INB co-chairs Anne-Claire Amprou and Precious Matsoso with WHO principal legal officer Steven Solomon.

The pandemic agreement will not be adopted at a special World Health Assembly (WHA) next month as countries still need “more time” to conclude the complex talks.

Co-chairs of the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) Ambassador Anne-Claire Amprou and Precious Matsoso broke this news at a media briefing on Monday evening.

The INB is midway through its 12th meeting after 32 months of negotiations. While some member states and stakeholders have cautioned against sacrificing content for haste, the Africa Group in particular was keen for an early adoption of the agreement.

“Member states have made progress on the text to reach a consensus on all the key elements of the pandemic agreement,” said INB co-chair Ambassador Anne-Claire Amprou.

But they “think that there are still work to do, and they want to use the coming weeks of discussions to continue making progress.” she added.

“Today, member states agreed we need to conclude the agreement as soon as possible and continue negotiations into 2025 with the goal of concluding the agreement by the next WHA scheduled in May 2025, so we are moving in the right direction with a strong political commitment by member states.”

Co-chair Precious Matsoso added that negotiators “are actually closer on some issues than we think” and that “broad principles had been agreed on but need more work, especially on some of the final details”.

Matsoso continued: “A clear opportunity exists for a middle ground and a place where there can be political will, trust and commitment so that the world can be better prepared for the threats today and also in future. I’m confident that we’ll reach that.”

Impact of Trump election?

Last week’s US election victory by Donald Trump cast a shadow over extending the talks.  As president, Trump withdrew the US from the WHO in 2020 and has promised to do the same if re-elected, describing the WHO as a “corrupt scam paid for by the US but controlled by China”.

However, when asked about the impact of Trump’s election on the process, WHO principal legal officer Steven Solomon said that the US was but one of the global body’s 194 member states.

“WHO is the UN agency for health. We are an international intergovernmental organization composed of 194 member states. The question relates to the national political decisions of one of WHO’s member countries, and permit me to refer you to the representatives of that country to respond.”

WHO principal legal officer Steven Solomon

‘Complex’ issues

Amprou stressed that member states were trying to create something new and many issues – such as the proposed Pathogens Access and Benefit Sharing (PABS) system – were “complex”.

Negotiators have discussed adopting a framework agreement with annexes on PABS (Article 12) and pandemic prevention (Article 4), the details of which would be decided on later.

However, Amprou said discussion on this is still ongoing: “The question is, how much detail do we need to operationalise the PABS and to operationalise prevention? Should we include everything in the pandemic agreement or in annexes, other instruments, appendices, whatever? 

“How to find the good balance? That’s why there is the option to have a parent agreement and further instruments.”

One of the most practical benefits of the proposed pandemic agreement is that a certain percentage of pandemic products – particularly vaccines and medicines – would be assigned to WHO for distribution during a pandemic.

This percentage started at 20% but has been halved in recent negotiations – but Amprou stressed the percentage was still being discussed.

“What we heard in the room is that there is a very strong commitment from member states to have a meaningful percentage allocated to to the system. So we will see at the end of the discussion.”

Matsoso added that, once that agreement is adopted, it means real work begins “because we must have the Conference of Party, countries must ratify the pandemic agreement, but you also have to ensure that there is operational elements that can help us.”

‘Abject failure’

INB observer Nina Schwalbe , CEO of Spark Street Advisors, described the decision not to call a special WHA in December “an abject failure of the international system”.

Former New Zealand Prime Minister Helen Clark submitted a statement to the INB earlier on Monday saying that the agreement – and its implementation – are “urgent”. 

“As you gather today, a teenager in western Canada has been hospitalized with H5N1. Mpox continues to infect and kill people in central and east Africa. Rwanda is doing its utmost to contain a Marburg outbreak. There are either no, or not nearly enough vaccines, diagnostics or treatments to equitably contain any of these pathogens,” said Clark, who was co-leader of the Independent Panel for Pandemic Preparedness and Response.

“The world is changing rapidly. Deadly pathogens are not waiting for a pandemic agreement to be adopted and to come into force, or for the results of elections.”

The 29th UN climate summit in Baku is the second consecutive COP to be hosted by a petrostate.

As 40,000 delegates’ flights streamed into Baku’s Heydar Aliyev airport over the weekend, battle lines were drawn on the opening day of COP29 in the Azerbaijani capital as developing countries demanded wealthy nations commit trillions of dollars to combat the climate crisis.

The high-stakes climate mega-conference launched on Monday, just weeks after its less prominent sibling, the UN biodiversity summit in Cali, Colombia, collapsed in disarray over the same fundamental question: who should pay to save the planet, how much, and by when.

Negotiators must now agree on a new global climate finance target by 2025 – a deadline set under the Paris Agreement – to replace the current $100bn annual pledge that wealthy nations promised in 2009 but have met just once. This new framework – known as the New Collective Quantified Goal – sits at the heart of talks, earning Baku the moniker “finance COP”.

With climate disasters wreaking trillions in damages worldwide, COP29 is the final opportunity for nations to align on this crucial financing ahead of the end-of-year deadline, yet countries remain deadlocked on nearly every detail of how to deliver it.

“We must be totally honest – current policies are leading us to three degrees of warming, temperatures that would be catastrophic for billions,” COP29 president and Azerbaijan’s minister of ecology Mukhtar Babayev told delegates as proceedings opened in Baku, citing recent findings from the UN Environment Programme pointing to a 3.1°C rise by century’s end.

“We are on the road to ruin,” he said. “Whether you see them or not, people are suffering in the shadows. They need more than prayers and paperwork.”

Last year’s Dubai summit managed what seemed impossible through three decades of climate talks: getting nations to name the “transition away” from fossil fuels, the root of the climate crisis, as necessary to avert the worst impacts of a warming planet.

In Baku, that bare-minimum breakthrough faces its first stress test. Yet hopes raised by the opening ceremony of seizing a historic moment to keep warming within 1.5C quickly gave way to a familiar deadlock – wording disputes delaying the opening plenary by six hours.

“We must do today what yesterday we thought was impossible,” Babayev said. “We are setting these expectations because we believe they are absolutely necessary – this is a race for our lives.”

‘Red alert’

Babayev’s stark warning came as the World Meteorological Organization (WMO) issued a “red alert” confirming 2024 is on track to be the hottest year ever recorded. Temperatures in the first nine months reached 1.54°C above pre-industrial levels, while Earth’s oceans absorbed record heat and glaciers melted at their fastest rate since measurements began in 1953, the UN weather agency found.

“This is unfortunately our new reality and a foretaste of our future,” said WMO chief Celeste Saulo.

Meanwhile, health experts at the talks are pushing to build on last year’s breakthrough health declaration at COP28, arguing investments in healthcare deserve equal status alongside established climate finance pillars of adaptation, mitigation, and loss and damages – warning that rising temperatures pose an unprecedented threat to global public health.

“Wealthy countries must commit to climate finance in the order of trillions to enable the delivery of climate action commensurate with the health risks faced by the world’s eight billion people,” Jess Beagley, policy lead at the Global Climate and Health Alliance, told Health Policy Watch.

“This must be based on grants, not loans, to avoid fuelling cycles of debt, poverty and ill-health. Failure to deliver adequate climate finance is a death sentence for the most vulnerable today, and our children tomorrow.”

Despite a year marked by record-breaking floods, deadly heatwaves, devastating hurricanes and raging wildfires, UN findings published last month found that no country globally implemented any policies with “significant implications” for reducing emissions in 2023 – marking a full year of climate inaction since the previous COP.

“Climate catastrophe is hammering health, widening inequalities, harming sustainable development, and rocking the foundations of peace,” UN secretary-general António Guterres said as talks opened in Baku.

“Those desperate to delay and deny the inevitable demise of the fossil fuel age … will lose.”

The finance fight

Developing nations, led by African and Arab states, are demanding at least one trillion dollars annually in public funds from wealthy countries. But nations including Canada, Japan and EU members argue such sums can only be achieved through private finance and “global investment flows” – the same fundamental disagreement that derailed this month’s biodiversity talks.

The debate is further complicated by questions over which nations should pay. The UN’s definition of “developed countries” dates back three decades, before China and India’s economic rise and corresponding emissions growth.

Recent assessments suggest developing nations require multiple trillions annually to address climate impacts, with some estimates reaching five to six trillion dollars.

While China now matches the EU in historic greenhouse gas emissions, Beijing is expected to remain staunchly opposed to being classified among nations required to provide climate finance, despite its position as both the world’s largest emitter and dominant clean energy manufacturer.

Major carbon polluters themselves face massive climate costs at home. A recent study of 4,000 extreme weather events shows direct damages alone cost two trillion over the past decade, with the US, China and India bearing the greatest losses. The $451bn bill from the past two years does not account for cascading impacts on health and economic activity.

“Let’s dispense with the idea that climate finance is charity,” UN climate chief Simon Stiell said in his opening remarks in Baku. “An ambitious new climate finance goal is entirely in the self-interest of every single nation, including the largest and wealthiest.”

COP29 president Babayev urged nations to see beyond the immediate costs.

“These numbers may sound big, but they are nothing compared to the cost of inaction,” he said. “This investment will pay off. A clear goal sends a strong signal to financial markets, provides certainty for long-term planning, and builds trust for collective action. We must invest today to save tomorrow.”

Health hits home 

As finance dominates the agenda, health experts warn the human cost of inaction is already mounting. The World Health Organization (WHO) estimates climate change and air pollution are driving almost seven million premature deaths annually, while people faced a record 50 days of health-threatening heat in 2023.

The WHO and over a hundred health organisations are pushing to embed health considerations in countries’ climate plans, due for submission ahead of COP30 in Brazil next year.

“Health workers are seeing the impacts of climate change firsthand, in the suffering of patients and communities they serve,” said Jeni Miller, executive director of the Global Climate and Health Alliance. “It is time for all governments to demonstrate readiness to protect people’s lives by getting serious about bold climate action … and spell out how and when they will achieve the fossil fuel phase-out promised at COP28.”

The global health coalition’s joint report demands any agreement on loss and damage compensation address the health impacts on climate-vulnerable communities. Global health advocates are also pressing for stronger protections for curbing industry influence in climate talks, citing concerns industries that harm global health in climate policymaking.

Conflict of interest concerns from the health community are particularly acute in Baku. Last year’s COP28 Dubai summit, led by oil executive Sultan Al-Jaber, saw more fossil fuel industry representatives than health sector delegates, with a record 2,456 fossil fuel lobbyists attending – nearly four times the number at the previous COP.

Transparency International warned ahead of the Azerbaijan summit that talks in Baku face similar risks of industry influence, prompting WHO to call for restrictions on fossil fuel industry participation in climate negotiations.

WHO: Climate Action Would Save Two Million Lives A Year

The human toll of climate change was brought home by the UN climate chief, as he stood beneath a photo of himself comforting an elderly neighbour in his Caribbean homeland of Grenada after her house was destroyed by a hurricane.

“At 85, Florence has become one of the millions of victims of runaway climate change this year alone,” Stiell said. “There are people like Florence in every country on Earth. Knocked down, and getting back up again.”

WHO estimates nearly 2.5 billion workers are now exposed to dangerous heat levels annually, while extreme weather events are driving increases in trauma and mental health problems.

Ahead of the summit, the UN health agency estimated urgent climate action could save two million lives each year through five key interventions, including heat warning systems and clean energy transitions.

“Health is the argument we need to catalyse urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.”

Climate crisis in the hands of a petrostate – again

Mukhtar Babayev, who spent 26 years at Azerbaijan’s state-owned oil and gas company Socar, takes over the presidency of UN climate negotiations from Sultan Al-Jaber, CEO of the UAE’s national oil giant ADNOC.

The UN climate process faces a deepening credibility crisis as Azerbaijan becomes the second consecutive petrostate to host the talks, with fresh revelations about fossil fuel dealings casting a shadow over proceedings in Baku.

“Actions speak louder than words,” Sultan Al-Jaber, the outgoing COP28 president, declared at the opening ceremony. Yet his home country, the UAE – the first nation to submit its third-generation climate pledge – is planning a 34% expansion in fossil fuel production by 2035.

Al-Jaber’s address also hailed COP28’s Oil & Gas Decarbonization Charter as “the most meaningful and comprehensive private sector partnership on decarbonisation to date.” But the voluntary agreement, largely written by the fossil fuel companies that signed it, appears toothless.

Analysis by Global Witness found signatory companies – from ExxonMobil and BP to national oil companies like UAE’s Adnoc – are set to collectively emit over 150 billion tonnes of CO2 by 2050, more than 60% of the planet’s remaining carbon budget to limit warming to 1.5C.

The charter “only commits signatories to ‘net-zero operations’ by 2050,” the analysis found, covering just production, not the burning of fossil fuels. “This means that up to 90 percent of these companies’ true carbon footprints aren’t covered by the pact.”

Azerbaijan’s climate credentials appear equally conflicted. State oil company SOCAR, which accounts for 90% of national exports, struck deals potentially worth more than $8bn while preparing to host COP29.

“The findings appear to confirm a pattern of petrostates using UN climate talks – which are designed to reduce greenhouse gas emissions – as an opportunity to clinch oil and gas deals,” Global Witness said, noting similar $100bn dealings by the UAE’s ADNOC in the run-up to its COP presidency.

The summit’s leadership has also raised eyebrows. COP29 president Mukhtar Babayev, a former oil executive who spent 26 years at SOCAR, faced fresh controversy after a senior COP29 official was caught on camera appearing to utilize the summit’s platform to make oil deals – echoing a near-identical incident involving Al-Jaber last year.

Leadership vacuum

Donald Trump’s promise to “drill baby, drill” amid record oil production is estimated by experts to be the final nail in the coffin for the 1.5C target.

The talks face additional headwinds as world leaders representing over half of global emissions stay away.

US president Joe Biden, Russia’s Vladimir Putin, the EU’s Ursula von der Leyen, China’s Xi Jinping, and India’s Narendra Modi are all absent, while only two G7 leaders – British Prime Minister Keir Starmer and Italian Prime Minister Giorgia Meloni – plan to attend.

Donald Trump’s election victory has also cast a dark shadow over COP29. The incoming president, who dismisses climate change as a hoax, withdrew from the Paris Agreement in his previous term.

His promised expansion of US fossil fuel production – already at record highs – could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target, experts say.

“It is clear the next administration will take a u-turn,” John Podesta, Biden’s climate policy advisor, told reporters in Baku. Yet he insisted the fight transcends US politics, pointing to the Inflation Reduction Act – America’s largest ever green investment – as proof of lasting progress.

“The fight is bigger than one election cycle in one country,” Podesta said. “This is not the end of our fight for a cleaner, safer planet.”

Trump isn’t alone

Estimated embodied emissions in upcoming licensing rounds in the next six months (top ten countries), according to IISD.

But the global emissions challenge extends beyond American politics: Major economies across the globe are undermining global climate goals by scaling up fossil fuel production.

An analysis published last month by the International Institute for Sustainable Development shows the US, Norway, Australia, Saudi Arabia, Russia, India and China among the top issuers of new drilling permits in the past year. All have more fossil fuel permits planned – potentially locking in expanded oil production for decades.

Some nations are already giving up on the process. Justin Tkatchenko, Papua New Guinea’s foreign minister, called COP29 a “total waste of time” that stands to produce “no tangible results for small island states.”

Stiell, the UN climate chief, whose own Caribbean island home faces rising seas, pushed back.

“This UNFCCC process is the only place we have to address the rampant climate crisis, and to credibly hold each other to account to act on it,” Stiell said. “We know this process is working. Without it, humanity would be headed towards five degrees of global warming.”

Climate activist Greta Thunberg, voicing the frustration of young people around the world with the UN climate process, didn’t mince words.

“Another authoritarian petrostate with no respect for human rights is hosting COP29,” she said, explaining her decision not to attend this year’s summit. “COP meetings have proven to be greenwashing conferences that legitimise countries’ failures to ensure a livable world.”

Image Credits: Gage Skidmore.

A children’s choir at the Bogota conference drew attention to how pervasive violence against children is.

The voices of the children’s choir echoed in the conference hall as a reminder that more than one billion children who experience some form of violence each year.

Their performance was part of the historic first high-level ministerial conference to end violence against children in Bogota late last week, which brought together government delegations, children, survivors, and other key stakeholders. 

“We need a pledge for a future of opportunities for each child, so this is a moment to join our voices and resources to protect our children and ensure a peaceful and just future,” urged Luis Gilberto Murillo Urrutia, Colombian Minister of Foreign Affairs in a welcome address to delegates to the largest governmental gathering to address the issue. 

Governments representing more than 100 nations agreed to a new global declaration to protect children from all kinds of violence, exploitation, and abuse.

Nine countries pledged to ban corporal punishment in schools: Burundi, Czechia, Gambia, Kyrgyzstan, Panama, Sri Lanka, Uganda, Tajikistan, and Nigeria. Dozens more pledged to investment in parenting support and national policies. 

Over half of all children globally experience some form of violence including corporal punishment in schools and at home, bullying, physical abuse, and sexual violence. These numbers, which include the one in eight girls and women who have experienced rape or sexual assault before the age of 18, according to new United Nations Agency for Children (UNICEF) estimates released last month. 

“Violence does more than harm individual children; it undermines the fabric of our society. It makes it harder for children to build happy, healthy lives and costs the global economy billions of dollars each year,” the WHO said in a statement. Despite this, the Conference represented the first global meeting to address the issue. 

The scale of children subjected to violence, and its lifelong implications created a sense of urgency at the conference, hosted by the Colombian and Swedish governments, in partnership with WHO, UNICEF and the UN Special Representative of the Secretary-General on ending violence against children..

“The results are serious harm to their physical and mental health and well-being setbacks to their education and future employment, unhealthy behaviors and perpetuating a cycle of violence from generation to generation, addressing this horrific reality requires concerted action from all of our removals at heavy level capitalist, schools, communities, and homes,” remarked Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in a video address at the conference opening.  

The WHO notes that this violence is often “hidden” and under-reported, with less than 10% of children receiving help. 

Yet this violence is preventable, as multiple speakers affirmed. The WHO’s INSPIRE package, a seven-point strategy to address violence against children, provides member states with “evidence-based strategies to stop the cycle of violence in a wide range of settings, in homes, through parenting interventions, in schools, through life skill training in social protection skills and through cash transfers in communities,” highlighted Tedros. 

The WHO notes that when countries implement such strategies, they can reduce violence against children by as much as 20-50%.

Evidence-based solutions ‘need to be scaled up’

Solutions include parenting support to help avoid violent discipline, school-based anti-bullying interventions and enabling safe school environments, and laws that reduce underlying risk factors like access to firearms and alcohol.

These have the potential to dramatically reduce the number of children who experience violence, said Alex Butchart, WHO unit head for Violence Prevention.

“There should be the implementation and enforcement of laws, for instance, that ban corporal punishment by parents in the home or by teachers in the schools,” Butchart told a media briefing.

“There should be efforts to denormalize the use of violence. It’s not okay to hit a child any more than it’s okay to hit an adult. There should be efforts to support families that are in danger of slipping under the economic safety level through cash transfers and home income strengthening, and there can be more work on ensuring that within school settings, education and life skills training for younger children and adolescents to help them negotiate tricky areas in life without resorting to aggression,” Butchart argued.

Country-level implementation will be a challenge, and advocates in the space hope the record attendance of government participants will spur meaningful change. 

The conference featured a “Break the Record” campaign to call attention to the “inaction in tackling violence against children,” said Together for Girls, a global partnership founded by sexual abuse survivors working to end violence against children.

Pledges to adopt child-friendly policies

All countries attending pledged to implement at least one of the 12 key policy areas proposed by conference organisers, ranging from parent and caregiver support to human, financial and infrastructure resources. Many also committed to  legislation that would create healthier environments for children.

Tanzania committed to investing nearly $70,000 in “Child Protection Desks” in all primary and secondary schools, to investigate cases of violence against children in schools, for example. 

The Solomon Islands pledged to raise the minimum age of marriage from 15 to 18 years by December 2025. Jordan will provide rehabilitation programs for “perpetrators of domestic violence against women and children as part of national response and preventive services.” And Brazilian government’s pledges included an acknowledgement that those living in peripheral territories have a greater burden of homicides and drug-related violence. 

Burundi, Czechia, Kyrgyzstan, Panama, Sri Lanka, Uganda, and Tajikistan have pledged to prohibit corporal punishment; while the Gambia and Nigeria have promised to end it in schools.

Several countries, including Saudi Arabia and Malaysia, have no prohibitions against corporal punishment, and many more have only partial prohibitions, like the US. 

“The ban against corporal punishment in 1979 was one of the most significant measures in Sweden for combating violence against children,” remarked Swedish Minister for Social Services, Camilla Waltersson Grönvall.

Addressing online harassment

Experts at UNICEF and WHO also pointed to the threat of online bullying and sexual exploitation. WHO estimates 15% of children have been bullied online.

“Online violence is real. It is, however, often not occurring in an online vacuum, but it is part of a continuum of violence between the interpersonal and the online world, and probably most often, the people that are perpetrating online violence are peers, friends, acquaintances known to the victim,” said Butchart. 

Nineteen countries made pledges to address online harms. South Africa’s national commitment states its pledge to “build the capacity of different stakeholders on online safety including parents, caregivers, children, frontline workers and strengthen the curriculum in schools promoting the online safety of children by 2027.”

Image Credits: WHO.

Zeinab Hijazi (left) and Jaime Young
Zeinab Hijazi (left) and Jaime Young

One in seven young people aged 10 to 19 live with a diagnosable mental disorder, according to the United Nations Children’s Fund (UNICEF). One in four children lives with a parent with a mental health condition. Suicide is the fourth most significant cause of death for adolescents globally.

The economic cost of neglecting youth mental health is estimated at around $387.2 billion annually for children ages 0 to 19, also according to UNICEF.

“Adolescents are really struggling globally,” Zeinab Hijazi, a clinical psychologist and global mental health lead at UNICEF, told Garry Aslanyan on a recent episode of his Global Health Matters podcast. “It is really unfathomable that we know this, and we know that all of these conditions, most of them are treatable, but they go undetected, and they go untreated.”

Mental health infographic
Mental health infographic

The state of mental health challenges amongst youth was the focus of the latest podcast in honour of World Mental Health Day on October 10 and in light of the growing causes behind these disorders.

Hijazi noted that many young people are contending with the devastating impacts of wars and conflicts in places like Gaza, the Congo, and Sudan, while others face the immediate threats of climate crises or unemployment.

Jaime Young, a passionate youth leader, mental health advocate, and family caseworker at the Saint Lucia Social Development Fund in the Caribbean, joined the discussion. In her region, a staggering 24% of youth experience mental health disorders, with anxiety and depression accounting for nearly 50% of mental health issues amongst those aged 10 to 19, Young explained.

Young identified one of the reasons as heightened stressors.

“We have a lot more stresses, and then depression can be something that, if you are not sure how to cope with or if you do not have that support, whether it is with your family or friends, you feel like your back is against the wall. You feel anxious, you have anxiety, you are depressed, and you cannot talk to anybody about it because access to actual resources, a counsellor or a therapist, is extremely expensive where available—and where they are not, they are just not.”

She pointed out that mental health disorders remain a “taboo subject” with a persistent “stigma” around seeking help. Additionally, the region often lacks affordable resources for youth mental health support.

Nevertheless, Young emphasised the need to raise awareness and take action. She urged those struggling with mental health issues to seek help.

“I would say prioritise your mental health,” Young said. “I know you might hear it everywhere or see it everywhere, but it is one thing when we are sick or have a broken bone; we make it our duty to go to the doctor. And it always baffles me that when we know or suspect we have a mental health issue, we do not look for the resources. We ignore it.”

She continued, “Do not ignore your mental health because you need your mind; you need to be healthy.”

Listen to the episode on Buzzsprout >>

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View more Global Health Matters podcast articles on Health Policy Watch >>

Image Credits: Global Health Matters | TDR.

US President-elect Donald Trump railed against “globalists” during his election campaign, and his victory will have serious ramifications for global health – particularly for action against climate change, scientific institutions and regulatory bodies, United Nations agencies and sexual and reproductive health.

1. Climate denial

“We will drill, baby, drill,” Trump told the Republican National Convention in July, describing the Biden administration’s “Green New Deal” aimed at reducing greenhouse gases as a “scam”. 

During his presidency, he persistently favoured industry over the environment, removing around 100 regulations relating to air pollution, water, vehicle emissions, toxic chemicals and wildlife protection, according to the New York Times.

For example, within weeks of assuming office in January 2017, Trump expedited the controversial Dakota Access Pipeline to transport crude oil through farms and pristine indigenous land. Oil and gas billionaire Kelcy Warren, whose company, Energy Transfer, was responsible for the pipeline, was the fifth-largest individual contributor to Trump’s latest election campaign with a $5.8 million donation, according to Forbes.

He also allowed oil and gas development in the Arctic National Wildlife Refuge in Alaska, one of the last remaining wilderness areas in the US, reauthorised use of an agricultural pesticide, sulfoxaflor, known to kill bees and lifted protections for endangered species.

He appointed industry-friendly people to run the Environmental Protection Agency (EPA) and reduced its budget, which drove these measures. However, this time, he might dismantle the agency almost entirely, giving states latitude to decide on environmental issues, according to threats made on the campaign trail.

In 2017, Trump announced his intention to pull the US out of the Paris Agreement – the commitment to confine global warming to 1.5°C – saying that it undermined the US economy, hamstrung its ability to open new oil and coal fields, and put the US “at a permanent disadvantage to the other countries of the world”.

Trump campaign national press secretary Karoline Leavitt told Politico that he will do the same thing in his second presidency.

Why it matters

This year is “virtually certain” to be the warmest year on record, with the average global temperature rise being 1.55°C above the pre-industrial era, according to a report from the European Union’s Earth observation programme, Copernicus. Record-breaking heat is driving global extreme weather from hurricanes and floods to drought and fires, threatening the lives and livelihoods of virtually everyone.

Trump’s win could lead to an additional four billion tonnes of US emissions by 2030 in comparison with current president Joe Biden’s plans, according to Carbon Brief , based on an aggregation of modelling by various US research groups. This is equal to the total emissions form the European Union and Japan combined, and would cause global climate damages worth more than $900bn, based on the latest US government valuations.

Reaction

“The nation and world can expect the incoming Trump administration to take a wrecking ball to global climate diplomacy,” said Rachel Cleetus, policy director at the Union of Concerned Scientists, told The Guardian.

Environmental justice organisation Greenpeace called on supporters to “resist attempts to roll back environmental and climate protections” and “lean into the intersections between climate justice and democracy protection, given the increasing attacks on freedoms of speech, assembly, and association.”

2. Undermining scientific and regulatory institutions

The US Centers for Disease Control and Prevention

Trump promoted several quack cures during the COVID-19 pandemic and has apparently promised the world’s leading vaccine skeptic, Robert F Kennedy Jnr, a position at the White House. 

Kennedy, who has no health qualifications, abandoned his presidential bid in favour of Trump. Trump has said he wants Kennedy to “go wild on health”. That is easy for Kennedy, whose  wild ideas including the rejection of most childhood vaccinations and that water fluoridation  causes brain disease.

It is unclear what position Kennedy will get, but Trump is almost certain to reform  and reduce the power of the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).

The CDC leads disease outbreak investigations, publishing public health recommendations and supporting the work of state and local health departments, which is where around two-thirds of its budget goes.

 The FDA sets regulatory policy, and decides on the authorisation of new medicines and medical devices. The NIH funds medical research.

Kennedy has described public health agencies as “sock puppets for the industries they are supposed to regulate.”

He wants to rein in Big Pharma, including by banning TV advertisements for drugs – tricky for Republicans who received significantly more pharma election donations than Democrats. 

Kennedy has also proposed that half the NIH’s budget should be for “preventive, alternative and holistic approaches to health.”

He also mused on X that “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.” 

Why it matters

 If citizens don’t believe in science or public health institutions, they are unlikely to follow their advice, which could slow recovery form disease and turn outbreaks into epidemics.

A Pew Research Center poll in late 2023 found that there has been a 16% drop in Americans’ view that science has a mostly positive effect on society, with only 57% supporting this view.

Decisions taken by the CDC and FDA are considered as the global “gold standard”, and are particularly important for countries that lack the resources to map disease responses and authorise medical products for themselves.

Reaction

“Among the most destructive impacts of a second Trump administration would be to foment distrust in health, medicine and science, ranging from vaccines to water fluoridation,” Professor Lawrence Gostin, the O’Neill Chair in Global Health Law at Georgetown University, warned on X.

“Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives.”

However, Gostin also noted that “Trump has no power to ban vaccines or water fluoridation. The states have public health power, not the president. And we have robust institutions that will hold.”

Meanwhile, former CDC head Dr Tom Frieden described the body as “the cornerstone of public health in the United States and a global resource—weakening CDC would endanger American lives.”

3. Defunding UN agencies

The WHO plays an essential role in assisting poor countries – in this case, assisting Zimbabwe to respond to a cholera outbreak.

Trump’s first administration froze the US contributions to the World Health Organization (WHO) in the middle of the COVID-19 pandemic, accusing it of being controlled by China.

Trump also cut US funding to the United Nations Population Fund (UNFPA), effectively shrinking the budget of the global sexual and reproductive health agency by around 7% – erroneously accusing the agency of supporting population control programs in China that include coercive abortion.

Trump also withdrew the US from the UN Human Rights Council, and UNESCO, the UN’s cultural agency.

This is likely to be repeated in Trump 2, 

Why it matters

The WHO leads global health efforts, coordinating and guiding its 194 member states on how best to respond to all health challenges – from infectious diseases such as COVID-19 to non-communicable diseases. It is particularly important in supporting low-income countries.

UNFPA provides maternal and reproductive health services throughout the world – excluding abortions. Its role is particularly in humanitarian settings where governments are unable to provide these services.

The loss of the US contribution to the WHO will weaken the global body’s ability to assist countries to react to health challenges. Likewise, the UNFPA will have to scale back its operations, which will impact on women in the poorest, conflict-ridden nations.

The US also contributes 22% to the UN’s core budget and 27% of the peacekeeping budget. 

Reaction

After Trump withdrew the US in April 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus accused Trump of “playing with fire” by politicising COVID-19, which would result in “many more body bags”.

However, a circumspect Tedros reacted to Trump’s re-election this week by saying: “The partnership between WHO and America is vital, and has significantly improved the health of both Americans and people across the globe. We look forward to working with your administration for global health security.”

Meanwhile, UNFPA has warned that women will “lose lifesaving services in some of the world’s most devastating crises” in places like Afghanistan, Sudan and Ukraine,” according to Reuters.

4. Sexual and reproductive health

A US protest against abortion restrictions.

Sexual and reproductive health (SRH) services are in the firing line, with Trump likely to support the expansion of domestic abortion bans, while entrenching opposition to abortion as a key pillar of US foreign aid. 

Despite the Trump victory, millions of people in seven US states voted to enshrine the right to abortion in their state constitutions, approving amendments in seven of 10 states where measures were on the ballot.

However, the Trump administration is expected to try to end access to medication  abortion,used in 63% of US abortions, including by prosecuting people who ship and transport abortion pills and supplies.  

Trump appointed anti-abortion judges to the Supreme Court who overturned the right to abortion, known as Roe v Wade. Seventeen US states have banned abortion since Roe v Wade was overturned, and many doctors are unsure of when it is legal to assist women to terminate pregnancies – even when they are obviously in distress. 

“In vast swaths of the US South and Midwest, patients are forced to cross multiple state lines to get [abortion] care, but many lack the means to do so,” according to the Center for Reproductive Rights (CRR).

“Obstetricians are fleeing states where abortion is banned because they cannot properly care for their patients, including those experiencing severe pregnancy complications. Obstetricians and medical school residents don’t want to work in these states, creating maternal health deserts.” 

One of Trump’s first presidential actions in 2017 was to prohibit foreign NGOs from receiving US government funding for health if they “provided, promoted, or discussed” abortion – known as the Expanded Global Gag Rule (GGR). 

Many family planning organisations lost their funding and women lost access to contraception in some of the continent’s poorest countries such as Madagascar and Ethiopia – ironically contributing to more unplanned pregnancies.

While legal abortion is out of the reach of most African women and girls, 19 African countries have eased access since 1994 – mostly in an attempt to reduce the maternal deaths caused by unsafe abortions.

But US groups have campaigned against this easing in Africa, led most recently by former Trump administration officials Valerie Huber, and Alma Golden.

Huber was the architect of an anti-abortion pact, the Geneva Consensus Declaration (GCD), adopted in the dying weeks of Trump’s rule in October 2020 with the support of an array of global human-rights polecats such as Iraq, Uganda, Belarus and Sudan.

The GCD also promotes “the natural family” – primarly aimed at removing any recognition of the existence of  LGBTQ people.

While Biden withdrew the US from the GCD, Trump has promised to rejoin it  “to reject the globalist claim of an international right to abortion.”

Project 2025, the controversial conservative blueprint for a Trump victory written primarily by his former officials, proposes that all US aid including humanitarian assistance, should be conditional on the rejection of abortion.

“Proposed measures for USAID [US Agency for International Development] include a significant restructuring, and reduction of budget, the removal of diversity, equity, and inclusion programs, and dismantling of the apparatus that supports gender equality and LGBTQ+ rights,” notes researcher Malayah Harper in an analysis of Project 2025.

In 2023, Republican congressional lobbying even put the brakes on the US President’s Emergency Plan for AIDS Relief (PEPFAR), claiming – incorrectly – that some grant recipients were promoting abortion. As a result of the right-wing lobby, PEPFAR projects now receive yearly budgets instead of five-year funding

Why it matters

Abortion bans have never stopped women and girls from trying to end unwanted pregnancies. It has simply driven them to unsafe providers whose methods often maim and even kill them.

Approximately 6.2 million women and girls had abortions in Sub-Saharan Africa in 2019, and the region has the highest rate of unplanned pregnancies and abortion-related deaths in the world – 185 maternal deaths per 100,000 abortions, according to  Guttmacher.

Reaction

Nancy Northup, CEO of the Center for Reproductive Rights (CRR), said that Trump’s re-election means “anti-rights extremists will soon be back in charge of the White House and the US Senate, wielding power to the detriment of vulnerable populations and seeking to undermine decades of progress on gender equality, a lynchpin of which is the ability of individuals to make decisions about their reproductive lives and have access to reproductive health care.”

Northup, whose organisation uses the law to advance reproductive rights, said the CRR “will scrutinize every action of the White House and federal agencies, amass the factual and legal record to counter agency actions, and work to stop harmful policies from going into effect.

“If they do, we will take them to court. We will vehemently fight any effort to pass a national abortion ban, to stop the provision of medication abortion by mail, to block women from crossing state lines to get care, to dismantle UN protections for reproductive rights and progress made at the national level in countries around the world, and more.”

Saoyo Tabitha Griffith, a Kenyan high court lawyer and women’s rights activist, warned that “African women and LGBTQ people must anticipate that Trump’s return will re-ignite an ideological war with real and physical consequences on their bodies”.

“Issues such as contraceptives, surrogacy, single parenting, safe abortion, HPV vaccines and sexual orientation are all going to be contested, not through science and data but by conspiracies and misinformation,” she added.

Image Credits: Mika Baumeister/ Unsplash, Clay Kaufmann/ Unsplash, Center for Reproductive Rights.

Extreme weather, infectious diseases and air pollution are driving at least two million climate-related deaths annually, WHO reports.

Two million lives could be saved annually through urgent climate action, the World Health Organization (WHO) declared on Thursday in a stark message to negotiators ahead of next week’s climate summit in Baku, warning that rising temperatures are wreaking havoc on global health, disrupting healthcare systems and fueling disease outbreaks worldwide.

The new WHO report, compiled by over 100 organizations and 300 experts, sets out a blueprint of five key climate interventions: implementing heat-health warning systems, electrifying primary healthcare facilities with solar power, improving water and sanitation infrastructure, transitioning to clean household energy, and reforming fossil fuel pricing.

The analysis shows that implementing heat-health warning systems in 57 countries could save 98,500 lives each year, while electrifying primary healthcare facilities with solar power across 63 nations could prevent 290,500 deaths annually by 2024. 

Improving water and sanitation infrastructure could save 173,000 lives, transitioning to clean household energy could prevent 133,000 deaths, and reforming fossil fuel pricing policies could avert over 1.2 million deaths annually by 2034.

“That’s comparable to anything else we can do [globally] in public health through a limited number of climate actions,” Dr Diarmid Campbell-Lendrum, WHO’s climate and health lead, said at the launch press conference. 

“This is something we have to do to protect people’s lives and their future – it brings very large health gains, we know it saves us money, and we know it’s a really good investment.”

Blueprint for action

WHO identifies ending fossil fuel subsidies as the most effective global public health interventions, potentially saving 1.2 million lives annually from reduced air pollution

The findings come at a crucial moment as nations prepare the third generation of climate pledges under the Paris Agreement, known as nationally determined contributions (NDCs), due before next year’s COP30 in Brazil. 

WHO is pressing governments to include detailed health planning and financing in these national commitments, urging negotiators to abandon their “siloed approach” to climate change and health, which WHO Director-General Dr Tedros Adhanom Ghebreyesus called “a moral and legal imperative.” 

While health is identified as a priority in 91% of national climate plans, few outline specific actions or financing mechanisms to protect health from climate risks.

The stakes are high: climate change is expected to cause 250,000 additional annual deaths between 2030 and 2050, while air pollution already costs $ 8.1 trillion annually (6.1% of global GDP). Despite these massive costs, health remains critically underfunded in climate action, with only 6% of climate adaptation funding and a mere 0.5% of multilateral climate funding going to health projects. 

Evidence suggests every $1 invested in climate adaptation can return up to $15 in benefits, while WHO estimates the return on its five key policies to prevent deaths from climate change would see a return of four to one. 

Yet securing funding remains a critical challenge. In the European Union, a leaked blueprint suggests its dedicated health budget may soon be merged with other funds or eliminated entirely, reflecting intense competition for resources amid inflation, wars, and wider climate impacts in even the world’s wealthiest nations.

One possible source of funding is fossil fuel subsidies, which WHO describes as “incoherent” with health goals, echoing last week’s Lancet report warning governments to stop “fuelling” the fire caused by oil, gas and coal by subsidising their use. According to the IMF, total subsidies amount to around $7 trillion annually – much of it reflected in health costs.

“The largest single component of [subsidies] is effectively health damages,” Campbell-Lendrum explained. “The costs are felt not in the atmosphere but in people’s lungs, triggering heart attacks, impairing children’s development, and giving them asthma.”

“If we were to invest those resources more wisely, then we would have both a healthier planet and much healthier local populations,” Campbell-Lendrum added. “We would also save those resources, and save all that money.”

Can’t claim they didn’t know 

The WHO report comes as new data confirms 2024 will be the first year global temperatures breach the 1.5C threshold above pre-industrial levels – a critical target of the Paris Agreement. UN agencies estimate the world is on track for “catastrophic” warming of 3.1C by the end of the century.

The crisis deepened further with Donald Trump’s White House victory on Tuesday, as his promised expansion of record-high US fossil fuel production could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target.

Despite these setbacks and the recent breakdown of the COP16 biodiversity summit casting a shadow over expectations in Baku, WHO remains optimistic that health impacts could drive meaningful progress at COP29.

“Health is the argument we need to catalyze urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.”

Climate health crisis 

A young girl reads under a malaria bednet. Photo: UNDP

The health impacts of the climate crisis are far-reaching and already being felt. The report documents how rising temperatures are increasing the spread of infectious diseases, worsening air pollution, threatening food security, and creating unprecedented challenges for healthcare systems worldwide. In 2023 alone, people faced an average of 50 more days of health-threatening heat compared to previous years.

Disease outbreaks are also intensifying, with dengue cases reaching record highs of over five million cases across 80 countries due to extreme rainfall and heat creating ideal conditions for mosquito-borne diseases. Over half of all pathogens worldwide are aggravated by climate change.

Meanwhile, extreme drought affected almost half the world’s land mass, pushing 151 million more people into food insecurity across 124 countries. 

The WHO’s findings build on data on the escalating climate-driven health crisis published by the Lancet last week. It found heat-related deaths among people over 65 have surged 167% compared to the 1990s, while people worldwide faced an unprecedented 50 more days of health-threatening temperatures last year and extreme heat made even light outdoor exercise dangerous for billions of people.

The burden falls disproportionately on those least responsible for emissions. The WHO notes that by 2050, climate change may push up to 16 million more women and girls into poverty than men and boys, while 920 million children are currently highly exposed to water scarcity. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones. 

“Whether it is the drought in southern Africa leading to malnutrition, the extreme heat which has become the norm each summer, or the recent flooding in Valencia … health is the lived experience of climate change,” said Dr Vanessa Kerry, WHO’s Special Envoy for Climate Change and Health. “We can no longer afford to ignore that fact.” 

A duty to safeguard health 

Electricity
Nearly one-eighth of the global population does not have access to health facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people around the world.

The healthcare sector itself faces a double challenge: responding to increasing climate-related health emergencies while also addressing its own significant carbon footprint. The report reveals that the global healthcare sector accounts for approximately 5% of greenhouse gas emissions – equivalent to the emissions of the fifth-largest country in the world.

“For the health community, this is incoherent and directly at odds with our duty to safeguard health,” the report states, calling for an urgent transformation of healthcare systems to become both climate-resilient and low-carbon.

On Thursday, the UAE – hosts of last year’s COP28 summit in Dubai – became the first country to submit its third-generation climate plan under the Paris Agreement, including commitments to achieve a net-zero healthcare system by 2050. However, critics note the plan fails to address the UAE’s planned 34% fossil fuel expansion by 2035, highlighting the tensions between climate action and economic interests.

Cities & shortage

Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions.

Other areas highlighted by the report include cities, which are identified as crucial battlegrounds for addressing the crisis, being responsible for over 70% of global emissions while also hosting more than half the world’s population. The report calls for urgent action to transform urban areas through clean energy adoption, sustainable transport systems, and improved infrastructure.

“We must reshape our cities to prioritise public transportation and human-powered vehicles, not just to reduce emissions but for the health benefits of daily exercise,” Dr Tedros said. “Green spaces can improve air quality, provide space for physical activity, enhance mental health, and help to cool urban areas.”

The WHO also highlights a critical shortage in the health workforce, projecting a shortfall of 10 million workers by 2030, with six million of these in sub-Saharan Africa – one of the regions most vulnerable to climate impacts.

With COP29 just days away, WHO officials closed with a call to action. 

“The stark reality is that climate change is magnifying existing global health challenges that we’ve yet to fix,” Kerry said. “Poor health doesn’t just affect our well-being, but epidemics, chronic diseases, maternal deaths, air pollution, and fuels insecurity across communities and countries, destabilises economies, widens inequities and drives political unrest.” 

“We must address health as a fundamental part of our climate response to prevent these cascading effects,” she added. “Success cannot be measured only in degrees degrees Celsius averted, but in the human cost of this crisis in lives saved.”

Image Credits: UN-Water/Twitter , Galen Crout , UNDP.

Dr Jean Kaseya

The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya.

The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening.

“Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC).

Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him.

Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent.

Mpox outbreak continues 

Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad.

While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted.

However, despite a high case load, Burundi had not yet reported a single death.

Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support.

While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children.

“The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo.

“The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.”

Kaseya added that children’s co-infection with measles was also contributing to the higher deaths.

However, he added that, as Burundi had not recorded any deaths despite high malnutrition,  “there are many things we don’t yet understand”.

The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available.

The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks.

So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted.

Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report.

There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday.

Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities.

This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need.

Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027.

The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist.

Big gaps in Asia, Africa 

The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts.

“We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo.

Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found.

The availability of climate services has improved in Asia and Africa at the back of increased investments.

Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate.

And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time.

Rising need for climate services

There is a growing awareness of the importance of climate services from countries as well as the funding these services.

Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies.

The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand.

The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era.

The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity.

Investments in climate services

Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report.

UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone.

Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form.

Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events.

WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services

“In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said.

“On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added.

Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO.

Smog envelops a South Delhi building – two images from the same spot but a month apart. 

For some years, the Indian government has monitored farm fires, a major source of Delhi’s air pollutions. Officials say the fire count is drastically down as a result, but researchers say their satellite surveillance is missing fires.

DELHI – Peak pollution season has been building up for the last few weeks, and a major government hospital says that cases are rising at its pollution clinic.

On 1 November, the city was the world’s most polluted city thanks largely to Diwali celebration firecrackers the day before – despite a firecracker ban passed in 2018. 

But the worst ranking came a couple of days later when there were few firecrackers but farm fires in two states, Punjab and Haryana, north-west of the Indian capital. 

At a hearing on air pollution a week before Diwali, the Supreme Court criticised both state governments and the government of India for failing to act against polluters, thus making the Environment Protection Act “toothless”. 

Advocate Aparajita Singh, acting as amicus curiae at the hearing, pointed out that neither the 2018 ban on fireworks nor regulations on stubble burning were being implemented. 

“Farm fires and stubble fires are a deadly combination,” Singh told the hearing.

Underscoring that citizens have the right to live in a pollution-free environment according to Article 21 of the Indian Constitution, the court directed the governments to initiate penal action against those setting fires.

These are usually farmers trying to clear the paddy stubble in time to sow the next crop. The court pointed out that despite some 1,000 fires in Punjab reported by the time of the hearing, fewer than 500 people had been fined. 

By 23 October, when the court directed the government to take action, it was reported that the pollution was so bad that the Chief Justice of India, D Y Chandrachud told reporters that he had stopped his early morning walks.

However, the states and central government all asserted at the hearing that they are taking measures that are having an effect.

The crux of their three-fold defence at the hearing is, first, that they are providing funds and subsidised machinery to help farmers clear the paddy stubble without burning,  second, that they are penalising farmers and charging them and third, as a result, the number of fires has reduced over the years.

A few days after the court directive, India’s agriculture minister Shivraj Singh Chouhan, said that the number of fires has halved in the last seven years, and by 35% in Punjab and 21% in Haryana, which impacts Delhi’s air quality. 

Scientists question drastic decline in farm fires 

But researchers told Health Policy Watch (HPW) that they doubted that there had been a decline in the fire count has happened. They base this on satellite observations of fires, burnt areas, and pollutants (aerosols) as well as ground measurements. 

The official fire count in Punjab has fallen from almost 79,000 in 2021 to roughly 32,000 in 2023, whereas in Haryana it’s gone from about 11,000 to about 3,300. 

These numbers are based on images from two satellites that pass over the region at around 10:30am and 1:30pm daily.  But researchers say that these satellites miss many fires as they are usually started later in the afternoon. 

Dr Hiren Jethva, a senior research scientist at NASA Goddard Space Flight Center and affiliated with Morgan State University., tweeted that while the downward fire trend has been drastic in 2022, 2023, and 2024, the aerosol loading, or pollutants, in the atmosphere has increased or remained near stable compared to previous years. 

This, he says, “raises suspicion” that farm fires are ignited after the satellite overpass time, which means the satellite cannot ‘see’, and therefore, detect the active fires.

“The total aerosol loading over the Indo-Gangetic Plain, in which carbonaceous smoke aerosols emitted from the farm fires are a major component around this time of the year, retrieved from the space doesn’t corroborate such decline,” Jethva told HPW.

“This raises a serious doubt that farm fires may not have gone done in previous years,” said Jethva. “Since the timing of igniting farm fires has been shifted to late afternoon, the fire counts show a downward trend.”

Jethva corroborates this assertion with another source: a South Korean satellite GEO-KOMSAT 2A. He points to two images from this satellite taken on 1 November 2024 (see below). The first is taken at 1:30 pm (India time) when the satellite on which the fire counts are based, makes an overpass. The second is taken at 4:20 pm. Unlike the polar-orbiting satellite making once or twice a day overpass, the geostationary satellite continuously monitors the same region at high frequency.

 The second image shows fires just a few hours later.

Pic Left: few or no fires at 1:30 pm IST on 1 Nov., and (right) several fires at 4:20 pm.

Jethva also investigated the shortwave-infrared signal, which is sensitive and useful to detect active fires, from the same satellite, and found a statewide eruption of fires in Punjab during later afternoon hours. 

 Dr Piyush Bharadwaj, an air quality scientist at Bengaluru-based Center for Study of Science, Technology and Policy (CSTEP), told HPW, that “many farmers in Punjab set the fires overnight which generally are not detected” in the morning and afternoon satellite overpass. 

Bharadwaj says another reason for the lower fire count could be that the overpass satellite uses instrumentation (MODIS) with a 1 sq km pixel resolution. 

“Many of the farm fires are much smaller than this,” says Bharadwaj who is Group Head of Atmospheric Composition Modeling group at CSTEP.

His group’s analysis of the fires during the last three years has shown a reduction of daytime fires from ~2500 to ~1000 fire counts, which is a 60% reduction. Even if there has been a decline in fire counts, as claimed by the government, this does not seem to have led to a decline in pollution over Delhi, Bharadwaj adds. 

“Delhi air quality on a year-to-year basis is determined by changing burning activity, meteorology and other emission sources. To our knowledge, the air quality has not improved over Delhi, and/or hard to say with the last five years of data.” 

A recent report by Dr Palak Balyan, of Climate Trends in Delhi, echoes this. Tracking the data in the stubble burning months of September to December from 2019 to 2023, Balyan found that while the fire count dipped by about 23% in Punjab and 44% in Haryana, the air quality index (AQI) in Delhi dipped only by about 5%. 

Fires fall 23 and 44% but Delhi’s AQI dipped only 5%

State 2019 2023 %change (’19-’23)
Punjab fire count 68550 52722 -23.09
Haryana fire count 14122 7959 -43.64
Delhi’s AQI 214.62 203.63 -5.12

Source: Climate Trends

Balyan further explains how much Punjab and Haryana’s fires impact air pollution in Delhi during September and December. Without the fires, the AQI in Delhi averages about 175, which is ‘moderate’ air quality as per the Indian air quality standards.

When the fire count goes up to about 600, the AQI worsens to 233 which is ‘poor.’ Beyond a fire count of 600, the AQI deteriorates to approximately 337 which is ‘very poor,’ when the official health warning reads respiratory illness on prolonged exposure. 

Fire activity AQI Category % Days
No Fire (Fire counts =0) 175 Moderate 5%
Climatological Fire activity

(Fire counts=500-600)

 233 Poor 2%
Above Climatological Fire

(Fire counts> 600)

 337 Very Poor 21%
Below Climatological Fire (0<Fire counts< 500) 229 Poor 72%

Source: Climate Trends

“Our analysis reveals a notable impact of fire incidents in Punjab and Haryana on air quality in Delhi,” says Balyan. “Specifically, it was found that fire incidents (September to December, 2019 to 2023) in these neighbouring states contribute to an increase in Delhi’s Air Quality Index (AQI) by approximately 103 units.”

A recent study submitted to the Delhi state pollution control committee shows just how much burning biomass contributes to Delhi’s pollution in November and December, which tend to be peak pollution months. 

Biomass burning, of which stubble fires are only one component, contributes 36% to air pollution in November but this dips to 21% in December. November is the time when farm fires peak and are largely stopped in Punjab and Haryana.

Biomass burning: November and December.

Researchers say there needs to be a ground-truthing exercise to accurately gauge the totality of farm fires. Additionally, a geostationary satellite with high-resolution and very frequent imagery over north India is needed.

HPW reached out to a spokesperson for the ruling party in Punjab but there has been no response for over three days till filing this report. 

Image Credits: Hiren Jethva.

Brazilian Health Minister Nísia Trindade (centre) addresses the meeting between G20 health and finance ministers in Rio.

Health Ministers from the powerful G20 nations have resolved to set up a “Global Coalition” to strengthen local and regional production to promote more equitable access to “safe, affordable, quality and effective health products and technologies”.

The primary focus of the coalition will be to strengthen the manufacturing capacities of countries to deal with “neglected diseases and persons in vulnerable situations”, according to a declaration adopted by the health ministers of the powerful group at their meeting in Rio de Janeiro last week.

It will start by identifying two or three projects to test approaches that could include “technical cooperation, advanced market commitments, voluntary technology transfer on mutually agreed terms, existing funding sources, regulatory cooperation and strengthening, and developing, regional environments that stimulate investments”. 

Two criteria will guide the selection of projects: the diseases they target and the technological platforms and capabilities they will use to promote more equitable access .

Brazil, the current head of the G20, is the key driver of the coalition and will serve as its the executive secretariat and presidency for the first two years. 

Membership will be voluntary and financed through projects by the involved participants and with no mandatory or fixed contribution from members or other institutions involved. 

It is “intended to promote synergies with existing and potential future initiatives, funding channels and philanthropic organisations,” according to the declaration.

The G20 stretches from the US to China, and also counts the African Union and the European Union as members. But non-G20 countries and international organisations that contribute to its objectives can join the coalition if approved by G20 members.

The World Health Organization (WHO) has already been invited to support the coalition by providing scientific and technical support, and help map existing projects to avoid duplication.

Praise for ‘visionary’ coalition 

The Global Council on Inequality, AIDS, and Pandemics, which is convened by UNAIDS  welcomed the establishment of the coalition to stimulate local production.

UNAIDS Executive Director Winnie Byanyima described the coalition as a “visionary, politically feasible solution [that] could transform global health for as long as it remains bold in vision and wide in scope.” 

Nobel Prize-winning economist Joseph Stiglitz, co-chair of the Global Council, said: “Reforms in both the developed and developing countries and in international agreements and institutions, and investments which help broaden the production of medical products and reduce prices are vital to address market failures and accelerate access to medicines for the people in greatest need.”

Brazilian Health Minister Nísia Trindade, who is also a member of the Global Council, said: “By building production capacity in every region, we can learn from past mistakes by ensuring that medicines for neglected and socially determined diseases are made around the world and that capacity is available to respond swiftly to future outbreaks.”

Brazil’s representative at the pandemic agreement talks.

The health ministers also discussed the pandemic agreement negotiations, which re-convened in Geneva on Monday.

Brazil’s representative at the negotiations described the G20’s decision to establish the coalition as “particularly timely” for occurring shortly before the 12th meeting of the intergovernmental negotiating body (INB).

The G20 health ministers’ declaration also expressed their support for the conclusion of the INB process, reiterating their “commitment to an instrument that is ambitious, balanced, effective and fit-for-purpose, including equitable access to medical countermeasures during pandemics”.

Finance and health ministers

Health has been a central concern of Brazil’s G20 Presidency, and the country also hosted the joint meeting of G20 Finance and Health Ministers last week, which focused on addressing the social determinants of health, debt-for-health measures to bolster countries’ investment in health and pandemic prevention, preparedness, and response (PPR)

“Ministers underscored the need to enhance investments in health systems to bolster resilience, safeguard the global economy, and mitigate disruptions, particularly in anticipation of future pandemics,” according to a statement from the meeting.

“Health equity is one of our priorities and a transversal principle in all the discussions we are promoting,” Brazilian Health Minister Trindade told the meeting.

 “From climate change and its impacts on health to the health workforce and the One Health approach, we need to tackle inequalities and protect our most vulnerable populations,” she said.

Trindade also stressed the importance of the “debt-to-health swap” instrument, which allows part of the debts to be converted into investments for the sector, but warned that such instruments should complement rather than replace the efforts to restructure debt.

 “There is consensus on the importance of maintaining a voluntary basis for participation in debt-for-health swaps and aligning them with larger international health and development financing structures to maximise their impact,” she explained.