Seventy-eighth World Health Assembly in May, where WHO member states approved a stripped-down base budget of $4.2 billion for the next two years (2026-27).

The World Health Organization has a draft $4.295 million contract with the Boston Consulting Group pending in its Global Management System (GSM), Health Policy Watch has learned – even while Save the Children has suspended its connection to BCG, over the reported involvement of two former staff members in the development of controversial projects in Gaza.

If approved and executed, the new WHO contract would be the second one in six months to be awarded to BCG. 

Some $2,849,745 was spent by WHO on the Boston-based consultancy between 7 April and 15 May, according to GSM records seen by Health Policy Watch – to support the first phase of WHO’s massive restructuring. 

The WHO reorganization has been triggered by the January withdrawal of WHO’s largest donor, the United States, and a subsequent budget crisis that left a $1.7 billion hole in WHO’s planned $4.2 billion base budget [not including emergencies] for the next two years (2026-2027). 

The initial BCG consultancy was disclosed by Health Policy Watch in April, after it was discussed at a WHO ‘Town Hall’ convened by senior management. At the time, WHO Staff Association President Catherine Kirorei Corsini told WHO colleagues that the consultancy was being financed by “voluntary and earmarked funding from Bill and Melinda Gates….  And this because it’s voluntary and earmarked, it cannot be used for anything else.” Her remarks were confirmed later by a WHO spokesperson.

Continuation of a second phase

Oropouche mosquito monitoring
Sampling disease-carrying mosquitos in Latin America; fears that pending budget cuts will gut the rank and file WHO staff first of all.

But according to the terms of reference attached to the first BCG contract, seen by Health Policy Watch, the $2.849 million consultancy that ran from 7 April-15 May, was only “Phase 1”,  to be followed by a longer and larger Phase 2 that would further “implementation” of HR restructuring “to support long-term strategic objectives” as well as support “procurement savings to maximize cost-efficiency.”

Should that second contract for $4.295 million be approved, that would make for a massive $7.144 million in consultancy awards to the firm over a period of less than a year. 

Asked to comment on the pending continuation of the work to a second phase, the amounts involved, or the issues around the past activities of BCG staff or former staff in Gaza, WHO did not respond as of publication time. 

BCG also did not respond to queries by Health Policy Watch. 

However, regardless of reputational issues, WHO staff have also questioned why the organization should be spending millions on external consultants to advise on its reorganization – at a time when its also facing massive staff cuts. 

Save the Children suspension

Save the Children Clinic in Deir al Balah, northern Gaza. The organization has a network of humanitarian operations across the war-torn enclave.

On Tuesday, Save the Children reportedly “suspended” its decades-long relationship with BCG, citing “utterly unacceptable” work on Gaza-related projects – including a plan to relocate about a quarter of Gaza Palestinians out of the enclave following a cease-fire, a decision reported by The New Humanitarian. 

“We suspended our work with BCG on June 13 and we are now awaiting the outcome of their review,” Save the Children spokesperson Belinda Goldsmith was quoted saying in an email to TNH on 8 July.  

Save the Children’s decision followed a report last Friday by the Financial Times that BCG had “modeled” the costs of relocating Palestinians out of Gaza as part of a politically controversial post-war reconstruction plan. 

Earlier in June, the FT also reported that BCG staff had also been involved in the early stages of planning for the conflict-plagued Gaza Humanitarian Foundation. The Israeli and US-supported entity that began distributing food aid in Gaza last month tried to sidestep UN aid channels, but soon became mired in controversy as hundreds of Palestinians were killed traveling to and from the Foundation’s four distribution sides  over the past several weeks.   

In an 8 July email to all staff, Save the Children International CEO Inger Ashing referred to the FT’s reporting on BCG’s involvement with the controversial GHF and  “modelling a plan to forcibly relocate Palestinians from Gaza”  as “utterly unacceptable”, TNH reported. 

“Following that, we suspended all ongoing work with BCG pending the outcome of their external investigation and asked all Member teams to do the same,” wrote Ashing, to national-level Save the Children organisations. 

BCG has repudiated its connection to controversial Gaza projects 

Only the most able-bodied can run the gauntlet to reach Gaza’s food distribution points, which include four GHF outposts and scattered UN delivery points.

In a response dubbed “correcting the record” Sunday, 6 July, BCG said that two former partners had engaged secretly in a Gaza post-conflict evacuation cost assessment – without BCG’s knowledge.   

“Recent media reporting has misrepresented BCG’s role in post-war Gaza reconstruction,” BCG stated. “Two former partners initiated this work, even though the lead partner was categorically told not to. This work was not a BCG project. It was orchestrated and run secretly outside any BCG scope or approvals. We fully disavow this work. BCG was not paid for any of this work.

As for the earlier work in relation to the GHF, BCG said that:  “In October 2024, a BCG team from the U.S., led by two partners, provided pro bono support to help establish an aid organization intended to operate alongside other relief efforts to deliver humanitarian support to Gaza. They failed to disclose the full nature of the work. These individuals then carried out subsequent unauthorized work. 

“Their actions reflected a serious failure of judgment and adherence to our standards.

“We are shocked and outraged by the actions of these two partners. They have been exited from the firm. BCG disavows the work they undertook. It has been stopped, and BCG has not and will not be paid for any of their work.

“We are acting with urgency and seriousness to learn from this and to ensure it does not happen again,” BCG added. “We deeply regret that in this situation we did not live up to our standards. We are committed to living our values—with accountability for our failures and humility in how we move forward.”

Image Credits: Wikipedia , WHO/Pierre Albouy, PAHO/WHO, Save the Children , X/Channel 4 .

A trial participant is prepared for a blood test as part of a trial of new TB drugs that can overcome drug resistant pathogens. Several HIV and TB trials were suspended following recent changes in US policy.

Human trials conducted outside the United States with funding from the US National Institutes of Health (NIH) halted by the Trump administration in May, may be permitted to continue.

On 1 May, the NIH outlawed US researchers from making subawards to foreign research partners, jeopardising billions of dollars of research throughout the world. As a result, some clinical trials on humans were halted midway despite dangers to trial participants and the huge waste of money.

However, the payment freeze to several NIH subawardees in South Africa was recently lifted, according the journal, Science, which reported that “an alternative payment scheme … could allow those studies to continue”.

Over the past two decades, South Africa has become a “preferred site” for HIV and tuberculosis research, both because of its high burden of HIV and TB and the excellence of its scientific community, according to Professor Ntobeko Ntusi, head of the South African Medical Research Council (SAMRC).

It has been disproportionately affected by the NIH’s change in policy towards subawards, which jeopardised at least 27 HIV trials and 20 TB trials, according to an analysis by the Treatment Action Group (TAG) and Médecins Sans Frontières (MSF).

In 2024, the NIH funded about 3,600 foreign subawards worth more than $400 million, according to Science.

The NIH wants to control allocations to foreign research groups, stipulating that they will need to apply directly to NIH for grants, not go via third parties. However, it will only have the new award procedures in place by 30 September, leaving thousands of research projects in limbo.

Explaining its position in an announcement on 1 May, the NIH said that it wants to “maintain strong, productive, and secure foreign collaborations” and  “ensure it can transparently and reliably report on each dollar spent”.

As a result, NIH “is establishing a new award structure that will prohibit foreign subawards from being nested under the parent grant. This new award structure will include a prime with independent awards that are linked to the prime that will allow NIH to track the project’s funds individually,” according to the announcement.

However, it now appears to have made exceptions for clinical trials involving people in the interim. 

“Staff guidance dated 30 June maintains that grant renewal and new applications including a foreign subaward submitted after 1 May will not be reviewed until the new tracking system is in place,” according to Science.

“But the document describes an exception for human subject research in applications submitted earlier, and for ongoing human studies. As a temporary measure, NIH grants staff can convert the subawards within these projects to special ‘supplements’ to the main grant that will go directly to the foreign collaborator, the document says.”

NIH official Michelle Bulls informed grants staff in a memo on 27 June that, although no new awards can be made to South Africa, “existing subawards with clinical research can continue under the new ‘supplement’ plan… and ongoing prime awards to South African researchers, which make up about 100 of the country’s NIH grants, ‘may proceed’,” according to Science.

Prof Ian Sanne, co-principal investigator of the Wits HIV Research Group Clinical Trials Unit, earlier described navigating the US funding cuts as a “major regulatory and ethics nightmare”.

One of the studies Sanne oversaw that was terminated involved a trial of microbicide rings filled with slow-release antiretroviral medication to prevent HIV that were inserted vaginally in trial participants, many of whom were at high risk of HIV infection.

However, restarting the research is not a simple matter as, in the two-month pause in NIH payments, trial participants have dispersed and research staff have been retrenched.  In addition, there is no guarantee that current subawards will qualify for awards under the new system.

NIH targets journal fees

Meanwhile, the NIH announced this week that it was cracking down on “excessive publisher fees for publicly funded research”.

The NIH claimed that “some major publishers charge as much as $13,000 per article for immediate open access, while also collecting substantial subscription fees from government agencies. 

“For example, one publishing group reportedly receives more than $2 million annually in subscription fees from NIH, in addition to tens of millions more through exclusive article processing charges (APCs). These costs ultimately burden taxpayers who have already funded the underlying research.”

In 2026, the NIH will introduce a cap on “allowable publication costs” (APC) to ensure that  publication fees “remain reasonable across the research ecosystem”. 

“This policy marks a critical step in protecting the integrity of the scientific publishing system while ensuring that public investments in research deliver maximum public benefit,” said NIH director Dr Jay Bhattacharya.

Image Credits: TB Alliance.

Ruth Halperin-Kaddari, Israeli legal scholar and womens’ rights advocate at the briefing.

A team of Israeli team of experts in law and gender have called on the United Nations to hold Hamas accountable for systematic use of sexual violence during attacks on Israeli communities near Gaza on 7 October, 2023, and in the course of holding some 251 Israelis and foreigners hostage over subsequent months. 

Speaking at a briefing with Geneva’s UN press corps on Wednesday, leading figures with The Dinah Project said the UN should outlaw, or blacklist, Hamas for using sexual violence, “as a tactical weapon of war” – while international courts should prosecute Hamas figures said to have led or carried out the violence.

“The hope is to… set the historical record straight and to have it affirmed by as many organizations as possible, and building upon this, continue also on the international political level, said Ruth Halperin-Kaddari,” a noted Israeli legal scholar and women’s rights advocate. She added. “We are hoping that the Secretary General will indeed follow on and blacklist Hamas.”  

A new report by the project, released Tuesday, cites at least 15 separate cases of sexual assault, including at least four instances of gang rape and other cases of genital mutilation, followed by the killing of the victims after their assault, during the 7 October attacks by Hamas gunmen, said Halperin-Kaddari, a lead author of the report. Nearly 1200 people died in the early morning Hamas assault on Israeli communities near the border with the Gaza Strip and young festival goers at the Nova music festival. 

Israeli Nova festival goers flee Hamas gunmen on the morning of 7 October, 2023; some were captured, raped and killed or raped, witnesses say.

Over a dozen former Israeli hostages have also testified that they either experienced first hand, or witnessed, various forms of sexual assault – including sexual violence, forced nudity, verbal sexual harassment and threats of forced marriage, the report found. 

The highly technical report by the team of Israeli legal experts also calls for a broader set of evidentiary  principles to govern the prosecution of sexual violence during conflicts more generally – saying that the direct testimony of wartime sexual violence victims is often impossible to collect – as many of them are subsequently killed.  

“Most victims were permanently silenced — either murdered during or after the assaults or remain too traumatized to talk — creating unique evidentiary challenges,” the report stated. 

So cases need to rely not only upon the victims’ own testimony, but the evidence of witnesses and forensic evidence. And when a pattern of systematic violence is identified, not only individual perpetrators, but the leadership of an armed group should also be held to account.    

“If we use the regular criminal law paradigm, the result is impunity.  You cannot actually point to a specific attacker, who attacked a specific victim,” said Nava Ben-Or, a retired Israeli judge, at the briefing.  “We need to a mass atrocity [section of] criminal law, which will enable the justice system to bring these perpetrators to justice.”

The report by the independent NGO was supported by the UK government as well as a variety of Israeli-and Jewish-affiliated foundations.

Report builds upon UN fact-finding mission

Pramila Patten, Special Representative of the Secretary-General on Sexual Violence in Conflict, briefs journalists in New York in March 2024.

The project builds upon a report by a UN fact-finding mission last year, following a 17-day visit by Pramilla Patten, UN Special Representative of the Secretary General on Sexual Violence and Conflict, to Israel and the Israeli-occupied West Bank. Her report found “reasonable grounds” to believe that multiple incidents of sexual violence occured during the 7 October Hamas onslaught.  There was also “clear and convincing” that hostages held by Hamas in Gaza were subjected to sexual violence, Patten said in a subsequent press release. 

Since Patten’s report, more Israeli hostages have been released from Gaza including some who relayed new evidence about sexual violence that they experienced directly, or witnessed, including some men as well as women, the Dinah Project’s authors note.   

Hamas did not comment immediately on the report.  

However, through the course of the grueling 21 month war, there have also been UN and Israeli media reports of sexualized forms of violence perpetuated by Israel against Palestinian detainees, particularly in Israel’s notorious Sde Teiman prison.

And earlier this year, a report by a UN Human Rights Council’s Commission of Inquiry on the Occupied Palestinian Territory, asserted that gender-based and sexual violence, including forced public stripping and nudity, sexual harassment.. and sexual assault” were “standard operating procedure” of Israeli Security Forces toward Palestinians – allegations that Israel “categorically” rejected. 

Calls for a new standard for prosecuting sexual violence in the context of conflicts

“I do not have any credence to opine what I think about, what my government is doing or not doing in Gaza,” said Halperin-Kaddari, in response to a reporter’s query about the broader charges that have since been levied against Israel for genocidal actions in Gaza since 7 October – including constant military attacks within civilian “safe zones” and restrictions on the entry of food, medicines and other humanitarian aid, as well as fuel and water.

“We are not the government… This report is an independent work of academia, experts. …  There were victims and they were not recognized. And Hamas is still viewed by too many organizations, too many countries, too many entities, including human rights entities…as part of the international human rights community, and hearing their silence….I take it as a total failure of the international human rights system,” Halperin-Kaddari added. “We demand that they come to terms with the realization that Hamas are deplorable as using the worst kind of crime against humanity of sexual violence in war.”

The Dinah Project leaders said that they also want to convey a universal message condemning sexual and gender-based violence in conflict settings. 

“We established the Dinah Project to take action, not only regarding October 7 victims, but also around the world,” said Sharon Zagagi Pinhas, a former chief military prosecutor, at the briefing.

 “And we aim to influence protocols and procedures around the world in different arenas, and the problems that and the challenges that we identified on October 7 are the same challenges that we identify in other places around the world. 

“It’s not just an Israeli initiative. It’s an initiative that is intended to continue and also to seek ways to help also victims, but also systems and organizations in finding ways to achieve accountability in cases of conflict related sexual violence around the world.

Added Halperin Kaddari, “We have already started… to establish working relationships and contacts with other sister organizations, whether it is Yazidi women or women in Ukraine. There is already an umbrella chain of organizations that work on the same field, which we are part of, and we will certainly develop this outreach to other areas.

“But we focus on the legal framework and on the legal theory. … And unfortunately, there is a universal need, and our message is indeed universal.” 

Image Credits: X/via Israel Ha Yom, UN News .

A researcher collects information on pathogens during a disease outbreak. How such information is shared in a fair and equitable way is the next phase of the pandemic agreement talks.

The next – and tricky – phase of cementing the World Health Organization’s pandemic agreement resumes on Wednesday (9 July) with the first meeting of the Intergovernmental Working Group (IGWG).

The IGWG’s main task is to negotiate an annex to the pandemic agreement on a pathogen access and benefit sharing (PABS) system. This system will set out how information about pathogens with pandemic potential is shared in a safe, transparent and accountable manner, and how those who share information will benefit from products that are developed as a result.

It is a hot potato given tensions between intellectual property rights for pharmaceutical companies and wide access to affordable medical products.

In addition, the IGWG will prepare the ground for the Conference of the Parties that will govern the pandemic agreement, and the terms of reference for a coordinating financial mechanism, which will help defend countries against outbreaks and pandemics.

According to WHO legal officer Steven Solomon, the PABS annex has to be completed by 17 April 2026 to meet the deadline of submission to the World Health Assembly in May 2026.

This means that the IGWG has merely nine months and eight days to complete its work to meet the deadline.

This week’s meeting will be dedicated to electing the office-bearers, setting out timelines and modalities for engagement with relevant stakeholders.

The first item on the IGWG agenda is the election of two co-chairs and four vice-chairs – one for each of the six WHO regions. As with the Intergovernmental Negotiating Body (INB) that ran the pandemic agreement talks, the co-chairs are to reflect developing and developed countries.

IGWG co-chair contender, the UK’s Dr Mathew Harpur.
IGWG co-chair contender, Brazil’s Ambassador Tovar da Silva Nunes

Ambassador Tovar da Silva Nunes, Brazil’s Permanent Representative to the United Nations Office in Geneva, and Dr Mathew Harpur, Deputy Director for Multilateral and G7/G20 Engagement for the UK’s Department of Health and Social Care, are strong contenders for co-chairs, according to sources.

The INB co-chairs, France’s Ambassador Anne-Claire Amprou and South Africa’s Precious Matsoso, are passing the baton to new leaders, although the pandemic agreement that they oversaw contains the outline of the PABS system.

Addressing a recent meeting in Geneva, Amprou said that preparatory work for the implementation of the pandemic agreement should start as soon as possible, in parallel with negotiations on the annex.

Amprou added that she though that the annex should be a short document and that “this negotiation should be much more technical than political [as] we know the political positions of different member states”.

As with INB meetings, open sessions of the IGWG will be webcast and stake-holders in official relations with the WHO will be permitted to attend and contribute at certain times.

Image Credits: Wildlife Conservation Society .

An anti-smoking campaign in China, the biggest consumer of tobacco products.

As the tobacco industry continues to innovate to preserve its market appeal, the health sector needs to become even more creative – advocating for new regulations to reduce tobacco’s appeal and increase product costs. Among those: limiting nicotine content, banning filter tips, and joining WHO’s new “3×35 initiative” to raise the price of tobacco products by 50%. 

We’re on the brink. For much of the last 20 years, smoking has been in decline worldwide, saving millions of lives, but we are at an inflection point. Trends point to a flattening in the decline of cigarette sales, and Big Tobacco is responding to two decades of public health progress with insidious innovation. If public health practitioners don’t out-innovate the industry now, we’ll be setting ourselves up to lose.

It is a monumental public health achievement that global tobacco use dropped by a third in the last 20 years. More than 5.5 billion people are now covered by some measure that discourages tobacco use, such as advertising bans, higher taxes and quit programs. For the first time, an entire region, Latin America, has smoke-free laws in place.

But we cannot expect the hard-won anti-tobacco laws of today – those that have created smoke-free spaces, banned advertisements around schools and removed flavors from cigarettes which have saved millions of lives – to protect us from the industry’s plans for tomorrow.

Despite its seemingly anti-cigarette rhetoric, the industry is not slowing down on its core product – monetizing addiction. There are too many signals to ignore: Philip Morris International shipped more cigarettes in the first quarter of 2025 than during the same period last year. British American Tobacco just launched a new cigarette brand in Korea. Japan Tobacco International is building a new factory in Morocco.

Industry is innovating around anti-smoking regulations 

Tobacco industry innovation includes a barrage of new tobacco products.

The industry is also innovating its way around current anti-smoking regulations, releasing a barrage of new products like e-cigarettes (vapes), heated tobacco products and nicotine pouches. When laws threaten to restrict or ban these addictive products, tobacco companies try to influence politicians to advocate for them, often as the “lesser evil”. 

These products are increasingly being targeted at the next generation. The industry has lobbied for heated tobacco products to be exempt from the UK’s new Tobacco and Vapes Bill so they can continue to be sold to people who would no longer be able to buy cigarettes. It also wants to continue promoting these products in a wide range of retail outlets, which has included items at children’s eye-level, near sweets in filling stations. 

Meanwhile, there are reports from across the UK of nicotine pouch giveaways at railway stations and tobacco companies sponsoring music events like the Reading and Leeds Festival, where many teens go to celebrate the end of exams.

If nothing is done to counter the industry’s strategies, not only will declines in smoking be reversed, but new epidemics will arise. Indeed, an e-cigarette epidemic already has, with vapes being used more by teens than adults in many countries. We’re risking a future where the next generation won’t have the same protections.

Out-innovating big tobacco 

But tobacco companies aren’t the only ones innovating. New ideas are emerging that can move the needle in the right direction, for good. 

We can require that cigarettes have less nicotine, so that fewer people get hooked for life. We can use technology to blur out tobacco company logos and branding in Formula 1 races, as in France, and address imagery on streaming platforms, like in India. 

We can institute “polluter pays” penalties where tobacco companies compensate for the environmental damage their products cause, like in Spain. We could ban filters to remove a product design element that makes it easier to smoke and eliminate the most littered single-use plastic in the world. We can prohibit the youngest generations from ever being allowed to buy tobacco.

These solutions can be agile and deployed at the national, provincial or city level. The generational end game law, which makes it illegal to sell tobacco to anyone born after a certain date, is being pioneered at the city level in Brookline, Massachusetts, in the United States. A similar law is set to go into effect in the UK soon.

To prevent a backslide into the era of smoke-filled rooms and Joe the Camel, these solutions need to be accelerated and supported in every country.

So there couldn’t have been a better time for the tobacco control community to gather than at the recent World Tobacco Conference in Dublin, Ireland. 

Experts and advocates from around the world convened in a country that itself is wrestling with stalled declines in tobacco use and a rise in youth e-cigarette use. While Ireland aimed to reduce tobacco use to less than 5% by 2025, recent data shows it hovering at 17%. Worryingly, a 2022 survey revealed that two in every five girls and a quarter of boys aged 15-17 had used an e-cigarette.

Convening in Dublin provided an opportunity to double down and renew the push for what we know works: advertising bans, smoke-free laws and – the gold standard – higher tobacco taxes. 

Raising real prices

Following that major meeting, the World Health Organization (WHO) has now launched a big new initiative urging countries to raise real prices on tobacco, alcohol, and sugary drinks by at least 50% by 2035 through health taxes. The “3 by 35” Initiative is based on studies showing that a one-time 50% price increase in these products could prevent 50 million premature deaths over the next 50 years. 

This period between Dublin and the upcoming UN High Level Meeting on Noncommunicable Diseases in September is a time to mobilize action behind these creative new solutions that can counter Big Tobacco well into the future.

The tobacco industry is playing the long game, and we need to, too. No public health win is permanent. If politicians and the public aren’t vigilant, Big Tobacco will continue trying to dismantle laws that protect health, while finding ways to bypass others. The next era of tobacco control requires innovative solutions – they will make all the difference. 

Dr Mary-Ann Etiebet is the President and CEO of Vital Strategies where she leads a team of over 400 people in over 80 countries working to advance long-term solutions for the growing burden of noncommunicable disease and injury.

Image Credits: Johannes Zielcke, Filter.

Delhi traffic officer Ashok Kumar explains the new rules on 1 July.

NEW DELHI – When drivers entered fuel stations on 1 July, they found bright new warning signs and traffic police positioned at the fuel pumps. Old vehicles would be identified by special, new cameras and denied fuel. Drivers  also risked having their vehicles seized for “liquidation.” 

The day marked the beginning of a widespread campaign by central government’s Commission for Air Quality Management (CAQM) in the Delhi region to reduce air pollution.  

Any gasoline-powered vehicle older than 10 years, or a diesel vehicle older than 15 years, was supposed to face action – and at least 80 such vehicles were seized initially.

Although some  6.1 million over-age vehicles are registered, the actual number on the roads is far lower, and some estimate it to be around 400,000. 

However, enforcement quickly fizzled out after the Delhi state government sought a pause following protests on social media. Many of these went viral and were also reported widely in the media. 

Enforcement aided by advanced new cameras

To identify these vehicles at the pumps and on the road, CAQM installed hundreds of advanced cameras with automated number plate recognition (ANPR) linked to a database. 

The ban on such older vehicles circulating in Delhi was first introduced in 2015, but after two days of protests over the enforcement, the Delhi government pressured CAQM to put the operation on hold. 

Chief Minister of Delhi Rekha Gupta tweeted that the decision should be suspended as it was adversely affecting the daily lives and livelihoods of millions of families. She called for a practical, equitable, and phased solution.

Delhi’s environment minister, Manjinder Singh Sirsa, cited several “technological gaps” in the ANPR system in a letter to CAQM posted on X on Thursday. These include that it lacks robustness, there are crucial glitches in the camera placement, sensors aren’t working, and the system is not fully integrated with databases of states neighbouring Delhi. He called for a “holistic approach and implementation” in Delhi and its neighbouring regions. 

However, a source told Health Policy Watch that ANPR was able to identify up to 6,000 overage vehicles per day during tests, and described it as a “foolproof” method. Tests conducted since last December showed that the system has worked well. 

Ironically, a day before the enforcement drive began, Gupta of Prime Minister Narendra Modi’s BJP Party said that the Delhi state government would follow orders of the courts and the CAQM.

Despite repeated inquiries from Health Policy Watch, CAQM did not provide any details on the future of the campaign in Delhi. However, it made it clear in a press release related to curbing pollution in neighbouring Haryana state, that it intends to continue to advocate for the liquidation of the ‘end-of-life’ (EoL) vehicles plan and ANPR cameras. 

The initial campaign in Delhi was supposed to be part of a regional initiative by Indian authorities that aimed to get an additional 4.5 million EoL vehicles off the road starting in two phases in November,  then April 2026. The rollout of ANPR cameras in other states and cities had also begun. 

However, as long as the Delhi State Government opposes enforcement, the agency will find it difficult to continue to clean up Delhi.  

Weak political appetite to tackle air pollution

The call for a pause signals the weak political appetite of the five-month-old Delhi government to take hard decisions to improve air quality in what has frequently been ranked as the world’s most polluted capital over the past decade. 

Even before Sirsa’s letter to CAQM last week, there was a perceptible shift in the party’s tone. In March, Sirsa promised an early crackdown on polluting vehicles that are a major contributor to Delhi’s annual air pollution, particularly in winter:

Older vehicles emit high levels of polluting nitrogen oxide (NOx), sulphur dioxide (SO2) and contribute to the microscopic pollutant, PM2.5. In 2024, PM2.5 levels reached peaks of 732 micrograms per m3 – about 73 times higher than the World Health Organization’s (WHO) 24-hour guideline level. 

But on 2 July after the protests, Sirsa blamed the previous Aam Admi Party (AAP) government for not enforcing the ban earlier:

The protests included many influential voices across the political spectrum. But most ignore health impacts and the fact that the older cars have outdated fuel standards, which means that they are inevitably more polluting, regardless of how well they may have been maintained. 

Health impact of vehicular pollution 

Drivers and passengers in heavy traffic with many polluting vehicles are typically exposed to excessively high levels of oxides of Nitrogen (NOx) from gasoline vehicles, as well as fine particulates, PM2.5 from diesel. 

Even short-term exposure to high levels of those pollutants prompts immediate, physiological responses, including headaches, irritation in the eyes, nose and throat, and difficulties in breathing. 

Chronic, long-term exposure to traffic pollution can have far more severe health effects, worsening asthma and other lung disorders, cardiovascular problems and high blood pressure, leading to premature death. 

Air pollution has also been identified in a new report as being a more significant cause of lung cancer in ‘never smokers’ than previously believed, according to a new study published in Nature. Patients from regions of the world with high levels of air pollution were more likely to have genomic mutations linked to cancer.

In Delhi alone, 7.8 years life years are estimated to be lost from air pollution while the average for India is 3.6 years. 

WHO’s South East Asia region, which extends east from Pakistan to Bangladesh, continues to have the highest overall burden of disease from air pollution, and India is one of the worst-affected countries. A little over two million Indians a year die from air pollution, with the worst effects concentrated in Delhi and other major cities. 

Air pollution is also linked to obesity, diabetes, metabolic dysfunction and genomic damage, points out Dr Sanjeev Bagai, a prominent paediatrician in Delhi. 

“Vehicular pollution is the lesser-mentioned culprit causing serious human harm,” he said in an interview with Health Policy Watch.

Vehicles are a big chunk of Delhi’s air pollution

In the Delhi region, vehicles contribute significantly to the air pollution crisis. According to officials, vehicles emit 78% of the nitrogen oxide (NOx), 41% of sulphur dioxide (SO2), and at least 28% of PM 2.5 particulate matter pollution –  although some estimates put it at 40% and as much as 50% in winter. Much of the NOx also converts to PM 2.5, which is so fine that it can settle deep into the lungs and other organs, causing damage. 

Neither the science nor the policy to get older vehicles off the road are new.  A ban on EoL vehicles has been in force since 2015, when it was first ordered by the nation’s top environmental court, the National Green Tribunal (NGT). The ban was upheld in 2018 by the Supreme Court and in 2024, a powerful panel headed by the country’s top bureaucrat, then Cabinet Secretary Rajiv Gauba, called out the “very slow progress” on implementing the ban. 

Science vs #DelhiFuelBan protests

Many of those criticising the crackdown claim that 10 or 15-year-old vehicles can remain in good condition. For instance, one social media user praised his father’s 16-year-old Mercedes as a so-called “zero pollution” vehicle.

The facts, however, don’t bear that out. Vehicles with the latest fuel standard –  Bharat Stage 6 (BS 6), equivalent to Euro 6 – emit far less pollution than earlier standards, according to a study by the International Council on Clean Transportation (ICCT). 

In its 2024 report, the ICCT said that so far, India’s “leap” from BS 4 to BS  was contributing to “significant reductions in tailpipe emissions.” Even 5- to 10-year-old vehicles with a BS 4 standard are approximately five or six times more polluting, while those that are 10 years or older, with BS 3 and BS 2 standards, can be 10 and 11 times more polluting, ICCT said.

But the claim that well maintained older vehicles are “clean” are being widely promoted, including by this influencer with over 15 million YouTube followers:

Protests across political spectrum

Criticism of the ban has come across most of the political spectrum. An opposition Member of Parliament, Saket Gokhale of the Trinamool Congress, called the ban “ridiculous” and a “major financial hit to the middle class”, affecting six million owners. He has written to the federal transport minister asking for the policy to be withdrawn:

A columnist appealed to Prime Minister Modi, who follows her on X, to allow old vehicles that comply with emission norms. She cites an automobile manufacturers group, which claims that a large number of these vehicles can meet stringent standards. 

Most air quality advocates are silent

On the other hand, the usually vocal air quality advocates were largely silent. The authorities also did not defend the ban once the protests began increasing. 

Approaches by Health Policy Watch to several organisations yielded no response. Amongst the few exceptions were Karthik Ganesan and Arpan Patra of the Council on Energy, Environment and Water (CEEW). 

In an article on Thursday in the Indian Express, they welcomed the measures as being a good, first step shortly before the campaign was suspended. 

“The restriction on the fuelling of end-of-life vehicles in Delhi firmly communicates the government’s intent to curtail pollution… This ban must cascade into the following logical next steps to truly clean up transportation emissions,” wrote Ganesan and Patra.

Until now, the government had largely relied on frequent, mandatory pollution checks on vehicles that pulled into service stations, but these use old technologies that only check for very high levels of smoke particles and carbon monoxide. They don’t capture data on fine particulate matter, nitrogen oxides and sulphates, which are the pollutants most harmful to human health. 

As for more sophisticated testing, there are only two vehicle fitness centres in the entire city of more than 22 million people capable of this.

Meanwhile, studies by the ICCT and others have demonstrated that filtering vehicles by their age rather than rudimentary and outdated emissions tests, is a more reliable means of getting polluting vehicles off the road. 

Cameras installed at Delhi service stations can identify older vehicles by their registration plates. But their use now hangs in the balance after the government suspended implementation of the ban on older vehicles.

Will the new Delhi government ever step up? 

Experts say that enforcing the ban is just one step in reducing Delhi’s air pollution at its source. Public transport is patchy and buses don’t reach many neighbourhoods. 

About 31% of urban neighbourhoods in Delhi fall outside a 500-meter radius of a public bus stop, a threshold recognised as the standard for walkable access under India’s Transit-Oriented Development (TOD) policy, according to a recent study.

If the government does eventually enforce the ban on old vehicles using its updated technology, it will also be expected to enforce other court orders and pollution curbs  like the ban on fire crackers and steps against waste burning. 

If it doesn’t, it will need to contend with the optics. As Ashwini Tewari, the chief of India’s largest bank, State Bank of India, pointed out recently, foreigners want to avoid the Delhi region, including the booming city of Gurgaon on its southern border, where major multinationals like Google, Microsoft, IBM and Deloitte have large offices. 

The quality of the Delhi government’s air pollution mitigation strategies thus has major economic implications at the national as well as local level. 

The record for this new BJP government, which came into power in February, remains very mixed. While it is continuing and extending policies such as more EV buses, it is also is facing criticism for a plan to install so-called ‘modern air purifiers’ in the park of an elite neighbourhood despite a failed earlier experiment with outdoor smog towers. 

The new plan is to install 150 such ‘air purifiers’ over 85 acres. But with Delhi is spread over 366,000 acres, any such initiative will be ineffective, as experience and studies have shown. 

Cutting pollution at source is always a better option, as air quality researchers point out. For now, a series of pollution maps of Paris, showing how a curb on vehicles improved air quality, has gone viral in India. 

Data maps show the effect of vehicle curbs on lower air pollution in Paris

 

Image Credits: Asian News International, Chetan Bhattacharji, University of Chicago, Airparif.

North Darfur capital of El-Fasher from above.

Mass atrocities, rape, famine, sexual and ethnically targeted violence have plagued Sudan’s civil war since it erupted two years ago. With peace nowhere in sight, a new report released by Médecins Sans Frontières (MSF) recounts in devastating detail: nothing has changed. 

Based on interviews with over 80 civilians, MSF data and direct observations from its medical teams, the report documents the violence and humanitarian catastrophe unfolding in El Fasher, the capital of North Darfur, where the Rapid Support Forces (RSF) have encircled hundreds of thousands of people while laying the city under siege.

Mass killings and starvation are underway, MSF found. Food, water, and humanitarian aid are blockaded. Food shops and markets, water towers and pumps, hospitals and healthcare facilities are under constant attack.

The Sudan Doctors Network reports 239 children have died from malnutrition in El Fasher since January as nearly half of Sudan’s remaining population facing acute food insecurity turn to boiling weeds and wild plants to survive.

Gunfire, airstrikes and artillery are already raining down on the city as the warring factions compete for control. But MSF warned further escalation is still possible: an all-out RSF assault on the capital.

“In light of the ethnically motivated mass atrocities committed on the Masalit in West Darfur back in June 2023, and of the massacres perpetrated in Zamzam camp in North Darfur, we fear such a scenario will be repeated in El Fasher,” said Mathilde Simon, MSF’s humanitarian affairs advisor. “This onslaught of violence must stop.”

‘Clean El Fasher’ 

An MSF nurse attends to a patient amid the violence in North Darfur, April 2025. / MSF

Ethnically targeted attacks by the RSF on non-Arab communities, particularly the Zaghawa, are “protracting the ethnic violence that has ravaged Darfur for over twenty years,” MSF said.

“RSF and their affiliates repeatedly shelled neighbourhoods and gathering places of civilians known to be from non-Arab communities, ground attacks were systematically carried out, involving the looting of belongings, killing of civilians and razing of houses and infrastructure,” the report found. “Sexual violence was widely perpetrated, and numerous abductions were reported.”

The RSF is a descendant of the Janjaweed militia that led the Darfur genocide, targeting non-Arabs across the region and killing an estimated 300,000 people from 2003 to 2005. 

Mohamed Hamdan Dagalo, the general known as Hemedti who heads the RSF, led Janjaweed paramilitaries that burned villages, killed civilians and raped ethnic Africans across his native Darfur during the genocide. These crimes led to the indictment of his then-commander and deposed Sudanese president, Omar al-Bashir, by the International Criminal Court for war crimes and genocide.

With the shadow of a repeat of history looming over the province, MSF reported several witnesses testified they overheard RSF soldiers airing plans to “clean El Fasher,” raising the spectre of a second genocide – or that it is already underway.

“Only God knows what will happen in El Fasher,” one man, 41, told doctors. “But if the RSF take El Fasher, they will carry out ethnic cleansing and genocide, like what happened in El Geneina.”

El Geneina, the capital of West Darfur, was systematically cleared of its Massalit population by RSF and allied militias through killing and forced displacement in 2023. The total number dead in the violence is unknown. A UN expert panel estimated between 10,000 and 15,000 people were killed, while Sudanese Red Crescent staff identified 2,000 bodies on the capital’s streets before they stopped counting.

As MSF urges the warring parties to spare civilians and grant access for humanitarian organisations to provide critical aid to people in need, RSF forces took control of the tri-border area with Libya and Egypt in June, gaining control over critical supply routes and threatening to open new fronts in the civil war. 

“As patients and communities tell their stories to our teams and asked us to speak out, while their suffering is hardly on the international agenda, we felt compelled to document these patterns of relentless violence that have been crushing countless lives in general indifference and inaction over the past year,” Simon said.

Despite a UN arms embargo, weapons continue flowing to both sides through neighbouring countries, several of which, including Libya, Chad and the Central African Republic, are major arms trafficking hubs, UN experts say. 

While Egypt and Saudi Arabia back government forces, the UAE, Libya and Russian-linked Wagner Group support the RSF. The UAE has invested over $6 billion in Sudan since 2018, viewing the resource-rich nation as key to expanding its regional influence.

Around 40,000 people have been killed and 13 million displaced since the civil war began in April 2023, according to the latest UN estimates.

Peace, at this juncture, is nowhere in sight.

Nowhere to hide

Over 400,000 people were forced to flee to El Fasher from the Zamzam refugee camp, the largest displacement encampment in Sudan just south of the city, after an RSF ground assault in April that killed more than 500 civilians.

Those who made it to the city “remained trapped, out of reach of humanitarian aid and exposed to attacks and further mass violence,” MSF said – and there is no way out.

“Survivors who managed to flee have undergone further violence along the road, with men being specifically targeted, women and girls being raped and civilian convoys attacked,” the report found. 

“The harrowing level of violence on the roads out of El Fasher and Zamzam means that many people are trapped or take life-threatening risks when fleeing. Men and boys are at high risk of killing and abduction, while women and girls are subjected to widespread sexual violence.”

The millions who successfully flee Sudan find crisis there too.The World Food Programme warned Wednesday that life-saving assistance may soon shut down in the Central African Republic, Chad, Egypt, Ethiopia, Libya, South Sudan and Uganda – all grappling with their own domestic food insecurity needs – as funding cuts and new arrivals overwhelm support systems.

“This is a full-blown regional crisis that’s playing out in countries that already have extreme levels of food insecurity and high levels of conflict,” said Shaun Hughes, WFP’s Emergency Coordinator for the Sudan Regional Crisis. “Refugees from Sudan are fleeing for their lives and yet are being met with more hunger, despair, and limited resources on the other side of the border.”

Rape as a weapon of war

Violence and attacks on healthcare forced MSF to shut down operations in El Fasher and Zamzam camp.

Sexual violence has been a central feature of the violence in Sudan throughout the war. While both the Sudanese Armed Forces and the RSF have been found to commit sexual war crimes, the overwhelming majority are attributed to the RSF and its allies.

The UN Independent fact-finding mission on Sudan and Amnesty International separately found the militia had engaged in widespread sexual and gender-based violence, rape, sexual slavery, and abduction, among other crimes against humanity. RSF forces are further accused of using mass rape as a weapon of war and to assist ethnic cleansing efforts, using rape as a tool to drive fear and force women to flee.

“I have a certificate for first aid nursing. [When they stopped us], the RSF asked me to give them my bag. When they saw the certificate inside, they told me, ‘You want to heal the Sudanese army, you want to cure the enemy!,'” one woman, 27, told MSF. “Then they burnt my certificate and they took me away to rape me.”

No comprehensive statistics on sexual violence in Sudan exist. The latest number on confirmed cases, compiled by the advocacy group Together Against Rape and Sexual Violence and published on 4 June, documented 377 cases of rape since the war began.

Data on rape and sexual assault in war zones are notoriously inexact. In Sudan, survivors face an array of barriers from social stigma, to lack of adequate medical support, and a dysfunctional judicial system with no means to protect or prosecute if they speak out. The Sudanese government’s Unit for Combating Violence Against Women previously warned verified rape cases may represent as little as 2% of the total.

Since the start of the war, the number of people at risk of gender-based violence has more than tripled to 12.1 million people – 25% of the country’s population. The number of gender-based violence survivors seeking services increased 288% in 2024, according to UN Women.

The most harrowing finding came from Unicef in May: 221 rape cases against children were recorded by since the beginning of 2024. The youngest reported survivors were four one-year-olds. Sixteen child rape survivors, including the infants, were under 5 years of age. 

“Children as young as one being raped by armed men should shock anyone to their core and compel immediate action,” said Unicef executive director Catherine Russell.

Unicef found an additional 77 instances of sexual assaults against children, mostly attempted rape cases. Two-thirds of recorded cases were girls, but 33% were boys, which the agency noted requires “specific attention as they may face stigma and unique challenges in reporting, seeking help, and accessing services.”

“Millions of children in Sudan are at risk of rape and other forms of sexual violence, which is being used as a tactic of war. This is an abhorrent violation of international law and could constitute a war crime. It must stop.”

Southern spiral

The violence consuming Sudan threatens to spill across its southern border, where South Sudan, the world’s youngest nation, stands on the brink of a new civil war of its own.

South Sudan won independence from Sudan in 2011, ending the longest civil war in the history of the African continent. Twenty-two years of violence, disease and famine killed 2 million people, the highest civilian death toll since World War II.

Independence was quickly followed by civil war. In 2013, a break-down of the power-sharing agreement negotiated two years earlier resulted in five years of war, killing 400,000 and displacing 4 million before a new power-sharing agreement brokered in 2018 brought fragile peace to the fledgling state.

That agreement collapsed once again in March when President Salva Kiir’s forces arrested his former deputy Riek Machar, mirroring Sudan’s trajectory when two rival generals, charged with overseeing the country’s transition to democracy, instead dragged the country and its 50 million people into all-out war.

Since March, violence against civilians in South Sudan has since reached its highest level since 2020, the UN reported Wednesday, with 1,607 attacks in the first quarter of this year. Those include 739 civilians killed, 679 injured, 149 abducted, and 40 subjected to conflict-related sexual violence between January and March.

The escalating violence is already pushing South Sudanese civilians towards famine. Over 22,000 people are likely already starving, while nearly 60% of the population faces life-threatening food insecurity as a result of the escalating violence, the IPC warned in June.

Armed groups move freely across the porous border drawn only in 2011, with overlapping ethnic militias and historic alliances threatening to erase the fragile line between two conflicts – trapping 61 million people, once again, in a renewed cycle of violence.

“Given this grim situation, we are left with no other conclusion, but to assess that South Sudan is teetering on the edge of a relapse into civil war,” Nicolas Haysom, the UN’s top official in South Sudan, warned when the peace deal collapsed. “It would devastate not only South Sudan but the entire region, which simply cannot afford another war.”

Image Credits: MSF, UN Sudan Envoy.

Nigerian veterinary para-professionals on an animal health training course supported by the UN Food and Agriculture Organization (FAO).

As the world observes World Zoonoses Day, it’s important to remember that human health is intimately tied to the health of animals, wild and domesticated. 

Five years after COVID-19, the world remains alert to health threats that can cross over from animals to people. 

Alongside growing concerns over high-profile spillovers like avian influenza, the silent threat of everyday zoonoses – from salmonella in poultry to leptospirosis in livestock – continues to affect hundreds of millions each year. These infections may not all make front-page news, but their impact on human health is significant and largely preventable. 

Furthermore, these zoonotic diseases are on the rise. Virus jumps from animals to humans are increasing around 5% annually, meaning these pathogens are forecasted to cause four times the number of spillover events in 2050 than in 2020.

Clear trend of rising zoonotic disease spillovers to humans – with fatal consequences.

Given the interconnectedness of human and animal health, the best way to prevent zoonotic disease in people is to stop it from spreading in animals. However, we are currently falling short in this task as the threat of zoonoses appears to be increasing. 

Despite the recent adoption of the world’s first pandemic agreement at the May World Health Assembly, which explicitly recognized the need for integrated approaches known as “One Health”, gaps remain in veterinary infrastructure worldwide. This leaves the door open to another devastating cross-species outbreak. 

To address this, the world must strengthen the veterinary sector, from improved use of animal vaccines and other medicines to increased training and services. Importantly, recruiting and empowering veterinarians on the frontline is a practical and cost-effective way to reduce these risks and protect public health. 

Overall, zoonotic disease incidence represents 60 % of infectious diseases in humans. Common zoonotic diseases, such as salmonella, can originate in unprotected animals. Thankfully, these types of risks can be controlled through veterinary tools, but only if they are available.

Meanwhile, just 13 zoonoses are responsible for 2.4 billion cases of human illness and 2.2 million deaths per year. For example, more than a million people globally are affected each year by leptospirosis, a dangerous and sometimes deadly disease caused by bacteria that transfers from animals to humans.

Emerging zoonotic disease events 1940-2012. The United States and Europe are also hotspots.

According to a new report from the World Organisation for Animal Health (WOAH), cases of avian flu in mammals doubled last year compared to 2023, for instance. In the EU, zoonotic diseases have been found to be on the rise. 

No animal health references in WHO pandemic agreement

Sampling dead animals in the Congo basin for zoonotic diseases that could spark an outbreak – or a pandemic.  The WHO pandemic agreement ignores animal health.

Despite opportunities to agree on and implement preventative measures, they have not been sufficient to address the risk at hand. The World Health Assembly recently adopted the first pandemic agreement, yet the agreement is missing any mention of veterinary medicine and animal health. Without this inclusion, the agreement can never fully fulfil its aim to prevent pandemics.

Disruptions from zoonotic disease outbreaks carry a significant cost to the global economy. The estimated direct cost of the loss of life due to zoonotic diseases is $212 billion annually, not including the costs associated with long-term treatment or ulterior damages. 

Conversely, the estimated cost of preventative measures, including monitoring and surveillance of risks as well as landscape management, is around $20 billion. In other words, preventing these diseases is more than ten times cheaper than dealing with the consequences.

Protecting food security and farmers’ livelihoods, especially in developing countries, is another reason to take a proactive approach to preventing zoonoses. When livestock contract a disease, farmers often must cull their flock or herd to prevent further spread of the illness. This impacts food availability and prices and creates massive losses for farmers.

While difficult to calculate, the estimated loss of animals due to disease varies from 20% globally to 50% in developing countries. Furthermore, the burden of zoonotic disease falls heavily on low- to middle-income countries, where health infrastructure is limited and communities rely heavily on livestock.

Countries must invest in veterinarians and proactive disease control

Kenya
A Kenyan herder, Kibet Ngetich Stephen, is visited by a community health volunteer who checks on the vaccination status of his herds, which can be exposed to anthrax and other deadly diseases due to their mingling with wild animals while out at pasture.

To build more resilience to zoonotic disease outbreaks, there are fundamental actions that must be undertaken. First, countries must invest in their veterinary workforces, training, and infrastructure. Investing in this field allows for well-resourced, trained, and capable veterinary services that can effectively address threats and protect animal health before an outbreak occurs.

In the UK, for instance, a new initiative offers farmers subsidised veterinary visits for multiple herds or flocks to help prevent disease.

Countries must also adopt proactive, rather than reactive, disease control strategies. Improving proactive strategies such as monitoring, detection, and vaccination can prevent or at least minimize the impacts of an outbreak. 

Furthermore, we must enhance public-private partnerships. Taking advantage of the speed at which the private sector can develop urgently needed technologies, such as vaccines, diagnostics and treatments, alongside the expertise of veterinarians and reach of public institutions, can ensure more effective measures against zoonoses.

With diseases like avian flu on the rise and everyday threats like salmonella continuing to impact public health, the world must adopt a coordinated approach to avoid zoonotic outbreaks. The losses caused by animal disease outbreaks are compounded by an order of magnitude when they spread to people. Improving animal health is the best way to protect the health of all.

Carel du Marchie Sarvaas is the executive director of HealthforAnimals, the global animal health association representing manufacturers of veterinary pharmaceuticals, vaccines and other animal health products.  He is a Dutch national and holds degrees from the University of Leiden and Johns Hopkins University.

John de Jong is the president of the World Veterinary Association, and a small animal practitioner in Boston, MA. He is also a former board member of the American Veterinary Medical Association serving as Chair (2015-2016) and as President (2018-2019).

Image Credits: FAO, BMJ, November 2023, ILRI/FLICKR, Sebastien Assoignons/ Wildlife Conservation Society, International Federation of Red Cross and Red Crescent Societies / The Kenya Red Cross Society.

The world faces a global health funding crisis, but John-Arne Røttingen believes the solution goes beyond money. It lies in stronger partnerships between governments, researchers, and citizens.

“Science is not enough to change the world,” said Røttingen, the newly appointed CEO of Wellcome, one of the world’s largest global health foundations. “It must be allied with collaboration and action across society.”

In a wide-ranging conversation on Trailblazers with Garry Aslanyan, Røttingen spoke about his leadership values, his vision for Wellcome, and the pressing need to rethink how global health is funded and delivered. A former head of CEPI and Norway’s global health ambassador, Røttingen said foundations like Wellcome must act as catalysts—not substitutes—for government and private-sector leadership.

“We need to engage governments more directly,” he said. “Ultimately, it is governments that are responsible for the health of their populations.”

Røttingen emphasized the importance of equity in science, calling for more research led by local experts in the Global South. He described visits to research centres in Malawi, Kenya, and Vietnam, where Wellcome supports programs that combine population health with advanced laboratory science.

But trust is also key.

“We need to double down on trust in science,” he said, citing public skepticism during the COVID-19 pandemic. That includes involving communities more directly in setting research priorities.

“We have to tackle problems that are important to people,” Røttingen added.

Røttingen urged the global health community to act fast as external funding shrinks and global crises multiply.

“We have some good indications of where we should go. We just need to act on them—and bring them to life,” he said.

 

Listen to previous episodes of the Global Health Matters podcast with Dr Gary Aslanyan on Health Policy Watch.

Image Credits: Global Health Matters Podcast.

Artificial intelligence can transform global health—but only if developed and deployed with equity in mind.

That was the message from two global health experts featured on the latest Global Health Matters podcast episode, “AI for Equity: Bridging Global Health Gaps.”

“In the future, a physician working in a remote area will have the best cardiologist in the world, the best pneumologist in the world, right next to them—ready to answer any questions,” said Alexandre Chiavegatto Filho, professor of machine learning in health at the University of São Paulo.

His team is developing mobile apps that allow frontline doctors to access AI tools through smartphones, even in areas without electronic medical records.

Jiho Cha, a South Korean parliamentarian and physician, has a similar vision. He believes AI can scale up health services in fragile settings, where doctors are scarce and health systems are overwhelmed.

“AI-powered information systems combined with fintech or blockchain technologies can improve health financing and delivery,” Cha said.

He described how AI can support nurses and community health workers by enhancing diagnostic and decision-making abilities.

However, both experts warned that the same technology could widen gaps if not handled carefully.

“If you leave AI by itself, it’s probably going to increase inequality,” Filho cautioned, noting that algorithms trained on wealthier populations tend to perform worse for low-income groups.

They said the challenge is to ensure AI is trained on diverse, locally relevant data and made accessible in low-resource settings. Otherwise, the digital divide will deepen.

“We have a huge opportunity in our hands,” Filho said. “But we need to make sure AI works where it’s needed most.”

Listen to previous episodes of the Global Health Matters podcast with Dr Gary Aslanyan on Health Policy Watch.

Image Credits: Global Health Matters Podcast.