Tomnjong Thadeus under a bed net with his three-year-old daughter Gabriella at their home in Soa, Cameroon. Gabriella and her mother have both had malaria and the family now sleeps under nets.

Global Fund investments have reduced deaths in HIV, tuberculosis and malaria by 61% and saved 65 million lives since 2002 – while simultaneously improving health service delivery, according to its annual Results Report released on Thursday. 

The past year (2023) has brought significant wins: a 55% reduction in the price of bedaquiline, the main treatment for drug-resistant TB and a 25% cut in the cost of TLD, the preferred first-line HIV treatment.

It has also introduced new dual-active ingredient insecticide-treated mosquito nets that are 45% more effective against malaria.

These wins are the result of what The Global Fund terms “marketing-shaping”: using its substantial buying power to encourage manufacturers to lower prices. 

While The Global Fund focusses on the three priority diseases, its impact has been far wider. 

‘’In 2023, we invested $1.8 billion, the highest amount ever in a single year, to strengthen health and community systems,” Executive Director Peter Sands told a media briefing on Wednesday.

“In this grant cycle period, [2024- 2026] we’re looking at investing around $6 billion in supporting countries to deliver better health outcomes, through pandemic preparedness, through stronger systems and through accelerating their journey towards universal health coverage.”

One significant area of investment, health facilities’ oxygen supplies, has assisted around 22 million patients with respiratory illnesses.

Peter Sands, Executive Director of The Global Fund.

Reducing health system pressure

The report also quantifies for the first time how its focus on the three diseases has alleviated stress on countries’ health services.

Currently, it supports 25 million people on antiretroviral medication – and this has saved around 1.66 billion hospitalisation days and 1.36 billion outpatient visits, which translates into   a saving of around $85 billion. 

“Where the three diseases absorb over 50% of health system resources, the impact of reducing their burden on overall health system performance can be dramatic,” said Sands. “It means lower infant and maternal mortality and fewer deaths from acute trauma and other conditions.

“In addition, our continued investments in community health workers, labs, supply chains, disease surveillance systems and other health system components better prepare countries to prevent, detect and respond to other diseases like mpox or future pandemics.” 

Nurse Everlyne Esige examines an pregnant mother at Vihiga Hospital in Kenya. A partnership between The Global Fund, Takeda Pharmaceuticals and the Liverpool School of Tropical Medicine has trained health care workers to integrate HIV, TB and malaria services into antenatal and postnatal care

Climate change challenges

The Global Fund invests 70% of its funding in the 50 most climate-vulnerable countries, and its operations have been affected by changing climate – from floods disrupting services to rising temperatures “cooking” valuable medicines. 

However, the most significant impact is on malaria.

“There are two different things going on, said Sands. “One is the gradual rise in temperatures, which means that communities and places that were previously not subject to malaria, often because of higher altitudes which were too cold at night for the mosquitoes, are now becoming susceptible to malaria.”

The second, which is more difficult to predict, is “the impact of climate change on the frequency of extreme weather events, leading to cyclones and flooding” such as seen in Malawi and Pakistan – and resulted in surges in malaria.

But addressing malaria is “particularly challenging”, added Sands, because it is surging in conflict zones there is  “increased resistance both of mosquitoes to insecticides and to the most commonly used treatments”.

To support countries to adapt to the impact of extreme weather and climate events, it restructured grants and offered access to emergency funds in countries such as Zambia, Kenya and Somalia. 

The Fund has also established partnerships with the World Bank and the Green Climate Fund that have “significant expertise and resources around both climate mitigation and adaptation”, said Sands. 

He stressed that very little funding has gone to climate adaptation in health and “we need to work together to respond more effectively to what’s happening, because, if anything, it appears to be happening faster and more significantly than projected”.

Human rights barriers

Lucy Mukasia, a clinician at Kibera Health Centre in Nairobi, Kenya, sorts antiretroviral medicines. But stigma and discrimination are still significant barriers preventing people with HIV from getting care.

In HIV, human rights barriers like punitive laws, stigma, discrimination and violence, including gender-based violence, prevent people from getting HIV prevention, testing, treatment and care. 

“The fight against diseases is as much a fight for justice and equity as it is a biomedical fight,” said Sands. “Even the most innovative biomedical tools will fail if those who most need them can’t get them.” 

To tackle human rights and gender-related barriers to accessing health services, the partnership expanded the Breaking Down Barriers initiative, which aims for inclusivity and equity in healthcare delivery. 

“Our model is anchored by a partnership that thrives on inclusive governance, making us a global movement of civil society, governments, private sector partners, technical partners and communities affected by the three diseases in more than 100 countries,” said Sands. “That partnership came to count enormously as we responded to the many challenges we faced in the year.”

Image Credits: Vincent Becker/ Global Fund, Brian Otieno /Global Fund, Brian Otieno/ Global Fund.

Robert Yates from the London School of Hygiene and Tropical Medicine.

GENEVA – Ensuring that universal health coverage (UHC) protects cancer patients and tackling commercial interests driving cancer were two issues in the spotlight of the World Cancer Congress.

Speakers stressed that they need to make their mark at the United Nations (UN) High-Level Meeting (HLM) on Non-Communicable Diseases (NCDs) in 2025, ensuring a bold rethinking of how healthcare is financed and protected from commercial interests.

The HLM will adopt a political declaration that will determine how NCDs including cancer are addressed to 2030, according to the WHO.

Speakers addressing the plenary called for the intersection of money, politics, and public health commitments to be addressed. 

Universal Health Coverage

“Universal health coverage (UHC) is not just a health goal; it’s a political strategy that leaders can rally behind,” said Robert Yates from the London School of Hygiene and Tropical Medicine. 

UHC aims to ensure that everyone can access essential health services without facing financial ruin and for cancer patients, often burdened by exorbitant treatment costs, this is not just a lofty ideal but a lifeline, Yates explained.

“There is no other way of financing this other than through a predominantly publicly financed health system,” Yates stressed. 

“If we’re serious about UHC, we have to be serious about increasing levels of domestic public financing and making sure that resources are allocated as efficiently and equitably as possible.” 

He urged advocates to focus their efforts on high-level policymakers, particularly ministers of finance and heads of government, to secure the necessary funds.

Cancer care, Yates argued, is central to the UHC agenda, from preventive measures like the HPV vaccine to advanced treatments. 

He pointed to the cost-effectiveness of many cancer interventions as a compelling argument for public investment, citing examples like the inexpensive HPV vaccine that can prevent cervical cancer. “We need to sell the broader benefits of investing in cancer care, including the economic advantages,” Yates said. “It’s about convincing politicians that this is what their populations want – and it’s politically popular.”

The economic impact of cancer and other NCDs extends far beyond individual patients, straining healthcare systems worldwide. 

Bente Mikkelsen,  the World Health Organization’s (WHO) Director of NCDs, said that only 28% of countries have integrated cancer care into their UHC plans. The consequence? Many patients face catastrophic out-of-pocket expenses, plunging families into poverty.

“We have to stop relying solely on international funding and look at sustainable domestic financing,” Mikkelsen urged. 

“Unless cancer is part of the UHC agenda, we will continue to see out-of-pocket payments driving people into poverty.” She emphasized that the link between poverty and NCDs forms a vicious cycle, as low-income individuals are more likely to suffer from these diseases and less able to afford treatment.

‘Voluntary actions don’t work’

Another significant barrier to addressing NCDs is the influence of commercial interests, highlighted Anna Gilmore, Co-Director of the Centre for 21st Century Public Health at the University of Bath

“What’s causing disease and killing us is increasingly the products of commercial organisations – tobacco, alcohol, ultra-processed foods,” Gilmore said. “And the greatest barrier to preventing disease is the practices of those same corporations.”

Gilmore pointed to the WHO Framework Convention on Tobacco Control’s Article 5.3 as a model for protecting public health policies from harmful corporate influences. Article 5.3 specifically requires governments to protect their public health policies from the commercial and other vested interests of the tobacco industry. 

It recognizes the fundamental conflict between public health and the tobacco industry’s profit motives, and it sets out guidelines to limit interactions with the industry, ensure transparency, and prevent conflicts of interest.

“The tobacco industry has a long history of trying to undermine public health efforts through lobbying, funding misleading research, and positioning itself as a partner in health initiatives,” Gilmore explained. 

“Article 5.3 is a critical tool in countering these tactics, as it explicitly calls for excluding the tobacco industry from policy-making processes and ensuring that their influence does not interfere with public health objectives.”

The guidelines under Article 5.3 recommend that governments avoid any partnership or interaction with the tobacco industry unless strictly necessary and ensure that any such interactions are transparent and accountable​. This model is cited as an effective way to protect public health from the influence of industries that profit from products harmful to health.

Fabio Gomes, Regional Advisor at the Pan-American Health Organization.

Fabio Gomes, Regional Advisor at the Pan-American Health Organization, echoed these concerns, highlighting how Latin American countries have started regulating harmful products and practices. 

“Countries have realized that we cannot move forward without regulating the products that are killing us,” he said, pointing to successful policies like warning labels on unhealthy foods and restrictions on marketing aimed at children. 

The regulation of these products is seen as essential to protect public health from the influence of powerful commercial interests that prioritize profit over people’s well-being.

The panellists stressed that confronting commercial interests is critical in the broader fight against NCDs. They noted that implementing measures similar to Article 5.3 for alcohol, sugary drinks, and ultra-processed foods manufacturers, could significantly advance public health protections. 

Gilmore highlighted how corporations often resist regulations that could prevent millions of deaths annually, such as taxes on tobacco or restrictions on unhealthy food marketing. She believes that regulations are vital in reducing the influence of industries that stand in the way of effective NCD prevention strategies. 

“Voluntary actions don’t work, regulation will always be essential,” she said.

A political battle for health

While calling for increased public financing and highlighting the need for high-level political advocacy to ensure cancer care becomes a priority within health agendas worldwide, Yates and others highlighted the need for the key players to be confident in directly reaching out to politicians such US Vice Presidential candidate Tim Waltz, who had personal experience of how financially devastating cancer can be on a family.

“We need to get political,” Yates stated. He urged cancer advocates to directly engage with ministers of finance and heads of government to secure funding for cancer services. He argued that integrating cancer care into UHC could drive broader political support, given its strong public appeal and the significant economic benefits associated with early intervention and prevention.

With the United Nations High-Level Meeting on NCDs approaching in 2025, the panellists emphasised the need to secure commitments from political leaders to increase funding and regulatory measures that could significantly impact global health outcomes.

Preserving cancer research integrity

Christoph Plass, Division Head at the International Journal of Cancer

One of the Congress panels addressed fraud in cancer research. Fraudulent science, including data manipulation, plagiarism, and paper mills, have been a persistent problems, particularly exacerbated by the influx of ‘fake’ papers post-COVID-19. 

Christoph Plass, Division Head at the International Journal of Cancer, highlighted the troubling trend of cell line misidentification in cancer research, which leads to inaccurate research findings. 

He emphasized the need for cell line authentication and research resource identifiers (RRIDs) to ensure the reliability of the data presented. His team found that many rejected manuscripts for cell line issues were published elsewhere without corrections—a practice that threatens the credibility of published research.

Julie Stacey, Editor-in-Chief of eBioMedicine, said that smaller journals often lack the resources for thorough peer review and investigative rigour, leading to the publication of flawed or fraudulent research. Larger journals have better systems in place but are not immune to these problems, often relying on whistleblowers to identify misconduct.

Sonali Johnson, from the Union for International Cancer Control (UICC), underscored how fraudulent research erodes public trust in science and medical research, making it harder to advocate for cancer control initiatives. 

Misinformation is especially harmful in cancer research, where public understanding is already limited. Fraudulent findings can lead to patients pursuing ineffective treatments, delaying necessary care, and wasting valuable resources. Johnson also pointed out that commercial interests from industries such as tobacco and fossil fuels manipulate science to promote their products, often creating confusion and mistrust about cancer-related risks.

The panellists agreed on the need for stricter editorial policies, transparency in research funding, and a stronger focus on ethical education for junior and senior researchers alike. The session emphasized that journals must take responsibility for maintaining the highest standards of research integrity, while funding bodies and institutions need to enforce stricter compliance measures to avoid the pitfalls of fraudulent science.

The session concluded with a call to action for the cancer research community to adopt more rigorous authentication processes, promote open science initiatives, and foster a culture of accountability.

Geneva, Switzerland—The 2024 World Cancer Congress opened Tuesday in Geneva, bringing together more than 2,000 delegates from more than 120 countries. Its convener said the congress underscores a global commitment to combating the growing burden of cancer.

World Cancer Congress kicks off in Geneva
World Cancer Congress kicks off in Geneva

Hosted by the Union for International Cancer Control (UICC), the congress aims to foster collaboration amongst cancer and health experts through a diverse three-day program of discussions, presentations, and networking opportunities.

UICC president, Prof Jeff Dunn, welcomed the delegates and highlighted the importance of international collaboration in the fight against cancer.

“We are here to share, learn, and strengthen our bonds in this shared quest to control cancer,” he said.

Despite global disruptions, he said the participants’ turnout reflects the urgency of addressing the rising cancer burden worldwide.

Dunn, a cancer survivor himself, spoke of his personal journey with mantle cell lymphoma, emphasising the role of community support in his recovery. He praised the congress partners, including the World Health Organisation (WHO), the International Agency for Research on Cancer (IARC), and various cancer societies.

The opening ceremony featured addresses from notable global health leaders. Dr Elisabete Weiderpass, director-general of IARC, highlighted the alarming increase in cancer cases, projecting that new cancer cases could rise by 77% by 2050, particularly in low- and middle-income countries. She stressed the importance of preventive measures, such as tobacco control and HPV vaccination, and addressing environmental and lifestyle risk factors to curb this trend.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus, addressing the congress via video message, acknowledged the progress made in implementing national cancer programs but called for more political leadership and faster action. He emphasised the need for countries to work towards achieving the Sustainable Development Goals related to non-communicable diseases, including cancer. European Union Health Commissioner Stella Kyriakides also delivered a message outlining Europe’s commitment through the EU’s Beating Cancer Plan, which includes initiatives ranging from cancer prevention to improving the quality of life for cancer survivors.

Global Impact of Cancer Orphaning and Mortality Disparities

New research plays a significant role at the congress and will be showcased throughout the event, with some highlights already shared during Tuesday’s opening press conference.

Researchers, for example, explored how many children worldwide have been orphaned by losing their father to cancer. Losing one or both parents can leave children at a lifelong disadvantage in terms of health, support, and education.

The study, conducted by the IARC in France, follows a 2022 report that found one million children lose their mother to cancer each year. This new research aimed to estimate the global number of children who become fatherless due to cancer-related deaths amongst men. The team found that in 2020, 5.5 million men died from cancer, leading to around 1.4 million new paternal orphans, amongst which 75% were due to paternal deaths occurring above 45 years old.

The latest findings also emphasised the disproportionate impact on regions such as Asia and Africa, showing a significant link between development levels and the number of new orphans.

The research also underscored the urgent need for strategies to reduce preventable cancer deaths and provide better support for affected children.

A separate first-of-its-kind study shared at the congress quantifies the socioeconomic burden of ovarian cancer across 11 countries and highlights the significant disparities between countries and income groups.

“An estimated 3.4 million cancer deaths could be avoided annually If every country had the same success in addressing cancer as the best-performing countries, with stomach, lung, breast, and colourectal cancers having the most potentially avoidable deaths,” the UICC said in a statement on the study. “The highest disparities in cancer mortality occur in sub-Saharan Africa and Southeast Asia.”

Researchers are also releasing an IARC assessment on the pandemic’s impact on cancer diagnosis and stage distribution. The study, based on data from population-based cancer registries in seven countries, found significant reductions in melanoma, breast, prostate, and lung cancer incidence, particularly during the early months of lockdown. These trends highlight the importance of preparing for future pandemics and the need to address screening and healthcare access disruptions, according to the UICC.

AI And Other Advancements

Artificial intelligence and other new technologies in healthcare that can transform patient care and enhance diagnostics and treatments are also being explored—both from the standpoint of the advancements they can provide and challenges like data privacy.

A prospective five-country observational study of the performance of a new artificial intelligence-based tool for cervical pre-cancer screening in the African region—Malawi, Rwanda, Senegal, Zambia, and Zimbabwe — was announced to be released on Wednesday. The study involved more than 24,000 women and evaluated the performance of an AI-based tool, Automated Visual Evaluation (AVE).

AVE showed significantly higher sensitivity (60.1%) than the other tools it was compared to.

“The study concludes that AVE could enhance cervical pre-cancer detection in resource-limited settings, supporting broader cervical cancer elimination efforts despite some trade-offs in specificity,” the UICC said.

Challenges of Cancer Care in Conflict Zones

WHO’s Andre Ilbawi provided insights into the plights of cancer patients in Gaza.
WHO’s Andre Ilbawi provided insights into the plights of cancer patients in Gaza.

Another focus of the event was cancer care during humanitarian crises. Key sessions, including some on Tuesday, addressed the challenges of providing care in places such as Sudan, Gaza and Haiti.

Andre Ilbawi, a cancer lead at the WHO, painted a stark picture of the challenges faced by cancer patients in Gaza in one session. He said that as conflict rages, the already fragile health system struggles to cope, leaving cancer patients in a precarious position.

“The first step in areas of conflict is preparedness,” Ilbawi explained, emphasising that proactive measures, such as setting up funds and protocols for evacuating critically ill patients, are crucial in these volatile environments.

Just last week, the WHO evacuated around 100 Gaza patients in one of its most significant efforts to date to the United Arab Emirates medical treatment.

Ilbawi noted that the recent conflict in Gaza has laid bare the vulnerabilities of healthcare systems in conflict zones. From a lack of essential medicines to disrupted care pathways, he argued that cancer patients in Gaza face enormous barriers to accessing treatment.

“Cancer was one of the complicated issues in NCDs and humanitarian crises,” Ilbawi said, underscoring the compounded effects of war, displacement, and systemic neglect on cancer care.

The need for coordinated international responses was a recurring theme in the session labelled “Leaving No One Behind: Advancing Equity for Refugees, Displaced People, and Underprivileged Communities.” Carlos Rodriguez-Galindo of St. Jude Children’s Research Hospital discussed how the global oncology community can and must mobilise rapidly in crisis situations. He drew parallels between the response efforts in Ukraine and Gaza, where international and regional oncology groups have worked together to ensure continuity of care for cancer patients.

“In Gaza, having boots on the ground made a significant difference,” Rodriguez-Galindo explained. “St. Jude’s had staff dedicated to tracking every cancer patient, knowing their names, diagnoses, and treatment needs, and coordinating with local and international bodies to ensure they received the necessary care.” This immediate response was instrumental in managing patient care during a chaotic and dangerous time, providing a model for supporting other conflict zones.

However, Ilbawi highlighted that the situation in Gaza differs significantly from other crises due to its protracted nature and the severe restrictions on movement.

“What worked well in Ukraine did not necessarily translate to Gaza,” Ilbawi pointed out. For example, while patient evacuations were managed relatively smoothly in Ukraine, Gaza’s complex political and security landscape has made similar efforts much more challenging.

Ilbawi stressed that the solution to these challenges lies in emergency response and in building sustainable, long-term healthcare solutions that integrate cancer care into the broader health system. He emphasised that parallel health systems—where refugees and local populations receive different levels of care—are not sustainable and do not serve anyone’s interests.

“Eventually, cancer care must be fully integrated into national health systems,” Ilbawi argued. “The humanitarian response can no longer be seen as a temporary fix; it needs to be part of a broader strategy that strengthens the entire health infrastructure.”

He pointed to the need for ongoing international collaboration and investment to build resilient health systems that can withstand the pressures of conflict and provide equitable care for all.

The panellists called for a united global effort to address the healthcare needs of cancer patients in conflict zones. They stressed the importance of multilateralism and upholding international agreements that protect health workers and patients in times of crisis.

“We must honour decades of international law and agreements that govern the protection of healthcare in conflict,” Ilbawi said. “These are not just policies—they are lifelines.”

The UICC announced that the next World Cancer Congress will be held in Hong Kong in 2026. Future leaders’ summits are planned in Australia and other potential locations in low- and middle-income countries.

Image Credits: WHO/G. Reboux, Paul Adepoju.

The 11th meeting on the Intergovernmental Negotiating Body (INB) is currently underway in Geneva.

The latest draft of the World Health Organization’s (WHO) pandemic agreement shifts key decisions to the Conference of the Parties (COP) – a body that will be set up after the World Health Assembly (WHA) has adopted the agreement.

The draft, developed by the WHO Bureau overseeing the Intergovernmental Negotiating Body (INB) talks, was distributed to delegates late on Monday.

Details about how to implement the contentious Pathogen Access and Benefit Sharing (PABS) system (Article 12) – a mechanism to share information and benefits about pathogens with pandemic potential – is one of those kicked down the road.

“The provisions governing the PABS system, including definitions of pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions, shall be developed and agreed in an instrument in accordance with Chapter III,” according to the draft.

Chapter III deals with institutional arrangements to bring the pandemic agreement into effect, primarily via a COP convened by the WHO “not later than one year after the entry into force of the WHO Pandemic Agreement”. 

The PABS system will also need to be recognised under the Nagoya Protocol, according to the new draft.

‘Lots of blanks’

Provisions for “pandemic prevention and surveillance” (Article 4) have also been kicked down the road to the COP, which will be charged with further developing these, “taking into consideration a One Health approach”.

In the One Health section (Article 5), the onus rests entirely on countries to develop and integrate measures governing animal and human health.

“This new text sets up a pandemic agreement ‘lite’ where there are lots of blanks left to fill in after the agreement,” says Elliot Hannon, Spark Street senior researcher and an observer at the negotiations.

“The Bureau’s new suggested language really shows they’re taking out the most contentious issues, particularly on PABS, and leaving the details to be worked out later. The aim, of course, is to meet their deadline and to produce some kind of agreement on PABS,” he added.

Hannon also pointed out that the language in the new draft had softened from terms like “hereby establish”, to “agree to establish”. 

“Almost all of the changes are designed to not have to deal with the intricacies of PABS right now. The same goes for Articles 4 and 5 on ‘prevention, surveillance’ and ‘One Health’,” he added.

“This is, obviously counter to what many Global South or developing economy countries are interested in and demanding, as they see the PABS system as a key ball game,” said Hannon.

New tech transfer definition

The draft introduces new two definitions:  “The transfer of technology is understood to mean non-coercive transfer and on mutually agreed terms,” according to the new text. 

“This understanding is without prejudice to other measures that parties may take pursuant to their domestic and/or national legislation, provided that such measures are consistent with their relevant international obligations regarding intellectual property,” it adds.

Meanwhile, it defines “know-how” as the “knowledge and skills required to manufacture products”.

“Negotiators are struggling to find compromise language on technology transfer,” noted Knowledge Ecology International director Jamie Love.

“Everyone knows it is important, but there is a lot of industry lobbying that is making it difficult to reach agreement.”

The 11th meeting of the INB ends on Friday. Negotiators have until May 2025 to reach agreement but keep getting stuck on PABS.

European Commission President Ursula von der Leyen announces Olivér Várhelyi as Commissioner for Health and Animal Welfare.

Hungary’s Olivér Várhelyi has been announced as the new European Commissioner for Health, in a portfolio that now includes animal welfare.

He succeeds Cyprus’s Stella Kyriakides, whose portfolio was health and food safety.

Várhelyi has been the European Commissioner for Neighbourhood and Enlargement since 2019, leading efforts to increase membership of the European Union.

“He will be responsible for building a European health union and continuing the work of beating cancer and on preventive health,” said Commission President Ursula Von der Leyen, announcing his appointment as part of her new European Commission College on Tuesday.

However,  before assuming office, all appointees still face questioning by Members of the European Parliament (MEPs), need the  support of two-thirds of the MEPs on their respective committees and the college has to be voted in by the Parliament.

Várhelyi was nominated by right-wing Hungarian Prime Minister Viktor Orbán. He has a legal background and has served in various positions in the Hungarian public administration, including in trade and industry and foreign affairs. 

Prior to becoming a commissioner, he was Hungary’s Ambassador to the EU. Hungary is one of the least democratic EU members, restricting NGOs, media and women’s and LGBTQ rights.

In July 2022, the European Commission referred Hungary to the Court of Justice of the EU for its 2021 amendments to the Child Protection Law “which included unjustified restrictions on LGBT content, with the excuse of protecting children”, according to Human Rights Watch.

In September 2022, the Hungarian Ministry of Health issued a decree making it mandatory for pregnant women seeking abortions to listen to the foetal heartbeat before terminating the pregnancy.

As Commissioner in charge of enlargement, Várhelyi was accused of not paying enough attention to aspirant EU members’ records on democracy and human rights. In particular, he was accused of “pushing” Serbia’s EU membership despite its failure to make progress on key democratic and human rights issues, according to a report by Politico.

His predecessor, Kyriakides, who describes herself as a human rights advocate on X, comes from Cyprus’s Democratic Party, a centre-right Christian democratic political party

Unlike Várhelyi, she has a background in health and worked in her country’s Ministry of Health between 1976 and 2006, as a clinical psychologist in the Department of Child and Adolescent Psychiatry.

She also championed efforts to combat cancer, serving as president of the First Breast Cancer Movement in Cyprus and then president of the European Breast Cancer Coalition, Europa Donna. 

Open plastic trash burning
Burning waste in a rural town in Egypt. 30 metric tonnes of plastic waste are open burned globally each year. Nearly 60% of plastic waste is burned, yet the issue has “not formed a central part” of the current Plastics Treaty negotiations.

Royda Joseph, a 32-year-old mother of three lives in a community next to the PuguKinyamwezi dump in Tanzania. “The dump is on fire every two days,” Royda told the UK NGO TearFund. “Sometimes, when it is on fire, the smoke is so dark and huge that you can’t see the person in front of you or the house next to you. Because of that smoke I get breathing problems and coughing, and eye problems too. The kids also get a lot of breathing problems: they cough a lot.”

In developing cities, from Lagos, to Cairo and New Dheli, air pollution generated by the burning of plastic waste is a daily reality – a 30 metric tonne a year reality according to a new Nature study from researchers at the University of Leeds in the UK. The study found that some 52 metric tons of plastic waste are improperly disposed of every year. And of that, some 57% of that waste is burned openly, launching a slew of toxic chemicals into the air, and disproportionately affecting communities in the Global South. 

The findings have particular meaning for health, which are not well understood. The resulting smoke is a complex mixture of chemicals – including known or suspected carcinogens like bisphenols, phthalates, and dioxins, and a less-understood threat, microplastics. 

The Nature study comes as negotiators gear up for the next round of discussions over an international treaty  on plastic pollution in November in Busan, South Korea. So far, the focus of negotiations has mainly been on the disposal of plastics in landfills and waterways – and not health-harmful air pollution exposures from incineration. 

Model estimated improper waste disposal across 50,000 municipalities worldwide

Graphic description of the sources of air, water and land-based ’emissions’ from unmanaged plastics debris.

Using artificial intelligence to model and estimate plastic waste across 50,000 municipalities worldwide, the researchers identified Sub-Saharan Africa, South Asia, and South-East Asia as “hotspots” for improperly burned or disposed of plastics. India, followed by Nigeria and Indonesia, tops the list as the largest pollution emitter, producing one -fifth of global plastic pollution at 9.3 metric tonnes of plastic waste. China, Russia, Pakistan, Cambodia, and Brazil also ranked as high pollution producers.  Some 1.5 billion of the world’s 8 billion people, mainly in the Global South, live without any waste collection services or with highly inadequate services. 

As a result, low- and middle-income countries in the Global South emit roughly two-thirds of the world’s unmanaged plastic waste, defined as un-contained debris that winds up in open landfills, along fields and roadsides, or in waterways – or conversely as incinerated microplastics. Altogether, uncollected waste in lower-middle income countries accounts for 38% of total global plastics incineration emissions and 51% of plastic debris. 

While in developed countries, plastics incineration occurs in high-temperature, high-tech industrial burning sites, with controlled emissions release, in developing countries most of this unmanaged plastics waste is burned in open pits or piles in neighborhoods and streets of cities, towns and villages, or on their periphery, the study notes.

Burning plastics release microplastics, other hazardous chemicals

Plastic waste sorting
Over 30 metric tonnes of plastic are burned each year, mostly in lower and middle income countries, leaving millions exposed to toxic air pollutants.

The resulting smoke is a complex mixture of chemicals – including known or suspected carcinogens like bisphenols, phthalates, and dioxins, and a less-understood threat, microplastics. 

The health effects can be severe, Gauri Sanjeev Pathak, an Associate Professor at Aarhus University in Denmark, told Health Policy Watch. 

“Such emissions have been tied to cancer, respiratory problems, immunological issues, and birth defects, among a host of other human and planetary health issues,” she said. 

“Both open burning and degradation of plastics entering the environment as unmanaged solid waste can produce microplastics,” added Katrina Smith Korfmacher, Professor of Environmental Medicine at the University of Rochester and co-director of the Lake Ontario MicroPlastics center. “Open burning poses well-known threats to human health,” she said.

One study estimated that humans may inhale up to 22 million particles of micro- and nanoplastics annually. Inhaling these pollutants can cause breathing problems, exacerbate existing respiratory conditions, and contribute to air pollution-related diseases.

Gaps in knowledge about the health effects of plastics air pollution exposures

Despite the growing number of studies on the health risks of microplastics, the World Health Organization (WHO) notes that “many gaps remain in the current scientific knowledge of the health impacts of different types of plastics and added chemicals and their breakdown in the environment,” in a December 2023 report to the WHO Executive Board

Along with the direct exposures to humans from incineration smoke, tiny particles of carcinogenic chemicals like dioxins and furans, eventually settle on cropland and in waterways, where they enter the food chain. Dioxins are potentially lethal persistent organic pollutants that can cause cancer and disrupt thyroid and respiratory systems, according to the United Nations Environmental Programme (UNEP). 

Pollution hotspots – South Asia, Sub-Saharan Africa, South-East Asia

Plastic pollution map
Estimate of plastics ’emissions’ for the year 20202, referring to how much plastic ends up improperly incinerated or dumped on land or in waterways.

Just nine countries account for more than half of mismanaged plastics pollution emissions to the air, land and water, in absolute terms. But some countries with low absolute emissions rank high in per capita terms. For example, China, the world’s fourth largest emitter of plastics pollution has a very low per-capita emission rate, while South Sudan has high per-capita rates but low overall emissions. 

In Latin America and the Caribbean, hotspots for per-capita emissions include municipalities in Paraguay, Belize and Haiti.

The study anticipates that Sub-Saharan Africa will become the world’s largest source of plastic pollution within the next few decades as absolute and per-capita emissions continue to climb. Several megacities stand out as key hotspots, including Lagos, Nigeria; Juba, South Sudan; and Nouakchott, Mauritania.

“Across the continent, there is barely any plastic treatment infrastructure in place,” said a WHO Africa Region article on plastic waste.

Waste scavengers on the front lines of exposures

A woman scavenger looks on as two colleagues burn plastic e-waste to recuperate metal wiring

In lieu of government waste collection, “waste-pickers” in the informal sector generally collect and sort plastics – burning much of it to recuperate valuable metals, including wire and other materials that they can then sell or reuse. 

Globally, nearly 60% of all plastic waste globally is collected by waste scavengers in the informal sector. Over 20 million people around the world earn an income in the informal waste sector, collecting, sorting, and selling materials for recycling or reuse, according to the UN Environmental Programme (UNEP). Around 20% of waste scavengers are women, and an uncounted number are children, a 2021 WHO report estimates. The job is hazardous and exposures to the toxic soup of chemicals, directly and through airborne pathways, can cause respiratory illnesses and skin infections, as well as cancers. In addition, women and children are at risk from adverse reproductive and developmental health effects. 

Advocates for safer conditions urge governments and companies to accept Fair Circulatory Principles so that the human rights of waste pickers and other informal workers are recognized. 

The estimates highlight the huge disparities in how countries are able to grapple with plastic waste.  For much of the Global South, waste mismanagement drives pollution, while the Global North’s robust waste collection and management means that a much smaller fraction of plastic waste ends up in the local environment.

Raising awareness about plastics air pollution exposures – and hopes for consideration in a treaty

Managing plastic waste
With more robust waste management systems, wealthier countries are able to keep plastic waste from contaminating the air, soil, and water, leading the UNEP to advocate for more waste management investment.

The updated estimates of pollution from plastics waste, and particularly from incineration, comes just a few months before the next round of negotiations at the Intergovernmental Negotiating Committee on Plastic Pollution in Busan, South Korea, 25 November-1 December.

The study authors hope negotiators will consider the burden of openly burned plastic, a topic that has “not formed a central part of discussions.”

Pathak stressed that “plastic pollution awareness campaigns or policies that focus only on plastic litter can often lead to increased open plastic burning, as communities and local officials engage in clean-up activities to care for their spaces or to meet waste management goals.

“Given low levels of awareness regarding the harms and the persistence of the toxicants from open burning and a lack of real alternatives to deal with collected wastes, communities often end up burning them. This is why it is crucial that policies and interventions to target plastic pollution, especially global interventions designed in the Global North, take a comprehensive view of the plastic problem and pay attention to local constraints and capacities.”

Korfmacher also echoed the need for research and awareness into “how plastics enter the human body and what effects different sizes, shapes, and types of plastics have on human health.” 

Image Credits: S. Samantaroy, Nature , SweepSmart, Nature/Cottom et al, 2024, WHO,2021.

Bavarian Nordic’s MVA-BN is the first mpox vaccine to get WHO pre-qualification.

Bavarian Nordic’s MVA-BN vaccine, has become the first mpox vaccine to be added to the World Health Organization (WHO) prequalification (PQ) list, enabling its use globally.

The WHO has also recommended that single doses be given in supply-constrained outbreak situations instead of the usual two doses, and “off label” use for children as the vaccine is not yet approved for under-18s.

WHO Prequalification (PQ) and Emergency Use Listing (EUL) are mechanisms used to evaluate quality, safety and efficacy of medical products, such as vaccines, diagnostics and medicines, and product suitability for use in low- and middle-income countries. 

“PQ is based on the review of full set of quality, safety and efficacy data on medical products, including risk management plan and programmatic suitability,” according to a Friday media release from WHO.

“WHO’s assessment for prequalification is based on information submitted by the manufacturer, Bavarian Nordic, and review by the European Medicines Agency, the regulatory agency of record for this vaccine,” the WHO added.

A month ago, WHO Director General  Dr Tedros Adhanom Ghebreyesus declared mpox a public health emergency of international concern (PHEIC) as the outbreak intensified in the Democratic Republic of the Congo (DRC) and neighbouring countries.

Since the global outbreak in 2022, over 120 countries have confirmed more than 103 000 cases. 

This year, there have been 25 237 suspected and confirmed cases and 723 deaths from different outbreaks in 14 African countries (8 September 2024). Morocco reported its first case on Thursday.

‘Off label’ for children

A child infected with mpox: since smallpox vaccinations were discontinued, children may be even more vulnerable.

“This first prequalification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa, and in future,” said Tedros. 

“We now need urgent scale up in procurement, donations and rollout to ensure equitable access to vaccines where they are needed most, alongside other public health tools, to prevent infections, stop transmission and save lives.”

The MVA-BN vaccine (marketed as Jynneous and Imvamune) is administered in people over the age of 18 as a two-dose injection given four weeks apart. After prior cold storage, the vaccine can be kept at 2–8°C for up to eight weeks.

Although, MVA-BN is not yet registered for use in children, the WHO’s head of Research and Development, Dr Ana-Maria Restrepo, told a recent media briefing that the DRC could use the vaccine “off label” for children, and that there were a number of studies – including clinical studies – that had established its efficacy in children. The majority of mpox cases in DRC are in children.

The WHO also noted that it could be used “off-label” for pregnant and immuno-compromised people “in outbreak settings where the benefits of vaccination outweigh the potential risks”.

WHO has also recommended single-dose use in supply-constrained outbreak situations. Available data shows that a single-dose MVA-BN vaccine given before exposure has an estimated 76% effectiveness whereas the two-dose schedule offers an estimated 82% protection.

Help for national regulators

“The WHO prequalification of the MVA-BN vaccine will help accelerate ongoing procurement of the mpox vaccines by governments and international agencies such as Gavi and Unicef to help communities on the frontlines of the ongoing emergency in Africa and beyond,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. 

“The decision can also help national regulatory authorities to fast-track approvals, ultimately increasing access to quality-assured mpox vaccine products,” he added.

The WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization reviewed all available evidence and recommended the use of MVA-BN vaccine in mpox outbreaks for people “at high risk of exposure”. 

Bavarian Nordic CEO Paul Chaplin said that his company is “highly encouraged” by the PQ, “which is a testament to the strengths of our vaccine and the quality of data we have generated through numerous studies, as well as in real life”. 

Company aims for two million doses in 2024

“Bavarian Nordic has recently filed a submission to the European Medicines Agency to extend the approval to adolescents 12-17 years of age and is also working with partners, including the Coalition for Epidemic Preparedness Innovations (CEPI) to evaluate the safety and efficacy of the vaccine in children 2-12 years of age,” according to a company statement.

“While we continue to work with WHO and other regulatory bodies to expand the approval to include children, who are severely impacted by the mpox outbreak, we are pleased that this approval will help accelerate access to our vaccine for communities across the entire African continent and we applaud the WHO for their swift review and action to make this happen,” added Chaplin.

Bavarian Nordic has undertaken to focus its production efforts on MVA-BN, which will enable it to produce two million doses by the end of the year, and potentially 13 million by the end of 2025, the company reported on Thursday.

Dr Rogerio Gaspar, WHO Director for Regulation and Prequalification, said the global body was “progressing with prequalification and emergency use listing procedures with manufacturers of two other mpox vaccines: LC-16 and ACAM2000. We have also received six expressions of interest for mpox diagnostic products for emergency use listing so far”. 

The LC-16 vaccine, produced by Japan’s KM Biologics, is licensed for use in children.

Image Credits: US Centres for Disease Control .

Around 20,000 delegates took part in the European Respiratory Society (ERS) conference in person and online

Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions, according to new research presented at the European Respiratory Society (ERS) International Congress in Vienna this week.

Researchers from the University of Bergen, Norway, found that even in Northern Europe, where air pollution levels are relatively low, exposure to particulate matter, black carbon, and nitrogen dioxide increased the risk of respiratory hospitalization by 30-45% for each measured increase in these pollutants.

The team analyzed data from 1,644 people across five Northern European countries, using the European Community Respiratory Health Survey. They examined respiratory hospitalizations from 2000 to 2010 and evaluated their connection to long-term exposure to air pollutants and green spaces between 1990 and 2000. 

Researchers considered particulate matter, black carbon, nitrogen dioxide, ozone and “greenness” — a measure of vegetation near homes.

 “Air pollution causes persistent inflammation and oxidative stress in the respiratory system,” explained Shanshan Xu, lead researcher from the University of Bergen. “These harmful processes contribute to the development and exacerbation of chronic respiratory diseases, which can escalate into severe health episodes requiring hospital care.”

While access to green spaces led to a decrease in hospitalizations, researchers found it also increased emergency room visits, primarily among people with hay fever.

“It is also likely that long-term exposure to air pollution could lead to a decreased tolerance or increased sensitivity to these pollutants, explaining why even moderate or low levels might cause severe health effects in certain populations,” Xu said.

Traffic and air pollution

A second study led by researchers at the University of Leicester revealed a strong connection between traffic-related air pollution and the progression from asthma to chronic obstructive pulmonary disease (COPD). The study also found that higher exposure to nitrogen dioxide increases this risk, especially in individuals with a genetic predisposition.

“For every 10 micrograms per cubic meter higher exposure to particulate matter, the risk of developing COPD was 56% higher among asthmatic patients,” said lead author Dr Samuel Cai.

“People with asthma should always be aware of air pollution around them and, if necessary and resources allow, take measures such as wearing masks, use an indoor air purifier and reducing outdoor activities when air pollution is at high levels.”

The findings underscore the critical need for effective clean air initiatives and regulations, according to Professor Zorana J. Andersen, Chair of the ERS Health and Environment Committee.

“Air pollution affects everybody, but most people are very limited in the actions they can take against it to protect their health,” she stated. “It falls to policy-makers to come up with some bold actions to tackle air pollution in our cities.”

The power of laughter and genetics

The ERS Congress, which welcomed nearly 20,000 delegates onsite or online over five days, covered a wide range of respiratory health topics. Notable presentations included studies on genetic risk factors for asthma, the impact of medical clowns on pediatric pneumonia patients, and the effects of fine particulate matter on respiratory immune responses.

Researchers presented a new method for calculating a person’s genetic risk of developing asthma. The study, involving about 12,000 participants, successfully predicted asthma-related conditions, with particularly strong results for childhood-onset asthma.

“Using the power of genetics, we were able to predict asthma and asthma-related outcomes in individuals by generating polygenic risk scores,” Bernard S. Striker, the lead author, explained. “We also showed distinct, genetically driven pathways underlying asthma pathophysiology, which could contribute to personalized treatment approaches and risk mitigation.”

In an unconventional study showcasing the congress’s diverse research, scientists found an unexpected aid for children’s respiratory illnesses: laughter. The research on pediatric pneumonia treatment showed that medical clowns significantly reduced hospital stays for young patients.

Dr Karin Yaacoby-Bianu, a pediatric pulmonologist from the Carmel Medical Center in Israel, reported that children with pneumonia who received twice-daily visits from medical clowns during their first 48 hours of hospitalization had shorter hospital stays – 43.5 hours on average compared to 70 hours.

“Laughter and humor may also have direct physiological benefits by lowering respiratory and heart rates, reducing air trapping, modulating hormones, and enhancing the immune function,” Yaacoby-Bianu said.

The results also showed children supported by clowning required fewer days of intravenous antibiotics. While the study didn’t investigate specific mechanisms, Yaacoby-Bianu suggested that by alleviating stress, medical clowns may indirectly support the body’s natural defense mechanisms, potentially reducing the need for antibiotic interventions.

“We proved that laughter is good for health,” Yaacoby-Bianu told Bloomberg. “Every procedure you try to do with a clown is much easier, much nicer. The child forgets that he is in a hospital.”

The conference also highlighted growing concerns over fine particulate matter (PM2.5) and its impact on respiratory health. A comprehensive review examined how PM2.5 affects the respiratory immune system, suggesting that exposure significantly impairs immune cells’ response to microbial infections, potentially contributing to the development of severe respiratory diseases.

Among the hundreds of presentations in Vienna, other cutting-edge topics included the unique health dangers of wildfire smoke, AI-supported respiratory illness diagnoses and lung disease, and the effect of asthma on miscarriages.

COP29 Presidency is looking to make health a permanent issue at this and future COPs.

Health will be an important focus of the upcoming annual United Nations (UN) climate conference taking place in November in Baku, Azerbaijan, according to the COP29 Presidency and the World Health Organization (WHO).

Like the previous COP, there will be a health day and there is a slew of health-focused initiatives, according to Elmar Mammadov, co-lead of the COP29 Global and Regional Initiatives and Action Agenda Team.

The COP29 Presidency and the UN Food and Agriculture Organization (FAO) have launched the Harmonia 4 climate resilience initiative to empower farmers, villages, and rural communities.

Then there is the ‘Baku Initiative on Human Development for Climate Resilience’, which is a multi-sectoral initiative on health, education, jobs, green skills, and youth.

In addition, the COP29 Presidency is exploring a coalition along the lines of Alliance for Transformative Action on Climate and Health (ATACH) that came out of COP26. ATACH is an informal voluntary network to share information-sharing and for cooperation administered by WHO.

“We would like COP29 Presidency to prioritize health on a permanent basis, to make it a long-term, sustainable topic to all COPs in the future,” Mammadov said. He added that the COP29 Presidency would like to bring together all the Presidencies since COP26, along with the WHO, and form a climate and health coalition.

The announcements were made during a webinar jointly organized by the COP29 Presidency and the WHO.

“It will be a very strong legacy on health, starting with the ATACH in COP26 and making sure that we have, every year, a more impactful presence on climate change and health,” said Dr Maria Neira, WHO’s Director of Environment, Climate Change and Health.

Neira hailed the plans for collaboration between COP29 Presidency and other UN agencies like FAO, apart from the WHO to liaise on various issues that affect health.

Elmar Mammadov, Co-Lead of the COP29 Global and Regional Initiatives and Action Agenda Team.

Integrating health into city planning

It has become increasingly clear that the national governments have been slow to move on climate policies despite public rhetoric. And hence the focus has shifted to local administration as they have shown to be more willing to act.

“One of the key topic is integration of health into city planning,” Mammadov said. There will be several events and round tables that would focus on this topic.

“And one round table will be dedicated to nature, healthy cities and urban agriculture. This round table also will produce communicable call to action, [and] particularly will address urban agriculture, healthy cities and nature, because afforestation, reforestation also is one of the key topic for cities,” Mammadov said.

The Presidency has introduced the ‘Resilient and Healthy Cities’ initiative that will keep a track of the healthiest cities and address urban health issues. The World Heart Federation also began ranking cities based on the response to cardiovascular health this year, along similar lines.

COP29 is looking at health through food security, gender equity and environment, among others.

Focus on making COP29 inclusive

The location, high cost of attendance, visa issues and the allocation of time at COPs has usually meant that many groups are excluded.

“We would like to make COP29 inclusive. We would like to hear all voices, all proposals,” Mammadov said. He added that the goal would be to incorporate health into global initiatives to ensure it is a central theme in climate action.

Meanwhile, the Presidency will encourage multilateral development banks and multilateral climate funds to invest in each of these areas, so they get the required climate finance.

Image Credits: Unsplash.

Dealing with dementia (illustrative)
Most caregivers of people with dementia in low-income countries are female relatives.

NAIROBI – Africa can harness community care, traditional health, exercise and digital tools to treat dementia as its population ages, according to experts on the second day of Nature’s “Future of Dementia in Africa” conference,.

The conference, the first of its kind in Africa, was presented in conjunction with the Davos Alzheimer’s Collaborative and Aga Khan University and ran from 11-12 September in Nairobi.

A key focus of the two-day event was the use of traditional, complementary, and alternative medicine in Africa and how it could be integrated with modern healthcare practices.

Razak Gyasi
Razak Gyasi

Razak Gyasi, an associate research scientist at the African Population and Health Research Centre, pointed out that by 2050, 2.1 billion people worldwide will be over the age of 60, with 80% of them living in Africa.

Ageing populations face numerous challenges, including financial loss, social isolation, and decreased mental and cognitive capacity, including dementia.

But addressing mental health in older adults doesn’t have to rely solely on Western medicine, said Gyasi.  Physical activity, for example, can improve mental health in old age, social inclusion increases a sense of belonging, and good sleep quality benefits brain function.

In his study on Ghanaians’ perceptions of traditional medicine, Gyasi showed that community members already use various alternative methods to support healthcare, from physical activity and social inclusion to massage therapy, herbal remedies, prayer, music, and aromatherapy.

The study focused on how people in the Sekyere South District of Ashanti in Ghana, perceive traditional medicine and its role compared to modern medicine. It explored key factors such as the accessibility of traditional medicine, the conditions it treats, its safety, effectiveness, and how it interacts with modern medical systems.

Gyasi’s research used a descriptive cross-sectional survey, collecting data at a single point from 120 participants: 70 traditional medicine practitioners, 30 healthcare users, and 20 modern practitioners.

Data was gathered through questionnaires, interviews, and observations of practitioners’ work environments in nine communities. Both qualitative (interviews and observations) and quantitative (survey) methods were used for data analysis.

The results show that alternative medicine has been effective in treating numerous medical conditions, including malaria, typhoid fever, arthritis, jaundice, infertility, strokes, broken bones, boils, piles, HIV/AIDS, and mental illness. However, there are risks due to the lack of formalised, coordinated interactions between allopathic and traditional healthcare providers.

Gyasi identified what he called “pull factors” that draw people toward traditional medicine and “push factors” that keep them away from modern healthcare.

People are drawn to alternative medicine because it takes a holistic approach and treats the “entire human system,” Gyasi showed. Traditional methods are also deeply rooted in people’s cultural upbringing. Many people believe in the spiritual connection between health’s physical and mental aspects, which draws people toward alternative care.

As one study participant asked, “How can I be cured with a treatment regimen that I do not understand?”

Allopathic deterrents

There are also deterrents within the mainstream health system. Some participants reported that they felt doctors lacked professionalism or embarrassed them during treatment.

Others cited the stigma associated with visiting “White man’s” practitioners. Additionally, many allopathic therapies have side effects that people are unwilling to endure, even if the treatment is effective. Finally, the cost of care is often prohibitive, making modern treatments inaccessible for many.

“The traditional system of medical practice is embedded in our culture and tradition,” Gyasi said. “If you ask any older African, whether from an urban or rural setting, this is what they grew up with. Trying to separate family traditions from the Western system isn’t right. Cooperation should be encouraged.”

He suggested that Africans should be able to benefit from both systems. For example, they might visit a clinic for a diagnosis but rely on traditional remedies within their communities for treatment.

“All of us need to come together and address these issues holistically,” he said.

Care for the Caregiver

Wambui Karanja
Wambui Karanja raised the burden placed on caregivers.

Another significant aspect is the unique role of caregivers in Africa. Wambui Karanja, a project manager at the Brain and Mind Institute at Aga Khan University, said that almost all those with dementia in low- and middle-income countries (96%) live at home.

This places a heavy burden on caregivers and greatly impacts the global distribution of caregiving time, particularly for women who contribute 71% of the global hours of informal care, with the highest proportion in low-income countries. These caregivers need better tools and support to care for those they look after.

Karanja highlighted the efforts of the Alzheimer’s Dementia Organisation of Kenya, which has been working to build caregiver capacity at all levels and equip them with the skills to provide basic care for people with dementia.

During the COVID-19 pandemic, the organisation partnered with the Alzheimer’s Society of Ireland to offer online support from both peers and professionals. A training program helped caregivers improve their understanding of dementia patients, practice self-care, and enhance communication.

Feedback from the program was overwhelmingly positive. Caregivers expressed relief that they finally had someone to listen to them and provide support, making them feel less isolated. The program also provided better insight into what to expect for those caring for loved ones in the early stages of dementia.

While some other African local organisations offer similar programs, Karanja emphasised that there aren’t enough resources or partnerships to adequately support caregivers, particularly in Kenya. She said more investment and collaboration are needed to provide the necessary assistance.

Digital tools

Edem Adzogenu, vice chair of the Nigeria Digital Health Initiative, discussed how digital tools could support the dementia community in general.

“A low-resource continent like Africa, where the kinds of investments that are required to go into clinical trials, etc., might not be available, early diagnosis and intervention is the smartest strategy,” Adzogenu said.

He explained that in Africa, dementia diagnosis typically begins only after significant memory loss but digital tools have the potential to change this.

As many people have access to smartphones, Adzogenu stressed that promoting digital health is more about education than training. He noted that digital tools can collect basic health information and conduct simple screenings to help identify early signs of dementia.

Even if elderly individuals struggle with the tests, younger caregivers or relatives can assist, he said.

During the COVID-19 pandemic, a digital health wallet was implemented in 22 African countries to ensure care continuity. Kenya was the first country to adopt it.

“With that platform, we can now build many other things on top of it, and we are using it for brain health as well,” Adzogenu said.

He again highlighted the widespread use of digital tools in Africa, particularly in areas like fintech and social media.

“It would be remiss to say the valuable aspect of our existence on this planet, our health, is not taking advantage of digital tools,” he concluded. “The question is … how do we create the frameworks to make it possible in health?”

Image Credits: rawpixel.com, Maayan Hoffman.