Oral polio vaccine is administered to a one-day old child in Ethiopia.

The world’s leading polio eradication programme faces a 40% budget cut next year as the paralysis-causing virus surges in its last strongholds of Afghanistan and Pakistan and war-torn regions, threatening to reverse decades of progress toward eradicating the disease.

“The Global Polio Eradication Initiative is facing a 40% budget cut in 2026,” Dr Hanan Balkhy, regional director of the WHO’s Eastern Mediterranean Regional Office, told the World Health Assembly on Friday — the same body that launched the global eradication effort 36 years ago.

The convergence of funding cuts, conflict, and viral resurgence now threatens to unravel humanity’s near-victory over a virus that would become only the second human disease ever eradicated after smallpox.

Polio paralysed or killed over half a million people worldwide every year at its peak in the 1940s and 1950s, attacking the nervous system and causing irreversible paralysis within hours, primarily affecting children under five. 

Since the Global Polio Eradication Initiative launched in 1988 — co-led by WHO with Rotary International, the US CDC, UNICEF, the Gates Foundation, and Gavi, The Vaccine Alliance — cases have dropped by 99% worldwide.

“We are at a tipping point. Either we invest now to finish the job or risk a global resurgence,” Balkhy told the assembly. “We do not have the luxury of time.”

Funding crisis deepens

The 78th World Health Assembly in progress in Geneva.

GPEI’s funding problems were out in the open before the current budget crisis. Last October, the initiative admitted it needed more time and money to reach its eradication targets, pushing the deadline to 2027 for wild poliovirus and 2029 for vaccine-derived strains.

The original eradication target was 2000.

The initiative raised its budget request to $6.9 billion through 2029, up from an original $4.8 billion. So far, GPEI has received or secured pledges for $4.6 billion, nearly matching its original target. But with the increased costs, the WHO-led initiative now faces a funding gap of $2.3 billion through 2029.

The budget shortfall stems significantly from the withdrawal of the United States from the WHO, with both USAID and the US Centres for Disease Control (CDC) disengaging from GPEI.

“As 2024 began, we were on the verge of eradicating wild poliovirus in Afghanistan and Pakistan, the last two polio-endemic countries,” Balkhy told the WHO’s executive board in February. “But then came a resurgence, alongside outbreaks of variant poliovirus in Somalia, Sudan, Yemen and the Gaza Strip.”

WHO’s Emergency Committee unanimously agreed last month that “the risk of international spread of poliovirus continues to constitute a Public Health Emergency of International Concern,” the UN health body’s highest level of alarm.

The wealthy elephant

Annual donations to global polio eradication broken down by country, foundation and international bloc for 2023.

The elephant in the room at the World Health Assembly was the US departure from global health efforts — no delegate directly mentioned it by name during the polio discussions, marking the first time the United States has not attended the meeting.

But Balkhy was more direct at WHO’s February executive board meeting.

“The disengagement of CDC and USAID is costing us already with the loss of their technical, strategic and functional support,” she told the board.

“In financial terms, this means a loss of $133 million to the GPEI, and a loss of $100 million for WHO’s polio-specific operations each year,” Balkhy said, with reference to this current year, 2025.  

The US has been GPEI’s second-largest historical donor averaging 22.6% of total funding since 1988, contributing $4.5 billion over the programme’s lifetime, second only to the Bill and Melinda Gates Foundation at 40%.

In 2023, the US contributed about $264 million, or 20% of funding to polio eradication efforts, directly and indirectly. That included about $117 million of the GPEI’s own $907 million budget and another $148 million for US Centers for Disease control laboratory services as well as World Vision field support on the ground.  A USAID factsheet published in January noted the agency also had supported 2,396 health facilities employing over 10,000 female health workers in the world’s biggest polio hotspot, Afghanistan, in the past year alone.

The gap between the US and other government donors is vast: Canada, the next largest single-country donor, has contributed just 5.5% of the total funding, while Germany has given 3.6%. Canada, now the second-biggest state donor after the US withdrawal, contributes $62 million annually, less than a quarter of what the US provided. 

Some nations have pledged to step up support in the wake of the US departure. Saudi Arabia, which had not donated to the programme in nearly a decade, pledged $500 million to GPEI in February. Canada committed an additional $151 million over the next three years late last year. Yet the funding gap remains large.

The US was also a major player in the polio fight outside GPEI itself. GPEI fundraising documents show the US CDC’s polio efforts totalled $354 million in 2021 and 2022, while USAID contributed $140 million over the same period.

The sweeping US cuts to its humanitarian programmes also include a $131 million grant to UNICEF’s polio immunisation programme, which funded logistics, delivery, and transport to reach millions of children with vaccines.

“We remind member states that investing in polio eradication has saved more than 20 million people from paralysis, helped provide a range of vital health services for children and is an investment in global health security,” a UN Foundation delegate said.

Cases surge in polio final mountain strongholds

78th World Health Assembly Session in progress

Wild poliovirus spreads through contaminated water or food and can cause irreversible paralysis within hours, while vaccine-derived strains emerge when the weakened virus in oral vaccines mutates in areas with poor sanitation.

Afghanistan and Pakistan, the last two countries where wild poliovirus remains endemic, saw cases rise dramatically in 2024. Afghanistan recorded 23 cases last year, up 283% from 2023, while Pakistan saw 63 cases, a 550% increase.

Endemic transmission remains concentrated in high-risk districts along the Hindu Kush mountain range that forms the rugged border between Pakistan’s southern Khyber Pakhtunkhwa province and Afghanistan’s eastern region, where cross-border movement, militant activity and attacks on vaccination teams complicate immunisation efforts.

WHO figures show 99 wild poliovirus type 1 cases were reported in 2024, with three additional cases recorded in 2025 as of 10 April. Environmental surveillance — testing sewage and water sources for the virus — detected 741 positive samples in 2024 (113 in Afghanistan, 628 in Pakistan), with 80 more reported in the first weeks of 2025.

India, which shares a border with Pakistan, stressed the need for regional collaboration at the assembly. “Regionally, it is crucial to foster collaboration and share data, synchronise vaccination campaigns and work together to prevent the re-emergence of disease across borders,” India’s delegate said.

Vaccine hurdles

A young boy partially paralysed by polio meets a Canadian soldier in Kandahar, Afghanistan.

The virus persists despite massive vaccination efforts and international support. Achieving the 95% coverage needed for herd immunity remains elusive in endemic regions where every child needs multiple doses. Vast distances, insecurity, and deep-rooted distrust complicate an already difficult task.

Over 534,000 children are vaccinated monthly in Afghanistan alone, with 11.4 million vaccinated last year, according to the WHO. Yet Afghanistan’s Islamic Emirate paused the polio immunisation programme twice in 2024 and now restricts vaccine delivery to mosques and village centres only, ending door-to-door campaigns that are crucial for reaching every child.

In Pakistan, only 84% of eligible children received two doses of the injectable vaccine in 2023. More than half of the polio cases in Pakistan last year were in children who hadn’t received a single dose.

Vaccine hesitancy remains entrenched in parts of both countries, with some believing vaccines affect fertility or are part of a Western conspiracy — distrust earned after the CIA operated a fake vaccination campaign while searching for Osama bin Laden in 2011.

The funding cuts compound these challenges on the ground.

“Cuts in development assistance are threatening both eradication efforts and essential services at this point,” said Dr Jamal Ahmed, Director of WHO’s Polio Eradication Programme and Chair of the GPEI’s Strategy Committee. “The challenge we have faced last year and a few years ago, and was highlighted by our member state today, is the global supply of vaccine and vaccine security.”

Vaccine-derived variants spread

Female
healthworker administers polio vaccination in house-to-house campaign in Pakistan’s sensitive northwestern region.

Beyond the wild virus, vaccine-derived poliovirus variants have emerged in 35 countries across Africa, Asia and the Middle East, as well as Spain in 2024.

These strains can develop when the weakened virus used in oral polio vaccines mutates in areas with poor sanitation and low vaccination coverage, regaining the ability to cause paralysis. Wealthier nations have shifted to inactivated polio vaccines, which are only effective at extremely high uptake rates and when polio is nearly eradicated.

Vaccine-derived variants were detected in Cameroon, Djibouti, Gaza, French Guiana, Ghana, Spain and Zimbabwe, WHO data shows. The United States reported 31 cases in 2022 — its first in a decade.

GAVI, the vaccine alliance, expressed concern about polio’s re-emergence in previously cleared areas.

“To achieve and maintain a world free of poliovirus, we must prioritise scaling up routine immunisation and reaching the under- and unvaccinated children worldwide,” GAVI’s representative told the assembly.

Conflicts drive resurgence

A doctor gives oral polio vaccine to children in Gaza. Vaccination rates in the territory have plummeted amid the war.

War and humanitarian crises create ideal conditions for polio’s spread as health systems collapse, vaccination campaigns halt, and populations flee their homes. Overcrowded displacement camps with poor sanitation allow the virus to circulate rapidly among unvaccinated children.

In Yemen, which had been polio-free since 2009, an outbreak of circulating vaccine-derived poliovirus emerged in 2020 amid civil war that has killed over 150,000 people, UN estimates show, with additional estimates of more than 227,000 dead from famine and lack of healthcare facilities due to the war.

“Cases of polio have reduced in the south of Yemen. Unfortunately, we still see cases recorded in the north of the country, in regions which are outside of the control of the legitimate authorities,” a Yemeni delegate told the assembly.

Gaza has faced similar challenges. While a February ceasefire allowed WHO to vaccinate 46,000 children, the campaign has since stalled. “Intensified attacks, a blockade of aid, and communities deprived of water, food and medicines… [we] have suspended the fourth vaccination round,” Balkhy said.

Sudan’s civil war, which has displaced millions and destroyed health infrastructure, has also seen vaccine-derived polio cases emerge as routine immunisation collapses.

“Because of the war and the financial constraints we are having … we are calling upon countries to show solidarity,” Sudan’s delegate said. “Help us in order to ensure surveillance and the protection of frontline officers and workers.” 

As war zones open new frontlines in the polio fight, whether the international community can mobilise the $2.3 billion needed to finish the job will determine the fate of global eradication efforts that have spanned nearly four decades.

Image Credits: UNICEF Ethiopia/Mulugeta Ayene 2018, WHO, CC, Pakistan Polio Eradication Program , Global Polio Eradication Initiative.

Saturday’s WHA session saw the approval of multiple resolutions, including new measures on health finance, rare disease and skin diseases.

The 78th World Health Assembly picked up momentum Saturday as countries adopted a Nigeria-sponsored initiative to stimulate more public health spending; and  first-ever WHO resolutions recognizing rare diseases and neglected skin diseases as global equity issues.

The resolution on strengthening health finance globally aims to accelerate progress towards long standing commitments on financing Universal Health Coverage. 

It echos a 2019 UN General Assembly appeal to governments to allocate “an additional 1% of gross domestic product or more for primary healthcare.” 

And it highlights potential fiscal levers that could raise more revenues for healthcare, such as “introducing and increasing taxes on tobacco, sugar and alcohol…  that reduces risk factors for noncommunicable diseases.”

Member states also are encouraged “to focus domestic resources on an affordable package of essential health benefits, based on evidence and developed through inclusive and transparent processes supported by health technology assessment.” 

The resolution is also noteworthy because it was initiated by Nigeria, Africa’s most populous nation. 

Countries’ commitments to finance UHC are way off track   

From 2020-2022, domestic public health expenditure (blue line) stagnated or declined while out of pocket spending (red line) grew fastest in the poorest countries, with donor funding filling in the gaps. Ke Xu, WHO health economist, presents latest data in December 2024.

Citing findings from the WHO’s 2023 Global Monitoring Report, the resolution notes that “the world is off track in making meaningful progress towards universal health coverage and alignment with the Sustainable Development Goal indicators  by 2030.”

According to the draft resolution, almost two billion people globally continue to face financial hardship from health expenditures, and over 340 million are being pushed or further pushed into extreme poverty due to out-of-pocket spending. “One billion people globally [are] spending more than 10% of their household budgets on healthcare,” the resolution states, noting the urgency for reforms.

While there was a 60% increase overall in per-capita health expenditures between 2000 and 2022 –  in low income countries this was largely driven by a sharp rise in out-of-pocket spending (OOP), a December 2024 WHO report on public health expenditures found. 

The spending outlays fall far below the longstanding commitments of the 2001 Abuja Declaration, in which member states pledged to set aside at least 15% of their national budget for the health sector. 

Over the last two decades, donor outlays made up for the stagnation in domestic spending on public health systems in the poorest countries, according to the December 2024 WHO report – but now that support has been cut drastically, due largely to the massive US reductions in global health outlays.

WHA Resolution urges member states to improve social protection 

Examining a pregnant woman. In the lowest income countries, out of pocket costs for basic procedures have soared since 2020.

The new WHA resolution urges member states to “tackle the causes of poor financial protection and improve access to healthcare services without financial hardship.” 

It emphasizes the importance of prioritizing public financing for health systems, encouraging governments to focus on “government revenue as the primary source of financing,” and recommends reducing fragmentation through “pooling of government funds, including revenue from direct and indirect taxes and levies, where applicable.”

Finally, the resolution also encourages global health initiatives, donors, and financial institutions “to finance domestic priorities with consideration of favourable terms, aligned with country planning, budgetary processes, monitoring and evaluation cycles,” and calls for improved transparency and reporting through systems such as national health accounts.

The resolution requests WHO “to prepare reports on health expenditures and the state of global health financing to be presented in 2026, 2028 and 2030” and to “provide support for improvement in the quality and availability of data and in the timeliness and transparency of tracking domestic and external financing flows.”

In the light of WHO budget cuts, that’s a politically significant request in that it should help preserve WHO’s work tracking public health spending by countries and regions. See related story. 

Public Health Spending in Low Income Countries Stagnates – Out of Pocket Costs Soar 

To support country-level reform, the Director-General is also asked to support member states in “the development of prioritized national health financing road maps to mobilize technical assistance and financial resources.” 

Strong support from member states 

The resolution, initiated by Nigeria, had strong support from Member States, with several highlighting national efforts to scale up domestic financing.

 Zimbabwe reaffirmed its commitment to sustainable health investments, announcing plans for a “proposed national health insurance scheme to ensure sustainable and equitable health.” This aligns with the resolution’s call for countries to reduce reliance on out-of-pocket expenditure and prioritize pooled, public funding for healthcare.

Public Services International, representing global public sector workers, called on Member States “to walk the talk of adequate public funding,” warning that the increased privatization of healthcare “undermines the essence of UHC.” They urged debt cancellation for developing countries to free up fiscal space for primary healthcare investment, and emphasized the importance of treating health workers with fairness and dignity—echoing the resolution’s provisions on workforce protection.

The International Federation of Medical Students Associations also backed the resolution, calling it a timely response to growing inequities. They advocated for “sustainable public health financing to reduce out-of-pocket costs” and emphasized that health system reforms must be “grounded in equity and people-centered primary healthcare.”

Ailan Li, Assistant Director-General for Universal Health Coverage at WHO, reaffirmed WHO’s commitment to supporting countries in implementing the resolution’s recommendations, noting that financing reform “is at the core of our work as we go forward.” .

First rare diseases resolution also approved

Incentives for R&D into new ‘orphan drugs’ for rare diseases are few – due to the comparatively low numbers of people affected.

During the session, Member States also unanimously adopted the resolution Rare diseases: a global health priority for equity and inclusion, the first of its kind within the WHO framework. 

A rare disease is described as a specific health condition affecting fewer than 1 in 2000 individuals in [the] general population, according to the resolution, which places rare diseases firmly within the global UHC and equity agenda.

Over 300 million people globally are living with one of more than 7,000 known rare diseases, many of which are chronic, disabling, and often undiagnosed or misdiagnosed, the resolution notes. 

Li called the measure a “landmark”. 

“These are complex issues to manage, they are expensive issues to manage, and that is the reason that we brought it into [WHO’s] GPW 14, with the support of so many member states and partners,” she said. She confirmed that WHO would proceed with the development of a 10-year global action plan, to be presented at  the World Health Assembly in 2028.

Beyond policy symbolism, the resolution outlines tangible action points: it urges countries to integrate rare diseases into national health strategies, improve access to diagnosis and treatment, and develop registries and data systems. It also emphasizes social inclusion, noting that individuals with rare diseases often face “stigmatization, social exclusion, and limited access to essential services.”

The adoption of the resolution was widely praised by civil society and health organizations advocating for rare disease patients. Delegates welcomed WHO’s commitment to ensure that “persons living with a rare disease… receive timely and appropriate healthcare services,” including through improved diagnostics, workforce training, and dedicated research efforts.

Strengthening medical imaging capacity and tackling skin diseases  

Over 600 million people are at risk of visceral leishmaniasis,transmitted by sandflies, which affects the spleen and liver, and is almost always fatal if untreated. After treatment, patients can also be stricken with a dermal form of the parasitic disease.

In other actions Saturday, the Assembly approved several more resolutions on:  strengthening medical imaging capacity; bolstering national uptake of norms and standards (EB 156/17 and EB156/14); raising the profile of skin diseases as a global health priority (EB156/24). It also endorsed a strategy for accelerating the eradication (Guinea Worm Disease) dracunculiasis (EB156/23) and reviewed progress on the 202o roadmap for accelerating the elimination of meningitis by 2030 (A78/4).  

“Over 10% of skin diseases are NTDs which disproportionately impact underserved communities in LMICs and cause physical, mental and social harm, yet diagnosis is limited and many treatments are outdated or toxic,” noted a representative of the Drugs for Neglected Diseases Initiative. 

Cutaneous leishmaniasis is a milder form of the disease, also common in the Middle East and parts of North Africa as well as Latin America.

“We support the resolution’s focus on R&D and access to health tools, but commercial R&D systems continue to neglect skin NTDs. Governments must drive innovation through collaborative models that prioritize patient needs and build local capacity, domestic leadership and regional collaboration is key.

“The recent Memorandum of Understanding signed this week by six African countries on visceral leishmaniasis elimination demonstrates the power of coordinated cross border efforts. National political commitment is vital through integrating skin NTDs into health plans, resource allocation and training frontline healthcare workers to improve early detection and care.”

See related story here: 

https://healthpolicy-watch.news/cross-border-collaboration-gains-political-traction-as-africa-targets-visceral-leishmaniasis-elimination/

Image Credits: Abanima at the Arabic language Wikipedia, CC BY-SA 3.0, , Twitter: @WHOAFRO, WHO, DNDi.

Kindness misdirected: an isolated older person single-handedly sustaining a pigeon colony.

In a rare moment for the World Health Assembly, delegates expanded their debates beyond the usual lexicon of disease pathogens to address something far more intimate: loneliness. 

The Assembly approved a first-ever resolution on Fostering social connection for global health:  the essential role of social connection in combating loneliness, social isolation and inequities in health, which aims to put the issue of social connection more squarely on the global health agenda – not as an afterthought or adjunct to mental health policy, but as a standalone priority. 

Co-sponsored by Spain and Chile, the measure calls attention to the growing global crisis of loneliness and social isolation, which are impacting health the world over, and significantly increasing the risk of conditions like cardiovascular disease, depression, and dementia. It urges member states to integrate strategies that foster meaningful social connections into national health policies, strengthen data collection, and promote public awareness. 

The resolution also highlights the disproportionate impact of social disconnection on vulnerable populations and the need for inclusive, cross-sectoral efforts—including digital technologies—to build more connected and resilient communities.

Approved by WHA delegates with very broad backing, the resolution frames social disconnection not just as a symptom of modern life, but as a concrete driver of physical and mental distress and illness.

Increasing risk of dementia, stroke and CVD 

Assistant Director Ailan Li: first time social connection is formally considered by the Assembly.

“Today marks the first time social connection has been formally considered at the WHA,” said Ailan Li, Assistant Director-General for Universal Health Coverage, Healthier Populations at the WHO, the division responsible for mental health. “This marks a crucial step in reframing how we understand mental and social wellbeing as central to health systems.”

For the WHO, the recognition of social connection is strategic. COVID-19 laid bare the consequences of disconnection. Following the pandemic, countries from the United Kingdom and Kenya began to address loneliness as a health risk factor, one that leads to more illness, worsens health outcomes and thus inflates health system costs.

“Social isolation and loneliness increase the risk of dementia, stroke, cardiovascular disease and premature death,” noted Saima Wazed, WHO’s Regional Director for Southeast Asia. “Until recently, these were largely overlooked. We are heartened [that] this is now changing.”

Beyond the pandemic, a range of long term trends have fostered social isolation, a report by the Director General notes, including: the sustained popularity of remote work and social media; the decline of extended family structures and the rise of single-occupancy households; increased motorized mobility that reduces street interactions; and a decline in religious practices in many countries.

Connecting people on streets, in schools and workplaces

Central Park, New York City: Well-designed outdoor spaces can foster chance encounters and more social connectivity, even in large cities.

Effectively, the resolution calls on governments to integrate policies that promote social inclusion, through a wide range of approaches. For instance, urban planning strategies can foster   more community and street interactions; education and workplace reforms can also support more social connectivity, as well as community mental health services that are accessible before problems become too severe.

The resolution urges WHO to provide technical assistance, coordinate research and develop guidelines for member states.

Conflict, displacement and natural disaster also tear apart social networks

Burkina Faso’s delegate highlighted the mental fallout of terrorism and displacement.

Delegates from Burkina Faso, Palestine, Vanuatu and others detailed how conflict, displacement and natural disasters also tear at the fabric of social networks, leaving people vulnerable to mental illness and neglect.

“Millions in Palestine are in need of mental health care and support,” said Palestine’s delegate, referring to the conflict in Gaza where the trauma of conflict, injury and death has been accompanied by the repeated forced displacement of communities and families, tearing social networks apart. 

The delegate from Burkina Faso highlighted the mental health fallout of terrorism and displacement, while Haiti cited the psychological strain caused by the current atmosphere of political instability, gang violence, and related displacement, not to mention the legacy of natural disasters like the 2010 earthquake. Vanuatu’s delegate connected social isolation to climate-related challenges like sea-level rise and loss of cultural sites. 

Thai happiness scale and other social experimentation

Social media has also reduced physical interactions in many settings, leading to more social isolation among young people.

Social disconnection isn’t just a problem in low-income or war-torn countries. The UK delegate described how the country launched a loneliness strategy in 2018.

Elsewhere, countries pointed to policy experimentation. Ireland described its media campaign targeting loneliness in older adults. Japan outlined its new national plan to counter isolation, including creating more spaces that foster community interaction and making it easier for people to seek support. Australia shared details of a national wellbeing framework that tracks indicators such as social connection. The delegate from Thailand, which has ranked seventh on a global happiness index, told the committee that the country has introduced a national “Happiness Scale,” which it plans to integrate into its national health surveys.

In Mexico, officials mentioned the ongoing integration of social health services with primary care and involving community structures to build social resilience. Kenya said it has launched workplace wellness policies and peer support networks, while Uruguay is collecting loneliness data to guide targeted interventions.

Youth delegates from Germany, Lithuania, Estonia and beyond also highlighted the need for the right policies for the young demographics. 

“We cannot expect children and youth to tackle addictive technologies on their own,” said Slovenia’s youth delegate. “We need policy changes that protect real-world social bonds.” This echoed the session’s focus on growing concerns that digital dependence is reshaping human interaction, especially among the young. Delegates noted that screen time, remote work, and social media algorithms may be increasing feelings of isolation.

Estonia’s youth delegate: calling for targeted policies on social media addiction and dependence.

Measuring a quiet emergency 

There was also a debate on how to measure what is often invisible. Countries called for better data collection tools and evidence-based policy guidelines. Some warned that without concrete indicators, efforts risk drifting into well-meaning rhetoric. “Measuring loneliness is not as straightforward as counting hospital beds or immunization rates,” said one delegate. “But we have to start somewhere.” 

WHO’s new Commission on Social Connection, formed in 2024, has a three-year mandate to study the issue and support national strategies. Its goals include building a global evidence base and creating practical toolkits for governments.

Meanwhile, some countries are embedding social connection into universal health coverage plans. Others are tying it to climate resilience, school health, or anti-poverty programs. Brazil emphasized the importance of recognizing inequalities in how loneliness is experienced, noting that marginalized populations such as incarcerated individuals, indigenous communities, and elderly women often face the highest risks.

 “Loneliness is not experienced the same way by all. Inequality determines who suffers most,” Brazil’s delegate said

Shared struggle 

Young people meet up in a park in Stepanakert, Nagorno-Karabakh, a region that saw fierce fighting in 2023, when Azerbaijan reconquered the region from a breakaway Armenia government.

Rich or poor, during peace and in times of war, what the WHA session highlighted is that social isolation is a shared struggle — and potentially a unifying one. 

And the WHA resolution is only a starting point. Implementing it requires political will, funding, and cross-sector partnerships.

While the Assembly may have elevated the conversation, delegates noted that the work ahead lies in city councils, health ministries and local communities. There is also the reality that social connection policies will have to compete for funding with traditional health priorities.

Member States also raised the issue of stigma, both around mental health and around admitting to loneliness. Several delegates advocated for public awareness campaigns to normalize conversations about social wellbeing. Others suggested that policies like “social prescriptions” where doctors refer patients to community activities, could help bridge the gap between clinical care and social engagement.

Looking ahead, some countries signaled plans to pilot new programs, drawing on lessons from the WHA session. The Philippines, for example, highlighted its integration of psychosocial support in emergency response. India mentioned its Elderline initiative, which offers social and mental support to older citizens. 

Going forward, a formal WHO report is expected in the coming year. Meanwhile, civil society organizations called for governments to involve communities in designing programs that promote connection.

“Social connection is everyone’s business,” said Li, echoing the concerns raised by youth leaders. “And the need for teachers, employers, faith leaders, and urban planners to take this seriously.”

Image Credits: Brett L/Flickr, licensed under CC BY-SA 2.0., Sergio Calleja/Flickr , Wikimedia/Pizzalover6, Adam Jones/Flickr.

Member states discussing NCDs in the World Health Assembly’s Committee A

“This is the most important year in the history of non-communicable diseases (NCDs),” declared Richard Horton, editor of The Lancet, at the World Heart Federation’s (WHF) 2025 Summit on the eve of the World Health Assembly (WHA).

ON 25 September, the United Nations (UN) hosts the Fourth High-Level Meeting (HLM) on NCDs and mental health. The world’s biggest killer is a major focus of this week’s World Health Assembly, as WHO, member states and civil society gear up for the September event.  In the lead-up, the WHA also approved new initiatives promoting the better integration of kidney healthlung health, as well as vision impairment and hearing loss into primary healthcare systems. 

But industry interference, lack of funds and poor policies and enforcement at country level remain critical obstacles in the pathway to raising the level of ambition for the High Level Meeting – and effectively reducing NCDs. To date, only 19 countries are on track to meet the global target of reducing NCDs by a third by 2030.

Out of the 19 countries on track, 10 are European nations, as well as high-income New Zealand, Singapore, and South Korea.

“Progress has stalled since 2015,”  a spokesperson for NCD Alliance (NCDA) told the WHA’s Committee A on Friday. “This stagnation is not due to a lack of evidence, but as a result of under-investment in health systems and health-harming industry interference.”

UN’s ‘zero draft’ declaration

The UN High Level Meeting on NCDs will take place on September 25, on the margins of the General Assembly meeting in New York City.

The Zero Draft of the HLM’s political declaration focuses on three key priorities: tobacco control, hypertension and improving mental health care. It proposes global targets of: 150 million fewer people using tobacco, 150 million more people controlling their hypertension and 150 million more people having access to mental health care by 2030.

NCDA CEO Katie Dain said that the positives of the draft are concrete targets, situating health as part of the broader development nexus and elevating mental health issues, as well.

The draft advocates for countries to impose excise taxes on tobacco, alcohol, and sugar-sweetened drinks at levels recommended by the World Health Organization (WHO) to help achieve this – a policy that is gaining more global traction now in light of the drastic funding cuts for global health.

Taxes on unhealthy foods and sugary sweetened beverages (SSBs), by country as of June 2024.

The NCDA and other civil society groups have been advocating for such taxes for several years as they offer a” triple win of raising revenue, reducing consumption of unhealthy products, and so reducing health costs”, said Alison Cox, the alliance’s director of policy and advocacy.

The NCDA also wants a tax on ultra-processed food high in fat, salt, and sugar and  “corrective taxes on fossil fuels” – as well as “subsidy reforms that support access to healthy, sustainable diets and clean energy sources”, according to its response to the zero draft.

Taxes – and bribes

Dr Viroj Tangcharoensathien (left), Dr Tom Frieden,  World Heart Federation (WHF) president Dr Jagat Narula, Nupur Lalvani and NCD Alliance CEO Katie Dain address the World Heart Federation Summit Sunday, 18 May, on the eve of the World Health Assembly.

While many see taxes as a panacea, Dr Viroj Tangcharoensathien of the International Health Policy Program in Thailand, warned that poor governance in some low- and middle-income countries (LMICs) has enabled harmful industries to bribe officials to undermine taxes.

Around 42% of high income countries have met the 75% tobacco tax rate recommended by WHO, in comparison to only 12% in LMICs and 3% in low–income countries, he told the WHF summit.

Dr Tom Frieden, a former director of the US Centers for Disease Control, who now heads Resolve to Save Lives, told the summit that “only 13% of people live in countries where there’s adequate tobacco taxation.”

Frieden added that issues undermining effective NCD taxes include “bribes from the killer industries to the people who make decisions; payment of farmers to go grow tobacco when it’s not economically viable but they want the tobacco farmer lobby in the country; payment to ‘astroturf groups’ in country to lobby [and] payment to news entities to cover taxation as if it’s a form of extortion.” 

Climate and NCDs: deepening links and demands for WHO support

A fire in a favela in Brazil

Over the past week at the WHA, WHO member states have described both their NCD problems, how they are addressing them, and the help they need – with the underlying lament being the lack of resources.

Several countries spoke about climate-related issues that are both exacerbating the NCD burden as well as hampering access to treatment – in extreme weather scenarios for instance. 

Three-quarters of deaths in countries in WHO’s Western Pacific region are from NCDs, but “the adverse effects of climate change, frequent natural disasters and other competing priorities have impeded progress on all aspects of NCD prevention and control”, Samoa told the WHA, speaking for the region’s nations.

Assistance for Small Island Developing States (SIDS) in the Pacific and other regions, needs to address “the environment-nutrition nexus”, added Samoa.

Notably, a new WHO draft action plan on Climate Change and Health is up for consideration by member states at this WHA session.

Despite the huge demand from many low- and middle-income member states for WHO support to address burgeoning climate-related health impacts, a final debate on the new WHO action plan was delayed until Monday, after a major oil producing state started to raise last minute objections, Health Policy Watch, has learned.  

Sight, hearing, kidney and lung health

Construction worker in Texas, where the state governor in 2023, order the cancellation of municipal rules in Austin and Dallas mandating water breaks for outdoor workers.

On Friday, the WHA also approved three resolutions that aim to: improve the detection of vision impairment and hearing loss at primary healthcare leavel, as well as ensuring better integration of kidney health and lung health prevention, diagnosis and treatment into PHC.

Member states also supported 17 November being observed as World Cervical Cancer Elimination Day to increase global awareness of the only cancer that can be prevented by a vaccine.

Around 9% of the global population lives with kidney disease, one of the fastest-growing causes of death globally that is projected to become the fifth leading cause of death by 2050, according to the WHO, WHA delegates also noted in the debate. 

That issue, as well, is closely associated with climate change in largely unrecognized ways. Namely, outdoor workers’ exposures to rising temperatures exacerbates risks of dehydration and heat stress, which over time, can lead to kidney failure. 

The problem of growing heat stress is worldwide – including high-income countries such as the USA, where the state of Texas, in 2023, cancelled rules requiring outdoor workers to get regular water breaks.

Concerns about kidney failure among outdoor workers returning home from Gulf countries have also gained traction, as per a 2022 report by the Vital Signs Project, by a coalition of NGOs in Nepal, the Philippines, Bangladesh and the United Kingdom, which aim to raise awareness about migrant worker deaths in BahrainKuwaitOmanQatarSaudi Arabia and the UAE

Air pollution a major driver of NCDs

Related to that, air pollution is also one of the world’s biggest drivers of NCDs, including heart disease and high blood pressure as well as  chronic lung disease and lung cancers. And yet it has remained a kind of “orphan” issue in the NCD agenda, with no target for reducing harmful air pollution exposures proposed in this year’s High Level Draft Declaration either.

In fact, more than half of the 7 milllion deaths from air pollution are in fact due to cardiovascular diseases, namely heart disease and stroke, according to a World Heart Federation analysis released during last year’s World Health Assembly.  Already, cardiovascular disease is the world’s top killer, claiming more than 20 million lives each year.

And “this will only get worse” over the next 15 years, warned the World Bank’s Helena Naber at a clean air event in Geneva on Friday, reporting on the results of a new Bank analysis.

Air pollution darkens ski in Delhi during a November 2024 seasonal emergency.

“Even if countries successfully implement all their energy climate and air pollution control policies and measures that are announced or planned now over the next 15 years, by 2040 we will still see a rise of 21% in the number of people who are exposed to pm 2.5 levels above [the WHO guideline] of five micrograms per cubic meter, and this will be due to combined effects of population growth and economic expansion – and as a percent increase, the highest will be in Sub-Saharan Africa.”

While the ballooning array of NCDs is a challenge, even for the most advanced countries, for low and middle income countries, the combined effects of dirty air, unhealthy foods, alcohol and tobacco are even more devastating in low and middle income countries that lack the health system resources to cope.  

Meanwhile, low-income countries such as Cameroon told the WHA that the increase in NCDs, particularly diabetes, has come with “exorbitant costs and unequal access to innovative technology, medication and treatment”. 

Ambitions for the UN High-Level Meeting

Unhealthy and ultraprocessed foods are adding to NCD risks in developing countries.

Poland, representing the European Union, told the WHA it wants “an ambitious, human rights and evidence-based political declaration” at the HLM to reverse the lack of progress on NCDs.

“We call for a comprehensive approach to NCDs and mental health across the life course. This includes health promotion, prevention, early detection, diagnosis, treatment, rehabilitation and palliative care,” said Poland.

Denmark, representing the Scandinavian countries, Iceland, Estonia, Lithuania and Latvia, expressed three ambitions for the HLM declaration: that it strengthens prevention and health promotion; addresses risk factors behind NCDs and poor mental health, including tobacco, nicotine products, alcohol and unhealthy foods; and protects people in vulnerable situations. 

In this regard, it wants children and adolescents protected “from harmful digital exposure and irresponsible marketing of alcohol, tobacco, nicotine and unhealthy foods”.

Women take part in a programme to prevent NCDs by promoting healthy diets in Tulagi, Solomon Islands.

Portugal called for “reshaping” where people live and make decisions. “Healthier food systems, active mobility and protection from harmful exposures must become the norm. This requires active engagement, not just of health ministries, but also education, urban planning, transport and the private sector,” Portugal told the WHA.

Australia acknowledged the complexities: “NCDs must be addressed by tackling the wider determinants of health,” but “the risk factors are complex, interconnected and extend far beyond individual health behaviours.”

Addressing the WHA on Friday, the World Heart Federation appealed for more ambitious targets to address cardiovascular disease, including “targeted action to treat 500 million more people with hypertension by 2030 and for 50% global hypertension control by 2030; at least 50% excise tax on tobacco, alcohol and sugar sweetened beverages, and the adoption of WHO air quality guidelines”.

The World Heart Federation speaker appeals for more ambitious targets to end NCDs in the UN political declaration.

A range of other non-state actors addressing the WHA called for an end to “siloed approaches to NCDs” – although they, too, are organised in silos.

NCDA CEO Katie Dain told the WHF summit that the HLM needs to “be about implementation of what works, investment and financing, particularly with a strong call for health taxes, and integration of NCDs” into PHC and universal health coverage.

But the challenges are enormous, particularly in light of dwindling finances. 

“It is only during a crisis that you can make disruptive change,” said Gavi CEO Sania Nishtar. “This crisis [of unprecedented financial disruption] is a moment for us to revisit the duplications, the fragmentation, the mission creep that crept into the system over time.

“We need a ‘one-window’ [health] system” for a woman who comes to a primary health care facility via public transport and needs her contraceptive, child immunisation and NCD needs addressed all at once, Nishtar told the WHF summit.

-Elaine Ruth Fletcher contributed reporting to this story.

Image Credits: Sven Petersen/Flickr, WHO, United Nations , WHO, Denys Argyriou/ Unsplash, Josh Olalde/ Unsplash, Chetan Bhattacharji, WHO / Blink Media, Neil Nuia.

WHO Director General Dr Tedros Adhanom Ghebreyesus appeals to Israel to open the aid gates.

WHO’s Director General Dr Tedros Adhanom Ghebreyesus made an emotional appeal to Israel on Thursday to end its 80-day blockade of food, medicine and other humanitarian aid into Gaza, asking “if you can have mercy?” and adding: “the war is hurting Israel, and it will not bring a lasting solution.” 

Fighting back tears, the Director General said, “People are starving; 81% of Gazans are under constant displacement orders, and the hospitals are on their knees.

“I can feel how people in Gaza would feel. I can visualize it. I can hear the sounds.. It’s really wrong to weaponize food, to weaponize medical supplies,” said the DG, noting he also suffers from PTSD due to his experiences in war-torn Ethiopia as a child.   

Gaza in mid-April: displacement and malnutrition

“A call for peace is in the best interest of Israel itself. The war is hurting Israel, and it will not bring a lasting solution. So I ask again…I ask if you can have mercy. It’s good for you, and good for the Palestinians and good for humanity,” Tedros said.

“And while saying this, I understand the situation in which the hostages are living,” he added,  referring to his own past meetings with released Israeli hostages.  “But I would still say that the ball is in Israel’s court, and I would expect more from Israel to contribute to lasting peace.”

Tedros was speaking at the end of the second day of bitter World Health Assembly debates over two WHA measures decrying health conditions in the “Israeli-occupied Palestinian territory,” with most of the focus on Gaza. 

Thursday’s resolution, essentially an updated version of a 2023 measure denouncing the devasting impacts on Palestinians of a war that began 7 October with a bloody  Hamas incursion into Israel, was approved by a vote of 114-2, with 55 WHA delegates absent or abstaining.  On Wednesday, another China and Egypt-backed decision on “health conditions in the occupied Palestinian territory and occupied Syrian Golan’, passed with a majority of 104-4, after several hours of debate. 

100 trucks of flour and food awaiting final permission to cross into Gaza  

Louise Wateridge, UN aid worker at a warehouse in Amman this week, stocked with supplies waiting for Israeli approval to enter Gaza.

Even as Thursday’s vote was taking place, there were signs that the Israeli blockade may finally be lifting. While only a handful of trucks  entered Gaza over the past few days, nearly 100 trucks filled with flour and other vital supplies were poised to enter Gaza Thursday evening, WHO officials reported, after having crossed the first set of Israeli controls at its Kerem Shalom passage. 

But both WHO delegates as well as UN humanitarian agencies remain nervous about how fast the aid may really move, as well as Israel’s declared plan to start delivering food and medicine directly, through a private United States contractor – sometime in the near future. 

Speaking of the private aid plan on Wednesday, WHO’s head of Health Emergencies Mike Ryan, said cautiously,  “We will work with any mechanism that works.”

But during the two-month ceasefire from January-March, some 25,000 trucks entered Gaza, coordinated by the UN agencies while “other mechanisms, especially those using private subcontractors, have proven themselves to be utterly ineffective and sometimes laughable,” Ryan pointed out. He was referring to a US-engineered plan to deliver aid via the sea in the early phases of the war, before the pontoon bridge delivery system sunk off of the coast of Gaza. 

Half a million Gazans on verge of starvation

WHO Health Emergencies Executive Director Mike Ryan – half a million Gazans could die from hunger.

Ryan also stressed the urgency of the situation, after more than 80 day blockade, and a situation of famine, or near famine, rated as IPC4-5 hunger crisis, throughout Gaza as per the latest reported of the UN Integrated Food Security Phase Classification (IPC).

“Half a million Palestinians are currently in Gaza classified as IPC 5. Do you know what IPC five means? It means they will die immediately, unless they receive food and assistance. Now there’s a statistic for you. Go away and think about that,” the veteran WHO emergencies director declared. 

“Israel must live up to and respect its obligations, and should stop using forced starvation against innocent Palestinian civilians,” said Ibrahim Khraishi, Palestine’s Ambassador to the UN in Geneva, at Thursday’s debate.

Ibrahim Khraishi, Palestinian Ambassador in Geneva

Along with the aid blockade, criticism is mounting even among Israel’s staunchest allies over not only the blockade but the expanded assault on Hamas that has shaken Gaza over the past several weeks. WHO and other aid agencies have reported on the repeated forced location of thousands of civilians; shrinking humanitarian spaces; more schools and hospitals shelled, shuttered, or in the line of attack; and dozens of casualties daily, including women and children.  Nearly 53,000 Gaza Palestinians have reportedly been killed since the start of the war, while around 1,700 Israelis have died in the hostilities. 

Member states denounce Israel’s blockade of humanitarian aid in Gaza 

United Kingdom recalls Monday’s joint British, French and Canadian statement on Gaza

On Monday, France, the United Kingdom and Canada issued a stiff warning to Israel on Monday over the deteriorating situation.

 “As my Prime Minister made clear earlier this week in his joint statement with President Macron and Prime Minister Carney, the military escalation in Gaza is wholly disproportionate,” said the United Kingdom’s delegate to the WHA on Thursday. 

“We acknowledge indications of a limited restart of aid, but Israel has blocked humanitarian aid entering Gaza for over two months, food, medicine, essential supplies are exhausted,” the delegate said, while also offering “heartfelt condolences, to Israel over the shooting deaths Wednesday evening of two Embassy employees in Washington DC by an attacker shouting “Free Palestine”. 

“As Mike Ryan said so eloquently …. the population now faces starvation. Gaza’s people must receive the aid they need. Humanitarian principles matter…  We urge Israel to allow a full resumption of aid into Gaza immediately, and to enable the work of the UN and other humanitarian agencies to save lives now,” the UK said.

IPC assessment for Gaza – deep red crosses indicate Phase 5 famine risk, affecting nearly half a million of Gaza’s 2 million Palestinians.0

As for Israel’s recently-announced plan to put in place its own mechanism for delivering humanitarian aid with the support of a US-contractor, France and other delegates, described the plans as “inadequate”, calling on Israel to allow UN agencies to resume their work. 

“An immediate return to the cease fire is essential, including release of all of the hostages and a permanent end to hostilities,” said Poland, in a statement on behalf of the European Union, on Thursday. 

“The EU is deeply concerned about recurring accidents resulting in the death of humanitarian aid workers in Gaza, and calls for accountability, unimpeded humanitarian aid access and distribution, as well as the supply of electricity to Gaza must be resumed immediately

The EU statement also “deplored the refusal of Hamas to hand over the remaining hostages,” saying it was time to “break the cycle of violence, and move toward a two-state solution, with Israelis and Palestinians living side by side in peace and security.” 

Iran opposes reference to hostage release; Israel opposes duplicating debates  

Iran rejects call for Hamas release of Israeli hostages in WHA measure approved Wednesday.

In Thursday’s vote, Hungary was the only member state along with Israel to oppose the resolution. But some countries that supported the two measures also expressed reservations over the lack of language holding Hamas accountable for its part in perpetuating the cycle of violence. Thursday’s resolution also contained no reference at all to the 58 Israeli hostages who remain under Hamas control – only 24 of whom may still be alive, the Netherlands noted.  

“We would have liked to see a call for the release of hostages and the condemnation of the appalling violence by Hamas that took place during the during and after the attacks on October 7,” said the Netherlands” delegate.   

On the other side side of the divide, Iran and a handful of allies disassociated their countries from from a reference in Wednesday’s measure calling for  “the immediate and unconditional release of all hostages held in Gaza, including children, women and older persons.”

The same paragraph also called for the “unconditional release of all Palestinian persons arbitrarily detained in Israel and victims of enforced disappearance and immediate humanitarian access to hostages and detainees in line with the International Law (PP26);”

“Iran strongly objects to the immediate and unconditional release of the hostages held in Gaza..and formally disassociates from this part of the paragraph,” the Islamic Republic delegate said.  

Israel’s Ambassador Daniel Meron, meanwhile, protested Thursday’s debate over Gaza as duplicating the hours long session on Wednesday –   highlighting what he described as a waste of resources for the budget-strapped UN health agency. 

Israel’s Ambassador in Geneva, Daniel Meron

“This decision here calls on the DG to report on the health situation in Gaza to three different bodies on four different occasions over the course of one year,” Meron said.

“Israel has never objected to the support program for the Palestinian population. However, we oppose politicizing health during these crucial times for this organization, one would expect to see words put to action when speaking about duplication, overlap and redundancy, poor allocation of resources and time.”

Ukraine debate also a focus on Thursday 

WHA votes on a resolution on the war in Ukraine

Along with the two measures regarding Gaza and Palestine, a third debate on the brutal war ongoing in Ukraine took up much of the remaining time of WHA delegates on Thursday. 

The decision on “the health emergency in Ukraine and refugee-receiving and hosting countries stemming from the Russian Federation’s aggression,” finally passed by a majority of 59-10 – but with 63 abstentions while 56 member states were absent from the vote altogether. 

An initiative by Belarus, Russia, China and Nicaragua to fold the Ukraine issue into the general WHO reporting on other health emergencies, was rejected by a vote of 50-12, also with 63 abstentions. 

The large number of absent voters or abstentions in the Ukraine polling seemed to reflect, however, advances in Russia’s diplomatic campaign of attrition, which has seen the gradual erosion of support for Ukraine in developing world capitals over a war that is perceived as Europe’s affair – a perception that the new US Administration has now seemed to adopt as well.  

But that doesn’t diminish the crisis still being faced on the ground in Ukraine, which continues to be subject to chronic, relentless Russian bombing of its cities, including thousands of attacks on health care facilities since the war began, according WHO. 

Out of a population of 10 million,  nearly 13,000 have died since the start of the war, according to the WHO’s report to the WHA.

“We have 3.9 million with diagnosably severe psychological stress and mental health disorders,” Ryan said. “More worrying, attacks on health care continue. There have been over 3,380 attacks since the beginning of the conflict (in 2022), but a 32% increase from 2023-2024.  So this is becoming more frequent, and it’s interesting in the context that the area that’s currently in dispute, or where there’s active fighting, is actually smaller than it was at the beginning fo the conflict.”

WHA also making other moves to enhance Palestine’s status

In contrast, the issue of Gaza and Palestine, continues to captivate member states in all regions of the world – from Latin America to Africa and Asia.    

And two more resolutions that make further symbolic enhancements in Palestine’s quasi-state observer status also are on the agenda at this year’s WHA session. 

In a measure approved on Wednesday, member states voted to include Palestine along with other WHO member states in the mechanisms of the International Health Regulations, which monitor, alert and report on potential health emergencies.

Another WHA measure, due to be debated before the end of the session next Tuesday, would allow the flag of Palestine to be flown along with those of other member states at WHO.

Last year, WHO member states voted to grant Palestine quasi-state status, giving it virtually all of the rights and privileges of a member state, short of voting. See related story here:

https://healthpolicy-watch.news/palestine-granted-quasi-who-member-state-status-without-voting-rights/

Image Credits: OCHA, IPC .

A plastic bag floats underwater near the surface in Bali, Indonesia. At current rates, plastic waste is expected to outweigh all fish in the sea by 2050.

Thirty-five million tons of plastic waste have been dumped into the world’s oceans since negotiations on the United Nations plastics treaty began in Uruguay two years ago.

When delegates gather for the final session of UN Environment Programme (UNEP) led talks in Geneva in August, known as INC-5.2, around 1.2 billion tons of unrecycled plastic waste will have been produced since negotiators from 175 nations first put pen to paper.

With plastic production set to rise 40% in the next decade, tens of billions of tonnes of large, small and microscopic chemical particles will scatter throughout rivers, landfills, streams and coastlines, be burned into the air, or discarded in oceans around the world. 

All of them pose a direct threat to human health and the environment.

Ana Paula Souza discovered this firsthand when she participated in a scientific study last year. Despite living what she calls “a very ordinary life” in Geneva far from recycling plants or petrochemical facilities, tests revealed she had been exposed to more than 30 toxic chemicals that leach from plastics—compounds that can disrupt hormones, damage the nervous system, and weaken immunity.

“We live in a world where, just by walking on the street, you’re already being exposed to plastics,” Souza, who works on environment and climate change issues for the UN’s human rights office, told a gathering at the Geneva Graduate Institute on Wednesday, ahead of the upcoming treaty talks. “I’ve been exposed, and you too, without our consent.”

The upcoming Geneva talks may be negotiators’ final chance to achieve what UNEP and environmental groups call “the most important multilateral treaty” since the 2015 Paris climate agreement.

The negotiations pit over 100 nations advocating for caps on plastic production and chemical regulation against petrochemical giants including Saudi Arabia, the United States, Russia, and China—countries that view plastics as a crucial revenue stream as renewable energy threatens fossil fuel demand.

With all 175 countries required to agree by consensus, and talks having already failed in Busan, South Korea, in November, the path forward remains uncertain.

“There is little assurance that the next INC will succeed where INC-5 did not,” the Global Alliance for Incinerator Alternatives said after the Busan talks collapsed. “There is a strong probability that the same petro-state minority will continue their obstructionist tactics and further imperil the plastics treaty process.”

For health researchers, mounting evidence of the plastic threat is becoming impossible to ignore.

Planetary experiment with unknown consequences

The convenience, cost, durability and usefulness of plastics in industries from fashion to food, medicine, construction and healthcare has led to a societal addiction that has become a planetary-scale human health experiment. Despite their lightweight design, humanity has produced 8.3 billion metric tons of plastic—with 6.3 billion metric tons discarded as waste.

Plastics have grown immensely in chemical complexity since their invention, evolving from simple fossil fuel derivatives into materials containing thousands of synthetic compounds. They now surround us—in our food, air, water, and rain. Yet we remain largely unaware of the potentially toxic effects of thousands of these chemicals now ubiquitous in modern everyday life.

Researchers have identified over 16,000 chemicals used in plastic production, with at least 4,200 considered “highly hazardous” to human health and the environment, according to a landmark report published last year by scientists at the Norwegian University of Science and Technology (NUST).

Around 5,000 of the compounds in plastic are total unknowns—scientists have not sufficiently studied them to understand their toxicity, leaving potential health effects up in the air.

The 16,000 are also just those scientists have been able to identify—the report’s authors admit there are likely many more compounds out there they haven’t caught yet. Only 980 hazardous chemicals— 6% —are currently regulated by international treaties.

“Chemicals present in plastic products cause hazards such as cancers, genetic mutations, and harm to the reproductive system,” said Albert Magalang, a Philippine environment and climate change specialist who is a member of his country’s national delegation to the treaty talks. “I know for a fact that the health sector is aware that about 10,000 chemicals are used in plastics [for which] they don’t have any hazard data.”

Science and regulation can’t keep pace

Just 6% of all plastic chemicals are regulated under multilateral environmental agreements. Around 1000 additional compounds are regulated at the national level by a small number of states.

The regulatory challenge is compounded by industry practices. When authorities restrict or ban chemicals, manufacturers often replace them with structurally similar substitutes that carry the “same or other unknown hazards,” according to the Plastics Health Map, an open-source database mapping research on plastic chemical exposures.

The pace of scientific evaluation adds another layer of delay. Studies on the health impacts of substitute chemicals typically commence years after their introduction to the market, creating a perpetual knowledge gap. As plastic chemicals proliferate faster than research can evaluate them, both regulatory systems and scientific understanding struggle to keep pace with determining their health effects.

This regulatory gap reflects a deeper problem: the vast majority of plastic chemicals lack basic safety information. Researchers don’t know their identities and structure 25% of the time, their functions 50% of the time, whether they’re present in plastic 56% of the time, and their hazards 66% of the time, the NUST report found.

“We face a major challenge in the lack of transparency across the plastics value chain,” said Andrea Zbinden, senior policy advisor for the Swiss Plastics Treaty delegation, which will host the talks in August. “I want to know, actually, what is in the plastic product that I’m using every day.”

Despite this knowledge gap—likely to persist for decades as new chemical compounds continue to multiply—leading health experts believe human health must be central to negotiations on the plastics treaty, which will be legally binding but requires consensus to pass.

“Human health must be central to the plastic treaty,” said Dr Maria Neira, WHO’s environment lead. “Plastics pose risks to human health, and the risks are happening across the entire life cycle, from production to destruction and then use and disposal.”

The push for binding global action

Picking through waste in Banjar City, Jawa Barat, Indonesia

The demand for transparency is driving Zbinden and a group of 94 countries to push for a global list of banned chemicals and plastic products—something that has proved contentious in negotiations. Given how quickly manufacturers replace regulated chemicals with similar compounds, Zbinden insists the list must be regularly updated to reflect the latest science.

“The treaty must also include a mechanism to regularly update the list based on the latest science and development,” Zbinden said. “While every effort should be made to reach consensus, it is important to establish a clear procedure for decision making to ensure the list can be updated effectively.”

Major plastic producers have strongly opposed including such measures. During negotiations in Busan, references to “chemicals of concern included in plastic products” were dropped from the Chair’s Text, raising concerns that obstruction from industry may force countries supporting the strongest health measures to pursue separate commitments outside the treaty framework if consensus fails again.

Support for strengthening the plastic treaty has grown steadily. Char shows the number of nations backing WWF’s “must-haves”: global chemical bans, circular economy design requirements, financing, and guarantees to strengthen the treaty over time.

The most ambitious coalition of nations is pushing for sweeping changes that extend far beyond chemical bans. In a position paper released after the failed Busan negotiations, the 70 countries comprising the High Ambition Coalition reaffirmed their “common ambition of ending plastic pollution by 2040” and emphasized that “effective and common legally-binding global rules are essential.”

They want binding transparency and reporting requirements on plastic polymer production and chemical composition, time-bound targets to reduce production and consumption of primary plastic polymers to sustainable levels, as well as enforcement of the principle that “polluters should be held responsible for their activities and products.”

The coalition’s concerns extend to another health threat: microplastics—particles so small they can cross into organs and the bloodstream.

Research in this emerging field has revealed that microplastics can alter cellular behaviour in internal organs, with scientists identifying a new condition called “plasticosis” in studies of birds. Humans now consume approximately five grams of these particles weekly through normal eating, drinking and breathing, yet their long-term health impacts remain largely unknown.

“We call on all INC members to seize this historic opportunity to conclude an ambitious and effective treaty that demonstrates our collective resolve to end plastic pollution for the benefit of current and future generations,” the coalition stated. “We encourage everyone to continue their efforts, hold governments to account.”

Economic case for action

The coalition’s sweeping demands are backed by mounting evidence that inaction carries enormous economic costs in health damages.

Plastic pollution isn’t cheap, especially for health systems. A study published last year by the Endocrine Society found that chemicals used in plastics generate over $250 billion in annual health costs in the United States alone.

In the European Union, researchers estimate exposure to hormone-disrupting chemicals costs over €150 billion annually in health care expenses and lost earning potential. These endocrine-disrupting chemicals are present in everyday products and pesticides, but industry lobbying has delayed EU action to identify and restrict their use.

With microplastics now found in human blood and plastic production showing no signs of slowing down, UNEP has warned that the economic costs of inaction on the chemical and plastic pollution crisis could reach 10% of global GDP.

These costs are not borne by plastic producers—they’re shouldered by public health systems and taxpayers. As governments spend billions treating the toxic effects of plastic derivatives, the petrochemical industry continues its lucrative expansion, with market value projected to grow from $584.5 billion to $1 trillion by 2030.

“Where is the implementation of the polluter pays principle? A lot of resources are spent from public taxpayer money to deal with the pollution and the negative externalities,” said Julia Carlini, an observer to the treaty negotiations from the Centre for International Environmental Law. “They are profiting from the extraction of fossil fuels and selling plastic products without paying their fair share.”

Despite the scale of estimated damages, economic arguments haven’t guaranteed action in other environmental crises. The World Bank estimated that air pollution causes $8.1 trillion in annual health damage, but that figure hasn’t moved the needle in UN climate talks. The challenge now is whether financial pressure will prove more persuasive than health concerns in pushing through a strong plastics treaty.

Political battle ahead at INC-5.2

With the final leg of negotiations just months away, it remains unclear how health will be integrated into the final treaty, if at all. The latest negotiating document includes a dedicated health clause, though nations have not agreed on this provision and it’s unclear how many support the approach.

During previous talks, countries argued over whether health should be addressed in a standalone provision, woven throughout the treaty, included in overarching provisions, or excluded entirely. Some delegations questioned whether health falls within the treaty’s scope at all.

The World Health Organization has stated it is “open to including a standalone article on ‘Health’ provided that health considerations and protections are included as a cross-cutting issue throughout the text.”

Many of the treaty’s core flashpoints have direct health implications. Articles Three and Six—which address regulating toxic chemicals in plastic production and capping new virgin plastic production—would deliver significant downstream health benefits.

Virgin plastic production depends 98% on fossil fuels, driving air pollution and environmental contamination. Toxic chemicals in plastics can enter the human bloodstream and cause severe health effects, particularly in vulnerable communities living near production or disposal sites.

“If we are going to [target] upstream interventions, it means reducing the unnecessary plastic production, especially in those single-use plastics,” Neira said.

Massive expansion of petrochemical production in the US, China, Saudi Arabia and Russia makes them unlikely to agree to the most ambitious demands from health and environmental advocates. Over 220 fossil fuel industry lobbyists attended the latest talks in South Korea, many embedded within national delegations, according to the Center for International Environmental Law.

The US made a stunning reversal under Joe Biden ahead of the last negotiating round, surprising observers by backing production reductions and aligning with the European Union, Canada and the High Ambition Coalition. But with Donald Trump in office, that support has evaporated.

“The treaty, and especially the notion that the best way to reduce plastic pollution is to scale back plastic production, will go nowhere in the United States,” PlasticsToday, an industry outlet, wrote following Trump’s victory. “And for the vast majority of the plastics industry, that is, indeed, an answered prayer.”

Image Credits: Naja Bertolt Jensen, Muhammad Numan, Fiqri Aziz Octavian, Antoine Giret.

Addressing today’s global health challenges requires more than funding and innovation—it demands humility, open communication, and a shared commitment to collective action, according to IFPMA Director-General David Reddy.

Reddy, speaking at an IFPMA side event during the 78th World Health Assembly, acknowledged the socio-political and financial barriers facing global health systems. However, he urged the audience not to lose sight of the hard-earned lessons from the COVID-19 pandemic.

“Some of the lessons during the pandemic were hard, and they cost this global community a lot,” Reddy said. “We shouldn’t let what they have taught us about the importance of health care slip out of mind so easily.”

The evening’s event explored how health can serve as the foundation for driving economic growth and national security, through partnership and political leadership.

The panel discussion featured three speakers, each offering a unique perspective: Dr Ricardo Baptista Leite, president of the UNITE Parliamentarian Network for Global Health, Dr Kerri Elgar, senior policy analyst at the Organization for Economic Cooperation and Development (OECD) and Dr Jenelle Krishnamoorthy, MSD’s head of global public policy.

From left: Dr. Jenelle Krishnamoorthy, Vice President and Head of Global Public Policy for MSD; Dr. Kerri Elgar, Senior Policy Analyst at the OECD; and Dr. Ricardo Baptista Leite, Founder & President of the UNITE Parliamentarian Network for Global Health
From left: Dr. Jenelle Krishnamoorthy, Vice President and Head of Global Public Policy for MSD; Dr. Kerri Elgar, Senior Policy Analyst at the OECD; and Dr. Ricardo Baptista Leite, Founder & President of the UNITE Parliamentarian Network for Global Health and the evening’s moderator.

Leite painted a complex picture of the current global health landscape. On one hand, he noted, public trust in institutions is eroding. On the other, “too many political actors… are proactively contributing to misinformation and are provoking what I would call intentional disruption.”

He went on to explain that defense spending now dominates the priorities of many governments—diverting critical resources away from health. This shift, he warned, puts low- and middle-income countries at heightened risk, as their health systems often depend not just on funding but on infrastructure and support from international partners—many of whom are now pulling out.

“The United States is the main actor cutting off without giving an opportunity for transition. And this has devastating effects,” Leite said. “When we look at that, the ripple effects will mean millions of lives will be disrupted, lives will be lost in this process.”

Leite called for an immediate rethinking of global health funding models, urging innovative and inclusive approaches.

“We have to have all hands on deck and find how we do that,” he said. “Unusual actors that haven’t been stepping up, now we have to find them and bring them on board, and we have to have more of a collaborative effort to redesign the way we deliver health and care altogether.”

He also criticized the “broken disease model” of today, warning that it is not fit for the future. Without sustainable investment in health systems, he said, the world is headed toward a two-tiered reality where the wealthy receive care, and the rest are left behind.

“That’s not the world any of us wants,” Leite said.

Alternative health financing channels

This conversation is not new, but the urgency around health funding has escalated due to the budget cuts implemented this year. Elgar noted that many global actors have been calling for alternative channels for external health financing for some time.

In addition, the healthcare funding dialogue needs to be reframed to focus on prevention and view healthcare as a sound investment rather than a liability or budgetary burden, said Krishnamoorthy.

“We have to take a step back and think: We are on the verge with research and development to find some of the most amazing cures and ways that we can live longer, fuller, healthier lives,” Krishnamoorthy said.

“That is so exciting, but I think we understand in the private sector that that’s only the first step. It’s a tough first step, but you have to make sure individuals have access to these medicines and vaccines.”

Krishnamoorthy highlighted that if, in 2025, the world adequately funded the top five non-communicable diseases (NCDs), by 2030 the global economy could save $47 trillion—roughly 20 times the current global health budget.

“We don’t usually think of it like that,” she said, offering a relatable comparison to car maintenance.

“Would you ever take a car out of a lot? Drive it but not get the oil changed, never get your tires turned, never change the filters until the engine just freezes up and you throw it out?” Krishnamoorthy asked.

She argued that too many national healthcare payment systems are structured in exactly that way.

“IFPMA commissioned an analysis that showed that adult immunization programs yield up to a 19 to one return on investment. So you know, these are some basic things,” she said.

Spending to save

To encourage governments to invest more in healthcare, the economic case must be made demonstrating the potential returns on investment that can be achieved through better policies, smarter spending, and prioritizing value for money, explained Elgar.

“It’s not just what you might spend in general, it’s what you might spend to save,” she said. “Increased investment in patient safety, for example, can reduce diagnostic error by around half and represent a direct cost saving of almost 8% in health budgets, which is huge.

“Efficient use of digital tools, including AI, are expected to improve productivity by five percent to 10% and then for every dollar invested in AMR [antimicrobial resistance] for example, and the intervention packages for AMR, the rate of return is $10.

“These are the sorts of arguments that appeal to finance ministers,” Elgar continued.

However, Leite acknowledged that some responsibility lies with policymakers themselves.

He said many parliaments have “gone too lazy” and stopped exploring innovative models of healthcare financing—particularly those that incentivize long-term health and well-being rather than short-term fixes.

IFPMA Director-General David Reddy
IFPMA Director-General David Reddy

To move forward, Reddy stressed the importance of maintaining open dialogue and collaboration.

“Effectively, we’re a family… But in times of crisis, families pull together—and that’s what we need to do at this time,” he said.

Image Credits: Maayan Hoffman, Joy Corthesy, IFPMA.

WHO Director General Dr Tedros Adhanom Ghebreyesus at the 78th session of the World Health Assembly.

African countries at the World Health Assembly called for increased support to health systems across the continent following major cuts to all World Health Organization (WHO) regional office budgets amid a financial crisis triggered by the US withdrawal from the agency and falling global health spending.

The African region suffered the largest total cut, losing over $150 million in funds for WHO operations across the continent.

“It is imperative that the WHO provides focused support to strengthen the capacities and the capabilities in countries, including through enhanced local production technology transfer and equitable distribution mechanisms,” the Ethiopian delegation said on Wednesday in a joint statement on behalf of the 47 countries in the WHO Africa region.

The statement added that African nations need support in “strengthening integrated clinical services and everyday systems to handle emergencies, and the readiness in countries to deliver a timely and effective response.”

Middle-income countries also made cases to be prioritised alongside low-income ones. “Health resilience can only be achieved with long-term, predictable and equitable financing. We are calling for the pandemic fund to be bolstered with increased accessibility for middle-income countries,” a delegate from Morocco said.

Evolution of country-level programme budgets, by region. All six WHO regions face a steep decline in annual funding when the next budget takes effect in 2026. 

The plea from low- and middle-income nations follows member states’ approval on Tuesday of a new WHO budget for the 2026-27 period that slashed $1.1 billion from its previous target while raising membership fees by 20%. All WHO regions suffered the same flat 14% cut amid the financial squeeze, except Geneva headquarters, which faces a drop of nearly a quarter year-on-year.

Even with an extra $170 million raised from member states on Tuesday, the agency faces a $1.5 billion funding gap on top of the $1.1 billion already slashed from projections for the biennial budget prior to the US exit from the body, highlighting the impossible choices facing WHO as it confronts the largest financial crisis in its 76-year history.

Countries said the funding cuts leave them increasingly vulnerable as new health threats emerge.

“Geopolitical instability, climate change and emerging diseases reinforce the need for international cooperation and predictable financing to overcome challenges in global health system,” the delegate from Bangladesh said. “We need empathy, solidarity and unity.”

Crisis deepens funding gap

Despite repeatedly slashing its target for the next two-year budget, WHO still faces a $1.5 billion shortfall to cover its core work. 

Before the US exit, WHO’s 2026-27 budget targeted $5.3 billion over two years to cover its core operations. After Tuesday’s vote, that target dropped to $4.2 billion, a 22% reduction affecting the UN health agency’s work worldwide.

During Tuesday’s budget debates, WHO officials countered criticism of cuts to cash-strapped regions with a harsh truth: every regional office outside Europe and Geneva still has more allocated funding than the agency can actually spend.

“We can only implement the budget if we have the financing,” Imre Hollo, director of strategic planning and budget at WHO, told member states.

The exit of US funds has affected 23.8 million people worldwide, causing closure or reduction in services at over 2,600 health facilities, WHO’s Independent Oversight and Advisory Committee said Wednesday.

The US had committed $154 million in voluntary contributions to WHO’s base budget (29% of total voluntary contributions) for 2024-25, plus another $235 million to emergency operations (15% of total voluntary contributions).

But not all of this funding came through.

“Along with the reduction in voluntary contributions from other donors, the freeze and withholding of voluntary contributions from the United States resulted in an 18% decrease in overall financing available,” the IOAC analysis found.

Global aid for health at decade low

When excluding COVID-19-related aid, health development spending is declining across many major donors.

The US government under the Trump administration has slashed $60 billion in total aid, with severe implications for global health programs covering malnutrition, maternal mortality, and prevention and immunization programs for HIV, malaria, tuberculosis and other infectious diseases.

The US cuts represent the extreme edge of a global trend in reducing aid, especially for healthcare.

Setting aside COVID-19 spending, health-focused overseas aid in 2023 stayed beneath 2019 figures across the United States, Britain, Germany, Canada, European Union bodies, France, Italy and the Netherlands. Healthcare development funding also dropped year-over-year from 2022 to 2023 in Germany, Italy and Canada.

“The share of official development assistance going to health has dropped to its lowest point in 10 years,” an analysis by ONE found in January. “All indicators suggest this will fall even lower in years to come at a time when progress against preventable deaths is at risk of backsliding.”

Analysis by the Centre for Global Development classified 37 nations as “highly exposed” to US aid cuts, facing losses equivalent to 10% or more of their government’s national health expenditures. Twenty-five countries face losses of 20% or more, while 10 face losses of at least 50%.

Extreme scenarios include Afghanistan, Somalia, South Sudan and Malawi, where US health aid equals 341%, 237%, 235%, and 207% of national health spending respectively.

“This will also have knock-on impacts on disease detection, access to medical countermeasures, R&D, and social determinants of health from nutrition to clean water in some of the world’s most vulnerable settings,” the UK delegation said.

Calls for efficiency amid crisis

WHO is urging countries to look at domestic options wherever possible, using the funding crisis as a chance to reduce reliance on external health financing and build domestic infrastructure.

“From expanding domestic financing to pioneering real-time data systems, many of you are advancing solutions that are scalable, sustainable and rooted in equity,” WHO Director-General Tedros Adhanom Ghebreyesus told ministers gathered in Geneva on Thursday.

“Data and sustainable financing are not just technical matters,” Tedros added. “They are political choices. They shape who is reached, how quickly, and with what quality of care. And they determine whether we progress or fall behind.”

Professor Senait Fisseha, Vice President of Global Programs at the Susan Thompson Buffett Foundation, urged countries to “use this moment to rethink data and financing in a way that best meets your needs and the needs of your people.”

“For countries to truly lead and for funders and development partners to start to learn how to follow, data and financing are a natural place to start,” Fisseha added. “That is where ministers are telling us to start.”

Development spending on health hit its lowest level in a decade in 2025.

As WHO asks member states to fight the crisis with efficiency gains and data-driven approaches, members are demanding the same from the agency. Financial constraints are forcing WHO to reduce its workforce alongside other cuts.

The agency’s emergency program exemplifies the squeeze, cutting its budget from $1.2 billion to $812 million while facing mounting crises.

“We’ve adjusted our workforce. We’ve strategically controlled our expenses. We’ve put in place more efficient processes,” said Dr Mick Ryan, outgoing director of emergencies at WHO. “But there are headwinds… increasing frequency and intensity of conflict, increasing frequency and intensity of natural disasters and epidemics.”

Discussions ahead of Tuesday’s budget vote made clear approval of the financial lifeline for the UN health agency – which included member states agreeing to the 20% membership fee increase – came with expectations that WHO would continue reform efforts to be more “efficient,” “transparent”, and “cost-effective.”

“We have already taken serious measures, and we will continue to take serious measures to reform the organisation for the better,” Tedros said following the vote to approve the new budget.

“There is a crisis,” he added. “But we will use this crisis as an opportunity and make sure our organization emerges sharper and more empowered.”

Push for flexible funding

WHO Director-General Dr Tedros Adhanom Ghebreyesus and Raul Thomas, the Assistant Director-General for Business Operations at WHO address the committee following the successful vote on the agency’s new budget.

A demand that emerged from states at the World Health Assembly was the need for WHO funding to be flexible. Agency funding frequently comes with restrictions and is earmarked only for certain regions or projects, leaving limited resources to respond to critical issues like climate change and women’s health.

“We urge flexible and non-earmarked voluntary contributions for WHO to overcome current financing constraints,” the Bangladesh delegate said.

A major step in this direction came this week as member states agreed to the membership fee increase, which brings the total for the base budget funded by flexible dues up to 40%, rising from just 16% in 2020.

However, the agency remains critically reliant on voluntary funds. WHO’s emergency and polio budgets rely entirely on voluntary funding and bring the total target budget for operations from 2026-27 to $6.2 billion – meaning WHO is still around 75% reliant on voluntary funds across all operations.

Sri Lanka recommended WHO engage in high-level negotiations toward resource mobilisation to secure sustainable funding.

“We support the call for diversified financing from global health donors, development banks and private sector partners,” the country’s delegate said.

Image Credits: WHO/X, ONE, ONE.

African health ministers pose with the signed agreement of intent to eliminate visceral leishmaniasis.

In a region where war, displacement, and weak health systems fuel a deadly disease, nine African governments are trying a new approach: eliminate visceral leishmaniasis by working together.

As neglected tropical diseases (NTDs) continue to strain underfunded health systems across Africa, a regional political coalition has formalised its intent to eliminate visceral leishmaniasis (VL) through cross-border collaboration.

Six countries – Chad, Djibouti, Ethiopia, Somalia, South Sudan, and Sudan – signed a Memorandum of Understanding (MoU) during a World Health Assembly side event, outlining a joint strategy for surveillance, treatment, and disease control across borders.

The initiative aligns with WHO’s 2021–2030 NTD roadmap and the regional visceral leishmaniasis elimination framework launched in June 2024.

“This is more than a health initiative. It is a movement for social justice, equity and development,” said Dr Ibrahima Socé Fall, Director of the Global NTD Programme at the World Health Organization, who delivered remarks on behalf of WHO Director-General Dr Tedros Adhanom Ghebreyesus.

But while ministerial signatures and declarations signal a shift in political will, national officials said frameworks alone will not fill treatment gaps, rebuild surveillance in conflict-affected regions, or overcome decades of structural neglect.

Visceral leishmaniasis is endemic to much of Eastern Africa, where outbreaks have historically defied borders, and weak infrastructure has complicated responses. The disease has killed over 200,000 people in the region in the past 40 years, and about 74 million remain at risk, according to Ethiopia’s health ministry.

Dr Ibrahima Socé Fall, Director of the Global Neglected Tropical Disease Programme at the World Health Organization.

Sudan, currently affected by one of the world’s most severe humanitarian crises, illustrates the fragility of progress. Displacement, vector breeding in camps, and disrupted supply chains are driving a surge in untreated cases amid the raging civil war.

“Today, only 21 of 44 diagnostic and treatment centres are functioning across seven states,” said a Sudanese representative.

The country’s health officials are now prioritising adaptive, conflict-aware strategies, including mobile teams and decentralised logistics, but warned that regional gains could unravel without sustained support.

Nigeria, while not among the signatories, voiced its intent to establish a similar MoU with neighbours. With 67 border-region local government areas, officials described cross-border VL transmission as a pressing risk.

“The cost of care is steep, and we bear 25% of the global NTD burden,” said a representative on behalf of Nigeria’s Coordinating Minister of Health. “We cannot address this in isolation.”

Tanzania echoed the call for accountability. “We must hold each other accountable, track progress, and adapt strategies,” said its health minister. “There is no more time for words, but we still have time for action.”

Beyond coordination, speakers drew attention to persistent barriers: limited domestic financing, weak integration into primary care, and outdated tools.

DNDi’s CEO, Dr Luis Pizarro, described current VL treatments as “toxic, painful, and costly,” particularly for rural populations, emphasising that research and development must no longer be viewed as a luxury.

“It is not acceptable in 2025 to rely on outdated treatments,” Pizarro said.

The Africa CDC urged states to rethink the framing of NTDs. “These are not neglected diseases—they are priority diseases,” said the representative of Dr. Jean Kaseya, Director General, Africa CDC, citing the need to embed NTD strategies in health security planning and push for domestic investment despite fiscal constraints.

The meeting closed with ministers endorsing a call to action that commits signatory countries to concrete steps in eliminating VL, including shared data systems, joint planning, and community-based delivery.

From left: Nancy Aburto, Azucena Milana-Dayanghirang, Moumouni Kinda, Claudia Hudspet, and Lina Mahy
From left: Nancy Aburto, Azucena Milana-Dayanghirang, Moumouni Kinda, Claudia Hudspet, and Lina Mahy

GENEVA – Although the past decade has seen progress in the fight against malnutrition, 148 million children remain stunted, 45 million suffer from wasting, and anaemia affects nearly one in three women globally, according to experts at the Geneva Health Forum (GHF).

In 2023 alone, 733 million people experienced hunger—152 million more than in 2019—and over 2.8 billion people were unable to afford a healthy diet. The GHF noted that malnutrition also remains a contributing factor in 45% of deaths among children under five.

Looking ahead, the global nutrition crisis could worsen.

Francesco Branca of the Institute of Global Health at the University of Geneva warned that the number of obese people worldwide is expected to rise from a billion today to 2.3 billion by 2050.

“Nutrition has to be where we take action,” he told a room on Tuesday at Campus Biotech, where this year’s GHF side sessions of the 78th World Health Assembly are being held.

“Where do we take action?” Branca asked. “It has to be people-centered. So the action has to be where the problem is. The action has to be in the centres where children are presented with malnutrition. The action has to be taken in primary health care offices where doctors find people with obesity. The action has to be where people are suffering from a lack of food, indeed, and that’s, of course, the responsibility of people providing services and people who are making decisions about those services.”

The three-hour session brought together global experts from diverse sectors. It was held against the backdrop of a recent decision by WHO member states to extend the Decade of Action on Nutrition (2016-2025) to 2030, aligning it with the 2030 Agenda for Sustainable Development. It also took place following the 2025 Nutrition for Growth (N4G) Summit in March, where 47 participating states made more than 400 commitments.

Speakers highlighted the need for stronger governance and integrated, multisectoral approaches to combat malnutrition. They emphasised bundling services to improve efficiency, implementing regulatory measures such as taxation and food labelling, and exploring innovative financing mechanisms.

According to Valerie Bellino, president of the Geneva Global Health Cooperative, the session’s aim was also to position Geneva as a driving force in promoting global nutrition solutions and to help build the long-term momentum needed to meet the 2030 targets.

A ‘village’ of solutions

Afshan Khan (right), Assistant Secretary-General of the United Nations and Coordinator of the Scaling Up Nutrition (SUN) Movement
Afshan Khan (right), Assistant Secretary-General of the United Nations and Coordinator of the Scaling Up Nutrition (SUN) Movement

Afshan Khan, Assistant Secretary-General of the United Nations and Coordinator of the Scaling Up Nutrition (SUN) Movement, spoke passionately about the importance of the N4G Summit. She highlighted the strong participation of civil society in the summit, describing it as “a whole village of solutions.”

Khan emphasised that the event featured a whole day dedicated to showcasing best practices from civil society partners and youth-led discussions about how the intersection of nutrition, health, climate change, and conflict is shaping their lives, now and in the future.

She added that there was also a dedicated day of engagement with the private sector.

“We have to be able to address all forms of malnutrition and undernutrition with the right kinds of quality nutritious foods available at an affordable price, as well as having foods that are low in trans fat or sugars,” Khan explained. “A really important component is how we influence what people eat, which is influenced by what companies are putting out there on the market.”

She reiterated that nutrition is not just a health concern, but a key pillar of economic development.

“The Nutrition for Growth Summit helped connect the golden thread of the importance of nutrition for long-term growth and development of children, for the health of women… and also the economic imperative nutrition brings to building human capital,” she said.

“There is a real opportunity to emphasise and stress more that an investment in nutrition has a $23 rate of return for each dollar,” Khan added, citing World Bank estimates. “Here we see an opportunity to show the power of nutrition and its ability to transform societies.”

Still, while some countries have stepped up, others are pulling back—and the consequences are already unfolding.

Khan also warned that ongoing conflicts, climate stress, and budget cuts are combining to put millions of lives at risk.

“The situation in Gaza is perhaps one of the most visible and stark, because it’s clearly a man-made crisis—as is Sudan, as is Yemen,” she said.

She explained that nutrition programs are often amongst the first to be cut when aid is reduced. For example, more than 600,000 people in Kenya living in drought-stricken areas are expected to lose access to lifesaving food and nutrition services. Similar cuts are taking place in Sudan.

According to the Standing Together for Nutrition consortium, a 44% reduction in aid could erase decades of hard-won progress, leaving 2.3 million children without access to essential treatment.

Khan warned that as many as 60% of these children may not survive without intervention: “The long-term projections on death due to some of these cuts are stark.”

Learning from success

A panel discussion during the session highlighted where nutrition efforts yield results, offering practical takeaways that others in the field could adapt to their national contexts.

Azucena Milana-Dayanghirang, Assistant Secretary and executive director of the National Nutrition Council in the Philippines, shared that her country faces a triple burden of malnutrition: undernutrition, overnutrition, and micronutrient deficiencies. To address this, the government launched a multisectoral platform centred on what she called “ABCDY,” where A stands for academia, B for businesses, C for civil society, D for donors, and Y for youth.

She explained that these nutrition-focused collaborations are being implemented at all levels, from the federal government to local government units.

“What is unique about the Philippines is that we have 7,000 islands—geographically isolated areas where malnutrition is highest,” Milana-Dayanghirang explained.

To tackle these challenges, the government rolled out the Philippine Plan of Action for Nutrition (PPAN), a six-year strategy from 2023 to 2028. The plan focusses on three core pillars: promoting healthier diets, fostering improved social behaviours, and strengthening governance.

“We develop policies,” Milana-Dayanghirang said. She pointed to one example: the Philippines instituted a sugar-sweetened beverage tax that has effectively reduced consumption, especially amongst teenagers and children.

She added that the country is now in the final stages of approving a national nutrient profiling model and food labelling program—tools she hopes will further strengthen the country’s nutrition agenda.

From left: Nancy Aburto, Azucena Milana-Dayanghirang, Moumouni Kinda, Claudia Hudspet, and Lina Mahy
From left: Nancy Aburto, Azucena Milana-Dayanghirang, Moumouni Kinda, Claudia Hudspet, and Lina Mahy

In an Africa case study, Moumouni Kinda, director of the Alliance for International Medical Action (ALIMA), shared that globally the treatment of children for malnutrition has expanded significantly, from treating no children for malnutrition 55 years ago to nearly nine million in 2023. Last year, Alima teams treated 350,000 malnourished children in 13 countries.

However, despite this progress, Kinda said his teams receive weekly reports from more than a dozen countries warning of imminent food shortages. Amongst the hardest-hit nations are Niger, Chad, and Nigeria.

“The violent shutdown of USAID and funding cuts in the United Kingdom and Europe are worsening an already critical situation,” Kinda warned. “But we have hope.”

He explained that that hope lies in the potential to secure more sustainable, local sources of funding. Like the Philippines, Kinda suggested that more African countries could implement a sugar-sweetened beverage tax to help finance nutrition programs.

He emphasised that the tax could be modest—”only one cent”—but if adopted by several countries, it could have a significant impact.

“If we approach 10 countries, this could be about $1.4 billion annually,” Kinda said, noting that such a sum could help treat millions of children across the continent.

The WHO’s Lina Mahy highlighted significant funding imbalances in the global food system. She pointed out that during the COVID-19 pandemic, from 2020 to 2022, the food industry made approximately $1 billion in profit every two days. In that same period, 62 new food billionaires emerged.

“We have to put that into perspective,” Mahy said. “We need to talk about – these power imbalances and inequalities and how to address them. WHO is ready to talk about these elephants in the room.”

Investing in food systems

The Aga Khan Foundation is working to help fill funding and service gaps in the global nutrition space. Claudia Hudspet, the organisation’s global health lead, said the foundation has committed more than $45 million over the next five years to better integrate nutrition into healthcare systems and improve access to affordable, healthy food.

One of the foundation’s key programs is the Central Asia Stunting Initiative (CASI), which targets high stunting rates in remote parts of Afghanistan, Pakistan, and Tajikistan. The program is designed to improve maternal and child health outcomes by supporting frontline health workers in assessing and addressing nutritional needs.

In partnership with the Aga Khan Health Service and local partners in Pakistan, the foundation helped develop a mobile application for Lady Health Visitors (LHVs) in the Gilgit-Baltistan and Chitral regions. The app enables LHVs (health workers that specialise in maternal anc child care) to assess the nutritional status of pregnant women, mothers, and children during household visits and provide targeted nutrition supplements when needed.

“The Central Asia Stunting Initiative really looks at integration into health systems,” Hudspet explained. She said a major focus is increasing the number of women giving birth in health facilities and ensuring that newborns are weighed at delivery.

“It’s a very simple intervention, but many babies aren’t weighed at birth, and we miss a lot of those low birth weight and small for gestational age babies, and we’re not able to give them the best start in life,” she said. “Identifying growth faltering and catching children before they lose weight or stature… improves our chances of success.”

In addition to stunting prevention, the foundation is working to integrate nutrition into early childhood development efforts through the Nurturing Care Framework.

Hudspet also emphasised the foundation’s growing interest in food systems, particularly the links between agriculture, climate resilience, and nutrition.

One of its flagship programs in this area is the Indian Ocean Coastal Regeneration Initiative (IOCRI), which Hudspet described as supporting sustainable livelihoods in coastal communities while restoring degraded ecosystems. The program aims to rehabilitate 100,000 hectares of coastal lands and strengthen local economies through renewable energy and nature-based solutions.

“While this is a climate initiative, initially, we also are integrating nutrition through things like blue foods; aquaculture nutrition champions looking at food supply and social behaviour,” Hudspet said.

Because the foundation and Aga Khan University are part of the same network, the foundation can also leverage data to monitor program impact and adapt as needed.

“We monitor these programs very intensively, and tweak and learn from them,” she said.

Nutrition as a climate health strategy

Climate change also added 41 days of dangerous heat in 2024, according to a report jointly produced by the team at World Weather Attribution (WWA) and Climate Central.

Nancy Aburto, Deputy Director of the Food and Nutrition Division at the Food and Agriculture Organization (FAO), said the growing body of data around food insecurity and its consequences offers new opportunities to move from talk to action.

“I’m going to start with a statistic that’s not very pretty,” she told the room. “It’s 2.8 billion people worldwide [who] cannot afford a healthy diet.”

But Aburto said that knowing this figure—and having tracked it for several years—has pushed researchers and policymakers to seek tangible solutions. One of the clearest, she said, lies in how we spend existing agricultural support.

“In 2022, the State of Food Security and Nutrition in the World report documented that worldwide support for food and agriculture was almost $630 billion a year,” she said.

When combined with recent true cost accounting from FAO that shows unhealthy diets account for about 70% of the $10 trillion in hidden costs to health systems, the case for repurposing that investment becomes even stronger.

“It tells us that we can repurpose that $630 billion a year to something that can help us reduce that $10 trillion cost burden on our health systems,” Aburto explained. “And that is moving us towards solutions for repurposing agricultural investments to diverse, nutritious foods, which can absolutely be monumental.”

She added that food systems reform has benefits beyond nutrition.

According to Aburto, shifting diets could reduce greenhouse gas emissions from the food and agriculture sector by up to 13%. The environmental benefit doesn’t stop there—healthier diets can also help protect forests, water systems, and biodiversity.

“This means enabling healthy diets is not just a solution for the nutrition community,” she said. “It’s a solution for the environmental community as well.”

Image Credits: Maayan Hoffman, WMO.