms,” said Harpur, who added that by last meeting, “it was really good to see some progress”. “Secondly, we have the implementation and the operation of the PABS system,” he added. This includes the issue of “equal footing” – namely, that rapid access to pathogens information and how the benefits deriving from this sharing are of equal importance. “How do we how do we swiftly share that information that keeps us all safer and but how do we also ensure equity,” said Harpur, adding that issues such as monetary contributions had to be agreed on to ensure equity. The third part is “governance and enforcement”. “You can have the best words on paper, but if they’re not enforceable, if they don’t work in practice, it is meaningless,” said Harpur. “So how do we ensure an effective governance system, with the advisory group, the role of the [Conference of the Parties] and, of course, the role of the Secretariat.” The next IGWG meeting runs from 9-14 February. Wild Poliovirus Transmission Persists in Afghanistan and Pakistan 05/02/2026 Arsalan Bukhari Polio cases are falling, but persistent transmission in Afghanistan and Pakistan, vaccine-derived outbreaks elsewhere, and funding gaps keep global eradication at risk. Polio remains a public health emergency of international concern despite a continued decline in case numbers, according to the World Health Organization’s (WHO) Director-General report presented to the Executive Board. The report warns that progress toward eradication remains fragile. Some 38 cases of wild poliovirus type 1 had been reported globally by 22 October 2025, down from 62 during the same period in 2024. All cases occurred in Afghanistan and Pakistan, the only two countries where wild poliovirus remains endemic. Environmental sampling has continued to detect the virus beyond core transmission areas, including during the low-transmission season, suggesting silent spread even where no clinical cases are immediately visible. Transmission concentrated in endemic reservoirs WPV1 cases in Pakistan and Afghanistan Wild poliovirus type 1 persists in a small number of reservoirs, particularly in southern Afghanistan, and the southern area of Khyber Pakhtunkhwa in Pakistan, the report notes. In Afghanistan, operational and communication strategies are being adjusted to improve coverage. Supplementary immunization improved markedly in the eastern region in early 2025, contributing to reductions in transmission. Vaccination teams continue to use site-to-site approaches in the south, supported by transit posts and advocacy for house-to-house vaccination to reach missed children. Pakistan is implementing the Polio National Emergency Action Plan 2024–2025 with a phased strategy aimed at restoring an emergency posture, closing operational gaps and sustaining high immunity. While high-level political commitment and intensified supervision have improved performance, subprovincial variation persists in parts of Khyber Pakhtunkhwa, Quetta and Karachi. Both countries are applying risk-categorization models to identify and reach migrants, mobile groups and other missed children, while strengthening coordination along virus corridors and addressing surveillance gaps. Microplanning, targeted campaigns, fractional-dose inactivated poliovirus vaccine and expanded subnational surveillance are part of these efforts. The Global Polio Eradication Initiative (GPEI), which leads implementation with national authorities, says its 2026 Action Plan will prioritize the low-transmission season to interrupt remaining chains of spread and close immunity gaps among persistently under-immunized populations. Vaccine-derived poliovirus outbreaks in low-coverage areas Vaccine-derived polio persists in low-coverage regions, with cases across 13 countries and new detections signalling ongoing cross-border spread. Beyond the two endemic countries, circulating vaccine-derived poliovirus remains a persistent challenge where routine immunization coverage is weak. WHO reported 151 cases of circulating vaccine-derived poliovirus type 2 across 13 countries as of late October 2025, compared with 182 cases across 16 countries a year earlier. Despite the decline, transmission continues in northern Nigeria, the Lake Chad Basin, the Horn of Africa, particularly south and central Somalia, Ethiopia and Yemen. Health experts say these outbreaks occur when weakened strains of the oral polio vaccine circulate for prolonged periods among under-immunized children, allowing the virus to mutate and spread. Some countries have recorded progress. Madagascar’s outbreak of circulating vaccine-derived poliovirus type 1 was declared closed in May 2025. In the Democratic Republic of the Congo, cases have fallen sharply in recent years following targeted responses, dropping to a single case in 2025. Limited detections of circulating vaccine-derived poliovirus type 3 were reported in Guinea, Cameroon and Chad, with outbreak responses underway. New environmental detections, including in Papua New Guinea and several European countries, underscore the risk of international spread through travel, population movement and surveillance gaps. Vaccination tools and integration expand Polio efforts are shifting toward new vaccines and integrated routine immunization to reach zero-dose children and strengthen health systems. While the standard oral polio vaccine remains the primary tool in eradication efforts, new products include the expanded use of the novel oral polio vaccine type 2 and combination formulations. With support from Gavi, the vaccine alliance, Senegal and Mauritania became the first countries to introduce the hexavalent vaccine into routine immunization schedules this year. WHO partners are also emphasising the integration of polio activities into broader health services. Coordination between GPEI, the Essential Programme on Immunization and Gavi has been strengthened to reach zero-dose children with multiple vaccines and to align polio assets with routine immunization systems. Addressing the Executive Board, a Gavi representative urged countries to promote integrated approaches to reaching zero-dose and under-vaccinated children with life-saving vaccination and primary health care, particularly in humanitarian and complex emergency settings, and to accelerate the transition of polio programme infrastructure into national systems to ensure long-term resilience. Humanitarian pressures complicate delivery In the Eastern Mediterranean Region, which includes both the endemic countries, ongoing crises continue to strain health services. Regional Director Hanan Balkhi told the board that the region carries nearly half of the world’s humanitarian burden and accounted for 40% of attacks on health care last year. She said WHO responded to 62 outbreaks in 2025 and delivered supplies to crisis settings, including Gaza and Sudan, but funding cuts have reduced the regional health emergency workforce by about half. Millions of treatments are now at risk, while clinic closures in Afghanistan and disruptions in Sudan have limited access to essential services. Cross-border collaboration between Pakistan and Afghanistan continues, supported by regional oversight and diplomatic engagement, to sustain polio eradication activities. Although the Polio Eradication Strategy has been extended through 2029, financing remains a constraint. Donors have pledged $ 4.7 billion of the $ 6.9 billion required, leaving a $ 2.2 billion shortfall. The Director-General’s report cautions that sustained political commitment, stronger routine immunization systems and adequate resources will be essential to interrupt remaining transmission and secure a lasting polio-free world. Image Credits: GPEI, RAJA IMRAN BAHADR / Unsplash.. Ukraine Features in WHO Emergencies Debate as Peace Talks Resume in Abu Dhabi 04/02/2026 Elaine Ruth Fletcher Ukraine: Russia is systematically attacking healthcare. Ukraine and its front-line allies unleashed a storm of criticism over Russia’s relentless attacks on Ukraine’s energy and health infrastructure in WHO’s Executive Board meeting Wednesday – condemning the Russian Federation for “weaponizing winter to make cities go dark, hospitals fail and civilians suffer.” “Russia is systematically attacking healthcare and the civilian lifelines it depends on,” said Ukraine’s delegate to the EB. “….But hospitals are no target, and a maternity ward is not a battlefield,” he added, noting that as of January 2026, more than 2500 attacks on health care workers and facilities had been verified in Ukraine since the war began in February 2022. Ukraine’s remarks were echoed in another joint statement by 40 other allied nations, led by Bulgaria and other European front-line states but also including Canada, Australia and Japan. Together, as well as individually, a long list of member states denounced the prolonged crisis in Ukraine, and its impacts on public health, mental health and women’s health services, in particular. Attacks on energy are an attack on health systems: Bulgaria. “While Ukraine continues to tirelessly work for peace, Russia continues its aggression and is even intensifying its deliberate attacks on the civilian population and infrastructure, violating international law,” said Bulgaria in its joint statement. “We commend WHO’s efforts in maintaining and strengthening the health system in Ukraine under these extremely challenging and dangerous circumstances.” Russia – debate is a ‘negative backdrop’ to peace talks Russia, meanwhile, said that the bitter criticism provided a ‘negative backdrop’ to the second round of US-brokered negotiations that began Wednesday in Abu Dhabi between the warring nations. “A few hours ago in Abu Dhabi, once again, we saw trilateral negotiations that began. They involved Russia, the US and Ukraine. But the EB discussions create “a very negative backdrop to those negotiations,” the Russian Federation delegate charged. “This clearly demonstrates that there is a wish on the part of some to drag out this war.” Russia also protested the annual Member State practice of producing a separate WHO report devoted to the Ukraine conflict since the war began in 2022. That’s distinct from the combined treatment of most other health emergencies, Russia noted. “It is not clear what criteria were used to cluster all health emergencies the world into a single group, whereas item 20 [the war in Ukraine] is worthy of a standalone discussion,” said the Russian delegate. “The regular specific discussion on this should take place on the basis of the work of the WHO standing committee on health emergencies.” His remarks made no reference to the other exception – the occupied Palestinian territories – which has been the focus of two annual WHO reports to member states, since the Israel-Hamas war began in 2023. Iran conflict another political subtext Israel calls for a report on WHO’s response to the bloody protests in Iran. In a discussion officially focused on Ukraine, debate also veered into other geopolitical fracture points, including the Gaza humanitarian crisis, Taiwan and the recent Iranian civil uprising – triggering fierce exchanges between Iran, Pakistan and Israel, as well as between China and allies of Taiwan. At the outset of Wednesday’s discussions, Israel’s EB delegate called for the WHO to produce a detailed report for the May World Health Assembly on the bloody protests in Iran, and specifically “the organization’s activities in support of medical care for those affected by the recent events – including access to emergency health services and treatment of the injured.” According to Iranian opposition accounts, regime members invaded hospitals to arrest or execute injured protestors. And some three dozen medical professionals who treated protestors have reportedly been detained. Iranian opposition media has put the overall death toll from the January protests at over 36,000 people, ten times the 3,117 fatalities reported by the regime. A recent Wall Street Journal article, meanwhile, cited a death toll of at least 10,000. Last week, WHO Director General Dr Tedros Adhanom Ghebreyesus issued his first social media message on the disturbances – although that came several weeks after the protests had peaked. I am deeply concerned by multiple reports of health personnel and medical facilities in Iran being impacted by the recent insecurity, and prevented from delivering their essential services to people requiring care. In recent days, there have been reports of health workers… — Tedros Adhanom Ghebreyesus (@DrTedros) January 29, 2026 Pakistan – standing “in solidarity with Iran” Iran protests Israeli initiative, supported by allies in regiong. Iran’s humanitarian crisis, however, has also become entangled by the broader geopolitical situation in the region – with critics and allies of the regime lined up accordingly. And the debate at the EB was no exception. Israel’s call to WHO for a report was therefore immediately reubuffed by Pakistan and others in the region as a political maneuver aiming to deflect attention from Israel’s record in Gaza – where where two years of war have reduced the enclave to rubble and intermittent attacks continue despite a cease-fire declared last October. “This is a clear attempt to abuse this forum for political point scoring and to divert attention from the catastrophic consequences of Israel’s own conduct in the occupied Palestinian territory and across the Arab region,” said Pakistan, speaking on behalf of the 57-member Organization of Islamic Cooperation (OIC). Pakistan rebuffs calls for a report on Iran. “The OIC stands in solidarity with Iran against these politicized accusations and calls on who to reject Israel’s malicious proposal and any attempt to instrumentalize the organization for narrow political purposes.” Added Egypt, asking WHO to detail its response to Iran’s recent civil uprising would not be “in line with the technical aspect of the [WHO] reports. We must adopt unified criteria that are applicable to all. Therefore, we would like to ask the secretary to make sure that the reports are purely technical.” In just the past 24 hours Israeli airstrikes and shelling of alleged Hamas targets have led to the deaths of some 21 Gazans, including several children, added Palestine’s representative to the EB, citing media reports. Meanwhile, European member states that have recently been critical of Iran’s human rights abuses, as well as of Israel’s, remained largely aloof. Africa and other developing regions appeal for more attention to health emergencies in their corner But the headline-grabbing flashpoints in Europe and the Middle East, should not be allowed to obscure health emergencies elsewhere in the world, other member states emphasized, a theme underlined by WHO’s broader reporting on health emergencies. Africa, for instance, faces crises including infectious disease outbreaks such as mpox, climate-linked drought, foods and food insecurity, and conflicts that have displaced millions of people, driving disease, hunger and sexual abuse. Long-burning conflicts include the Sudan crisis, driven by UAE-backed RSF rebels, and a civil war in eastern DR Congo, led by Rwanda-backed M-23 fighters, who have taken over the regional capital of Goma. “The African region knows through experience that humanitarian crises as well as the massive displacement of populations weaken health care systems,” said the delegate from Comoros, speaking on behalf of 47 African member states. “They worsen inequalities and threaten the progress that has been made towards universal health coverage. Even so, “health crises that are linked to conflicts that should not draw attention away from other global health emergencies, especially such as those in Africa, recurring epidemics, climate change as well as food insecurity,” she stressed. But against the backdrop of the United States’ withdrawal from the global health agency “the African region would like to rereaffirm its commitment to work with the WHO, as well as all member states, to make sure that health remains a fundamental right that is protected everywhere at all times,” the Comoros delegate added. “We call on reinforced international cooperation. We call on unwavering solidarity as well as concerted action so that no one is left behind.” $9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Wild Poliovirus Transmission Persists in Afghanistan and Pakistan 05/02/2026 Arsalan Bukhari Polio cases are falling, but persistent transmission in Afghanistan and Pakistan, vaccine-derived outbreaks elsewhere, and funding gaps keep global eradication at risk. Polio remains a public health emergency of international concern despite a continued decline in case numbers, according to the World Health Organization’s (WHO) Director-General report presented to the Executive Board. The report warns that progress toward eradication remains fragile. Some 38 cases of wild poliovirus type 1 had been reported globally by 22 October 2025, down from 62 during the same period in 2024. All cases occurred in Afghanistan and Pakistan, the only two countries where wild poliovirus remains endemic. Environmental sampling has continued to detect the virus beyond core transmission areas, including during the low-transmission season, suggesting silent spread even where no clinical cases are immediately visible. Transmission concentrated in endemic reservoirs WPV1 cases in Pakistan and Afghanistan Wild poliovirus type 1 persists in a small number of reservoirs, particularly in southern Afghanistan, and the southern area of Khyber Pakhtunkhwa in Pakistan, the report notes. In Afghanistan, operational and communication strategies are being adjusted to improve coverage. Supplementary immunization improved markedly in the eastern region in early 2025, contributing to reductions in transmission. Vaccination teams continue to use site-to-site approaches in the south, supported by transit posts and advocacy for house-to-house vaccination to reach missed children. Pakistan is implementing the Polio National Emergency Action Plan 2024–2025 with a phased strategy aimed at restoring an emergency posture, closing operational gaps and sustaining high immunity. While high-level political commitment and intensified supervision have improved performance, subprovincial variation persists in parts of Khyber Pakhtunkhwa, Quetta and Karachi. Both countries are applying risk-categorization models to identify and reach migrants, mobile groups and other missed children, while strengthening coordination along virus corridors and addressing surveillance gaps. Microplanning, targeted campaigns, fractional-dose inactivated poliovirus vaccine and expanded subnational surveillance are part of these efforts. The Global Polio Eradication Initiative (GPEI), which leads implementation with national authorities, says its 2026 Action Plan will prioritize the low-transmission season to interrupt remaining chains of spread and close immunity gaps among persistently under-immunized populations. Vaccine-derived poliovirus outbreaks in low-coverage areas Vaccine-derived polio persists in low-coverage regions, with cases across 13 countries and new detections signalling ongoing cross-border spread. Beyond the two endemic countries, circulating vaccine-derived poliovirus remains a persistent challenge where routine immunization coverage is weak. WHO reported 151 cases of circulating vaccine-derived poliovirus type 2 across 13 countries as of late October 2025, compared with 182 cases across 16 countries a year earlier. Despite the decline, transmission continues in northern Nigeria, the Lake Chad Basin, the Horn of Africa, particularly south and central Somalia, Ethiopia and Yemen. Health experts say these outbreaks occur when weakened strains of the oral polio vaccine circulate for prolonged periods among under-immunized children, allowing the virus to mutate and spread. Some countries have recorded progress. Madagascar’s outbreak of circulating vaccine-derived poliovirus type 1 was declared closed in May 2025. In the Democratic Republic of the Congo, cases have fallen sharply in recent years following targeted responses, dropping to a single case in 2025. Limited detections of circulating vaccine-derived poliovirus type 3 were reported in Guinea, Cameroon and Chad, with outbreak responses underway. New environmental detections, including in Papua New Guinea and several European countries, underscore the risk of international spread through travel, population movement and surveillance gaps. Vaccination tools and integration expand Polio efforts are shifting toward new vaccines and integrated routine immunization to reach zero-dose children and strengthen health systems. While the standard oral polio vaccine remains the primary tool in eradication efforts, new products include the expanded use of the novel oral polio vaccine type 2 and combination formulations. With support from Gavi, the vaccine alliance, Senegal and Mauritania became the first countries to introduce the hexavalent vaccine into routine immunization schedules this year. WHO partners are also emphasising the integration of polio activities into broader health services. Coordination between GPEI, the Essential Programme on Immunization and Gavi has been strengthened to reach zero-dose children with multiple vaccines and to align polio assets with routine immunization systems. Addressing the Executive Board, a Gavi representative urged countries to promote integrated approaches to reaching zero-dose and under-vaccinated children with life-saving vaccination and primary health care, particularly in humanitarian and complex emergency settings, and to accelerate the transition of polio programme infrastructure into national systems to ensure long-term resilience. Humanitarian pressures complicate delivery In the Eastern Mediterranean Region, which includes both the endemic countries, ongoing crises continue to strain health services. Regional Director Hanan Balkhi told the board that the region carries nearly half of the world’s humanitarian burden and accounted for 40% of attacks on health care last year. She said WHO responded to 62 outbreaks in 2025 and delivered supplies to crisis settings, including Gaza and Sudan, but funding cuts have reduced the regional health emergency workforce by about half. Millions of treatments are now at risk, while clinic closures in Afghanistan and disruptions in Sudan have limited access to essential services. Cross-border collaboration between Pakistan and Afghanistan continues, supported by regional oversight and diplomatic engagement, to sustain polio eradication activities. Although the Polio Eradication Strategy has been extended through 2029, financing remains a constraint. Donors have pledged $ 4.7 billion of the $ 6.9 billion required, leaving a $ 2.2 billion shortfall. The Director-General’s report cautions that sustained political commitment, stronger routine immunization systems and adequate resources will be essential to interrupt remaining transmission and secure a lasting polio-free world. Image Credits: GPEI, RAJA IMRAN BAHADR / Unsplash.. Ukraine Features in WHO Emergencies Debate as Peace Talks Resume in Abu Dhabi 04/02/2026 Elaine Ruth Fletcher Ukraine: Russia is systematically attacking healthcare. Ukraine and its front-line allies unleashed a storm of criticism over Russia’s relentless attacks on Ukraine’s energy and health infrastructure in WHO’s Executive Board meeting Wednesday – condemning the Russian Federation for “weaponizing winter to make cities go dark, hospitals fail and civilians suffer.” “Russia is systematically attacking healthcare and the civilian lifelines it depends on,” said Ukraine’s delegate to the EB. “….But hospitals are no target, and a maternity ward is not a battlefield,” he added, noting that as of January 2026, more than 2500 attacks on health care workers and facilities had been verified in Ukraine since the war began in February 2022. Ukraine’s remarks were echoed in another joint statement by 40 other allied nations, led by Bulgaria and other European front-line states but also including Canada, Australia and Japan. Together, as well as individually, a long list of member states denounced the prolonged crisis in Ukraine, and its impacts on public health, mental health and women’s health services, in particular. Attacks on energy are an attack on health systems: Bulgaria. “While Ukraine continues to tirelessly work for peace, Russia continues its aggression and is even intensifying its deliberate attacks on the civilian population and infrastructure, violating international law,” said Bulgaria in its joint statement. “We commend WHO’s efforts in maintaining and strengthening the health system in Ukraine under these extremely challenging and dangerous circumstances.” Russia – debate is a ‘negative backdrop’ to peace talks Russia, meanwhile, said that the bitter criticism provided a ‘negative backdrop’ to the second round of US-brokered negotiations that began Wednesday in Abu Dhabi between the warring nations. “A few hours ago in Abu Dhabi, once again, we saw trilateral negotiations that began. They involved Russia, the US and Ukraine. But the EB discussions create “a very negative backdrop to those negotiations,” the Russian Federation delegate charged. “This clearly demonstrates that there is a wish on the part of some to drag out this war.” Russia also protested the annual Member State practice of producing a separate WHO report devoted to the Ukraine conflict since the war began in 2022. That’s distinct from the combined treatment of most other health emergencies, Russia noted. “It is not clear what criteria were used to cluster all health emergencies the world into a single group, whereas item 20 [the war in Ukraine] is worthy of a standalone discussion,” said the Russian delegate. “The regular specific discussion on this should take place on the basis of the work of the WHO standing committee on health emergencies.” His remarks made no reference to the other exception – the occupied Palestinian territories – which has been the focus of two annual WHO reports to member states, since the Israel-Hamas war began in 2023. Iran conflict another political subtext Israel calls for a report on WHO’s response to the bloody protests in Iran. In a discussion officially focused on Ukraine, debate also veered into other geopolitical fracture points, including the Gaza humanitarian crisis, Taiwan and the recent Iranian civil uprising – triggering fierce exchanges between Iran, Pakistan and Israel, as well as between China and allies of Taiwan. At the outset of Wednesday’s discussions, Israel’s EB delegate called for the WHO to produce a detailed report for the May World Health Assembly on the bloody protests in Iran, and specifically “the organization’s activities in support of medical care for those affected by the recent events – including access to emergency health services and treatment of the injured.” According to Iranian opposition accounts, regime members invaded hospitals to arrest or execute injured protestors. And some three dozen medical professionals who treated protestors have reportedly been detained. Iranian opposition media has put the overall death toll from the January protests at over 36,000 people, ten times the 3,117 fatalities reported by the regime. A recent Wall Street Journal article, meanwhile, cited a death toll of at least 10,000. Last week, WHO Director General Dr Tedros Adhanom Ghebreyesus issued his first social media message on the disturbances – although that came several weeks after the protests had peaked. I am deeply concerned by multiple reports of health personnel and medical facilities in Iran being impacted by the recent insecurity, and prevented from delivering their essential services to people requiring care. In recent days, there have been reports of health workers… — Tedros Adhanom Ghebreyesus (@DrTedros) January 29, 2026 Pakistan – standing “in solidarity with Iran” Iran protests Israeli initiative, supported by allies in regiong. Iran’s humanitarian crisis, however, has also become entangled by the broader geopolitical situation in the region – with critics and allies of the regime lined up accordingly. And the debate at the EB was no exception. Israel’s call to WHO for a report was therefore immediately reubuffed by Pakistan and others in the region as a political maneuver aiming to deflect attention from Israel’s record in Gaza – where where two years of war have reduced the enclave to rubble and intermittent attacks continue despite a cease-fire declared last October. “This is a clear attempt to abuse this forum for political point scoring and to divert attention from the catastrophic consequences of Israel’s own conduct in the occupied Palestinian territory and across the Arab region,” said Pakistan, speaking on behalf of the 57-member Organization of Islamic Cooperation (OIC). Pakistan rebuffs calls for a report on Iran. “The OIC stands in solidarity with Iran against these politicized accusations and calls on who to reject Israel’s malicious proposal and any attempt to instrumentalize the organization for narrow political purposes.” Added Egypt, asking WHO to detail its response to Iran’s recent civil uprising would not be “in line with the technical aspect of the [WHO] reports. We must adopt unified criteria that are applicable to all. Therefore, we would like to ask the secretary to make sure that the reports are purely technical.” In just the past 24 hours Israeli airstrikes and shelling of alleged Hamas targets have led to the deaths of some 21 Gazans, including several children, added Palestine’s representative to the EB, citing media reports. Meanwhile, European member states that have recently been critical of Iran’s human rights abuses, as well as of Israel’s, remained largely aloof. Africa and other developing regions appeal for more attention to health emergencies in their corner But the headline-grabbing flashpoints in Europe and the Middle East, should not be allowed to obscure health emergencies elsewhere in the world, other member states emphasized, a theme underlined by WHO’s broader reporting on health emergencies. Africa, for instance, faces crises including infectious disease outbreaks such as mpox, climate-linked drought, foods and food insecurity, and conflicts that have displaced millions of people, driving disease, hunger and sexual abuse. Long-burning conflicts include the Sudan crisis, driven by UAE-backed RSF rebels, and a civil war in eastern DR Congo, led by Rwanda-backed M-23 fighters, who have taken over the regional capital of Goma. “The African region knows through experience that humanitarian crises as well as the massive displacement of populations weaken health care systems,” said the delegate from Comoros, speaking on behalf of 47 African member states. “They worsen inequalities and threaten the progress that has been made towards universal health coverage. Even so, “health crises that are linked to conflicts that should not draw attention away from other global health emergencies, especially such as those in Africa, recurring epidemics, climate change as well as food insecurity,” she stressed. But against the backdrop of the United States’ withdrawal from the global health agency “the African region would like to rereaffirm its commitment to work with the WHO, as well as all member states, to make sure that health remains a fundamental right that is protected everywhere at all times,” the Comoros delegate added. “We call on reinforced international cooperation. We call on unwavering solidarity as well as concerted action so that no one is left behind.” $9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Ukraine Features in WHO Emergencies Debate as Peace Talks Resume in Abu Dhabi 04/02/2026 Elaine Ruth Fletcher Ukraine: Russia is systematically attacking healthcare. Ukraine and its front-line allies unleashed a storm of criticism over Russia’s relentless attacks on Ukraine’s energy and health infrastructure in WHO’s Executive Board meeting Wednesday – condemning the Russian Federation for “weaponizing winter to make cities go dark, hospitals fail and civilians suffer.” “Russia is systematically attacking healthcare and the civilian lifelines it depends on,” said Ukraine’s delegate to the EB. “….But hospitals are no target, and a maternity ward is not a battlefield,” he added, noting that as of January 2026, more than 2500 attacks on health care workers and facilities had been verified in Ukraine since the war began in February 2022. Ukraine’s remarks were echoed in another joint statement by 40 other allied nations, led by Bulgaria and other European front-line states but also including Canada, Australia and Japan. Together, as well as individually, a long list of member states denounced the prolonged crisis in Ukraine, and its impacts on public health, mental health and women’s health services, in particular. Attacks on energy are an attack on health systems: Bulgaria. “While Ukraine continues to tirelessly work for peace, Russia continues its aggression and is even intensifying its deliberate attacks on the civilian population and infrastructure, violating international law,” said Bulgaria in its joint statement. “We commend WHO’s efforts in maintaining and strengthening the health system in Ukraine under these extremely challenging and dangerous circumstances.” Russia – debate is a ‘negative backdrop’ to peace talks Russia, meanwhile, said that the bitter criticism provided a ‘negative backdrop’ to the second round of US-brokered negotiations that began Wednesday in Abu Dhabi between the warring nations. “A few hours ago in Abu Dhabi, once again, we saw trilateral negotiations that began. They involved Russia, the US and Ukraine. But the EB discussions create “a very negative backdrop to those negotiations,” the Russian Federation delegate charged. “This clearly demonstrates that there is a wish on the part of some to drag out this war.” Russia also protested the annual Member State practice of producing a separate WHO report devoted to the Ukraine conflict since the war began in 2022. That’s distinct from the combined treatment of most other health emergencies, Russia noted. “It is not clear what criteria were used to cluster all health emergencies the world into a single group, whereas item 20 [the war in Ukraine] is worthy of a standalone discussion,” said the Russian delegate. “The regular specific discussion on this should take place on the basis of the work of the WHO standing committee on health emergencies.” His remarks made no reference to the other exception – the occupied Palestinian territories – which has been the focus of two annual WHO reports to member states, since the Israel-Hamas war began in 2023. Iran conflict another political subtext Israel calls for a report on WHO’s response to the bloody protests in Iran. In a discussion officially focused on Ukraine, debate also veered into other geopolitical fracture points, including the Gaza humanitarian crisis, Taiwan and the recent Iranian civil uprising – triggering fierce exchanges between Iran, Pakistan and Israel, as well as between China and allies of Taiwan. At the outset of Wednesday’s discussions, Israel’s EB delegate called for the WHO to produce a detailed report for the May World Health Assembly on the bloody protests in Iran, and specifically “the organization’s activities in support of medical care for those affected by the recent events – including access to emergency health services and treatment of the injured.” According to Iranian opposition accounts, regime members invaded hospitals to arrest or execute injured protestors. And some three dozen medical professionals who treated protestors have reportedly been detained. Iranian opposition media has put the overall death toll from the January protests at over 36,000 people, ten times the 3,117 fatalities reported by the regime. A recent Wall Street Journal article, meanwhile, cited a death toll of at least 10,000. Last week, WHO Director General Dr Tedros Adhanom Ghebreyesus issued his first social media message on the disturbances – although that came several weeks after the protests had peaked. I am deeply concerned by multiple reports of health personnel and medical facilities in Iran being impacted by the recent insecurity, and prevented from delivering their essential services to people requiring care. In recent days, there have been reports of health workers… — Tedros Adhanom Ghebreyesus (@DrTedros) January 29, 2026 Pakistan – standing “in solidarity with Iran” Iran protests Israeli initiative, supported by allies in regiong. Iran’s humanitarian crisis, however, has also become entangled by the broader geopolitical situation in the region – with critics and allies of the regime lined up accordingly. And the debate at the EB was no exception. Israel’s call to WHO for a report was therefore immediately reubuffed by Pakistan and others in the region as a political maneuver aiming to deflect attention from Israel’s record in Gaza – where where two years of war have reduced the enclave to rubble and intermittent attacks continue despite a cease-fire declared last October. “This is a clear attempt to abuse this forum for political point scoring and to divert attention from the catastrophic consequences of Israel’s own conduct in the occupied Palestinian territory and across the Arab region,” said Pakistan, speaking on behalf of the 57-member Organization of Islamic Cooperation (OIC). Pakistan rebuffs calls for a report on Iran. “The OIC stands in solidarity with Iran against these politicized accusations and calls on who to reject Israel’s malicious proposal and any attempt to instrumentalize the organization for narrow political purposes.” Added Egypt, asking WHO to detail its response to Iran’s recent civil uprising would not be “in line with the technical aspect of the [WHO] reports. We must adopt unified criteria that are applicable to all. Therefore, we would like to ask the secretary to make sure that the reports are purely technical.” In just the past 24 hours Israeli airstrikes and shelling of alleged Hamas targets have led to the deaths of some 21 Gazans, including several children, added Palestine’s representative to the EB, citing media reports. Meanwhile, European member states that have recently been critical of Iran’s human rights abuses, as well as of Israel’s, remained largely aloof. Africa and other developing regions appeal for more attention to health emergencies in their corner But the headline-grabbing flashpoints in Europe and the Middle East, should not be allowed to obscure health emergencies elsewhere in the world, other member states emphasized, a theme underlined by WHO’s broader reporting on health emergencies. Africa, for instance, faces crises including infectious disease outbreaks such as mpox, climate-linked drought, foods and food insecurity, and conflicts that have displaced millions of people, driving disease, hunger and sexual abuse. Long-burning conflicts include the Sudan crisis, driven by UAE-backed RSF rebels, and a civil war in eastern DR Congo, led by Rwanda-backed M-23 fighters, who have taken over the regional capital of Goma. “The African region knows through experience that humanitarian crises as well as the massive displacement of populations weaken health care systems,” said the delegate from Comoros, speaking on behalf of 47 African member states. “They worsen inequalities and threaten the progress that has been made towards universal health coverage. Even so, “health crises that are linked to conflicts that should not draw attention away from other global health emergencies, especially such as those in Africa, recurring epidemics, climate change as well as food insecurity,” she stressed. But against the backdrop of the United States’ withdrawal from the global health agency “the African region would like to rereaffirm its commitment to work with the WHO, as well as all member states, to make sure that health remains a fundamental right that is protected everywhere at all times,” the Comoros delegate added. “We call on reinforced international cooperation. We call on unwavering solidarity as well as concerted action so that no one is left behind.” $9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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$9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Intellectual Property Dispute Stalls WHO Decision on Global AMR Strategy 04/02/2026 Felix Sassmannshausen Nepal, alongside Ethiopia, successfully proposed reopening talks on technology transfer rights, addressed in the WHO’s Global Action Plan on AMR. A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks. Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved. Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration. In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies. Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law. Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical. To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May. A blueprint to counter AMR The Global Action Plan on AMR focusses on equitable access and diagnostics. Patients receiving the correct antibiotics helps to prevent the spread of resistance. The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035. AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders. Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution. It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention. Divide between donor countries and Global South South African delegates aligned themselves with Brazil, rejecting the current draft regarding “voluntary” technology transfers. High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation. Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools. The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action. Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity. Market failure spurs intellectual property dispute A compromise proposed by Ethiopia opened the path to informal negotiations before the World Health Assembly in May. The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats. Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools. Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz. WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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WHO to Overhaul Global Emergency Care Strategy as 2030 SDGs Fade Out of Reach 04/02/2026 Felix Sassmannshausen The 158th session of the Executive Board adopted a resolution to overhaul the global emergency care strategy. The World Health Organization (WHO) is set for a massive shift in global health priorities with a new emergency care strategy, moving away from isolated hospital “silos” toward a seamless continuum of care. On Tuesday, the Executive Board unanimously adopted a 10-year strategy (2026 to 2035) for Integrated Emergency, Critical, and Operative Care (ECO), positioning primary health services as the front line in the race to achieve universal health coverage (UHC) by 2030. The emergency care strategy, set for final approval at the World Health Assembly in May, aims to fix “fragmented systems” that delegates say lead to avoidable loss of life. From climate-threatened islands to conflict zones, member states framed the new plan as a critical pillar. Barbados portrayed the ECO strategy, not just a medical issue, but as “a matter of national security,” referring to Small Island Developing States (SIDS) severely threatened by the effects of the climate crisis. Their delegate emphasised the need for resilient infrastructure and a crisis-ready workforce to ensure social stability and manage surge capacity during disasters and outbreaks. Other resolutions on high-tech medicine saw advances, despite warnings of a technological divide leaving low-resource countries behind. A global strategy on organ transplantation was deferred altogether due to ethical debates. Primary care is the new front line Primary healthcare workers are at the front line of the new emergency care strategy. With the world remaining “largely off track” on health-related SDGs, as the Central African Republic stated, the new global emergency care strategy places primary health care (PHC) at the key to achieve UHC. Consensus emerged that high-tech emergency wards are ineffective if the entry point to the health system is broken. PHC is the first point of contact between individuals and the health system, prioritising prevention and basic treatment, ensuring essential services are integrated into daily life. Workforce shortages threaten global health Zimbabwe, speaking for the WHO African Region, said that primary health workers must be better equipped and distributed to provide health security. However, deep concerns regarding the fragility of the global health workforce took centre stage. The WHO African Region, speaking through Zimbabwe, said it had tripled its health workforce to 5.1 million since 2013, but the region emphasised that these workers must be better equipped and distributed to provide genuine health security. This is to be able to provide accessible primary healthcare in accordance with the ECO strategy. The European Union (EU), represented by Bulgaria, warned of a projected shortfall of 11.1 million health workers globally by 2030 that must be “urgently addressed”. Only boosting the supply of professionals through fair recruitment would avoid “brain drain,” they warned, calling for optimising skills mix and digitalisation. Regarding the workforce crisis, the International Council of Nurses (ICN) warned that “chronic underinvestment in the nursing workforce limits their scale and impact.” The council urged member states to invest in creating a primary health care-enabled nursing workforce with “decent working conditions, safety and protection, career opportunities, equal pay and measures to prevent burnout”. Concerns over high-tech equity divides The delegate from the Republic of Korea highlighted the country’s institutionalisation of its telemedicine framework. High-tech solutions were frequently framed as ways to improve access to healthcare in underserved areas. The Republic of Korea highlighted its recent amendment of the Medical Service Act to institutionalise a telemedicine framework. Italy noted it is investing in telemedicine to achieve flexibility for populations with limited mobility. Regarding high-tech solutions, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) stated that the industry contributes by “expanding R&D collaborations,” strengthening data ecosystems, and improving diagnostic capabilities through “genomic sequencing and AI-enabled decision-making tools”. They called for advancing “dedicated and efficient regulatory pathways such as adaptive or collaborative review models”. However, as the EB moved to adopt resolutions on precision medicine, focusing on advances in genomics, and bioinformatics to shift health systems toward predictive and personalised care, a stark divide regarding equity emerged. Delegates from low-resource settings warned that the “high-tech” agenda ignores basic access realities. While countries like El Salvador actively use digital transformation tools to expand access to healthcare, their delegates cautioned that “medical excellence is useless if it does not reach everybody.” Universal health coverage must serve as a bridge to guarantee that access to health depends on “need and not capacity to pay”, they warned. Ethics and trafficking fears halt global organ strategy In a deviation from the session’s momentum, the board hit the brakes on a proposed global strategy for organ transplantation. Citing the complexity of ethical, legal, and system-level challenges, the Board voted to defer consideration of the strategy until the 80th World Health Assembly in 2027. The debate revealed deep regional and ethical fissures. The Eastern Mediterranean and African Regions advised that any future implementation must be preceded by robust legislative frameworks to prevent the trafficking of organs and protect vulnerable patients. The Holy See also intervened to outline strict ethical boundaries, urging a focus on adult stem cells and ethical alternatives. The decision to delay aims to allow time for more inclusive consultations to address these complex legal and ethical landscapes. Image Credits: WHO/Christopher Black , European Union/Lukasz Kobus, Felix Sassmannshausen. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. 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Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org.
Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. Posts navigation Older postsNewer posts