Air pollution remote sensor India
Remote sensing equipment and camera capturing real-world emissions data of vehicles in India as they drive by.

New research shows how 310 premature deaths and 230 new children’s asthma cases can be prevented every day over the next 15 years if governments act against polluting vehicles and accelerate the move to electric vehicles.

Pollution from fossil-fuel vehicles is most lethal for two age groups, those above the age of 65 and those under five, a new study shows.

Five countries, China, the United States, Indonesia, India, and Mexico, are estimated to have the most road transport-attributable cases for children and older people in 2023. For lower-income countries, transitioning to cleaner transport is difficult for most countries, particularly as several are dumping grounds for heavily polluting vehicles from richer countries. 

In 2023, there were 251,500 new asthma cases in children linked to nitrogen dioxide (NO2) from road transport.  Back in 2015, tailpipe emissions were linked to 385,000 fine particulate matter (PM2.5) and ozone- (O3) related deaths globally, with road transport accounting for 64% of these mortalities.

Among those who conducted the research are the International Council on Clean Transportation (ICCT), widely known for exposing Volkswagen’s diesel emissions cheating scandal, along with George Washington University and the University of Colorado Boulder. 

The authors say this study fills a crucial gap in existing literature and provides important evidence needed to support governments at all levels.

They provide a detailed analysis of how different policies could improve health outcomes across more than 180 countries and 13,000 urban areas. The study warns that vehicle pollution could cause up to 1.9 million premature deaths and 1.4 million new cases of asthma in children by 2040 unless strong policy action is taken now.

At its core, the science is straightforward: vehicle exhaust releases tiny particles (PM2.5) and gases like nitrogen dioxide (NO₂) and volatile organic compounds (VOCs), which then react in sunlight to form ground-level ozone — a harmful pollutant. These pollutants penetrate deep into the lungs and bloodstream. In young children, these trigger asthma. In older adults, it raises the risk of heart and lung diseases and early death.

The report suggests a pathway to save these millions of lives and asthma cases in children. The report emphasises that no single policy is enough. A combination of interventions is needed to tackle the crisis. 

Saving the most lives

Accelerating the switch to electric vehicles could cut air pollution and save many lives.

The best case scenario they evaluated would mean a country adopting and enforcing modern vehicle emission standards (like Euro 6 and eventually Euro 7), accelerating the transition to electric vehicles (EVs), phasing out older, more polluting vehicles, and ensuring that the electricity grid becomes cleaner, so that EVs don’t simply shift pollution from roads to power plants.

The largest gains from adopting this mix would be visible in low and middle-income countries (LMICs) that are yet to adopt Euro 6 equivalent standards. Currently, richer nations are dumping polluting vehicles in LMICs.

Implementing the best standards in these countries could achieve 56% and 63% of the total benefits of all identified measures combined for avoidable premature deaths and new paediatric asthma cases, respectively.

Halving air pollution by 2040

China, India and the USA are among the five hotspot countries portrayed here, in terms of avoidable deaths in top ten urban areas. Row a) is PM2.5- and ozone-attributable premature deaths and (b) NO2-attributable new paediatric asthma cases. Yellow labels show cumulative share of avoidable burden from the top ten urban areas, and brown data labels show their corresponding share of population from applicable age groups in the region.

The newly peer-reviewed study released this month aligns with the WHO’s 15-year goal to cut air pollution-linked deaths by half. On 26 May, all WHO regions endorsed this plan at the World Health Assembly in Geneva. The World Bank’s assessment is that if it’s business-as-usual, there will be a rise of 21% in the number of people who are exposed to PM 2.5 levels above [the WHO annual guideline] of five micrograms per cubic meter.

While the goal is a reduction in vehicular emissions, the report highlights the pathway for the next 15 years would be combining Euro 6 (and eventually Euro 7) and ambitious electric vehicle (EV) policies. This could avoid an additional 323,000 (39%) premature deaths and an additional 419,000 (100%) new paediatric asthma cases cumulatively worldwide from 2023 to 2040, compared to focusing on EVs alone (EV). 

But for countries that have already adopted Euro 6/VI-equivalent standards, an ambitious EV transition is vital to achieve further emissions reductions.

The new report, an updated version of a study first reported by Health Policy Watch here, identifies the most vulnerable countries by various criteria. 

Five hotspot countries 

The global hotspots for these impacts are not surprising given the density of population and vehicles. China, India, Indonesia, the United States, and Mexico together account for the largest number of avoidable deaths and new asthma cases linked to nitrogen dioxide from road transport.

Roads account for 93% of carbon emissions from Indian transport, compared with 84% in the US and 81% in China. 

“India ranks among the top five countries with the highest number of premature deaths and pediatric asthma cases from road transport emissions, with COPD and NO₂-related asthma posing major health burdens,” Amit Bhatt, ICCT India’s managing director told Health Policy Watch.
“Children under five and adults over 65 are especially vulnerable, underscoring the need for targeted policies. Though urban youth under 20 make up just 33% of the population, they account for up to 68% of avoidable NO₂-related asthma cases, highlighting the urgent need for city-level interventions. Accelerating EV adoption and ensuring a clean power grid offer India significant health and environmental gains.”

Populous middle-income countries, namely China, India, Pakistan and Indonesia, the report says, have the highest potential avoidable health impacts. These countries lead in avoidable premature deaths and ‘years of life lost.’ China, Egypt, Indonesia and India have the most avoidable new paediatric asthma cases.

Poor countries, those with lower social development indices, are likely to experience increases in new paediatric asthma cases due to growth in populations under 20 years old and changes in exposure. 

Cities are especially critical. Although urban areas house only a third of the world’s children, they account for 68% of avoidable pediatric asthma cases. 

This makes city-level action, like low-emission zones, public transport electrification, and walkable infrastructure, crucial in the fight for clean air.

Image Credits: ICCT, Ernest Ojeh/ Unsplash, ICCT.

Africa needs 6.4 million mpox vaccines in the next few months to address the outbreak, which is now concentrated in Sierra Leone, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

Three-quarters of Africa’s confirmed new mpox cases are in Sierra Leone, all concentrated in high-density areas in all districts, with 648 confirmed cases in the past week. Yet the country only has around 10,000 vaccine doses.

Meanwhile, Ethiopia reported its first three cases this week: parents and their baby who were diagnosed in Moyale, a town in the Oromia district near the border with Kenya.

“Given also the proximity of Somalia, and knowing all the challenges that are there, we need to be really very bold and aggressive to control this outbreak at the source so that it doesn’t expand further,” according to Dr Ngashi Ngongo, Africa CDC’s mpox incident manager.

The 16,915 confirmed cases for the first five months of this year are almost as many as the total for the entire 2024.

Mpox vaccinations are being carried out in seven countries, and while the Africa CDC has appealed for more vaccine donations, the 1.5 million LC16 vaccines from Japan are estimated to finally arrive over the weekend.

Nineteen African countries have active mpox cases, and 2,836 new suspected cases were reported in the past week. 

Meanwhile, 20 countries have cholera outbreaks affecting some 127,409 people, and addressing this is on the agenda of the African Heads of State meeting on 2 June, according to Ngongo

Seventeen member states have measles outbreaks, seven have dengue in seven member and four have Lassa fever.

WHO says there is an 80% chance that at least one of the next five years will exceed 2024 as the warmest on record.

Global temperatures are expected to remain near record levels over the next five years, and there is an 80% chance that at least one of the next five years will exceed 2024 as the warmest on record.

This is the key takeaway from a new report from the World Meteorological Organization (WMO). The temperature rise is expected to worsen the climate impacts on countries, their economies, and sustainable development.

“We have just experienced the 10 warmest years on record. Unfortunately, this WMO report provides no sign of respite over the coming years, and this means that there will be a growing negative impact on our economies, our daily lives, our ecosystems and our planet,” WMO’s Deputy Secretary-General Ko Barrett said.

There is an 86% chance that at least one of the next five years will be more than 1.5°C above the 1850-1900 average, which is commonly known as the pre-industrial era, after which the use of fossil fuels began on a large scale.

The Arctic region continues to warm at a higher rate than the global average, and that risks pushing up the rate of sea level rise.

This report comes a few months after WMO’s State of the Global Climate 2024 report, which confirmed that 2024 was likely the first calendar year to be more than 1.5°C above the pre-industrial era. It was also the warmest year in the 175-year observational record of the world.

In 2015, following the Paris agreement, world leaders agreed to limit global warming to 1.5°C. But this report of the WMO now projects that there is a 70% chance that the five-year average warming for 2025-2029 will be more than 1.5 °C.

For now, though the long-term warming that is an average of temperature over decades, typically over 20 years, remains below 1.5°C.

Rising global temperatures

The average global mean near-surface temperature that combines temperatures for both air and the sea surface is predicted to be between 1.2°C and 1.9°C higher for each year between 2025 and 2029, when compared to pre-industrial era.

The report forecasts that there is a 70% chance that the five-year average warming for 2025-2029 will be more than 1.5°C shows that the warming is intensifying.

This forecast is up from 47% in last year’s report (for the 2024-2028 period) and up from 32% in the 2023 report for the 2023-2027 period.

The WMO reiterated that every additional fraction of a degree of warming matters. It drives more harmful heatwaves, extreme rainfall events, intense droughts, melting of ice sheets, sea ice, and glaciers. It also worsens heating of the ocean and rising sea levels.

Fast warming Arctic region, wetter Sahel

The warming in the Arctic region is predicted to be more than three-and-a-half times the global average over the next five extended winters (November to March). This risks melting its large reserves of ice and pushing up the rates of sea level rise.

On the whole, the warming in the Arctic is projected to be at 2.4°C above the average temperature during the most recent 30-year baseline period (1991-2020).

This is likely to result in reductions in sea-ice concentration in the Barents Sea, Bering Sea, and Sea of Okhotsk, which are in the Arctic region.

Precipitation patterns are also projected to change, with wetter-than-average conditions projected for the semi-arid Sahel region in Northern Africa for the May-September period between 2025 and 2029, according to the report.

Similar conditions are predicted for northern Europe, Alaska, and northern Siberia.

The South Asian region has also been wetter in recent years, and the report forecasts similarly wet periods for the 2025-2029 period.

However, drier-than-average conditions over the Amazon are predicted.

Continued monitoring is essential, but is under threat

The scientific community has repeatedly warned that warming of more than 1.5°C risks unleashing more severe climate change and extreme weather, and every fraction of a degree of warming matters.

“Continued climate monitoring and prediction is essential to provide decision-makers with science-based tools and information to help us adapt,” Barrett said.

However, with funding cuts to US federal agency National Oceanic and Atmospheric Administration (NOAA), weather and climate observations available for climate reports has begun to fall.

Reports like this one from the WMO rely on multiple data sources from a range of organizations to validate their findings, which the defunding of NOAA has affected in recent months.

These reports are meant to provide policymakers with the updates they need ahead of the UN climate change conference, COP30, that will take place later this year.

This is an important COP as it will consider updated climate action plans from countries known as Nationally Determined Contributions, in which countries list the actions that they commit to taking to cut down their carbon emissions.

This report is produced by the UK’s Met Office, which is acting as the WMO Lead Centre for Annual to Decadal Climate Prediction. It provides a synthesis of the predictions from WMO-designated Global Producing Centres and other contributing centres around the world.

Image Credits: WMO/João Murteira.

WHO-Director General Dr Tedros Adhanom Ghebreyesus addresses the 78th World Health Assembly.

Adopting a pandemic agreement and securing a 20% increase in member states’ fees to support the World Health Organization (WHO) were the 78th World Health Assembly’s greatest achievements.

“The words ‘historic’ and ‘landmark’ are overused, but they are perfectly apt to describe the adoption last Tuesday of the WHO pandemic agreement. Likewise, your approval of the next increase in assessed contributions was a strong vote of confidence in the WHO at this critical time,” said WHO Director General Dr Tedros Adhanom Ghebreyessus at the end of the WHA on Tuesday.

Other significant decisions involve new targets to reduce the impact of air pollution; the first ever resolutions on lung health and kidney health, measures to restrict the digital marketing of infant formula and baby food – and even a strategy on traditional medicine.

But the United States’ absence from the WHA cast a long shadow over proceedings, not least of all because it has left a 21% hole in the WHO’s budget.

Despite increased disease outbreaks and the proliferation of non-communicable diseases, the global body has to retrench staff and merge departments.

The WHO’s 36-year-old polio eradication programme faces a budget cut of 40%

Numerous member states are also reeling from significant cuts to their own health budgets since the Trump administration’s shuttering of the US Agency for International Development (USAID), downscaling the US President’s Emergency Plan for AIDS Relief (PEPFAR), and outlawing its National Institutes of Health from contracting foreign sub-grantees.

‘Mired in bureaucratic bloat’

The US chair at the WHA remained empty for the first time in history.

The only contact the US had with the assembly was via a six-minute video message at the opening plenary from Health Secretary Robert F Kennedy Jr. 

In contrast to messages of support and appreciation for the WHO from world leaders, Kennedy described the body as “mired in bureaucratic bloat, entrenched paradigms, conflicts of interest and international power politics.”

Accusing the WHO of being beholden to China and “corporate medicine”, Kennedy invited member states to join the US in creating “new institutions”.

Then, on the final day of the WHA on Tuesday, Kennedy posted pictures on social media with Argentinian President Javier Milei and a gold chainsaw, saying that they’d had a “wonderful meeting … about our nations’ mutual withdrawal from the WHO and the creation of an alternative international health system based on gold-standard science and free from totalitarian impulses, corruption, and political control.”

Given the intensity of member states’ discussions about increased assessed contributions (membership fees) and their across-the-board expressions of gratitude for WHO guidance in tackling a range of health challenges, it is unlikely that many countries will leave the WHO to join a Trump-Kennedy alternative.

Throughout the WHA, member states expressed appreciation for the WHO, particularly its technical assistance and support in addressing specific health challenges.

‘Weaponising food’ in  Gaza

Votes rather than consensus decided two major tension points during the WHA. The first involved the occupied Palestinian territory, particularly in light of Israel’s 80+-day aid blockade.

The WHA eventually passed an updated version of a 2023 measure denouncing the devasting impacts on Palestinians the war, and a decision on “health conditions in the occupied Palestinian territory and occupied Syrian Golan”. This requests the WHO Director-General to monitor and report back on a range of issues including “acts of violence against the wounded and sick, medical personnel and humanitarian personnel exclusively engaged in medical duties”; malnutrition and famine; Palestinian access to water, sanitation and shelter, as well as Israel’s obligations to the territory.

In solidarity with Palestine, which is not a full member state, the WHA raised its flag at the assembly, and a tearful WHO Director-General Dr Tedros Adhanom Ghebreyesus appealed to Israel to allow sufficient aid into the territory where half a million people face immediate starvation, stating: “It’s really wrong to weaponise food, to weaponise medical supplies.”

Tension over climate action

Katarzyna Drążek-Laskowska, director of the Polish health ministry’s International Cooperation Department, chaired Committee B.

However, by far the biggest tensions emerged during discussion on a WHO Draft Global Action Plan on Climate Change and Health, with Saudi Arabia – backed by Russia and the Eastern Mediterranean Region (EMRO) – trying to delay its approval for another year.

Despite WHO consultations on the plan since last July, the Saudi alliance claimed insufficient consultation as the reason for trying to block the plan.

The 15-page plan hinges on three action areas: 

  • Leadership, coordination and advocacy, aimed at ensuring “the integration of health in national and international climate agendas and vice versa”;
  • Evidence and monitoring, aimed at creating “a robust and relevant evidence base”  for  policy, implementation and monitoring;
  • Country-level action and capacity-building to “promote climate change adaptation efforts to address health risks and support mitigation efforts that maximize health benefits”.

Debate on the plan pitted African nations that are part of EMRO against the 47 African countries in the Africa region, with the role of Egypt being particularly noteworthy.

During the pandemic agreement negotiations, Egypt chose to negotiate alongside the Africa region yet on climate, it switched back to EMRO and was a vociferous campaigner for delaying the plan.

While EMRO deployed various procedural moves to delay the plan, the Africa region supported its full adoption, said Mozambique on behalf of the 47 African member states.

“The African region is disproportionally impacted by climate change, and although our continent contributes minimally to the global emission, it bears the greatest burden,” said Mozambique.

However, when the final vote was called, the EMRO group decided to abstain rather than vote against the plan, which was passed by 104-0 with 19 abstentions.

Katarzyna Drążek-Laskowska, director of the Polish health ministry’s International Cooperation Department, who chaired the mammoth climate discussion in Committee B, praised delegations, saying that multilateralism meant “unity not uniformity”.

“Consensus may not always be easy, but it remains our strongest foundation,” said Drążek-Laskowska, who also chaired the budget discussions that saw member states agree to a 20% increase in their membership fees.

Under the new budget, assessed contributions (member states’ fees) will make up 40% of the WHO’s base programme budget of $4.2 billion for 2026-27. The core budget does not include emergency humanitarian appeals or polio programmes, which bring the total budget target up to $6.2 billion.

Now that the WHA has ended, two crucial processes lie ahead. The first involves concluding negotiations on the annex to the pandemic agreement dealing with the Pathogen Access and Benefit Sharing (PABS) system.

‘Critical’ pandemic agreement annex

Dr Tedros presents a ceremonial gavel to Namibian Health Minister Dr Esperance Luvindao, who chaired Committee A

Namibian Health Minister Dr Esperance Luvindao, who chaired Committee A that adopted the pandemic agreement, said that the outcome “reflects compromise, while it advances global collaboration, equity and access”. 

“We also look ahead to the next phase of negotiation on the pathogen access and benefit sharing (PABS) system, which will be critical to the success of future preparedness efforts,” said 31-year-old Luvindao, who assumed her position as the youngest ever African health minister in March.

An Intergovernmental Working Group (IGWG) will guide the PABS negotiations, and is due to conclude talks on annex by next year’s WHA. Only then will the pandemic agreement be open for ratification and once 60 countries have ratified it, the agreement will enter into force.

UN High-Level meeting on NCDs

The other process involves concluding negotiations on the political declaration for the United Nations High-Level meeting on NCDs and mental health in September.

A significant portion of Committee A’s time was devoted to discussion on NCDs, as countries across the globe struggle to curb these.

Only 19 countries – 10 from Europe – are on track to reduce NCD-related mortality by 30% by 2030, and the WHO has spent decades working on strategies to assist member states, including its 16 Best Buys interventions to address NCDs.

Kennedy told the WHA in his video address that the US is “fundamentally shifting the priorities of our health agencies to focus on chronic diseases”. This would include removing food dyes and other harmful additives; investigating the causes of autism and other chronic diseases; seeking to reduce consumption of ultra-processed foods, and supporting “lifestyle changes that will bolster the immune systems and transform the health of our people”, he said.

But the US could learn from nations that have spent decades tackling NCDs, including European nations that have substantially fewer harmful food additives than the US because of EU laws.

Interference in countries’ policies from harmful industries, particularly the tobacco, alcohol and ultraprocessed food industries, are a major obstacle to reducing NCDs – and high taxes on these is a significant deterrent to their consumption.

Paying tribute to WHO member states at the close of the WHA, Tedros said that all the resolutions adopted “express the collective will of the nations of the world, the United Nations, to work together on a shared approach, to share problems”.

No nation can address the magnitude of health challenges facing the world alone.

Image Credits: WHO, WHO/X.

Final vote on the WHO Climate Change and Health Action Plan shows the “green” lights of approval by 109 member states

A new WHO Climate Change and Health Action plan was approved by a key World Health Assembly (WHA) Committee Tuesday evening – after hours of high-stakes, high-drama parliamentary maneuvers by a cluster of oil-rich World Health Organization (WHO) member states to shelve the plan failed.  

WHO member states accepted the original plan by a vote of 109-0, with 19 abstentions. Hours earlier, the WHA rejected a Saudi-led initiative to delay approval of the plan for another year by a vote of 86-23 with 11 abstentions. The Saudi initiative was backed by Russia as well as other countries of WHO’s Eastern Mediterranean Region (EMRO), which includes oil rich Gulf states, and Iraq, Iran and Libya.

A final vote on the actual climate and health action plan was delayed for hours by a range of procedural and technical maneuvers, including two more sets of proposed amendments proposed by EMRO, which failed, as well as a series of debates and procedural questions about how to vote and the order in which the voting should take place.  

The debate was unusual as it focused on an action plan linked to a new WHA resolution on Climate Change and Health that had already been approved last year by an overwhelming majority of WHA members. As the very last item on this year’s packed WHA agenda, it also delayed the closing of the entire Assembly by several hours.

Near 6 pm Egypt’s delegate proposed yet another last-minute amendment “in the spirit of consensus” which provoked another procedural vote, when Peru asked to close the debate.

Egypt proposes a third amendment to the action plan “in the spirit of consensus.” Peru then asks to close the debate.

As the amendments and procedural motions dragged on for hours into the evening, delaying the final vote for longer and longer, it was clear that opponents of the measure were exhausting member states, but proponents remained in the room to see the measure over the goal.

“We’re really testing the rules of procedure today,” quipped WHO legal counsel, Derek Walton at one point.

Even after all of the amendments were exhausted and it appeared that the plan had finally been adopted by consensus, Egypt’s delegate objected once more, saying that the EMRO region could not support it.

That led to the final, definitive ballot by member states on the action plan –  which was overwhelmingly approved.

Claims of insufficient consultations and misalignment?

Saudi delegate explains the take on the WHO Climate Change and Health action plan in WHA debate.

The plan’s opponents maintained that there were insufficient consultations, although WHO and member states held multiple rounds of talks with member states at regional and global level over the past year.

In its statements Monday and Tuesday, Saudi Arabia also seemed to suggest that WHO should not be supporting developing countries’ efforts to access clean energy or mitigate emissions because historically they pollute less.

“As an oil producing sector, we are aware of our role in [energy] transformation, but can’t ask developing countries to pay the price for transformation when they are not responsible for the problems,” said the Saudi delegate, during the initial debate.

Saudi Arabia wanted a postponement of the action plan until next year, until the plan “can be aligned with different national contexts… and to take due account of national diversity.”

But in the final ballot of the day, Saudi and other EMRO states abstained from voting rather than be counted amongst the plan’s opponents.

Saudi Aramco’s economic stake in more fossil fuel expansion

Saudi has a clear national political and economic stake in defining WHO’s climate and health agenda as narrowly as possible.  

Its own state-owned oil company, Saudi Aramco, has the biggest fossil fuel expansion plans of any major oil and gas multinational, overshooting a 2022 International Energy Agency’s scenario for net zero emissions by more than any other multinational. 

Saudi Aramco: the fossil fuel company with the highest overshoot of the International Energy Agency’s net zero emissions scenario (2022).

WHO’s advocacy around shifting health facilities to cleaner and renewable energy sources, and around the co-benefits to health that low-carbon transport, cities, and economies may rub member states that aspire to keep the world on a fossil fuel economy for decades to come in the wrong way.   

Battleground Africa 

Oil and gas projects in Africa set to quadruple (2022); 90% of projects in sensitive forests, are in the Congo Basin, the world´s second largest rainforest.

Sandwiched in the middle of the debate are low-income countries, particularly in Africa, whose governments stand to benefit from large oil and gas projects – but are also bearing the biggest brunt of climate’s impacts. 

As Mozambique’s delegate stressed Monday, on behalf of the 47 African member states: “The African region is disproportionally impacted by climate change, and although our continent contributes minimally to the global emission it bears the greatest burden.”

The African group supported the “full adoption of the global action plan on climate change and health,” he concluded. 

Africa, with its low present-day levels of fossil fuel consumption and emissions but rich mineral reserves locked in rich tropical forests, peatlands, and offshore, represents one of the last frontiers for multinational oil and gas companies to both expand extraction and consumption dramatically, keeping the world on a firmly fossil fuel trajectory for another 50 years. 

In contrast, Asia, led by China, is investing more heavily in renewables. Even India’s massive Adani Group is now investing heavily in solar, wind and hydropower,  even if  coal and oil remain economic mainstays for CEO Gautam Adani, a close associate of Prime Minister Nahrendra Modi.  

India’s Adami Group promotes its green energy plans on its website.

Developed nations calling for healthier, low carbon development

Conversely, many European and other developed nations want WHO’s work to also focus on healthier, more low-carbon strategies that reduce the trajectory of future climate emissions  – alongside adaptation to the inevitable.

Those nations have called on WHO to support national plans for healthier non-motorized and electric transport; urban and building design; as well as nutrition options which also reduce carbon emissions. They have also called on health facilities efforts to “decarbonize” their own high-emissions operations. 

“As a health community, we therefore have a two-fold responsibility firstly, promoting climate measures by positioning the health argument as a strong driver of increased climate ambition,” said Poland, speaking on behalf of 34 member states, including the European Union. 

“This means stimulating broader awareness and education in climate and health and incentivizing other sectors, such as the transport sector on active mobility and the food sector on sustainable and healthy diets.”   

 Clean, reliable energy in low-income countries 

Solar panels being affixed to a hospital in Alberton, South Africa.

Beyond the rhetoric and oft-artificial divide of adaptation and mitigation, African nations appear eager to get WHO’s help to introduce cleaner, greener energy for thousands of  health facilities that lack reliable power, or those that lack any reliable power at all. 

As Mozambique said: “We call for urgent action to build climate resilient health systems across the continent.”  

A 2023 WHO study estimated that 12-15% of health facilities in South Asia and SubSaharan Africa respectively lack access to any electricity at all. 

About half of the health centres in sub-Saharan Africa also lack reliable electricity, according to WHO data. This shortage disrupts essential services such as emergency care, maternal health services, and vaccine refrigeration.

And one billion people worldwide are served by health facilities with no electricity or unreliable electricity services.  See related story: 

One Billion People Lack Access to Health Facilities with Reliable Electricity

Through its ATACH initiative, WHO has been working with countries to build climate resilient and low-carbon sustainable health systems. 

Its efforts have been supported by the International Renewable Energy Agency (IRENA) as well as foundations and philanthropies that are helping health actors access finance as well as plan energy systems that not only bring them electricity, but also ensure their financial sustainability.  

IRENA, as well as the International Energy Agency have long argued that the distribution of health facilities in rural Africa is such that renewable energy or hybrid systems, delivered through mini-grids, are the only affordable and practical solution – than grid power, delivered from centralized, fossil fuel plants. 

Central and eastern Africa have the highest proportion of health facilities with no electricity access – 50% or more in some regions.

Disruptive agenda?

But such initiatives, however modest, are also potentially disruptive. If the politically weak health sector demonstrates that it can electrify with renewables, then why not other more powerful productive sectors, like agriculture, and households? 

The African Development Bank’s Power Africa Initiative, launched by US President Barack Obama in 2013, has been supporting efforts to develop renewable energy grids in rural and off-grid locations – as the quickest and cheapest way to electrify African communities and households. 

Some 600 million Africans lack any electricity access whatsoever, and thus rely upon polluting wood and other biomass for cooking as well as kerosene for lighting — leading to one of the world’s largest disease burdens from household air pollution exposures. 

A majority of the world’s population still without access to clean cooking energy is in the developing world.

Meanwhile, an ambitious new African Energy fund aims to connect about 300 million Africans to electricity, through stepped up development of renewable sources, through a new $40 billion African Energy Fund, part of a new ADB initiative launched in February.  

But in the wake of the collapse of USAID, a major Power Africa partner, and the withdrawal of the United States from African clean energy initiatives, their fate remains unclear. US policy, heavily oriented towards more fossil fuel extraction at home and abroad, is unlikely to support renewables in Africa for the duration of the Trump Administration’s term. 

While the US was not present at this World Health Assembly, if they had been, they would have been cheering on the Saudi and Russian efforts. 

 

Image Credits: Rainforest Foundation and Earth Insights, 2022, Adani Group , Netcare-Alberton Hospital, WHO, T20 Policy Brief, July 2023.

Nigeria’s AMR plan was recognised as a best practice by the WHO.

From hospitals facing up to 80% antibiotic resistance to gonorrhoea that is resistant to almost all treatment, antimicrobial resistance (AMR) is a serious and growing problem, countries told the World Health Assembly (WHA) on Tuesday.

But it has been 10 years since the global action plan on antimicrobial resistance was adopted, and the WHA endorsed the World Health Organization’s (WHO) proposal to present an updated plan to next year’s assembly.

This also follows a request from the United Nations High-Level Meeting on AMR last year for an updated global action plan by 2026.

By 2024, over 170 countries reported that they had national AMR action plans, but only 29% of countries had costing, budgeting and monitoring implementation. Member states also reported that a lack of financing and technical capacity are key constraints.

Slovenia outlined the damage already caused by AMR: “In 2021, AMR was linked to nearly five million deaths, over one million directly. This is not a future threat, it’s a present crisis. ”

“A particularly alarming example is drug-resistant gonorrhoea, once easily treatable, it is now resistant to nearly all antibiotics, raising the risk of untreatable infections, infertility and increasing HIV transmission,” said Slovenia.

“Preventing infections is our first line of defence,” added Slovenia, urging countries to focus on “improving infection control, hygiene, waste management and vaccine access” to reduce both infections and antibiotic demand.

‘Critical blindspots’

Bangladesh described AMR “misuse in animal health, pharmaceutical runoff in the environment, and weak regulatory oversight beyond the human health sector” as “critical blind spots that must receive the same priority as the human health interventions”. 

Nigeria’s second national action plan on AMR launched in 2024, focuses on “domestic resource mobilisation and multi-sectoral engagements.”

“With surveillance systems operational in multiple human, animal and environmental health laboratories and a dedicated national budget line now in place, Nigeria has met the who 2025 minimum standards for infection prevention and control (IPC) and is proud to have been recognised in the WHO 2024 global IPC report as a global best practice,” said the country representative.

But Nigeria acknowledged “lingering challenges”, and to address these, it is “prioritising sustainable, innovative financing, decentralised governance and sub-national capacity-building, expansion of surveillance into primary and community health sectors and integrating stewardship efforts across the health system”.

Indonesia told the WHA that it needs support in “strengthening surveillance efforts, laboratory infrastructure and R & D”. It supports an updated plan that will guide AMR “governance, financing, workforce development and concrete strategies to address socioeconomic determinants of AMR”.

Barbados, whose Prime Minister Mia Mottley chairs the Global Leaders Group on AMR, called for accelerated action on AMR and “sustained technical and financial support, especially for small island developing states”. 

Spain, which confessed to being one of the biggest consumers of antibiotics in primary healthcare, said it had implemented controls in 2014 that had slowed this trend. 

“We’ve launched a new plan for 2025-2027 focused on strengthening surveillance, professional training and research and development for new antibiotics and therapeutic alternatives,” Spain told the WHA.

Numerous countries reported financial challenges in addressing AMR, including countries such as Micronesia, whose AMR efforts were supported by the US Centers for Disease Control (CDC)  However, several countries reported getting support from the UK-based Fleming Fund.

The WHO will submit a draft of the updated report to next year’s executive committee.

WHO is urging countries to work to create a framework to regulate and standardize traditional medicine products.

The World Health Assembly delivered a landmark victory for traditional medicine and indigenous cultures Monday evening, approving a strategy that calls for increased investment in research and integrating ancient healing practices into modern healthcare systems worldwide.

The approval marks a breakthrough moment for advocates of traditional medicine, with nations across Asia, Africa, the Middle East and Latin America celebrating the decision. Iran called it “a visionary yet realistic roadmap” to integrate thousands of years of medical like its own.

But the strategy text shows WHO walking a careful tightrope, embracing practices that represent “accumulated wisdom and healing practices passed down through generations” while demanding they meet modern scientific evidence standards that could take decades to satisfy.

The strategy that will be in place between 2025-2034 was passed after an intense discussion that saw the European Union voice concerns about quality and safety, embodying the tension between empirical science and millennia-old traditions at the heart of the UN health body’s move.

“We urge the organization to be firm and vocal against harmful and or inefficient practices that may be disguised as alternative medicines,” said the delegate from Poland who made a statement on behalf of the EU and its 27 member states.

The strategy does not imply a preference for TCIM practice over biomedical practice, WHO said. While acknowledging traditional medicine’s “immense value” as a “vast repository of knowledge,” the strategy consistently emphasises that integration must be “scientifically valid” and “evidence-based.”

“It seeks to harness the potential contribution of TCIM to health and well-being based on evidence,” the strategy reads. “It is also designed to prevent misinformation, disinformation and malinformation.”

More than 80% of the world’s population in over 170 of the 194 WHO member states use traditional medicine of some form. In some industrialized countries like France and Canada, usage reaches nearly half the population. 

The WHO’s move reflects recognition of a field that serves billions of people worldwide and acknowledges the significant contributions of indigenous cultures to medicine. Around 40% of pharmaceutical products have their origins in traditional medicine, according to the WHO.

“The history, the cultural heritage, the ancestral knowledge…all anchor our traditional medicine work,” said Dr Bruce Aylward, Assistant Director-General for Universal Health Coverage at WHO, while assuring countries of WHO’s support as they find the best ways to integrate their traditional practices in their national systems.

Between Tradition and Evidence

78th Session of the World Health Assembly

This strategy begins what will be a long and expensive process to standardize and regulate care with traditional methods. Hurdles lie ahead, from financing and research capacity to government wrangling over how to establish global standards.

The scale of the task is enormous: systematically studying thousands of years of accumulated knowledge to meet regulatory standards for integration into national health systems. Yet no countries nor WHO made any pledges for further investment in traditional medicine research, and the strategy contains no funding figures either.

“I think that what’s new in this [final] version that wasn’t there before is also looking at the cross-sector value of traditional approaches and learning. There is this big section on protection of indigenous practice and knowledge, and how we can learn from them,” said Tido von Schoen-Angerer, a Geneva-based physician and President of the Traditional, Complementary and Integrative Healthcare Coalition (TCIH).

The central challenge remains evidence. WHO is encouraging countries to integrate traditional medicine into their national health systems, but only when supported by rigorous scientific research that much of traditional medicine currently lacks.

“I don’t think anybody expects WHO to recommend something that is not fully evidence-based,” Schoen-Angerer said. But at this point, while there is strong evidence for some traditional medicine, there is next to nothing for others.

Schoen-Angerer told Health Policy Watch that there was opposition to this draft from Europe, though Asian, African, Middle-Eastern and Latin American countries were largely onboard.

“You have very good evidence for some methods like acupuncture, mindfulness, et cetera, for certain herbs, and you have less evidence for other practices,” Schoen-Angerer said, adding that the WHO’s push for more investment will help create more evidence in the coming years.

This view received pushback from Switzerland-based civil society group Medicus Mundi International Network—a reaction that puts the tension of applying modern science to ancient tradition on full display, raising the question of whether tradition can ever be truly “scientifically valid” by Western paradigms.

“The WHO’s draft Traditional Medicine Strategy (2025–2034) recognizes the value of traditional and Indigenous healing but falls short by privileging Western scientific paradigms over Indigenous epistemologies,” said the delegate from the organization.

“Centering ‘evidence-based’ validation risks displacing practices rooted in land, culture, and spirituality,” she added.

The Funding Challenge: Big Ambitions, Modest Resources

WHO wants countries to spend on research, but the strategy lacks concrete funding commitments—a familiar challenge in the current global health arena. No countries, groups or WHO itself made new funding announcements in Geneva during the passing of the strategy.

The expectation is that WHO’s new strategy will encourage countries to allocate more funding for research, but the strategy places far more burden on member states than on WHO itself.

While directing countries to “establish a national research agenda” and “allocate dedicated resources,” WHO’s own commitments are limited to developing guidelines and technical documents.

The lack of WHO investment likely stems from its own financial crisis. The organization is currently facing a $1.5 billion budget deficit after already slashing its budget by nearly a quarter.

In 2022, India gave WHO $85 million over ten years to build evidence and towards the setting up of WHO Global Centre of Traditional Medicine in Jamnagar. 

Historically, such specialised areas struggle for funding. Women’s health, for example, receives only about 10% of U.S. National Institutes of Health funding.

Conversation on Standardizing Care

WHO’s latest strategy on traditional medicine asks countries to invest in research and create evidence

Traditional medicine spans both oral and codified forms of medicine, and this draft seeks to get countries to work towards creating unified standards—a complex task given the vast diversity of practices across cultures and continents.

“We urge WHO to support countries in developing context-sensitive methodologies, including those that encompass non-codified and oral traditions, to ensure scientific rigour,” a delegate from Thailand said.

The EU, which had already pushed back against the strategy prior to this week’s vote, urged WHO to be guarded as it engages with the industry to prepare standards.

“We strongly recommend preventing conflicts of interest in line with FENSA (Framework of Engagement with Non-State Actors), when engaging with industry and practitioners to devise regulations, and standards for TCIM products and activities,” the delegate from Poland said.

Balancing Rights of Indigenous People with the Challenge of Spurious Products

The WHO’s endorsement has created new opportunities for countries to address a persistent challenge: how to protect legitimate traditional medicine practices while cracking down on fake cures and fraud operations under the cover of spirituality.

Such problems are already widespread globally. For instance, the Indian company Patanjali, which claims to sell products rooted in India’s traditional medicine system of Ayurveda but is embroiled in several lawsuits for “false and misleading” claims. The company in its early years saw fast growth due to its branding and benefited from a relatively lax regulation system for traditional medicine products. 

African nations like Comoros and Togo acknowledged that while TCIM is widely used in their countries, the sector remains unregulated and training the providers remains a challenge.

“It has a great deal of potential, and it has been practised for a very long time by our ancestors. However, it is not within a framework or well-regulated,” the delegate from Comoros said.

In many small island nations, indigenous people are the custodians of TCIM. In others, TCIM is often the only available healthcare for large parts of the population.

“Our traditional medicine, while not fully aligned with the formal, traditional, complementary and interpretive medicine definition, is rooted in local customs, indigenous knowledge and natural resources,” said the delegate from Micronesia, a group of islands in the Pacific Ocean. “We see these practices as important to supporting our health systems and advancing universal health coverage.”

Thailand, too, said it was important to uphold the rights of indigenous people and ensure that any profit made from using local biodiversity and indigenous knowledge ought to be shared with them—a contentious issue that will get pushback from pharmaceutical companies, who argue that paying for access to resources would hinder innovation. 

Image Credits: WHO, WHO, WHO.

Panel discussion: Addressing the Global Crisis of Substandard and Falsified Medicines – A Panel Discussion Enhancing the Work of WHO Member States Mechanism through Regional Engagement, Stakeholder Collaboration and Operation Agility
Panel discussion addressing the Global Crisis of Substandard and Falsified Medicines.

GENEVA, Switzerland — One in 10 medicines in low- and middle-income countries are substandard or falsified, a pervasive health crisis the World Health Organization (WHO) estimates kills over one million people globally each year.

As the cost in millions of lives and billions of public health dollars from falsified medicines rises, member states at the 78th World Health Assembly agreed on Monday to postpone crucial reforms to WHO’s mechanism to combat these dangerous products.

Citing a need for “extended meetings” to develop a new framework and “theory of change,” the assembly deferred reforms to the WHO Member State Mechanism on Substandard and Falsified Medical Products (MSM) until at least late 2025.

The mechanism’s steering committee will meet for annual talks in November 2025, then present findings to the WHO executive board in January 2026. The board will then submit recommendations to the 79th World Health Assembly, where nations will finally vote on the reforms they delayed Monday.

The bureaucratic timeline means effective measures remain stalled until at least May 2026.

Until then, what Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, termed an “urgent need for coordinated international response” remains unmet.

“This issue remains one of the most pressing challenges to public health worldwide,” Nakatani told the assembly, pointing to recent tragedies involving contaminated cough syrups, the alarming rise of falsified weight-loss drugs mimicking semaglutide—the diabetes medication known as Ozempic that has become a cultural phenomenon for weight loss—and synthetic opioids infiltrating medicine supplies.

The delay leaves the international response to the falsified medicines epidemic in a holding pattern as the lucrative illicit trade fueling the crisis generates unprecedented profits.

Estimates place the counterfeit medicine market’s value at up to $432 billion per year—more than 200 times WHO’s annual budget—making pharmaceuticals the world’s largest illicit activity ahead of human trafficking, arms sales, and narcotics.

Countries will continue their national efforts to combat the falsified medicines crisis despite the stalled reforms.

Yet within this crisis, as nations seek funding for domestic surveillance systems, WHO has acknowledged it lacks the resources to provide the support countries need. WHO officials said widespread cuts to global health, humanitarian aid, and development assistance worldwide complicate funding for both the global mechanism and essential domestic capacity building.

“Given the financial crisis facing WHO and countries,” said Dr Alex Ross, Director of Organisational Learning at WHO, the reforms being postponed include revisiting the scope and priorities of the mechanism.

Despite Ross’s frank assessment of the funding gap, the WHO’s review of the falsified medicines mechanism endorsed by member states in Geneva offers no specific budget figures or targets to address the “financial sustainability concerns” it repeatedly cites.

The shortfall will hit the most vulnerable countries hardest as they struggle to fund surveillance improvements amid stretched public health budgets and lack resources to strengthen regulatory systems that could better protect their populations from the threat of counterfeit medicines.

Africa bears the heaviest burden, with an estimated 18.7% prevalence of falsified and substandard medicines—nearly double the average in low- and middle-income countries worldwide.

“Millions of people in Africa continue to die from preventable causes due to substandard and falsified medical products,” the African bloc, representing the continent’s 47 nations, told the assembly.

A 2023 UN Office on Drugs and Crime report documented a devastating toll in sub-Saharan Africa alone: 267,000 annual deaths from falsified antimalarial drugs and 169,000 from fake antibiotics for childhood pneumonia.

“These are not isolated events,” Nakatani warned the assembly. “These are symptoms of the systemic vulnerabilities in the regulatory oversight, supply chain security, and global information sharing.”

A global problem

Rutendo Kuwana, WHO’s team lead for substandard and falsified medicines incidents, quantified the cost to health systems at a UN side event during the assembly, placing estimated losses at $75 million to $200 million each year treating victims of these faulty medical products.

“We have issued several product alerts recently, including with regards to some contaminated medicines and toxic syrups that caused the deaths of more than 300 children,” Kuwana said.

The children’s deaths he referenced include over 300 who died in 2022 in The Gambia, Indonesia, and Uzbekistan from cough syrups contaminated with diethylene glycol and ethylene glycol—industrial solvents used in place of pharmaceutical-grade ingredients.

The situation is deteriorating: in 2023, the number of substandard and falsified incidents reported to WHO doubled compared to 2019.

Beyond contaminated medicines, Kuwana warned of the alarming rise of nitazenes, synthetic opioids more powerful than fentanyl that have been linked to a surge in overdose deaths across Europe and North America, with UK authorities reporting a spike in nitazene-related fatalities in 2024.

“People are purchasing illegal narcotics and taking them, assuming they contain ecstasy or something like it, but they are also adulterated with these nitazenes,” Kuwana said.

“This is not only in LMICs but in high-income countries,” he added. “No country is immune.”

A Failing System

WHO officials told the assembly that the agency’s evaluation of the falsified medicines mechanism, presented to its executive board in January, reinforced long-held concerns about its efficacy.

“It confirms what many of us have long observed, that while the mechanism remains a vital platform, persistent challenges, particularly in securing sustainable funding and ensuring consistent engagement, continue to hinder its full potential,” said Dr Chikwe Ihekweazu, WHO Regional Director ad interim for Africa.

He noted that “public awareness of the dangers of substandard and falsified products is still low” and “many countries lack robust surveillance systems for emerging threats such as adulteration of medicines with highly potent and dangerous synthetic opioids.”

Despite the challenges, progress is being made.

Forty-five of 47 African nations now have focal points integrated into WHO’s surveillance system, a significant increase from just five at the time the report was presented to the executive board in January, leading to 39 alerts between 2020 and 2025.

National Success Stories

Panel discussion: Addressing the Global Crisis of Substandard and Falsified Medicines – A Panel Discussion Enhancing the Work of WHO Member States Mechanism through Regional Engagement, Stakeholder Collaboration and Operation Agility
Panel discussion: Addressing the Global Crisis of Substandard and Falsified Medicines – A Panel Discussion Enhancing the Work of WHO Member States Mechanism through Regional Engagement, Stakeholder Collaboration and Operation Agility.

Nigeria exemplifies what aggressive national action can achieve.

The country’s drug regulatory agency has conducted inspections of over 11,000 shops, seized and destroyed more than 140 trucks of banned or unregistered products, and developed risk-based classifications for domestic manufacturers, Dr Adebisi Jaiyeoba, Deputy Director of Nigeria’s National Agency for Food and Drug Administration and Control said in Geneva.

Nigeria is promoting local production of six key medicines to reduce dependence on imports vulnerable to counterfeiting.

Dr Ketut Putu Yasa, head of the Indonesian College of Thoracic and Cardiovascular Surgery, described the scope of the challenge: “This is a global health emergency.” He called for more coordinated regulatory systems across countries and greater supply chain transparency.

In the Eastern Mediterranean region, conflict and fragile health systems have created ideal conditions for counterfeit medicines to flourish—one example of many global hotspots.

War disrupts regulatory oversight, destroys supply chains, and creates desperate populations willing to accept medicines from questionable sources. Yemen’s situation is particularly dire, with reports indicating that significant proportions of medicines enter through illicit channels, exacerbated by the country’s civil war since 2014.

The problem extends across Western Asia, where a Global Initiative Against Transnational Organized Crime report found that up to 35% of the region’s medicines—from antibiotics and vaccines to insulin and chemotherapy drugs—are illicitly sourced. Countries including Iraq, Lebanon, Syria, Turkey, and Iran face severe medicine shortages that criminal networks exploit.

The economic desperation fueling this trade creates a vicious cycle: counterfeit medicines cost 10 to 50 times more than legitimate versions when addressing shortages, yet are also sold at below-market prices to attract buyers who cannot afford genuine drugs. This dual market traps both the desperate and the economically vulnerable.

“Substandard and falsified medications compromise the effectiveness of healthcare, increase morbidity and mortality and erode public trust in health services,” the Eastern Mediterranean regional bloc declared. “Unfortunately, such products are circulating with increasing frequency due to limited regulatory capacity, exacerbated by the COVID-19 pandemic.”

“Conflicts and fragile health systems have all contributed to this problem,” the bloc stated.

Youth Joins the Fight

Experts in the field also emphasised engaging patients and youth as key to combating falsified medical products.

“We need to ensure patients’ voices are part of surveillance, planning and evaluation,” said Dani Mochi, CEO of the International Alliance of Patients’ Organizations, noting that patients can aid awareness, report dangerous products, and advise regulatory agencies.

Tanushree Jain, Chairperson of Public Health for the International Pharmaceutical Students’ Federation, called for “intergenerational solutions” and suggested a dedicated fund for youth engagement.

“Allow youth champions to act as local leaders to fight [substandard and falsified] products,” Jain urged. “They can play a pivotal role… and energize and mobilize their peers.”

Image Credits: Guilhem Vellut, Maayan Hoffman.

Dr Tedros (centre) welcomes the restrictions on digital marketing of breastfeeding substitutes in Committee A.

The World Health Assembly has finally closed a loophole used by infant formula manufacturers to market their product: digital marketing.

Back in 1981, when the International code of marketing of breast-milk substitutes was adopted by the World Health Organization (WHO) and UNICEF, digital marketing did not exist. Updated regulations were introduced in 2012 , but this too was before the widespread targeting of consumers via social media platforms and their targeted algorithms. 

The World Health Assembly approved a resolution on Monday that gives member states the opportunity to get technical support from the WHO on how to implement its guidance on “regulatory measures aimed at restricting digital marketing of breast-milk substitutes”.

The resolution, put forward by Brazil and Mexico, also calls on the WHO Director-General to compile country lessons and challenges in implementing the guidance, and report back on progress in 2028.

“This resolution will help us to push back” against those promoting breastmilk substitutes, Director General Dr Tedros Adhanom Ghebreyesus told delegates in Committee A after they had passed the resolution.

Dr Bruce Aylward, WHO Deputy DG for Universal Health Coverage, added that the WHO was working with partners “to develop artificial intelligence tools that will help you identify violations against national laws to help with the enforcement”.

Global sales of formula milk were estimated to reach $164.76 billion in 2024.

Mothers interviewed by  a multi-country study. reported being “targeted by online marketing and being inundated by marketing for formula milk including promotions prompted by their search behaviour for infant feeding advice and information”.

In addition, a “suite of alternative formulas presents formula milk products as satisfying all possible needs”. 

The committee also resolved to incorporate the World Prematurity Day into the WHO calendar during the discussion on 

Some 13.4 million babies are born preterm, and preterm birth complications are the leading cause of death amongst children under the age of five, according to the resolution.

“With extremely pre-term children, the probability of death in a low income country is over 90% in the first few days of life, and it’s less than 10% in high income countries,” said Aylward.

Sexual and reproductive rights

The resolutions were adopted as part of a discussion on the Global strategy for Women’s, Children’s and Adolescents’ Health, tabled at the WHO executive board. 

The report highlights that countries are off track to reach the targets of the Sustainable Development Goals (SDG) related to maternal, newborn and child mortality by 2030. 

The maternal mortality rate is only expected to drop to 176 deaths per 100,000 live births whereas the SDG target is 70 deaths per 100,000 live births, said Tedros.

“The 60 countries who are not on target, should accelerate. I think focus on the 60 countries will be very, very important. There are proven tools to make that happen.

“But the concern that we have is that, in many countries, investment is declining, especially in maternal health and child health, so our call is to reverse that,” he added.

Poland, speaking for the EU, pushed for a rights-based approach to sexual and reproductive health.

Poland, on behalf of the European Union and nine candidate member countries, spoke about the need for sexual and reproductive health to have a human rights approach

“The EU reaffirms its commitment to the promotion, protection and fulfilment of the right of every individual to have full control over and decide freely and responsibly on matters related to the sexuality and sexual reproductive health, free from discrimination, coercion and violence,” said Poland. 

“The EU further stresses the need for universal access to quality and affordable comprehensive sexual and reproductive health information education, including comprehensive sexuality education and healthcare services.”

Finland, speaking for its Scandinavian neighbours and several surrounding countries, explicitly articulated that women should have access to safe abortion.

This sentiment was echoed by Germany, which stated: “We are concerned about the growing health disparities, and must ensure a human rights-based approach to health with gender equality and equity at the centre, whilst addressing gender-based and age-related violence. Access to comprehensive SRHR services, including modern contraception, safe abortion and post abortion care and comprehensive sexuality education are essential.”

There was no pushback from countries that would usually object to references to abortion, and the the committee session passed without disagreement.

 

Hungry children wait in line at a soup kitchen in northern Gaza in May.

Vital medical aid from World Health Organization supply trucks has yet to reach the beseiged Gaza enclave since the doors of an 80-day blockade inched open a week ago, said Hanan Balkhy, WHO’s director for the Eastern Mediterranean Region, at a UN-Geneva press briefing on Monday.

The chaos on the ground in Gaza, against a widening Israeli war and a halting resumption of some humanitarian aid deliveries, contrasted sharply with the largely symbolic vote by the World Health Assembly on Monday authorizing WHO to “raise the flag” of Palestine along that of other WHO member states.

The decision to ‘raise the flag’, approved by a vote of 95-4, was the fourth measure on the status of Palestine and the crisis in Gaza to come before the WHA in its 2025 session.  Only the Czech Republic, Germany, Hungary and Israel  voted against the measure, while 27 member states abstained.

“The WHA’s endorsement of this decision would … send an important message to Palestinians that they have not been forsaken. It would demonstrate that the Palestinians right to self determination is inalienable, and as such, cannot be subject to a veto, nor erased,” said South Africa’s delegate, during the WHA debate.

Eastern Mediterranean Regional Director Hanan Balkhy at a UN-Geneva press conference on Monday.

On the ground in Gaza, meanwhile, no WHO trucks of medical supplies have so far been allowed entry to  the beseiged enclave since Israel first began to allow some aid deliveries to resume last week, easing an 80-day blockade. Balkhy said 51 WHO trucks were poised and waiting to enter from Egypt’s El Arish crossing point.

As of Friday, while 415 humanitarian aid trucks had been cleared to cross into Gaza, only 115 had been “collected”, and none had been allowed to enter the northern part of the enclave, which is seeing the heaviest fighting now, she added, quoting a Friday briefing by the UN Secretary General, Antonio Guterres.

The UN numbers corresponded roughly with those of Israel’s military coordination arm, COGAT, which reports that 388 trucks entered the enclave since the beginning of May. But many trucks have also been overhwlemed by hungry Gazans before UN aid agencies could collect and deliver the aid in a more systematic aid. See related story:

WHO Director General Appeals to Israel to End Deepening Food Crisis and Conflict in Gaza

Balkhy said that 43% of essential medicines are at “zero-stock” levels in addition to 64% of medical supplies and 42% of vaccines, citing data from Gaza’s Hamas-controlled Ministry of Health. Patients with chronic and life-threatening conditions—including kidney failure, cancer, blood disorders, and cardiovascular disease—are among the most affected, she added, saying, “WHO’s stocks in Gaza are dangerously low and will run out soon,” citing problems with dozens of products from common antibiotics to cesarean delivery kits.

Since 2 March, 57 children have reportedly died from the effects of malnutrition, Balkhy added, also citing Gaza Ministry of Health data. And 71 000 children under the age of five are expected to suffer from acute malnourishment over the next eleven months, if conditions don’t change radically.

Delays in mounting of private Gaza humanitarian aid effort

Her comments came against a day in which Israel’s planned opening of private aid distribution points for Gaza aid, intended to sidestep UN agencies and Hamas, was reportedly delayed for a second time.

That followed Sunday’s resignation of the Jake Wood, head the Gaza Humanitarian Foundation, the private entity that had been awarded a tender by Israel to deliver the aid, with US approval.

In a statement distributed by the Foundation, Wood was quoted saying that plans for the distribution hubs would not meet the “humanitarian principles of humanity, neutrality, impartiality and independence, which I will not abandon.”

Various UN organizations have also declared that they won’t cooperate with the Geneva-based GHF, which had earlier said it would distribute some 300 million meals in its first 90 days of operation. In an interview with CNN,  UNICEF’s James Elder described the plan as “unworkable” – with only a “handful” of distribution points.

“Think about a mom who has a couple of children and her husband has been killed.  And she has to walk three or four miles in a militarized zone to pick up aid and then walk back,” Elder said. He noted that the plan would also force most Gazan’s to relocate to the southern part of the tiny enclave to access any aid at all.

In a WHA meeting last week, WHO’s Health Emergencies Executive Director Mike Ryan had asserted that “we will work with anything that works” – but added that the UN agencies already had a proven track record of aid delivery – demonstrated during the last ceasefire.

Sudan is another, ignored, flashpoint

Another devastating crisis that is not getting the attention it deserves is Sudan, Balkhy asserted in her meeting with UN journalists Monday.

“Simultaneous outbreaks—cholera, polio, measles, dengue, malaria—are overwhelming a health system shattered by conflict. Access to care is vanishing, as violence displaces millions and blocks life-saving aid. Hunger and malnutrition affect 25 million—including 770,000 children facing severe acute malnutrition this year. Immunization rates have plunged to below 50 per cent, from 85 per cent before the war,” the EMRO Regional Director said.

“Attacks on health and vital infrastructure are rampant,” she said noting that drones have also hit Port Sudan and other aid entry points.

Throughout the conflict,  WHO has delivered over 2,500 metric tonnes of supplies, and supported hospitals treating over 1 million people, including ,75,000 children for severe acute malnutrition. Some 30 million people have received vaccines for cholera, measles, or polio. And in November 2024, Sudan introducted the malaria vaccine, reaching 35,000 children so far.

“But aid cuts are threatening progress,” she added. “The health pillar of Sudan’s Humanitarian Response Plan is just 9.7 per cent funded. WHO’s response has a 67 per cent funding gap,” she pointed out, calling for “sustained support to save lives and rebuild Sudan’s health system; unimpeded access and international support for cross-border humanitarian operations; and an immediate end to attacks on civilians, civilian infrastructure and health care.”

Image Credits: WHO .