Petroleum-based dyes will be removed from popular cereals, drinks and other foods, the US Department of Health and Human Services has announced.

The US Health and Human Services has reversed course on an earlier decision to slash funding to the widely acclaimed Women’s Health Initiative, supported by the National Institutes of Health. An HHS spokesman Thursday said that the Trump Administration would restore the support to the widely-acclaimed initiative, which has been responsible for a range of landmark studies on women’s health in its 24 years of activity, including findings in 2002 that hormone replacement therapy is associated with a higher risk of breast cancer.   

“These studies represent critical contributions to our better understanding of women’s health,” said Andrew Nixon, a spokesman for the Department of Health and Human Services, in a media statement.

The news came in another tumultuous week of Trump Administration executive orders and decisions affecting the nation’s health research endeavors including: new guidelines banning NIH grants to research institutions with diversity and equity policies as well as a historic agreement with the food industry to remove synthetic, petroleum-based dyes from the U.S. food supply by the end of 2026.

Agreement to phase out artificial dyes framed as “voluntary”

The agreement on food dyes, announced Tuesday by the Department of Health and Human Services is the first significant move by new HHS Secretary, Robert F. Kennedy Jr. to address an epidemic of obesity and chronic diseases in his “Make America Healthy Again” (MAHA) movement. 

During an HHS press conference, new US Food and Drug Administration (FDA) Commissioner Marty Makary said that HHS had reached an agreement with major food producers to remove about eight petroleum-based dyes voluntarily, saying, “I believe in love, and let’s start in a friendly way and see if we can do this without any statutory or regulatory changes.” 

However an HHS press release later said that the FDA would be “establishing a national standard and timeline” for the food industry to transition from petroleum to natural dye alternatives. 

It also stated that it would be “initiating the process to revoke [FDA] authorization for two synthetic food colorings—Citrus Red No. 2 and Orange B—within the coming months,”  while “working with industry to eliminate six remaining synthetic dyes, FD&C Green No. 3, FD&C Red No. 40, FD&C Yellow No. 5, FD&C Yellow No. 6, FD&C Blue No. 1, and FD&C Blue No. 2—from the food supply by the end of next year.

HHS also is asking food companies to remove FD&C Red No. 3, a recognized carcinogen, sooner than the 2027-2028 deadline previously set by the government.

Dyes are familiar to consumers in  Froot Loops ®  and other brand name foods 

Tumeric is one example of a plant-based food dye with anti-inflammatory properties – although it can also have blood-thinning effects.
Mars M&Ms®

Artificial dyes are used in brand name foods like M&Ms® chocolate, Kellog’s Froot Loops ® breakfast cereal, and Gatorade ® drinks. 

The HHS said that it would be authorizing four new natural color additives in the coming weeks, while also accelerating the review and approval of other natural dye alternatives, to expedite the transition. 

And it said that it would be partnering with the National Institutes of Health (NIH) to conduct more comprehensive research on how food additives impact children’s health and development.

“For too long, some food producers have been feeding Americans petroleum-based chemicals without their knowledge or consent,” said Kennedy, in the HHS announcement.  “These poisonous compounds offer no nutritional benefit and pose real, measurable dangers to our children’s health and development. That era is coming to an end. We’re restoring gold-standard science, applying common sense, and beginning to earn back the public’s trust. And we’re doing it by working with industry to get these toxic dyes out of the foods our families eat every day.”

“We have a new epidemic of childhood diabetes, obesity, depression, and ADHD,” added Makary. “ADHD is not a genetic problem and our obesity epidemic is not a willpower problem, it’s something adults have done to children,” he said. 

Prior research has found links between childrens’ consumption of synthetic food dyes and behavioral problems, as well as links between some dyes and cancer in animals. In 2023, California became the first state in the US to ban four leading food additives, including carcinogenic red dye No.3.

Food experts said that the HHS ruling on food dyes was a positive step but doesn’t go far enough: 

“This is certainly a good thing for consumers and public health but it doesn’t address the underlying problem, which is the FDA’s system for regulating food chemicals is broken,”  Thomas Galligan, a food additives scientist at the Center for Science in the Public Interest, told STAT News. “What we’d like to see the MAHA shift toward is addressing these systems-level failures.”

Women’s health initiative funding cuts left legacy research in jeopardy  

The initial announcement of the plans to dramatically reduce NIH funding for the Women’s Health Initiative (WHI) was made on Monday, included a notice defunding 40 WHI regional centers as of September. The regional centers have been critical to the long-term research by WHI that has followed cohorts of women through decades.

However, on Thursday, HHS said that NIH had exceeded the Trump administration target for a 35% reduction in contract spending by federal agencies, and therefore WHI’s support to the regional centers as well as its headquarters at the Fred Hutchinson Center Center would continue at current levels.

“We are now working to fully restore funding to these essential research efforts,” said HHS spokesperson Nixon.

WHI logo

Since 1991, WHI has studied more than 161,000 women, following the health of thousands for years or even decades. Along with its findings on HRT and breast cancer, the WHI has  also found that calcium supplements don’t prevent fractures and low-fat diets don’t prevent breast or colorectal cancer.

“We are thrilled to learn about this news,” Jean Wactawski-Wende, told National Public Radio, after hearing about the reversal.  She leads one of the project’s regional centers that were slated to lose their funding.

Slashing the support would have affected older women, in particular, WHI said, noting that they are “one of the fastest-growing segments of our population.”  

NIH bans grants to research institutions with DEI policies 

The NIH funding cuts coincide with new guidelines banning the award of future NIH grants to researchers or research institutions that practice “diversity, equity and inclusion” (DEI) policies.  Institutions or grant recipients that have policies of diversity, equity, inclusion and accessibility (DEIA) would also be barred from new grants and would face termination of existing grants, stated the new NIH directive, issued on Monday, 21 April.     

Researchers at institutions that boycott Israeli companies would also be barred from applying for grants, or obtaining grant extensions, the NIH directive issued on Monday stated. 

While the directive is targeted to “domestic institutions” academic centers abroad, and most notably in South Africa, have also reported on the termination of certain NIH grants – because they practice DEI policies, or address LGBTQ+ populations or other vulnerable groups.    

Health research in South Africa is facing an unprecedented crisis due to the termination of funding from the United States government,” reported the South Africa Medical Research Council, in mid-April. “Though exact figures are hard to pin down, indications are that more than half of the country’s research funding has in recent years been coming from the US.”

Confusion about new rules 

The new, nationwide NIH rules on grant awards also follow a series of recent Trump administration moves targeting half a dozen elite universities with freezes of billions of dollars in federal grants, including research support to dozens of vital health research initiatives. 

NIH had already been instructed to suspend awards to those elite schools that have had other federal funds frozen by the Trump administration, due to alleged anti-semitism on campus or their DEI policies, STAT news reported on 18 April, citing an internal email that originated with HHS. 

The schools named in the email were Columbia, Harvard, Brown, Northwestern, Cornell, and its affiliated medical school, Cornell-Weill Medicine. 

The evolving government, NIH and US Centers for Disease Control rules regarding DEI have been the focus of considerable confusion as US researchers have also reported problems with grant suspensions, payment delays and approval of manuscripts for publication due to their use of common terms like “female” or “sex” or references to “health equity” in their work. 

“I find it ironic that an administration that insists there are only two biological sexes seemingly wants us to pretend there are no differences between them,” observed John Quackenbush, chair of the Department of Biostatistics at Harvard’s T.H. Chan School of Public Health, in a STAT news op-ed about how a series of recent research proposals he had initiated to study the relationships between sex and aging have been caught in a web of NIH dead-ends and delays.

Updated Friday, 25 April 2025 with news of the HHS reversal of its decision to slash funds to the Women’s  Health Initiative. 

Image Credits: Flickr/ShellyS, arthritiswa.org.au, wikipedia/Mars, WHI.

Dr Tedros Adhanom Ghebreyesus on 10 April – facing tough budget cuts.

A new, and near final iteration of WHO’s reorganization will shrink its programme divisions even further than previous drafts – from 10 to only four – with health systems emerging as one key pillar of the revamped organization. 

At the same time, disease control departments and preventive health teams – such as health promotion and environment, climate and health, will all fall under one division – for the first time in years, according to a copy of the plan, obtained by Health Policy Watch.   This is in contrast to a previous “straw draft” that that had etched out five divisions, including health systems and health workforce rolled into a division with environment and health promotion. 

New WHO Organizational plan reduces the existing 10 divisions at headquarters to just four.

And along with the four mainstream divisions – the office of the Chief Scientist and “Chef de Cabinet, i.e. external relations,” would be retained as separate entities. 

The new plan for WHO’s headquarters, which boasts 34 departments as compared to nearly 60 now, was presented by WHO Director General Dr Tedros Adhanom Ghebreyesus to both WHO staff as well as to WHO member states at separate, closed sessions on Tuesday. 

Key takeaways from the latest plan include the combining of HIV and TB operations – two political powerhouses with deeply interlinked patterns of prevention, diagnosis and treatment that could generate co-benefits from a merger. There’s also the apparent disappearance of the health and migration department, which had been preserved in earlier iterations, under the now-extinct division of Healthier populations. Antimicrobial resistance (AMR), previously paired with One Health as a department in Healthier Populations, is now in Health Systems, on its own. One Health is relegated to yet another team or unit in the Department of Environment, Urban Health and Climate Change.  Critics will find that the decision to treat AMR strictly as a health sector issue ignores mounting evidence about the deep interlinkage between AMR prevention, One Health and environment – including the urgent need to address animal health – particularly the livestock sector – which consume the lion’s share of the world’s antibiotics.  

No projection about numbers of staff to remain in Geneva

Tedros made no projections as to how deeply WHO’s staff at headquarters, now numbering 2,600 people, would have to be slashed – although observers have said it could be by more than 40% in light of the fact that WHO’s Geneva-based operations also have the highest costs and the deepest deficit.

The new plan also does not relate explicitly to the possibility, discussed previously, of relocating some headquarters departments or teams wholesale to a WHO regional office. Polio eradication, however, remains a separate department under the Office of the Director General, leaving relocation as a possibility, at least in theory. And WHO’s head of Business Operations, Raul Thomas, also affirmed at the Town Hall meeting that regional relocation remains a possibility – even if the functions remain under a headquarters-based division. 

WHO staff salary gaps by region, as portrayed in slides circulated to WHO directors in mid-April.

“There is a committee that is looking into what programmes can be relocated, how we can make synergies across the organization, relocating a programme from x, to y, on the …basis that programme continues to be a headquarters progamme, it does not become regional, and what kinds of synergies regions can make in terms of technical support – and how regions can capitalize on the fact that they have that support closer to the countries, and with reduced travel costs, ” Thomas said. 

Globally, WHO faces a looming $600 million budget shortfall for 2025 and a $1.9 billion budget gap for the 2026-2027 biennium budget of $4.2 billion – following January’s announcement by US President Donald Trump that he intends to withdraw from the global health agency.  Although that withdrawal would not formally take effect until January 2026,  the United States has so failed to pay its dues for 2024, even before January’s change in administration, and is unlikely to do so now, WHO officials have conceded.  

Opportunity from crisis

Despite the stark shortfall, Tedros sought to put a more optimistic light on the crisis, noting that by 2030-31, member state assessed contributions to WHO would nearly double, from $895 million in 2024-25 to $1.7 billion in 2030-31 – even without the United States’ participation.   

“The refusal of the U.S. to pay its assessed contributions for 2024 and 2025, combined with reductions in official development assistance by some other countries, means we are facing a salary gap for the 2026–27 biennium of between US$ 560 and US$ 650 million,” Tedros said, addressing member states just after the staff Town Hall. 

“This is the reality we are facing, and which is driving the prioritization and realignment, the new structure, and the reduction in our workforce – although when we do this, we see it as an opportunity to change the organization. However, we need to realize that this reality would have been much worse if Member States had not agreed to increase assessed contributions progressively to 50% of our budget – and we thank you for that historic commitment.”

That’s providing that WHO member states continue to honour that commitment to gradually raise the level of member state assessments, as per a WHA decision reached in 2023.  At the upcoming World Health Assembly, May 19-27, WHA members will be asked to approve yet another stepwise increase in assessed contributions.  

Another report to go before this year’s WHA shows member states in arrears by more than $215 million on their payment of 2024 assessed contributions – of which the United States’ portion comprises only about one quarter, or $58 million.  Member states voting rights can be temporarily suspended, if payments aren’t made.

Contributions in arrears, as reported to the World Health Assembly, which convenes from 19-27 May in Geneva.

Along with that WHO remains heavily reliant on voluntary contributions, which amounted to some $2.5 billion in 2024, including $446 million in donations from the United States.

New senior leadership team by end April, directors in May

Timeline for WHO reorganization, including staff reductions and reassignments.

As next steps, the new division heads at Headquarters would likely be named by the end of April, Nicollier said. 

That would be followed by the appointment of directors of the surviving departments at headquarters and at Regional Offices over the course of May, in line with Division head recommendations and an Ad Hoc Review Committee.  Directors not retained at headquarters or in Regions would be offered reassignment elsewhere. 

In March, Health Policy Watch published an investigation of WHO’s dramatic expansion of high-level directors (D2) positions between 2017, when Tedros first took office and 2024, estimating that their costs amount to nearly $100  million annually, worldwide.  However, directors at headquarters whose posts are cancelled will have to be offered jobs found elsewhere, if they are on long-term contracts, as most are.  See related story.

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

Drilling down further over the course of June and July, detailed department organizational charts for each department would be developed – with a “matching and mapping” exercise to choose staff for the positions that remain. 

For rank and file staff, as well, Nicollier pledged to honor existing contract terms – which mean that staff on long-term (continuing) contracts or fixed-term contracts for more than 10 years would be offered reassignment and relocation options if their current post is abolished.  He also pledged to involve the WHO staff and its Staff Association in the next stages of the “matching and mapping” exercise. 

Senior Leadership – competency versus political balance? 

WHO Director General Dr Tedros Adhanom Ghebreyesus’ Senior Leadership Team will shrink from 11 to 6 members, not including the DG.

The new reorganisation, while seemingly radical, would in fact bring the agency’s core functions back to a template similar to the one that was left by WHO’s previous Director General Dr Margaret Chan, when she finished her 10-year tenure as head of the agency in July 2017.

But with senior leadership at headquarters being reduced from 11 to just six officials, not including the Director General, the next big question looming in the minds of WHO staff, member states and observers is who will remain? 

“There is no problem in merging and going back to a simpler organizational map, like at the time of [former WHO Director]  Margaret Chan. It’s a critical time, putting together prevention, control and response is not a problem,” said a WHO senior scientist, who spoke with Health Policy Watch on condition of anonymity.  “The problem is that we still don’t really know yet what functions or teams (out of nearly 60) will be prioritized or deprioritized.” 

“And now more than ever, with just seven senior staff, including the DG, Chief Scientist, Chief of Cabinet, and four Division heads, and in a time of crisis, we need to make sure that this new WHO leadership has the reputation and clout to represent WHO.   

“But because Tedros needs to go for a balanced team in terms of gender, geographical representation, etc, I’m afraid that the selection could wind up being one that doesn’t represent the organization as well – simply because some members of his existing team are  not perceived as strong leaders.”

WHO staff are also asking questions about why the Organization wasn’t able to anticipate the crisis earlier – given the fact that US President Donald Trump’s election occurred in November 2024 – and his hostility to WHO was a known factor even before the decision in January to withdraw. 

“There are many other questions about why we reached this point, without an earlier analysis of the situation.  What are the lessons that we need to learn?” said one staff member.  

“It’s been four months, and now what we have is just an organigram.” 

-Updated Wednesday, 23 April with the published text of the WHO Director General’s remarks to member states.

Image Credits: Salvatore di Nolfi/EPA, WHO, WHO , WHA78/A78_23, WHO .

A WHO field staffer talks to a woman fetching water in the Pacific Island nation of Kiribati. Can WHO’s pending reorganization and the deep budget cuts faced at headquarters actually strengthen staff presence on the ground?

The US-based Boston Consulting Group has been working with WHO’s senior leadership, under contract, to develop the major reorganization and cost-saving plan, now pending final presentation to staff and member states next week, Health Policy Watch has learned. 

Members  of the Staff Association Committee confirmed to WHO staff members on Thursday, that BCG has been involved in the strategic planning for dramatic cutbacks in the agency’s workforce. The cutbacks come on the heels of recent revelations of a $2.5 billion WHO budget gap between 2025-2027, including a $600 million shortfall in 2025, following the announced withdrawal of WHO’s largest donor, the United States, in January.     

The Staff Committee members were speaking at a Staff Association Open House, excerpts of which Health Policy Watch later heard.  

The Staff Association representatives did not confirm the amount of the BCG contract – although other informed sources suggested it was several million dollars, or more.  Asked to comment, a WHO spokesperson said, “What Staff Association President Corsini said is correct regarding earmarked funds for support to the restructuring.” 

Monies for private consultancy were earmarked 

The consultancy’s costs are being covered by a dedicated grant from the Bill and Melinda Gates Foundation, Staff Association leaders said, quoting WHO Human Resources officials, at the Open House.  

“These are voluntary and earmarked funding from Bill and Melinda Gates to HRT [WHO Human Resources and Talent Management] for restructuring,” asserted WHO Staff Association President Catherine Kirorei Corsini. 

“And this because it’s voluntary and earmarked, it cannot be used for anything else. And what they are doing now is a request of member states.  

She said WHO HR officials also assured the Staff Association “that a due process was followed. There was bidding…. There was a committee that sat down to review, because they were also questions of, how was this done? So they assured us that the usual detailed process of hiring someone on an LTA [long term consultancy agreement] was followed.”

Even so, some WHO staff have expressed dismay with the fact that large consultancy grants are being awarded to expensive private firms at a time of budget crisis. It was the expansive plans laid by outside consultancy firms during WHO’s 2019 “Transformation” that set the stage for the present crisis, noted one staff member, in a comment at the Open House.

“Why?… I do not have an answer, but the thing that we can say is that, again, this is not going to be a matter of core funds of WHO that could be used for staff being sent elsewhere,” Corsini answered.

Other staff were not so sure. 

“Why do we need a consulting firm?” one staff member asked, speaking anonymously to Health Policy Watch, noting that within the WHO’s 9473-strong global staff, including nearly 4000 professionals, there should be sufficient expertise to carry forward a reorganization plan.

“If you spend $6 million on a big consulting firm, then you have to let 20 people or more go. The money is spent in a matter of weeks, not in a whole year,” the staff member pointed out. 

Final version of proposal for top-level reorganization due to be presented next week 

WHO Organization as of January 2025 boasted 10 divisions, and nearly 60 departments

A final draft of the top-level reorganization is due to be presented by WHO’s Senior Leadership to Staff in a Town Hall on Tuesday. Presentation of the proposed draft to member states was also reportedly delayed until next week, due to the long Easter weekend that begins Friday in Geneva, sources told Health Policy Watch.  

According to the two options on the table last week, the number of departments at Headquarters would be reduced by nearly half, from nearly 60 as of January to about 32. That would presumably also reduce the number of high-cost directors, who numbered nearly 80 at headquarters as of July 2024 – more than the departments they are supposed to lead.  Some headquarter functions would also be moved to lower-cost regional offices or other European cities where WHO also has a presence.  See related Health Policy Watch Story here:

EXCLUSIVE: WHO Poised to Halve Divisions and Directors at Geneva Headquarters in Response to Budget Emergency 

There were, however, reports that WHO Director General Dr Tedros Adhanom Ghebreyesus had this week presented his own plan to senior management – with significant variations in the existing drafts now circulating.

The final result, therefore, risks boosting the number of departments and directors upwards again – due to intense pressures from senior managers, some sources feared.   

The explosion in directors’ positions was the focus of a 10 March Health Policy Watch investigation – which found that the number of directors, in the most senior, D2 grade, had nearly doubled since 2017.  

Taken together, the cost of D1 and D2 directors, along with five regional directors and a 12-member “senior leadership team” at WHO’s Headquarters cost the organization about $92 million annually, the Health Policy Watch analysis found, basing its estimates on published WHO salary and salary-to-total cost scales. 

Already senior leadership is offering some of the directors facing cuts a relatively high-paying parachute – jobs as the WHO reprsentative in a country office.  An email sent by HRT to senior management this week sought to “draw attention to the career opportunities available at the country level, specifically for WHO Representative (WR) positions.”

The message cited opportunities in over two dozen WHO offices in Africa, the Middle East, Europe, Asia and the Caribbean – including Senegal and Nigeria; Bulgaria and Slovenia; Egypt and Palestine.  Although some of the posts on offer, such as in the violence-wracked Democratic Republic of Congo and the Demoratic People’s Republic of Korea (North Korea), could hardly be said to be plum positions.

Transparency, management structures, prioritizing internal staff talent 

WHO staff salary gaps by region, as portrayed in slides circulated to WHO directors this week.

Speaking at the Staff Association Town Hall, SA leadership sought to reassure staff that Association representatives were now  being engaged in some aspects of the Administration’s restructure planning – after initially being left largely in the dark. 

“Feedback has come through loud and clear from staff,” said Jerome Zanga Foe, a Staff Association vice president, who called for “involvement for the Staff Association and staff at the division and at the department level and at also the highest level in the organization –  not just updates after decisions are being made.

“The Staff Association was not brought into the initial prioritization meetings,” he acknowledged. “But at the same time, we have now been included in several key committees, and the DG has committed to another town hall, which we’re going to be having next week. We hope engagement will be more of a two-way engagement… early and transparent and structural.”

Cautious optimism on a slimmer management structure  

One of two options for the WHO’s reorganization, considered at the WHO senior executive meeting on Saturday.

Foe also expressed cautious optimism over the slimmed-down management structure reflected in the draft organigrams circulating over the past two weeks, saying: 

“The message was clear that any credible…effort needs to look at leadership structures too, and we have seen some movement there. The updated organigrams show a smaller senior structure, and the management confirmed that post abolition and reassignment rules apply equally to ADGs and directors. It’s a positive step.” 

Finally, he said that the Staff Association would press the WHO administration to “prioritize internal talent” in the process of cutbacks and reorganization – before turning to external hires or consultants.

“Management is developing a talent pool to help match affected staff with future roles,” he said. “We see that as an encouraging step, but how this works in practice is what will really matter, and we promise to follow up on that. We are continuing to advocate that wherever possible, roles currently held by consultants or left vacant should be made available to staff at risk.”

Consultants’ shouldn’t replace staff who are cut 

Sources: Tables 1 and 20 – July 2017 and July 2024 WHO HR Update – Workforce Data.

At the same time, other Staff Association leaders stressed that consultants also play a legitimate role in the organization: 

“There’s been a degree of consultant bashing, but consultants do have a proper role in the organization, and if anything, we would like to see some of these consultants be moving to staff positions,” said Anthony Fake, another Staff Association vice president. 

Holding any kind of staff post, per se, should not, de facto, guarantee first priority for a future job selection, said VP Lianne Gonsalves. 

“We want to see function and ideally performance factored in. … For this committee of staff members, current contract type, whether they be continuing fixed or temporary, is not a proxy for their respective performance in, or commitment to, this organization. 

At the same time, she reaffirmed that long-serving WHO staff should have first priority in global re-assignments, if their current functions are terminated. 

“What we will be doing is making sure that for continuing appointments and fixed term appointments [of 1-2 years] who have more than 10 years of continuous service with the organization, those folks are going to be entitled to global reassignment, and we will be part of that, making sure that those staff are looked over, looked after in that process.” 

Gonsalves added:   “I can assure you that we will be keeping a very close eye …that what we don’t see is a reduction in workforce, followed by an immediate outsourcing to have that same work completed by consultants.”

Since 2017 the number of WHO consultants has exploded, from an estimated 3200 full-time equivalent positions to approximately 7600 in July 2024 – approaching the number of regular WHO staff. 

Notes: Includes FTEs for APWs and Consultants; Assumes each SSA is a FTE because no other equivalent is provided in the HR reports.

At the Open House, Staff Association leaders also denied reports that they were considering a preemptive legal action against WHO to contest any potential violation of staff contract terms in advance – describing it as not feasible. 

“I don’t think you can file preemptive lawsuits,”  Gonsalves said. “So that’s not something that we are doing.”

Image Credits: WHO / Yoshi Shimizu, WHO, 2025, WHO .

Dr Jean Kaseya, Director General of Africa CDC.

New weekly cases of mpox across Africa have dropped to around 2,000 for the first time this year giving hope that the outbreak may be waning, according to Dr Jean Kaseya, Director-General of Africa Centres for Disease Control and Prevention (Africa CDC).

In the mpox epicentre of the Democratic Republic of Congo (DRC), new cases dropped to 1,453 – the first time this year that this has been below 2,000 – despite an increase in testing. 

Mpox in DRC, 17 April 2025

There has also been a decrease in confirmed cases in the DRC and a significant increase in contact tracing.

Mpox in health workers – a priority in the continental vaccination efforts – has almost halved since November when over 100 health workers were infected.

Seven countries are currently vaccinating against mpox, with over 595,000 people vaccinated so far.

However, mpox cases in Uganda continue to rise, with 271 cases confirmed over 247 the previous week.

China, Switzerland and the UK have all reported mpox cases in the past few weeks.

“I’m calling the emergency consultative group meeting on the 17 May. Our experts will analyse all data and all evidence, and they will tell us if we still need to continue with the public health emergency of continental security (PHECS) for mpox,” said Kaseya.

One human case of anthrax

One person has been identified with anthrax in Uganda. 

Meanwhile, in the eastern DRC – a hotspot for various disease outbreaks – anthrax has only been identified in animals, including hippos in Virunga Park in north Kivu.

Around 50 hippos as well as buffalo have died from the disease in the park, according to earlier reports from the park’s director, Emmanuel De Merode.

However, recent animal deaths in South Sudan and Uganda indicate the disease may have spread across the borders.

“We don’t have any evidence today that humans are affected, but will continue to follow what’s happening,” said Kaseya.

Anthrax is caused by bacteria in soil and animals can become infected when they inhale the spores in soil, plants or water.

Health financing

Over the past two weeks, Kaseya has been traveling internationally to try to drum up more funding for health on the continent to fill the huge hole left by departing aid – particularly from the United States.

The continent has lost 70% of its official development aid since 2023, down from $81 billion to $25 billion this year – and some countries are on the brink of running out of essential medicines including antiretroviral medicine to treat HIV.

“There are reports of people migrating to other countries just to get ARVs,” Kaseya disclosed.

He has met the CEO of Ethiopian Airlines Mesfin Tasew to explore the possibility of a levy on airline tickets that could be used for health programmes.

In addition, a meeting with the government of the United Arab Emirates (UAE) is likely to result in investment in local manufacturing, and the digital agenda, supply chain management and the health work force, Kaseya said.

“Emirates is one of the countries making huge progress in the health system by using AI, and we are moving toward a strong programme with this country for Africa,” he added, saying that details of this collaboration would be announced soon.

Latest report released by the International Council of Nurses highlights the challenges faced by those in the nursing profession.

Nearly half of national nursing associations (48.4%) report a significant increase in nurses’ migration or exodus from the profession altogether since 2021 – against stagnant salaries, poor health system performance, and growing violence directed at nurses along with a continually increasing workload.

These are among the key findings in a new report by the International Council of Nurses (ICN), warning of a deepening crisis in the global nursing workforce.

The report is backed by surveys showing that around 72.1% of National Nursing Associations (NNAs) reported little or no increase in nursing salaries since 2021, including in more affluent OECD countries. When accounting for inflation, over one-third, or 36.4%, of NNAs indicated that nurses have effectively experienced a decrease in salary in real terms.

Increased violence against health care workers, poor pay, and exhaustion are driving many nurses to leave the profession altogether.

“A shocking 86.2% of nurses’ associations reported experiences of violence from patients or the public, yet a third of countries had no policies in place to protect nurses from workplace violence,” said ICN’s President Pamela Cipriano, in launching the new findings.

Compensation has stagnated in OECD countries.

Growing demands on nurses’ time

These findings come against a background of growing demands on nurses in their day-to-day duties since the height of the pandemic in 2021 – as reported by some 61.7% of nursing associations.

The report, Our Nurses. Our Future. Caring for Nurses Strengthens Economies, is complemented by a survey of 68 NNAs between 2021–2024. The ICN is a federation of over 130 national nurses’ associations representing millions of nurses worldwide.

“The publications we are launching today show that many of the world’s nurses are at breaking point, pushed into burnout and facing enormous physical, mental, and emotional pressures. Unacceptable working conditions, inadequate compensation, and a failure to protect nurses from workplace violence and occupational hazards or provide opportunities to advance and practice at full scope are driving this crisis, which affects not only nurses but the health of entire populations,” said Cipriano.

Some 38% of national nursing associations rate their country’s capacity to meet current healthcare needs as “poor” or “very poor”, the survey of NNAs also found – partly as a result of the cumulative pressures on the nursing workforce and their exodus.

Threats to safety and low pay are major threats

Pamela Cipriano, president of the International Council of Nurses (ICN)

Along with low pay, various threats to safety while at work are among the key issues nurses face, she added.

“The survey results also underscore a failure to protect nurses’ safety,” Cipriano said.

“Our report highlights how direct attacks on nurses and healthcare workers in conflict settings have also dramatically increased.”

Outside of conflict settings, however, violence directed against nurses is often a result of the frustration patients and their caregivers have towards the health systems, as many nurses work in resource-poor settings. In India, for instance, violence against healthcare professionals is a huge issue, often linked to the over-extended public healthcare system.

Violence against nurses is a global issue.

Report’s recommendations

The report flags a range of solutions for policymakers and governments. Investment in the right resources and equipment, safe and decent working conditions, and training support are among the top three “asks.”

It also suggests improving work culture so that nurses can thrive in a supportive environment.

Another one is to improve access to healthcare for healthcare professionals themselves.

Poor health among health care workers accounts for approximately 2% of national health care expenditure on average, draining valuable resources, according to the findings.

“Remove barriers to health care access for nurses by streamlining pathways to ensure easy, timely access to preventive care, treatment and support services. Ensure these services are readily available and designed to meet nurses’ unique needs,” it states.

And finally, there is a need to pay nurses fair and competitive compensation.

Investing in nurses’ well-being would boost health sector productivity by 20%

Global shortage of nurses reaching record numbers.

Despite mounting evidence of the nursing workforce crisis, many leaders and decision makers continue to prioritize short-term solutions over the sustainable investments that are needed to address the root causes of the health workforce emergency, ICN’s CEO, Howard Catton noted. Fundamental to that is the growing nurses shortage.

International Council of Nurses CEO Howard Catton
Howard Catton, CEO of the International Council of Nurses

The report makes an economic case for investing in more nurses, as well as increasing their well-being. “For nurses, improving their health and resource allocation could boost health workforce productivity by as much as 20%, which directly translates into cost savings and improved health care delivery,” it states.

“We have clear evidence that supporting and caring for nurses is not a cost: it is a smart and strategic investment in the health and prosperity of all people, with the total potential value of initiatives to improve nurses’ wellbeing is estimated at $100-300 billion based on capturing lost workforce productivity alone,” Catton said. He said the estimates are based on the World Economic Forum & McKinsey’s 2025 Thriving Workplaces report, which estimated that investing in workers’ health, more broadly, could unlock some $11.7 trillion in global economic returns.

“Extrapolating those figures to the proportional size of the nursing workforce, we get a possible opportunity value of $100-$300 billion, in increased economic returns,” Catton said, framing those as reduced sick leave and attrition, absenteeism, etc.

Savings obtained from investments outweigh the costs

Numerous case studies show that investments in nurses’ health can yield clear economic returns.

“There is no concrete number put on the amount of investment required to bring about these benefits, however we do know that there is a strong return on investment on investing in nursing and in health: studies show that every dollar invested in health systems can generate a $2-$4 return (McKinsey Global Health Institute/Remes et al., 2020),” Catton added.

ICN has said that it will continue to push for increased protections for nurses at the upcoming World Health Assembly, 19-27 May, where WHA member states will consider the extension of a global strategy on Nursing and Midwifery, currently scheduled to expire this year.

“ICN is strongly advocating for this to be extended and prioritized, amidst grave risks to global health funding and a historic and chronic lack of investment in the health and care workforce,” said Richard Elliott, ICN spokesperson.

“The WHA has to decide to extend the current global nursing strategy,” Catton added.  “We obviously want a positive decision and are lobbying hard for that. However we are concerned that health workforce budgets at WHO and in countries are at risk and could be seen as a soft target for cuts. WHO in our view, has for a long time not invested proportionately in the health workforce – and given that it is so central to delivering so much, we are therefore very alert to risks of cuts.”

WHA will also include discussions on the Global Strategy on Human Resources for Health: Workforce 2030 and the most recent results of country compliance with the WHO Global Code of Practice on the International Recruitment of Health Personnel, which was released and reviewed at the WHO Executive Board in February.

“A strong, well-supported nursing workforce is more critical than ever to address global health challenges and support healthy, productive populations. It is now time for action to move nurses from being invisible to invaluable across all regions,” Cipriano said.

Image Credits: Unsplash, International Council of Nurses , International Council of Nurses, 2025, Studioregard.ch.

The final green text of the pandemic agreement, alongside INB co-chair Anne-Claire Amprou.

At around 3am Wednesday, after three years of often intense negotiations, World Health Organization (WHO) member states agreed on a draft Pandemic Agreement, which sets out basic terms of engagement to prepare for, prevent and respond to pandemics.

Bleary-eyed negotiators and co-chairs Precious Matsoso and Anne-Claire Amprou welcomed the final greening of the entire text after another tough, long day of talks.

“Now the real work begins to make this agreement a reality,” said Matsoso, with the draft due to be presented to the World Health Assembly (WHA) next month. Once adopted, it will become a legally binding document.

Amprou, admitting that she addressed the Intergovernmental Negotiating Body (INB) with great emotion, said: “Together, we have achieved an impressive work that has led to a massive step forward for global health, health security, equity and international solidarity. The world is watching us, and you can be very proud of what you have just achieved.”

For an hour after the entire agreement was finally “greened” at the WHO headquarters in Geneva, negotiators expressed their support – and often relief.

Tanzania, speaking for 77 African states, described the agreement as a “significant, and challenging step forward in our collective commitment to enhancing global health security. 

“While the process may not have yielded all the outcomes we aspired for, it has opened an important avenue for future collaboration and growth in our efforts to be better prepared to face potential pandemics,” said Tanzania.

Tanzania on behalf of Africa.

“We have not achieved all our objectives in the negotiation, but we believe that the new agreement, if effectively implemented, will make the world more resilient and better equipped to face the global health security challenges of the future,” said the European Union (EU).

“The COVID 19 pandemic was suffering on a worldwide scale and tested public health system to the limit. Our collective achievement today shows that international solidarity, enhanced collaboration and decisive action are the way forward.”

Germany stressed that, “once adopted, the pandemic agreement will serve as a new collective tool to jointly address the risks of future pandemics across the full spectrum of necessary action”.

Germany also warned that countries would need to ensure its practical implementation.

“This why we have also advocated strongly for transfer of technology to be voluntary for technology holders, and this is how we understand the current provisions in the text,” stressed Germany, highlighting one of the most contested aspects of the talks.

Germany addresses the final session of the INB.

At around 4am, WHO Director-General Dt Tedros Adhanom Ghebreyessus got his turn to address the INB, saying that the agreement “reflects your resilience, unity and unwavering commitment to the health and well being of people everywhere.

“In the face of enormous challenges, you have come together, rising above borders and differences, united by a common goal, the protection of humanity,” said Tedros.

“By reaching this milestone together, you have made history and shown how powerful collaboration can be,” added Tedros, who paid special tribute to “my African compatriots who saved the day with your flexibility”.

A WHO statement issued after the close of the meeting stressed that the agreement: “affirms the sovereignty of countries to address public health matters within their borders, and provides that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.”

An extensive and damaging misinformation campaign incorrectly asserted that the agreement is a “power grab” by the WHO aimed at imposing various demands on countries.

A group of protestors against the WHO and the pandemic agreement, representing a wide range of interests, march in the streets of Geneva outside last year’s World Health Assembly in June 2024

Sharing pandemic products

The INB was set up in December 2021 to negotiate an agreement to ensure more equitable access to vaccines, therapeutics and diagnostics (VTDs) in the next pandemic. 

Over time, much of the agreement has been watered down – but it has retained one of the important stipulations: that the WHO will get 20% of the real-time production of vaccines, therapeutics, and diagnostics (VTDs) for the pathogen causing the pandemic, with 10% as a donation.

The WHO will then distribute these vaccines, medicines and tests to low- and middle-income countries according to need – partly righting the inequitable access to vaccines during COVID-19 when wealthy countries hoarded scarce vaccines.

All manufacturers who want to be part of a Pathogen Access and Benefit-Sharing (PABS) system will need to agree to this 20% allocation – although the details of the PABS system still need to be agreed on.

“My initial mandate was for 45% of VTDs to be made available for the WHO because you can be effective with that. But negotiations are negotiations, give and take. You have to be flexible,” Dr Aquina Thulare, who heads the South African negotiations, told Health Policy Watch. 

Further tough negotiations lie ahead to bring this PABS system into existence, something that has been deferred to the Conference of the Parties that will bring the agreement into being.

Dr David Reddy, Director General of  the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), said  that the industry has “made proactive commitments to deliver equitable access, pledging to reserve an allocation of real-time production of vaccines, treatments and diagnostics for priority populations in lower income countries and take measures to make them available and affordable”.

 But Reddy stressed that “intellectual property protection and legal certainty are essential for the innovative-based pharmaceutical industry to invest in high-risk R&D and enable voluntary partnerships that we will need in the next pandemic.

“We hope that in subsequent negotiations Member States maintain the conditions for the private sector to continue innovating against pathogens of pandemic potential.”

Recognition of human-animal connection

The agreement also sets out countries’ obligations to prevent disease outbreaks from becoming pandemics – including a “One Health” approach to prevent zoonotic diseases – those that spread from animals to humans.

“By embedding One Health and prevention at source into the pandemic agreement, member states are finally acknowledging what science has long confirmed: we cannot prevent future pandemics without improving how we treat animals and our environment in the present. This is a paradigm shift in the scope of global health policy and a victory for animals, for people, and for the planet,” says Nina Jamal, from the animal rights group Four Paws.

“For the first time, an international binding agreement has enshrined One Health principles and collaborative surveillance,” noted Wildlife Conservation Society’s Dr Chris Walzer.

Research and development

Medecins sans Frontieres (MSF) and DNDi, which develops new treatments for neglected tropical diseases, expressed support for the “groundbreaking research and development (R&D) access requirements”.

“Countries have recognised that when they finance research and development for new treatments, diagnostics, or vaccines through public funding, they need to attach conditions to that funding that ensure public benefit,” said Michelle Childs, Director of Policy Advocacy at DNDi.

Other positive issues highlighted by MSF include the commitment to ensuring frontline healthcare workers get priority access to medical products during emergencies, building a global supply chain and logistics network, and more transparency in government purchasing agreements.

Impact on young people

Katja Čič, a member of the WHO Youth Council based in Slovenia, said that the COVID-19 pandemic “cancelled the world in a few weeks… Schools were closed. Work happened over Zoom, socialising got uprooted. Stress was through the roof. Lots of people as their loved ones.

“Young people will live with the long-term consequences of today’s decisions the longest and be the most impacted. Everyone deserves to grow up in a world that can handle a health crisis, whether that means we will get a faster warning when something’s wrong, equal access to vaccines and tests and treatments, or our education is not disrupted.”

Success of multilateralism

“The pandemic agreement is a beacon of unified multilateral cooperation at a critical time, and we salute the member states for their tenacity and commitment in getting to this point.” said Helen Clark, Co-Chair of The Independent Panel for Pandemic Preparedness and Response, the Pandemic Action Network, Panel for a Global Public Health Convention and Spark Street Advisors.

Clark, and her co-chair Ellen Johnson Sirleaf, urged leaders to take action today to build the platforms which will stop an outbreak from becoming a pandemic.

“We need to invest in regional resilience today because it will take time,” said Sirleaf. “Don’t wait. Start now to build regional capacities for research, development, and manufacturing of pandemic countermeasures. ”

“Recently announced cutbacks to global health funding have devastating implications for global health security,” added Clark. “Currently, countries will need to scramble for the funds required in the event of another pandemic emergency. Leaders should be investing now in pandemic preparedness and emergency response – domestically, regionally, and internationally. We can’t afford another pandemic, but we can afford to prevent one.”

Dame Barbara Stocking, chair of the Panel for a Global Public Health Convention, described the agreement as “a breakthrough in global collaboration – helping countries better prevent, detect, and respond to future pandemics” but highlighted that “there’s still work to do on surveillance for both humans and animals, and on government preparedness”.

Thulare also sees the agreement as a triumph for multilateralism in the face of the rise of “very conservative governments, not just in the US, but also in Europe and elsewhere”.

“We have to make sure that we save this multilateral space, and we also save the WHO, which is the most neutral arbiter – especially in pandemics,” Thulare added.

Germany noted that the pandemic agreement “has the potential to become a milestone for multilateralism and global solidarity”, and pledged that it “has been and will remain, a committed and reliable partner for the World Health Organisation and an advocate of pandemic prevention, preparedness and response”.

United States President Donald Trump removed the US from the WHO – and explicitly from the negotiations upon assuming office in January, while Argentina also dissociated itself from both the WHO and the agreement.

However, 191 countries remained in the process – including those at war with one another, making consensus even more commendable.

Image Credits: Kerry Cullinan.

Then German Chancellor Angela Merkel and WHO Director General Dr Tedros Adhanom Ghebreyessus open the WHO’s Hub for Pandemic and Epidemic Intelligence in Berlin in 2021.

Germany’s contribution to global health has been transformative – and as its new coalition government takes shape, now is not the time for it to weaken this commitment

Germany has long stood as a global leader, not just in public health but also in shaping international cooperation on health through platforms like the G7 and G20. 

With a deep-rooted commitment to strengthening global health security, combating antimicrobial resistance, and advancing universal health coverage, Germany has consistently prioritized health interventions that have transformed health systems and saved countless lives. 

It remains one of the most influential contributors to the World Health Organization (WHO), providing both expertise and funding, and hosts the WHO Hub for Pandemic and Epidemic Intelligence in Berlin, an initiative critical to enhancing global preparedness for future health threats.

As the fourth-largest donor to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and the third-largest contributor to the Pandemic Fund, Germany’s influence in global health is unmatched. 

According to the Organization for Economic Cooperation and Development (OECD), Germany ranks second globally in disbursements for global health, only behind the United States. 

In 2023 alone, Germany’s total disbursement for development assistance for health was $5.29 billion. Yet, despite these significant achievements, the work is far from over. Strengthening resilient health systems, particularly in vulnerable regions like sub-Saharan Africa, requires sustained commitment and leadership.

Concerning coalition talks

At a time when many nations are retreating from international cooperation in favor of domestic priorities, Germany’s unwavering commitment to global health has been particularly commendable. 

However, the coalition talks for a new federal government have been deeply concerning. Proposals to cut development spending – specifically the idea to eliminate the Development Ministry – would severely undermine Germany’s pivotal role in global health. 

Such cuts would disproportionately affect funding for critical health programs, particularly those addressing poverty, food security, climate change, and access to clean water–factors essential for improving health outcomes and building pandemic resilience in vulnerable regions like sub-Saharan Africa.

Beyond immediate health impacts, these cuts would exacerbate existing inequities, particularly among marginalized communities, reversing hard-won gains in economic empowerment and self-reliance. By increasing the number of people pushed into poverty due to health-related expenses and weakening progress in health outcomes, such a move would stall the momentum of economies that were beginning to make meaningful strides toward sustainable development.

It is no surprise that even senior politicians from the parties negotiating to form a new coalition government were raising alarms. 

Severely diminish influence

Reducing Germany’s development budget would not only jeopardize critical partnerships with non-governmental organizations (NGOs), which are vital in addressing the socio-ecological drivers of health, but would also severely diminish Germany’s influence in global health leadership. 

Weakening support for these initiatives poses a direct threat to public health efforts worldwide, at a time when global solidarity is more crucial than ever.

It seems like the alarm bells were heard, at least partially. The fact that the Development Ministry will not be folded into the Foreign Office is an encouraging development. However, it will require an adequate budget.

If cuts to development spending were to be implemented, this would leave a lasting impact–weakening Germany’s leadership in global health and ultimately putting public health efforts worldwide at risk. 

Health threats do not respect borders; a localized outbreak can quickly escalate into a global pandemic, as the world witnessed with COVID-19. Weakening health systems in one region endangers everyone, everywhere. 

Cutting health aid to Africa would not only compromise the continent’s ability to tackle diseases such as mpox, Ebola, and Marburg, but would also erode the resilience of health systems and weaken global health security.

Cost of cutting aid

Cutting aid to global health now is not a sustainable savings strategy – it is a recipe for future disaster at a much greater cost. Development assistance funds some of the most cost-effective health interventions in the world, including vaccinations, maternal and child health services, and malaria prevention. 

A single dollar invested in primary health care in Africa often yields disproportionately high returns in lives saved and economic productivity. Without this investment, the consequences are dire: medicine stockouts, disruption of lifesaving services, and the resurgence of preventable diseases.

Foreign aid has already been instrumental in significantly reducing child mortality, controlling HIV/AIDS, and improving maternal health across sub-Saharan Africa. Rolling back this support now risks undoing decades of progress. What took years to build through public-private partnerships, local capacity building, and health systems strengthening could unravel in mere months.

Africa’s health financing gap

While Germany’s leadership in global health is evident, the reality of Africa’s health financing gap is staggering. The continent faces a $66 billion annual health funding shortfall, which has been exacerbated by the recent USAID funding terminations and stop work orders. 

Even with the Abuja Declaration, which calls for African countries to allocate 15% of their budgets to health, it is still insufficient. 

Sub-Saharan Africa’s combined GDP stands at about $2 trillion, with an average tax revenue of 15% of GDP, amounting to roughly $45 billion for healthcare spending for a population of 1.2 billion people. This works out to about $40 per capita – which pales in comparison to the $4,000 spent per capita in Europe.

Germany’s potential cuts would exacerbate this gap, leading to greater vulnerability, particularly in the face of pandemics. This underscores the need for sustained investment in global health. 

At the recent Africa Health Agenda International Conference (AHAIC) 2025 in Kigali, stakeholders from across the globe emphasized the importance of reframing health as an investment, not a cost. Strengthening health systems through cross-sectoral partnerships is crucial to building self-sustaining and resilient systems across Africa. 

Equally important, these systems must be intentionally redesigned to foster equity, promote respectful collaboration, and prioritize the creation of genuine, inclusive partnerships.

Call for continued commitment

Germany’s contributions to global health have been transformative, and its leadership has set a strong foundation for resilient health systems worldwide. 

However, the work is not yet complete. Addressing today’s global health challenges requires open, collaborative partnerships – not solitary efforts – and shared responsibility for designing impactful programs. 

While economic pressures understandably require difficult choices, cutting development funding now would risk reversing decades of progress, putting both African and global populations at greater risk.
The lessons from COVID-19 are clear: global solidarity and preemptive investment are non-negotiable in preventing future health crises.

Germany must maintain its leadership and reaffirm development finance as a vital pillar of its foreign policy. Now is the time for the incoming government coalition to strengthen – not weaken – Germany’s commitment to global health, ensuring that the mistakes of the past are not repeated.

Dr Githinji Gitahi is the Group CEO of Amref Health Africa.

Ralph Achenbach is the  Executive Director of Amref Health Africa Deutschland

 

Europe is the world’s fastest warming continent and the year 2024 was its warmest on record.

Europe is the world’s fastest-warming continent and 2024 was the warmest year on record, with record temperatures in the central, eastern and southeastern regions, according to the latest European State of the Climate 2024 report published jointly by the World Meteorological Organization (WMO) and Copernicus Climate Change Service (C3S).

Severe storms and flooding claimed 335 lives last year and affected around 413,000 people. Scientists also reported that the east was extremely dry, while the west witnessed warm and wet conditions.

“This report highlights that Europe is the fastest-warming continent and is experiencing serious impacts from extreme weather and climate change. Every additional fraction of a degree of temperature rise matters because it accentuates the risks to our lives, to economies and to the planet. Adaptation is a must,” WMO Secretary-General Celeste Saulo said in a press statement.

The report has a silver lining. The proportion of electricity generation by renewables in Europe reached a record high in 2024, and now stands at 45%.

This is the eighth annual report, released in April every year, and the second that has been published jointly with Copernicus, the European Union’s earth observation program.

Climate change hotspots

In 2024 Europe saw climate impacts ranging from heatwaves to wildfires.

Europe experienced the most widespread flooding since 2013. Almost one-third of the continent’s river network experienced flooding that exceeded the ‘high’ flood threshold.

The continent saw both hot and cold extremes. The numbers of days with ‘strong’, ‘very strong’ and ‘extreme heat stress’ were all the second highest on record.

Nearly 60% of Europe saw more days than average with at least ‘strong heat stress’. But there was a record low number of days with at least ‘strong cold stress’ too.

“These extreme events led to an estimated 18 billion euros of damages, 85% of which is attributed to flooding,” said Samantha Burgess, deputy Director of C3S during a press conference to discuss the report’s key findings.

Last year was the warmest ever for Europe with record-high annual temperatures in almost half of the continent.

All European regions saw a loss of ice due to record temperatures. Glaciers in Scandinavia and Svalbard saw their highest rates of mass loss on record. In September, fires in Portugal burned around 110,000 ha (1100 km2) in one week, representing around a quarter of Europe’s total annual burnt area. An estimated 42,000 people were affected by wildfires in Europe.

“We observed the longest heatwave in southeastern Europe and record glacier mass loss in Scandinavia and Svalbard, an archipelago between Norway and the North Pole. But 2024 was also a year of marked climate contrasts between eastern and western Europe,” Carlo Buontempo, C3S director said during the press conference.

While the entire continent is not a climate change hotspot, experts said that some areas within Europe do fit those criteria.

“A good example of this is the Mediterranean region, which is widely recognized as a climate change hotspot with above average warming, a projected decrease in precipitation, rising drought, risk wildfires and strong socio economic and ecological vulnerabilities. Similarly, the alpine region in Europe is also experiencing above average warming and sensitive changes in the cryosphere,” Burgess said.

Impact of funding cuts to NOAA now visible

In recent months the United States government has cut funding to the country’s climate monitoring system, the National Oceanic and Atmospheric Administration (NOAA).

This has affected scientists who have been laid off from their jobs and has also limited the number of observations NOAA makes around the world. Scientists acknowledged that this has affected the quality of the report that uses data from multiple data sources.

“Observations are absolutely fundamental to monitor what we’re doing, and NOAA is providing a lot of observations. What we’ve seen since March is that there has been a drop in the number of observations delivered by NOAA due to funding cuts,” said Florence Rabier, Director-General of European Centre for Medium-Range Weather Forecasts or ECMWF.

“Any observation loss is a loss for climate monitoring, for calibration of satellite, for verification of forecasts. So, in terms of both science and observations for weather and climate, I think it would indeed have an impact on the whole community,” she told the press conference.

Progress on some fronts

Cities across Europe have been focusing on initiatives to respond to climate change.

The report spotlighted some progress that was made by cities and countries. In 2024, Europe generated 45% of its electricity needs from renewables, up from 43% in 2023.

The number of EU countries where renewables generate more electricity than fossil fuels has nearly doubled since 2019, rising from 12 to 20, according to reports.

In addition, around 51% of European cities have adopted climate adaptation plans, which is almost double the 26% in 2018. Urban areas are responsible for 70% of all carbon emissions globally and the United Nations has pushed for cities to take action as they can play a big role in our response to the climate crisis.

Around 100 scientists in Europe and around the world worked on this report, and WMO head Saulo emphasized the need for continued action: “Every fraction of a degree matters. Climate adaptation is not the future option. It’s a very real necessity now, today, not tomorrow.”

Image Credits: Unsplash, European State of the Climate 2024 report.

US Health Secretary Robert F Kennedy Jr.

The United States federal government’s response to the rapidly spreading measles outbreak has faced steep criticism after Health and Human Services (HHS) Secretary Robert F Kennedy Jr (RFK Jr) falsely claimed the vaccine’s protection “waned quickly” and hasn’t been “safely tested.” 

While Kennedy endorsed the measles vaccine as the most effective way to protect against the disease, he has simultaneously sowed doubt in multiple statements. 

Meanwhile, a second unvaccinated US child has died from measles, a highly contagious but vaccine-preventable virus. 

More than 712 patients have been affected as of 10 April, according to the Centers for Disease Control and Prevention (CDC). 

The outbreak is quickly becoming the largest, and deadliest, in recent US history, threatening the country’s measles elimination status, which it has enjoyed since 2000.

Since then, slipping vaccination rates have meant communities have lost the herd protection needed (a vaccination rate of at least 95%) to keep cases from spiraling out of control. Prior to this outbreak, a child hadn’t died from measles since 2003 in the US.

Public health experts – pediatricians, epidemiologists, and government officials -– and Kennedy’s anti-vaccine supporters have criticized HHS for its contradictory and misleading statements.

“RFK Jr has stated that the measles vaccination routinely causes deaths, which is not true. The truth is that measles vaccination has prevented more than 60 million deaths globally. Vaccinating your children not only protects them, but also entire communities,” said Dr Tom Frieden, former CDC Director during the Obama administration and CEO of Resolve to Save Lives.

 “Measles has historically killed between one and three people per 1,000 cases, and those that died were usually immunocompromised. This year is different: two of the three deaths have occurred in healthy children,” noted W Brian Byrd, Public Health Director in Tarrant County, Texas, in a social media post.

“Most of us believe this outbreak is larger than what is being reported.”

Cases spread to Oklahoma, Ohio, Pennsylvania, Indiana, Arkansas

The US measles outbreak began in West Texas in late January, concentrated in unvaccinated children and adolescents. Three measles-related deaths have been reported – two unvaccinated children and one unvaccinated adult.

Since the outbreak began, 11% of the 712 cases have been hospitalized, according to the CDC. The World Health Organization (WHO) reported a 17% hospitalization rate. 

Measles is the most contagious infectious disease, causing high fever, runny nose, and a full-body rash. There is no specific treatment for measles. 

While the epicenter of the outbreak remains Western Texas and New Mexico (90% of cases combined), a total of 25 jurisdictions – including Indiana, Ohio, Michigan, Pennsylvania, and Arkansas – have reported cases, some for the first time in years.

Measles in the US, 9 April 2025

Across the country, childhood vaccination rates have dipped to 92.7%, several points lower than the 95% threshold the WHO stipulates will maintain herd immunity. 

In Gaines County, Texas, the epicenter of the outbreak, the vaccination rate is around 82%.

The measles, mumps, and rubella (MMR) vaccine is proven safe and effective, according to the CDC, with rare side effects. Despite this, counties across the country have struggled with falling vaccination rates.

“Talking to the community, they really stopped vaccinating about 20 years ago, which is in line with what we’ve seen in other communities across the United States,” said Katherine Wells, director of public health of a West Texas city.

Mixed messages and mass lay-offs hamstring response

Entire disease communication teams were dismantled during the HHS’s recent sweeping purge of scientists, regulators and public health experts. 

The “reduction in force” (RIF) notices terminated over 10,000 HHS employees across divisions and agencies, including those responsible for communicating with the public about health emergencies. All agency press officers were fired.

In addition, scientists studying vaccine hesitancy recently lost their National Institutes of Health (NIH) funding.

“Eliminating communications staff from CDC means we all have less information on how to protect ourselves from health threats,” said Friedan. 

Jeremy Kahn, Food and Drug Administration (FDA) media relations director, was one of the many communications personnel removed. 

“Whether explaining the nuances of a medication recall or providing guidance during emerging health concerns, our communications helped Americans make informed decisions based on facts rather than fear. There is no question that this delicate balance of transparency and reassurance made tangible differences in public health outcomes,” he said in a LinkedIn post.

In the meantime, Kennedy appeared on several media platforms to discuss his department’s response.

This included claiming that the US’s response should be the “model for the rest of the world,” incorrectly comparing the US’s number of cases to the total cases from Europe’s 44 countries.

Kennedy also claimed that cases were slowing, directly contradicting Texas health officials’ projections that the surge in cases would probably last until the end of the year.

“We think these cases are undercounted,” Dr Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security said at a press conference with Texas health officials, as reported by Politico. “So, you can’t say something is flattening if you don’t know the denominator of cases.”

In a CBS interview, Kennedy made several other claims that have been debunked by health experts: that vaccines were developed without placebos and that they were tested for “three or four days.” Both statements are misleading, according to vaccine experts.

MAHA backlash

Not only has Kennedy’s comments sparked backlash from the public health community, but also from his own ardent anti-vaccine “Make America Healthy Again” (MAHA) following.

After Kennedy posted that vaccines were the most effective way to prevent disease, Del Bigtree, the communications head of his presidential campaign and anti-vaxx advocate wrote on X: “Your post got cut off. The MMR is also one of the most effective ways to cause autism.” 

However, numerous studies have debunked the claim that the vaccine causes autism. 

“Health freedom” advocate Dr Mary Talley Bowden, who gained a following over her support of ivermectin, replied to the post with “I’m sorry, but we voted for challenging the medical establishment, not parroting it.” Ivermectin is a treatment for parasites that was promoted by anti-vaxxers and alternative health advocates as a treatment for COVID-19, although studies have found has little effect on the virus.

But Kennedy’s fluctuating position and mixed messaging appear to be jeopardizing the response to the outbreak, especially in getting more children vaccinated. 

“That’s the way to stop it. This only ends with immunity,” said Jennifer Nuzzo, director of the Pandemic Center at The Brown University School of Public Health, in a statement to NPR. 

Funding chaos shutters disease surveillance labs

Health professionals – including those working on outbreak investigation, maternal mortality, and vector-borne disease – across HHS’s 13 divisions saw mass layoffs as the Trump administration attempts to reduce the size of the federal workforce.

Measles surveillance and messaging were not the only HHS functions crippled in the past weeks.Part of HHS’s unprecedented purge of employees was the closure of the preeminent CDC laboratory dedicated to tracking sexually transmitted diseases (STDs) which affect one in five Americans.

The CDC lab was only one of three globally that tracks particularly notorious drug-resistant STDs.

Leading STD experts, including David C. Harvey,, executive director of the National Coalition of STD Directors, called the lab closure “alarming” and a “critical loss of an essential health function that the federal government should be providing to protect the health of all Americans.”

“The lab closure removes one of the critical tools we use to protect people from drug-resistant infections at the same time our ability to prevent STIs has been set back by massive cuts and layoffs,” Harvey told the news site Healio. 

“We are urging Secretary Kennedy to reinstate these labs and staff in order to protect the public against the ongoing STI epidemic and other infectious diseases.”

It’s not only the US that will be forced to limp its way through outbreaks.

The US was the sole funder of the World Health Organization’s global measles and rubella network of more than 700 laboratories. These key labs face “imminent shutdown” in the wake of US funding cuts, the WHO director general  said to the media last month. Without “Gremlin,” the global surveillance network, outbreaks would not be detected, said Dr Kate O’Brien, WHO director at the department of immunization, vaccines and biologicals.

Surveillance plays a crucial role in understanding disease burden and trends – as well as in identifying outbreaks, like measles. Without public health laboratories, and the staff to communicate during an outbreak, “we are flying blind,” said Dr Tom Frieden, during a podcast interview. 

Image Credits: CBS, CDC.

The ten division heads currently in WHO Director General Dr Tedros Adhanom Ghebreyesus’ Senior Leadership Team could soon be reduced to just five.

The number of WHO programme divisions would be reduced from 10 to just five and the number of directors in headquarters would shrink from nearly 80 to around 30 in an emergency reorganisation plan reviewed by the agency’s executive management group at a closed-door retreat on Saturday.   

The plan, to be presented to member states this week, also proposes to move some departments housed in Geneva to WHO’s Regional Offices, where costs are far less, or HQ outposts away from Geneva even if the operations remain associated with headquarters. 

Examples include a possible move of WHO’s entire polio operation to the Eastern Mediterranean Regional Office in Cairo; the region is responsible for Afghanistan and Pakistan which are the only countries where transmissions of wild poliovirus still continues. Similarly, there are discussions about moving WHO’s Department of Traditional Medicine to India, a leader in the field, and so on. 

Other core functions or departments might be moved out of Geneva to satellite offices elsewhere in Europe, so that they can remain in proximity to headquarters, without the associated costs. Along with its regional office in Bonn, WHO already has offices or research centres in Lyon, Germany, Italy, and Denmark. Other venues could also be considered, sources told Health Policy Watch. 

But even these dramatic steps, informed observers say, will not be enough to generate the savings required to cover an expected $600 million budget deficit for 2025, along with a projected $1.9 billion gap for the upcoming budget biennium of 2026-2027 triggered by the United States’ withdrawal from the organisation in January.  

And given that the lion’s share of the WHO deficit is in its Geneva headquarters, it’s expected that staff there will likely have to be reduced by some 40% or more, from more than 2,600 people today to around 1,400-1,500 employees – some of whom may also be re-assigned to satellite offices.  

Perform, Power, Promote, Provide and Protect

One of two options for WHO’s reorganization, considered at a WHO senior executive meeting Saturday.

The latest iterations of the WHO “straw draft” organigram, seen by Health Policy Watch on Friday, included two highly similar options presented to Saturday’s meeting of WHO’s executive leadership. The leadership will fine-tune a final option prior to the presentation of the plan to member states, in a meeting set for this week.  

Both options model WHO’s new organisation around five “P’s” said to embody the agency’s internal functions and external mission. They include: perform, power, promote, provide and protect.

The focus of each WHO division, follows intuitively from those keywords. Science, data and medical product standard-setting is centred in the “power” division; environment, nutrition, sexual and reproductive health, and health promotion fall under “promote. Communicable and non-communicable diseases, as well as the health systems and workforce are clustered in “Provide”, while health and humanitarian emergencies fall under “protect.”

The reorganisation would roll back WHO’s lumbering bureaucracy from today’s nearly 60 programme departments to about 32, slashing the number of directors as well. In the January 2025 organigram directors of departments and special programmes housed at Headquarters numbered 63. According to the last WHO Workforce Data report, of July 2024, however, there were around 80 D1 and D2 directors based at headquarters – more than the number of departments and programmes to be managed.

As of Juy 2024 there were nearly 80 directors (D1,D2) at WHO Headquarters – more than the number of departments. [Note, one director would be attributable to the Global Services Center in Kuala Lumpur].
On a global level, the swollen number of senior directors together with even higher-earning division heads, regional directors, and the director general and his deputy, have been costing the organisation nearly $100 million a year, a 10 March Health Policy Watch investigation found.

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

Back to basics?

WHO Organization as of January 2025 boasted 10 divisions, and nearly 60 departments, not including the Director General’s Office.

The new reorganisation, while seemingly radical, would in fact bring the agency’s core functions back to a template similar to the one that was left by WHO’s previous Director General Dr Margaret Chan, when she finished her 10-year tenure as head of the agency in July 2017. 

During her second five-year term in office, Chan, who ran a fiscally conservative administration, pared down operations at headquarters from eight to five divisions in a model that is not dissimilar to those featured on the “straw drafts” circulating over the past two weeks. 

After July 2017, the agency swelled in numbers of directors, departments and divisions – as well as staff and consultants – during the “Transformation” initiated by  Chan’s successor, Dr Tedros Adhanom Ghebreyesus.  

Ostensibly, that transformation aimed to shift more resources in countries and regions. It also created a new Science division, welcomed by many as a forward-looking measure that could consolidate many of WHO’s standard-setting functions with new challenges in digital health and AI. 

But as per the Health Policy Watch assessment in March, the transformation also saw the multiplication of departments and divisions at headquarters, adding costs to WHO’s uppermost layers. 

The number of WHO’s top-ranked directors (D2), nearly doubled to 75, with most of those costs associated with new or upgraded posts at headquarters. 

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

Along with being expensive, WHO’s new organisation turned out to be a rather cumbersome  beast, neither easy to grasp or entirely logical. WHO staff themselves often stumble over both the names and the focus of three core divisions, all bearing mutations of “Universal Health Coverage (UHC)” in their titles.  There were fears that the broad distribution of divisions and departments fostered more siloed functions, as compared to a more interdisciplinary approach to global health challenges.   

Embedded within the large and complex structure, whole new teams were created, such as the Office of the Deputy Director General, which were then equipped with significant staff – over two dozen people, according to the last detailed organigram of the DDG’s office published in 2019.   

Staff protests and discontent?

Salary gap by region for 2025 as presented to WHO member states in March, shows more than half of the deficit is in headquarters.

The draft new organisational mapping, while simpler, may also correct some of those knock-on effects, although it will have big political ramifications, as well, if adopted.

For instance, the deputy director general and his office is not mentioned at all in the latest iterations. Does that mean the current DDG, Mike Ryan, might even return to his previous position as executive director of health emergencies, should the new plan be implemented? Or will he possibly retire as he was rumoured to be planning two years ago?  That remains to be seen.   

What’s clear is that the tremors will be felt well beyond the senior leadership of the organisation as the cuts that Tedros pledged would “start” at the top and ripple downwards into the staff rank and file. 

A WHO Staff Association Open House is planned for Thursday to take up the issue of the pending changes, none of which have yet been discussed with Staff Association representatives. 

The Staff Association also is considering a pre-emptive, class action suit to ensure that staff rights are protected, one insider told Health Policy Watch. In 2018, staff pursued a similar action to protest a planned 7% reduction in take-home pay based on what they contended was an erroneous cost-of-living adjustment for Geneva based professional staff – and were successful.  UN-wide revisions in cost of living scales that were subsequently made, and approved by WHO’s Executive Board in February, did not result in any net loss in pay.

“Tedros, in his Town Hall presentation to staff [2 April], promised to make cuts based on functions, not based on contracts,” the source explained. “OK, you can cut the functions, but at the end of the day, WHO staff on long-term (continuing) contracts should get the first priority for the jobs that are left; those on fixed term (1-2 years), come next; then temporary staff (less than one year); and then consultants – who should go altogether. 

“The main issue is that there still is no transparency,” one WHO staff member complained. “So many people are going to lose jobs. And there are a lot of eyes on Tedros. At the end of the day, the buck stops with him.” 

–Updated 14.04.2025 to note that a member state meeting on the reorganization is expected to be held this week.

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