A previous meeting of the Intergovernmental Working Group (IGWG) that is negotiating a pathogen access and benefit-sharing (PABS) system.

There are only six negotiating days left to nail down the final piece of the Pandemic Agreement, but huge areas of disagreements still exist between World Health Organization (WHO) member states.

The talks, which start on Monday, are set to go until 11pm each night at the WHO headquarters in Geneva – but this may not be enough time to bridge the significant differences between member states on what the Pathogen Access and Benefit Sharing (PABS) system should look like.

The PABS system is the crucial operational annex to the Pandemic Agreement adopted by the World Health Assembly (WHA) last May, and is supposed to be adopted by this May’s WHA.

“Of course, there are differences between member states, but I can also see that they are closing the gaps. And we believe there will be landing zones on areas where there are still differences,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday.

“I’m confident that the PABS could be agreed, and the agreement on PABS will also help us to start the ratification process of the pandemic agreement that was approved by the member states last May,” Tedros added.

However, the latest PABS Annex text released by the Intergovernmental Working Group (IGWG) Bureau on 9 March, shows that there is little agreement so far. (Greened text shows agreement, while yellow shows significant consensus).

Balancing sharing and benefiting

The crux of the PABS system rests on how countries share data about pathogens with pandemic potential, the obligations on parties (including pharmaceutical manufacturers) that get access to this information, and how those who share their data benefit from any vaccines, diagnostics and therapeutics (VDTs) that are developed as a result.

Aggrey Aluso, executive director of the Resilience Action Network Africa (RANA), said the world needs a legally binding PABS agreement and the “highest level of political accountability”.

Without this, Aluso advocated for missing the May World Health Assemby deadline and “[taking] more time to get something that will really be transformative”.

Aluso was addressing a media briefing in Brussels on Wednesday, hosted by the AIDS Healthcare Foundation (AHF) shortly after it had held a protest at the European Parliament to demand that the European nations ratify a PABS system that ensures equitable access to medicines and vaccines during health emergencies.

AHF Europe head Daniel Reijer called on European countries to support a legally binding PABS system that “guarantees fair and timely access to vaccines, tests and treatments for all countries, and not only after a pandemic is officially declared, but during health emergencies as they are unfolding”.

Several powerful European countries, particularly Germany and Switzerland, have advocated for voluntary sharing of any VDTs. Protecting their powerful pharmaceutical industries, they have argued that the compulsory sharing of VDTs will stifle innovation and impinge on intellectual property rights.

AIDS Healthcare Foundation Europe head Daniel Reijer

New obligations in latest PABS draft

The latest PABS draft sets several obligations for member states sharing pathogens. PABS materials “shall” be shared “as soon as available, on a priority basis”, with one or more of the WHO Coordinated Lab Network (WCLN) laboratories of their choice. This includes uploading the pathogen sequencing information.

However, while pathogen sharing is mandatory and speedy, the draft adopts less prescriptive approach to benefit-sharing – the stickiest aspect of the entire talks.

Pharmaceutical manufacturers who participate in PABS are expected to donate at least 10& of their VDTs to the WHO and a further 10% “at an affordable price”.

During the less serious public health emergency of international concern (PHEIC) – such as the recent mpox outbreak –  manufacturers are to “implement benefit-sharing provisions, including options” regarding access to VDTs.

Participating manufacturers are expected to pay an annual fee to be part of PABS.

They are also expected to commit to at least two out of five options, namely: capacity-building and technical assistance; research and development cooperation;. facilitating rapid access to VDTs for public health risks; granting non-exclusive licenses to manufacturers in developing countries to produce VDTs; and finally, “other forms of technology transfer as mutually agreed”.

Several other loose ends remain. African countries and the Group for Equity, a large alliance of countries from different regions, want contracts with manufacturers to be included as part of PABS – something opposed by Europe.

Legally binding – or bust

The Zimbabwean delegate at the WHO Intergovernmental Working Group (IGWG).

Meanwhile, at the last meeting of the IGWG, the Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions all stated that they wanted a legally binding PABS system – or bust.

“PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population.

Zimbabwe, speaking for the Africa Group, said: “Equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.”

Meanwhile, The Elders – an association of former world leaders – have urged member states to deliver a PABS Annex that is “equitable and operational from day one”. 

“Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. 

“Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation.”

The Elders also called on member states to “include additional negotiating days if needed to reach consensus by the current deadline”.

Running alongside the PABS negotiations, the United States is pursuing bilateral agreements with developing countries that make its health aid contingent on recipient countries agreeing to provide the US with rapid access to information about dangerous pathogens.

To date, the US has signed 24 bilateral health agreements in terms of the Trump administration’s America First Global Health Strategy – their somewhat chaotic alternative challenge to the Pandemic Agreement.

As further impetus for the PABS talks to succeed, The Elders called for “The multilateral architecture for pandemic preparedness and response” to be  “protected as a collective endeavour”.

They noted: “Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.”

Big gains and then stalled progress in reducing early childhood mortality, says WHO DG Dr Tedros Adhanom Ghebreyesus at a WHO briefing.

Under-five deaths have fallen globally by more than half since the year 2000. However, since 2015, the pace of reduction in early childhood mortality has slowed by more than 60%, a new UN report shows. 

The report, co-authored by UNIICEF, WHO and the World Bank, also shows that while great gains have made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa.

The report provides the clearest and most detailed picture to date of how many children, adolescents and youth are dying, and where, said WHO’s Dr Tedros Adhanom Ghebreyesus in a Geneva press briefing on Wednesday.

Progress in reducing childhood mortality has slowed by 60% since 2015.

The report also fully integrates estimates on the causes of death for the first time ever. It found, for instance, that more than 100 000 children aged 1-59 months – or 5% – died from acute severe malnutrition in 2024. 

That is but one reflection of how children in fragile states and conflict zones are far more at risk, and their relative mortality rates far higher. 

Children in fragile states and conflict zones face outsized risks of death.

Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth and in the first month thereafter, Tedros said. 

Some 36% of those deaths are due to complications arising from preterm birth, while 21% is due to complications related to labour and delivery.  Infections, including neonatal sepsis and congenital anomalies, were also important causes, the report found.

Based on trends from 2020-2024 the data reflects trends during the pandemic period – but not the more recent impacts of sharp cuts in global health aid seen last year. 

Diarrhoeal and pneumonia remain big killers despite sharp declines   

Cause specific early childhood mortality declines.

Beyond the first month, infectious diseases and particularly malaria, diarrhoea, and pneumonia remain the leading killers, the report found. 

This is despite the fact that diarrhoeal deaths have decreased by 75% since the year 2000 – largely as a result of safe drinking water access and better awareness about early interventions. Pneumonia deaths, meanwhile, have declined by 63% due to higher vaccination rates against the most serious bacterial pathogens as well as falling rates of exposures to household air pollution from biomass stoves. These represent the two biggest achievements in terms of early childhood mortality reductions.  

Rates of malaria death have declined by only 41% and malaria is now the single largest killer of under-fives (17%)  – with most deaths occurring in endemic areas of sub-Saharan Africa. Progress in reducing malaria mortality has also slowed significantly after big gains up to 2015. 

Malaria deaths remain concentrated in a handful of endemic countries – such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment.

Child deaths heavily concentrated in a small number of regions

Mireille Ola is feeding her premature baby at a special unit of the CHU Hospital in Treichville, Côte d’Ivoire. The boy weighed 1700 grams at birth. But 16 days later he now weighs 2 kg thanks to the speciala programme.

In 2024, sub-Saharan Africa accounted for 58% of all under-five deaths and 54% of all deaths of children, adolescents and youths up to age 24. 

That, as compared to representing 38% of those deaths in the year 2000.  

Early childhood deaths are now heavily concentrated in Sub Saharan Africa.

Leading infectious diseases are still responsible for 54% of all under-five deaths in the African Region, as compared to only 9% in Europe and Northern America, and 6% in n Australia and New Zealand. 

“These stark disparities reflect unequal access to proven, life-saving interventions,” states the WHO report. 

Progress in even the poorest states — with political will  

Mahima provides Kangaroo Mother Care to her premie at a special newborn care hospital unit in Uttar Pradesh, India. KMC is a crucial practice that helps  regulate the baby’s temperature and improve breathing.

Even so, progress in countries in many of the world’s low- and middle income regions demonstrates what is possible when there is political will, stressed Tedros in his remarks. 

“For example, in 2022 Sierra Leone declared child mortality a national emergency. Since then, almost 1 million children have been screened for malnutrition, and the number of children who have not received any vaccines has been reduced from 15,000 in 2024 to 9000 last year. 

“Likewise, North Macedonia has achieved one of the fastest recent declines globally, cutting neonatal mortality by 87% since 2015 through improvements in emergency obstetric and newborn care.”

“One of the main reasons for the decline in child mortality is immunization. In 1974 only 5% of the world’s children were vaccinated against killer diseases, including measles. Today, that number stands at 85%.” 

He credited the WHO Essential Programme on Immunization (EPI), founded iin 1974, for playing a signifiicant role in that transformation. Building on the momentum of the global smallpox eradication effort, EPI supported countries in setting up national immunization programmes, which were further bolstered by the creation of Gavi, the Vaccine Alliance, in the year 2000, and its rollout of low-cost vaccine procurement programmes. 

 “Since 1974 EPI has helped to save more than 150 million lives from diseases like measles et tetanus, diphtheria and pneumonia,” Tedros said, adding:

“WHO calls on governments, donors and partners to make child survival a political and financial priority, to focus on those at highest risk; to strengthen accountability; and to invest in primary health care so that every child has the chance not just to survive, but to thrive.” 

Image Credits: UNICEF/FrankDejongh, WHO , UNICEF .

SAGE chairperson ​​Professor Anthony Scott announcing new recommendations on Typhoid, Polio and COVID. 

Countries with a high incidence of typhoid or antimicrobial resistance to its leading pathogen, Salmonella Typhi, should introduce typhoid vaccinations, according to the World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization.

In new guidance issued Wednesday, SAGE also recommended routine COVID-19 vaccination for groups at highest risk of severe COVID-19 disease every six months and reducing polio vaccines from three to two doses in countries at low risk.

SAGE, which meets every quarter, spent last week considering global reports on emerging disease challenges and setting priorities in a context where countries are facing “uncertain funding, competing priorities and eroding public trust”, said chair ​​Professor Anthony Scott.

“Typhoid fever is estimated to cause about six million cases and 72,000 deaths worldwide,” said Scott, who is professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine.

“Children between five and nine years of age are most likely to have laboratory-confirmed typhoid fever and thus carry the largest share of cases,” said Scott, adding that protection from a single dose of typhoid conjugate vaccine (TCV) can decrease over time, particularly in children under two.

SAGE is thus also recommending a booster dose for children aged around five years of age in very high typhoid incidence settings.

SAGE first recommended rolling out the TCV in 2018, said Scott, so many high incidence countries have “already either implemented or have set in train the process of implementing the vaccine”.

In Southeast Asia, Pakistan, Nepal, Bangladesh and India are considering the vaccine. In Africa, Zimbabwe, Kenya and Niger, are also considering the vaccine, said Scott.

However, he warned that “the epidemiology of the disease varies quite widely, even within country, and it’s a particularly difficult disease to characterise and diagnose.”

COVID-19 vaccines for vulnerable groups

Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals.

“While the global burden of severe COVID-19 has declined worldwide thanks to broad immunity, both from vaccine and past infection, the virus continues to cause significant illness and death,” said Scott.

SAGE recommends COVID-19 vaccination every six months for groups at highest risk of severe disease – the elderly, older adults with significant comorbidities or severe obesity, residents in care homes and and moderately or severely immunocompromised individuals. 

SAGE also recommends one dose for pregnant women, ideally during the second trimester.

However, Dr Kate O’Brien, head of the WHO’s Department of Immunization, Vaccines and Biologicals, acknowledged that country support from the vaccine platform, Gavi, to buy COVID-19 vaccines had ended last year which would impact on the availability of these vaccines.

Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary, added that while the current COVID-19 vaccines prevented severe disease, the weakness was that they did not prevent transmission.

“To reduce transmission, we would really like to see vaccines that have an impact on mucosal immunity,” said Wilder-Smith.

Dr Annelies Wilder-Smith, WHO Vaccine Policy Team Lead and SAGE Executive Secretary

Reduction in polio doses

Wild polio virus transmission remains endemic in only two countries, Pakistan and Afghanistan. 

“SAGE is deeply concerned about the continued transmission of wild polio virus type one in both of these countries, as well as disruptions that are hindering the shipment and laboratory testing of stool and environmental samples from Afghanistan,” said Scott.

Circulating vaccine-derived polio virus type two had also been detected in “several African countries”, including northern Nigeria and Somalia.

“There’s an urgent need to strengthen routine immunisation and reach zero dose children, to curb circulating vaccine-derived polio virus type two transmission,” Scott stressed.

But in countries at low risk of polio, it is possible to reduce the number of bivalent polio doses from three to two, “provided this combined schedule will sustain mucosal immunity”.

Administering a polio vaccination – low risk countries could reduce doses from 3 to 2. SAGE says

Acute resource reductions

O’Brien acknowledged the current context of conflicts, and economic challenges, resulting in  national health budgets being reduced.

The challenge for countries’ National Technical Advisory Groups on vaccines is to ensure that they have the surveillance systems to know where diseases occur and where the target should be, she said.

“The focus of 2026 and onward is to protect the core of the core of immunisation programmes and to integrate the efforts across different initiatives and for countries to make decisions on where they will focus the resources,” said O’Brian.

However, she noted that the WHO recommended vaccinations for 14 diseases, and over 80% of countries cover 10 or more of those diseases.

“This has been an incredible success story that has allowed for health impact and health gains to be made, including the reduction of infant mortality. But we’re entering a very challenging phase, and countries will need to make increasing decisions on optimization of their vaccine schedules,” she warned.

Image Credits: Pakistan Polio Eradication Program .

Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite
Garry Aslanyan, Catherine Kyobutungi and Ricardo Baptista Leite

Global health is facing a crisis not only in funding, leadership, and trust, but also in information integrity, according to speakers on the first episode of The Inside Track, a new series from the Global Health Matters podcast.

Host Garry Aslanyan was joined by Catherine Kyobutungi and Ricardo Baptista Leite for a conversation on how misinformation spreads, why trust in science has eroded, and what health leaders can do to push back.

Kyobutungi said the problem has grown alongside an expanding information economy, where sensationalism often travels faster than facts. Scientists, she argued, have not adapted quickly enough to a landscape shaped by influencers, closed online communities and monetised content.

“The biggest, maybe the most colossal failure that … the global health community had was a failure of communication,” she said, pointing to the COVID-19 pandemic and the inability to clearly explain concepts such as risk to the public.

Baptista Leite warned that the issue goes beyond disagreement. In many cases, he said, people are no longer arguing over the same set of facts.

“If someone comes along and says, No, it’s not a chair, it’s a horse,” he said, “then the conversation becomes impossible.”

Still, both speakers said the answer is not retreat. Kyobutungi urged scientists and global health professionals to return to the public square, speak more clearly and engage not only with those spreading falsehoods, but also with the wider audience watching from the sidelines.

Later in the episode, the panel turned to a recent article on the spread of chikungunya in Europe, using it as an example of how climate warnings often fail to produce meaningful action. The discussion closed on a more hopeful note, highlighting promising work in artificial intelligence and a new Africa-led HIV vaccine trial.

For Kyobutungi, the battle is not lost. But the momentum, she suggested, must still be won back.

Listen to the full conversation >>

Read more about Global Health Matters podcasts on Health Policy Watch >>

Image Credits: Global Health Matters Podcast.

Prof Ntobeko Ntusi and Dr Garry Aslanyan
Prof Ntobeko Ntusi and Dr Garry Aslanyan

South Africa and the African continent must play a far greater role in shaping the future of global health, according to Ntobeko Ntusi, president and CEO of the South African Medical Research Council.

Speaking during a Trailblazers episode of the Global Health Matters podcast with Dr Garry Aslanyan, Ntusi said his world-view was shaped first by his parents, then by teachers and mentors, and later by his experience treating patients with HIV at a time when treatment was not yet available in South Africa.

He said watching patients die during those years fuelled “a desire to have universal access and universal healthcare, but also a desire to ensure equity in all aspects of health and science.”

Ntusi said successful science councils must do more than fund research. They must explain the value of science to society, help governments understand why health research matters and align their work with national priorities.

In South Africa, he said, that means focusing on the country’s “quadruple burden of disease,” including HIV and tuberculosis, non-communicable diseases, mental health, violence, trauma, and maternal and child health. He said the council is also prioritising climate and health, digital health and AI, antimicrobial resistance, pandemic preparedness and universal health coverage.

Ntusi said violence remains one of South Africa’s deepest challenges and cannot be treated as a health issue alone. “These are not just health issues,” he said. “They are societal issues, and they need a whole of government and a whole of society.”

He also called for a major shift in how the world thinks about global health. Ntusi said he prefers the term “global majority” over Global South, noting that 85% of the world’s population lives in low- and middle-income countries.

“The first acknowledgement is that global health is failing in measures of equity by whatever measure one uses,” he said.

For Ntusi, leadership starts with clarity. The most important quality a leader can have, he said, is “self-awareness.”

Listen to the full episode >>

Read more about Global Health Matters episodes on Health Policy Watch>>

Image Credits: Global Health Matters.

This chart illustrates the trajectory of net bilateral Official Development Assistance (ODA) for health from DAC countries.
Projected health aid spending through 2027 shows a precipitous drop in international commitments, forcing global health reform.

Unprecedented reductions in international aid have served as a powerful catalyst for long-overdue global health reform, according to a comprehensive new report published by the Wellcome Trust on Wednesday.

The extensive synthesis of five regional dialogues involving 114 countries reveals that sweeping financial pullbacks from traditional funders are forcing a fundamental restructuring of international medical cooperation.

John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust.
John-Arne Røttingen, Chief Executive Officer of the Wellcome Trust.

“What happens next depends on our willingness to move forward together – and to seize this moment to build a healthier future for all,” said John-Arne Røttingen, chief executive officer of the Wellcome Trust, upon the report’s release in March 2026.

He emphasised that if stakeholders navigate these structural shifts correctly, history will view this as the dawn of a positive new era for international care.

The Wellcome analysis underscores that the prevailing aid-centric model is no longer viable, as major traditional benefactors drastically scale back their commitments.

Development assistance for the health sector is projected to plummet by 60% by 2030, returning to levels last seen in 2009, a recent European Union (EU) and Like-Minded Donors’ Reflection Process revealed.

These financial shortfalls severely threaten to unravel decades of progress against infectious diseases and maternal mortality. The EU and other donors acknowledged this contested multilateralism, noting that external assistance must now be treated as temporary and catalytic rather than perpetual.

The current architecture is widely criticised as fragmented, overly centralised, and structurally incapable of addressing the shifting burden of non-communicable diseases. Systemic inefficiencies and deep power imbalances have left low- and middle-income countries heavily reliant on volatile external financing, thereby eroding their domestic sovereignty.

In response, a powerful consensus is emerging that authentic global health reform must empower low- and middle-income countries (LMICs) and regional coalitions to govern their own agendas.

To navigate this outlook, the report outlines three critical pillars for structural reform: decentralising global health governance, overhauling international financing, and securing regional sovereignty over data and medical manufacturing.

Driving global health reform through regional power

114 nations participated in five cross-continental dialogues to outline the global health reforms.
114 nations participated in five cross-continental dialogues to outline the global health reforms.

As traditional Western funding wanes in a multipolar world, geopolitical analysts note that middle powers are actively navigating this rupture by seeking innovative funding mechanisms and stronger partnerships with multilateral development banks.

The urgent necessity for structural change has propelled regional organisations, such as the Africa Centres for Disease Control and Prevention (Africa CDC), firmly into the spotlight. These bodies are increasingly viewed as the rightful anchors for policy setting, technical cooperation, and the pooled procurement of essential medicines.

To safeguard digital independence, stakeholders are increasingly advocating for unified digital public infrastructures, such as the proposed African Health Data and Governance Framework. This framework would ensure that African health data is stored, managed and used within the continent to actively protect national sovereignty. By maintaining local control, this approach empowers African nations to monetise their own data through value addition, such as for clinical trials, rather than relying on external systems.

In Latin America and the Caribbean, stakeholders have similarly proposed a Health Catalytic Platform (LAC-HCP) to coordinate investments in regional public goods, such as AI-powered health data architectures and shared technology assessments.

Experts assert that meaningful global health reform must move away from a fragmented, disease-specific approach towards integrated primary care systems driven by local governments. In this new approach, global health initiatives should step back from being the centre of gravity and instead act as facilitators that support and accelerate country-driven goals.

The international architecture is being actively pressed to become leaner, with the World Health Organization (WHO) focusing strictly on its core mandate of normative guidance. Concurrently, operational control and implementation should be increasingly ceded to capable regional and national actors.

Sovereign debt crisis threatens global health reform

Decades of progress in maternal and adolescent health could be jeopardized by impending donor funding cuts.

The success of global health reform is severely threatened by the macroeconomic reality that nearly 60% of countries eligible for International Development Association (IDA) support currently face debt distress. Policy experts warn that without alleviating these unsustainable debt burdens, LMICs will lack the fiscal capacity required to transition away from donor dependence.

To circumvent these debt-trap dynamics and the precipitous decline in external assistance, proponents are shifting their focus toward entirely new financing streams that do not rely on traditional lending. These include global solidarity levies, regional solidarity funds and expanded domestic taxation to finance sustainable primary care.

​​Global Health Infrastructure is Changing. Why Getting it Right Matters

Countries are already pushing ahead, with France, Kenya and Barbados leading a coalition to invest proceeds from aviation sector taxes into resilient health investments and fair transitions. At the national level, the Democratic Republic of Congo recently implemented a 2% import tax to generate health revenues, while Zambia increased its budget allocation to health to 13%.

In Latin America and the Caribbean, stakeholders have similarly put forward a Regional Health Solidarity Fund to pool resources and coordinate regional health investments. Additionally, international coalitions are increasingly proposing structural economic interventions, including a global hub for debt swaps for development hosted at the World Bank.

Furthermore, nine major financial institutions and countries have formed an alliance to promote the inclusion of debt pause clauses in official lending.

While proponents see these as vital tools, critics argue that these approaches fail to address the scale of the crisis and often replace traditional aid with conditional financial oversight. Instead, many advocate for unconditional debt cancellation to provide immediate liquidity, echoing long-standing historical demands.

“Unless the issue of who owns the money is changed, we are stuck,” stated an African government official during the consultations for the EU and Like-Minded Donors’ Reflection Process.

Empowering civil society and regional cooperation

The proposed "Sovereign Architecture" (blue) moves away from the failing, centralized donor model toward a decentralized system.
The proposed “Sovereign Architecture” (blue) moves away from the centralized model toward a decentralised system.

Civil society organisations have also demanded a radical redistribution of influence, arguing that community voices remain marginalised in high-level decision-making forums. The Wellcome report highlights that equitable global health reform demands formal participation mechanisms over informal, tokenistic arrangements.

Furthermore, the COVID-19 pandemic vividly exposed the fragility of highly concentrated production systems, prompting urgent calls for distributed manufacturing capabilities. Regional dialogues have confirmed that shaping health markets through pooled purchasing and local production is critical to guaranteeing equitable access to life-saving commodities.

“Africa is saying: we don’t just want vaccines delivered to us, we want the capacity to produce them ourselves… The world must adjust to this new reality,” an Africa Dialogue participant stated during the regional consultations published in the report.

The current financial contraction offers an opportunity to dismantle outdated donor structures and forge a highly resilient, decentralised network that respects country ownership, the report underscores.

To translate this perspective into tangible global health reform, the Wellcome Trust will host a major global convening in April 2026, gathering stakeholders from five global regions to explore areas of emerging consensus and establish concrete pathways for action. The synthesis report and the regional priorities it highlights are intended to support and guide current reform efforts at both the global and regional levels.

The organisation will remain engaged in these varied dialogues because their overarching goal is “to foster coherence and promote holistic thinking and action,” Fabian Moser, policy advisor at Wellcome and one of the authors of the paper, explained in response to a query by Health Policy Watch.

Image Credits: Nadia Marini/MSF , Hera/EU, Wellcome Trust, Felix Sassmannshausen/HPW.

A doctor and her young patient. The American Academy of Pediatrics is opposing changes to the US childhood vaccination schedule.

A United States judge has temporarily halted US Health Secretary Robert F Kennedy Jr’s anti-vaccine agenda, ruling on Monday that Kennedy’s firing of the country’s vaccine advisory committee and changes to childhood vaccinations were likely illegal.

US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 members of the Advisory Committee on Immunization Practices (ACIP) are likely to have violated the Administrative Procedure Act. 

Murphy has issued three temporary stays – on the changes to the vaccination schedule, the appointment of 13 ACIP members and all decisions of the Kennedy-appointed ACIP. These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women.

“Faced with plaintiffs’ motion for preliminary relief, the court concludes that plaintiffs are likely to succeed in showing that the reconstitution of ACIP and the January 2026 changes to the childhood immunization schedule violate the Administrative Procedure Act,” Murphy ruled.

Reacting to the ruling, AAP president Dr Andrew Racine said on Monday evening that it “effectively means that a science-based process for developing immunization recommendations is not to be trifled with and represents a critical step to restoring scientific decision-making to federal vaccine policy that has kept children healthy for years.” 

The AAP represents over 67,000 paediatricians throughout the US.

Dr Jason Goldman, president of the American College of Physicians, described the ruling as “a win for public health and reaffirms that national vaccine policy should be guided by rigorous, evidence-based science, not politics.”

Dr Georges Benjamin, president of the American Public Health Association, said that “trust occurs when we engage the public in a transparent process, not one where decisions are made behind closed doors by unqualified individuals and presented in a disingenuous way.” 

Seven professional bodies are co-plaintiffs in the case against Kennedy, including the American College of Physicians, American Public Health Association, Infectious Diseases Society of America, the Massachusetts Public Health Alliance, and the Society for Maternal-Fetal Medicine. Three unnamed pregnant women are also plaintiffs.

Appointment of ‘vaccine skeptics’

The AAP case focused initially on changes in recommendations for COVID-19 vaccines but was later extended to oppose the changed schedule for childhood vaccines, after the US Health and Human Services (HHS) reduced the number of recommended vaccines from 17 to 11. 

The AAP argues that the HHS arbitrarily and illegally overhauled the Centers for Disease Control and Prevention (CDC) vaccination schedule “without following the evidentiary-driven, and legally required processes.”

It also argues that Kennedy and the HHS have failed to “examine the relevant data and articulate a satisfactory explanation” for:

  • the appointment of vaccine skeptics to ACIP after all previous members were fired;
  • votes taken by ACIP changing recommendations on the hepatitis B and COVID-19 vaccines and urging manufacturers to stop using thimerosal as a preservative in influenza vaccines;
  • the alteration of the immunization schedule, which no longer recommends shots for hepatitis A and B, rotavirus, respiratory syncytial virus, flu and meningococcal disease for all infants; and
  • the removal of the CDC’s routine recommendation for healthy children and pregnant women to receive the COVID-19 vaccine.

Memos released by HHS in response to AAP’s lawsuit show that the department based its decision to restrict COVID-19 vaccines on scanty reports that lacked scientific evidence, according to weekend reports

“The memos overlooked hundreds of studies on the benefits and safety of COVID vaccination and set the precedent for making changes to vaccine recommendations based on ideology instead of evidence,” the Guardian reported.

Data from the US CDC itself, based on COVID-19 vaccination of more than a million pregnant women, found that the vaccine “did not increase health risks for pregnant women or their babies” and “the benefits of receiving a COVID-19 vaccine outweigh potential risks”.

The studies showed “no increased risk for complications like miscarriage, preterm delivery, stillbirth, or birth defects”, while COVID-19 infection could cause stillbirths, preterm delivery and hospitalisation of babies.

ACIP meeting stopped

The ACIP meeting scheduled for later this week will no longer go ahead. One of its agenda items was on COVID-19 vaccine injuries, with speculation that the committee is preparing to discontinue COVID-19 mRNA vaccines altogether.

ACIP vice-chair and vaccine sceptic Robert Malone described Murphy’s decision as “activist judicial intervention” in a lengthy Substack post devoted mainly to defending his qualifications.

However, Kennedy’s anti-vaccine agenda is polling badly with the US public, according to Republican polling company Fabrizio Ward.

An extract from the Fabrizio Ward poll on vaccines.

In a report issued last December, Fabrizio Ward reported that its polling showed “strong bipartisan support for routine childhood vaccines in the nation’s most competitive House districts, with majorities across political affiliations acknowledging their benefits and safety” – including with voters in Kennedy’s Make America Health Again (MAHA) camp.

“While the MAHA agenda is broadly popular in the area food and agriculture, vaccine skepticism stands as an outlier, rejected by most voters even within the MAHA movement,” the company notes.

Image Credits: American Academy of Pediatrics, Fabrizio Ward.

A black carbon monitoring station at a glacier in Nepal has recorded the effects of black carbon on melting ice.

BANGKOK – The combination of heat and “super pollutants” is emerging as a critical threat to human health, according to experts at the Better Air Quality (BAQ) conference which ended last Friday in Bangkok.

Short-lived super pollutants – methane, black carbon, hydrofluorocarbons (HFCs), nitrous oxide and ground-level ozone – contribute to half of global warming and millions of premature deaths. 

These pollutants have a short life span, but some can be transported thousands of kilometres in days.  Meanwhile, rising heat and humidity can create dangerously high heat stress temperatures and worsen the impact of breathing polluted air. 

“From a biological pathway perspective, one hypothesis is that heat stress may increase susceptibility to the respiratory toxicity of PM2.5 (a fine particulate matter pollutant), potentially through airway dehydration, epithelial irritation, and enhanced inflammatory responses,” Steve HL Yim, a professor of environmental health at Singapore’s Nanyang Technological University, told Health Policy Watch.

Long-term exposure to black carbon already heightens the risk of cancers such as lung adenocarcinoma, commonly seen in non-smokers. Short-term exposure to black carbon may exacerbate asthma and Chronic Obstructive Pulmonary Disease (COPD or chronic lung disease), while short-term exposure to ozone may result in lung function damage.

Yim’s research shows how a global increase of just 0.1 microgram/cubic metre in black carbon (soot) concentration is associated with a 12% increase in the incidence of lung adenocarcinoma, a type of lung cancer usually associated with air pollution.

Risk for Global South

The combination of super pollutants and heat are on the rise in many parts of the world, especially in the Global South where tropical and developing nations are struggling to balance climate change adaptation while pursuing rapid development.

“The situation in Southeast Asia, South Asia and Africa is worse compared with North America and Europe,” said Yim, who is an expert member of the World Health Organisation’s (WHO) Global Air Pollution and Health Technical Advisory Group.

The risk is threefold, Yim explained. First, the emissions in the three regions are high. Second, the latest technologies take time to be transferred to the three regions. Third, there is no regulation or standard, measurement network in the three regions. 

Trans-boundary air pollution in South East Asia already causes health problems, and hot weather in these regions could create a “synergistic health effect… (that is) very serious”.

Professor Steve Yim from Singapore’s Nanyang Technological University

The sources of super pollutants are all around us. Black carbon comes from burning biomass and fossil fuels; methane from waste, cattle, agriculture, and industry; ozone indirectly from vehicles thanks to a chemical reaction between heat and vehicular exhaust; and HFCs from sectors such as refrigeration and air conditioning.

Tackling these pollutants can be highly effective, according to Jane Burston, CEO of the Clean Air Fund, a global philanthropy. 

“Half of the global warming that we have experienced to date is because of super pollutants,” said Burston.

“Because they don’t spend very long in the atmosphere, the quicker we can reduce them, the quicker this will impact climate change, which is why they’ve come to be known as the emergency brake on climate change.”

Burston says preventing super-pollutants could potentially avoid more than half a degree of warming by 2050 and prevent millions of premature deaths. Air pollution was linked to over eight million deaths in 2021. 

Convincing governments to act

Development and funding agencies spoke candidly, calling on governments to step up national action and regional cooperation, which can be hard given the tension between several neighbours. 

Patrick Bueker, senior technical advisor at the German Society for International Cooperation (GIZ), called for a “carrot-and-stick approach” for policymakers. The “carrot” involves demonstrating the benefits of regional co-operation in Southeast Asia, such as sharing best practices and data. Bueker suggested a new regional declaration, building on the existing Association of Southeast Asian Nations (ASEAN) agreement on transboundary haze.

The “stick” requires citizens to “push policymakers into acting on air pollution. We haven’t seen any improvement in the region,” Bueker said. 

While the effects of particulate matter (PM2.5) is well known, there is less awareness of ozone, which affects health and agricultural productivity. An informed public can “push policymakers to action”. 

From left: Clyde Hutchinson (ADB-Korea Climate Technology Hub), Patrick Bueker (GIZ) and Parth Sarathi Mahapatra (ICIMOD) with  Jane Burston, Clean Air Fund CEO (right).

Citizen science vital for air pollution

Clyde Hutchinson of the Asian Development Bank (ADB) identifies citizen science as a major opportunity, emphasising this as key to shared responsibilities: “Technology is accessible and cheap, (air pollution) sensors are cheap. We can do everything on our phone; all of us can be climate scientists now.”

Hutchinson says his role as a technology specialist of the ADB-Korea Climate Technology Hub is to “match-make” funding and technology with policy action. 

“There’s no challenge with technology or funding. So what is going wrong here? 
Why can’t we get these programs underway? And that’s part of my job. How do we match both the funding and the technology?” asked Hutchinson.

Complicated regional dynamics

The impact of open and biomass burning and fossil fuel combustion, mainly in India and Nepal, has already accelerated the melting of Himalayan glaciers. A pollution monitoring station on a Nepalese glacier at approximately 5,000 metres above sea level captured proof of this, and the culprit is black carbon.

The Indo-Gangetic Plain-Himalayan Foothills region is one of the largest, most polluted airsheds in the world, and is also in a politically sensitive neighbourhood. A key agency, the International Centre for Integrated Mountain Development (ICIMOD), working on air quality, has a difficult task as two of its member, Pakistan and Afghanistan, are engaged in conflict. 

Political co-operation remains unlikely even though ICIMOD has shepherded an air quality agreement – the Thimphu Outcome. Separately, the World Bank is providing hundreds of millions of dollars as loans across the countries. 

Despite the tensions, ICIMOD representative Parth Sarathi Mahapatra says countries “could come together voluntarily to form a cooperation platform.” 

Mahapatra, an air pollution mitigation specialist, says scientific evidence as provided from the Himalayan glacier and customising solutions from a local to the national level could encourage South Asian policy makers to act on super pollutants. Black carbon alone is affecting the richest source of freshwater, after the poles, for millions of people downstream from the glaciers. 

Against rising heat, government action can no longer afford to proceed at a glacial pace.

Image Credits: Nanyang Technological University, Chetan Bhattacharji.

A Beirut shelter for displaced Lebanese – across the region an estimated four million people have been uprooted from their homes.

The deepening conflict across the Middle East has displaced nearly 3.2 million people in Iran, according to new estimates by UNHCR, as well as nearly 800,000 people in Lebanon, mostly in the southern region, according to a new WHO situation report. 

After the Lebanese Shi’ite militia Hezbollah entered the war on 2 March firing barrages of rockets at northern Israel, Israel struck back with multiple evacuation orders and intense air strikes on Hezbollah strongholds in the country’s southern region, as well as Beirut’s Dahiya quarter, which are still continuing. 

Health services in some 50 clinics and five hospitals in southern Lebanon have been suspended, WHO said, with 25 attacks on Lebanese health care facilities  across the country, leading to 16 deaths, as of 11 March. WHO has verified 18 attacks on health care since 28 February, resulting in 8 deaths among health workers. Over the same period in Lebanon, 25 attacks on health care have resulted in 16 deaths and 29 injuries.  

Israel’s northern region, under almost hourly Hezbollah bombardment since 2 March, has also seen population displacement. Northern and central Israel, targeted by missiles daily, has seen the suspension of all but critical health operations – which have largely moved underground. 

Toxic smoke covers Tehran

Tehran covered by toxic smoke at 8 a.m. on 8 March.

Meanwhile, analysts are increasingly worried about the risk of severe environmental health hazards if the  region’s sensitive water and oil infrastructure is further damaged in the conflict. 

Iran’s capital, Tehran, was covered for two days by a blanket of toxic air pollution last week from after air strikes last week on one of the city’s main oil depots. 

“Petroleum fires and smoke from damaged infrastructure exposed nearby communities to toxic pollutants that potentially cause breathing problems, eye and skin irritation, and contaminated water and food sources,” noted WHO’s Eastern Mediterranean Regional Office in a situation analysis released on Wednesday, the first since the war began on 28 February with a joint US-Israeli attack on key military and strategic targets that killed Iran’s Supreme Leader Ayatollah Khamenei.

Water desalination infrastructure threatened

Dubai’s downtown and tourism industry are sustained by dozens of water desalination plants.

Both Iran and Bahrain have seen airstrikes on sensitive water desalination infrastructure over the past week including:  

  • UAE (2-3 March 2026): Damage from an Iranian strike was reported near Doha’s Fujairah F1 power and water complex (UAE), although the plant itself was not damaged. Iranian strikes on Dubai’s Jebel Ali port also reportedly hit close to a massive complex of some 43 desalination units that are key to the city’s drinking water production. 
  • Kuwait (2 March) – At Kuwait’s Doha West plant, falling debris  from an intercepted drone caused a minor fire at its power and water desalination station. 
  • Qeshm Island, Iran (March 7, 2026): Iran accused the U.S. of striking a desalination plant, affecting the water supply for 30 villages.
  • Bahrain (March 8, 2026): Bahrain reported that an Iranian drone attack caused material damage to one of its desalination plants.

The spectre of more such attacks would be a “nightmarish” scenario for both water-stressed Iran as well as Gulf States that depend overwhelmingly on desalination for drinking water supplies, in the words of one Gulf-based media outlet, The Straits Times. 

Occupied Gaza and the West Bank

Some 42,000 Gazans will need prolonged rehabilitation care and support due to war-related trauma injuries and amputations.

In Gaza, medical evacuations for treatment abroad remain suspended since 28 February, while hospitals continue to operate under strain amid ongoing shortages of medicines, medical supplies and fuel, which is being rationed to prioritize essential health services such as emergency and trauma care, maternal and neonatal services, and management of communicable diseases.

In the occupied West Bank,  increased movement restrictions and checkpoint closures are delaying ambulance and mobile clinics’ access across several governorates, WHO reported in its update. Israeli settler extremists have also seized upon the chaos of the war to ramp up attacks on Palestinian West Bank settlements, while uniformed soldiers turn a blind eye or even cooperate. At least six Palestinians have been killed since the beginning of March – five by settlers and one by the Israeli military.

Disruptions to WHO emergency shipments 

The war in Iran has paralyzed the delivery of WHO supplies from Dubai’s international humanitarian hub, the world’s largest.

Temporary airspace restrictions have continued to disrupt the movement of medical supplies from WHO’s global logistics hub in Dubai. More than 50 emergency supply requests, intended to benefit over 1.5 million people across 25 countries, are affected, said WHO in its update.  Current priority shipments include supplies planned for Al Arish, Egypt, to support the Gaza response, as well as Lebanon and Afghanistan. “he first shipment, containing cholera response supplies for Mozambique, is expected to depart from the hub in the coming week.”

Iran’s use of cluster munitions against Israel 

In its attacks on Israel, Iran has also increasingly resorted to the use of cluster munitions which explode and scatter over many kilometers of civilian areas.

Israelis spending the night in an underground train station to avoid Iranian missiles.

The weapons are largely banned by international law – although neither Israel or Iran have signed the agreement. Nor have the United States, Russia, China and India. 

The combined potential risks of Hizbullah rockets and the widely scattered bomblets from just one Iranian missile have sent millions of Israelis into shelters multiple times a day over the past two weeks, with those in the biggest hotspots relocating underground, as well as destroying homes, damaging transport arteries – and causing a number of deaths. 

The documented use of cluster munitions by Iran, as well as other impacts of the war on civilian targets and healthcare operations in Israel, Cyprus, Turkey or other countries in the Eastern Mediterranean region are not included in the regional assessment by WHO’s EMRO regional office – because they are all members of the WHO’s European Region. 

WHO Emergency Assessments – a regional or HQ product?

When asked why WHO assessments on the ongoing Gulf War, as well as other cross-regional  events, are published solely by the EMRO region – rather than one from Headquarters, which could provide a more inclusive,. cross-regional perspective, a WHO spokesperson said that typically WHO emergency situation assessments are published by WHO’s regional offices because they are closer to the emergency at hand. 

However, that’s not always the case. For instance, African emergency issues are typically published on the WHO Headquarters Emergency site – rather than the African regional site – such as this January update on the health and humanitarian crisis triggered by the war in Sudan. 

Over the past two weeks of war, there have been over 1,885 deaths from the war according to WHO.

“The situation is terrible for the whole region and civilians are the ones suffering the most, including in the health sector,” the WHO spokesperson said.  

Image Credits: https://x.com/HananBalkhy/status/2032121759814517168/photo/1, X/Mohamed Safa@mhdksafa, Dubai Economy and Tourism Bureau., WHO/EMRO , Dubai Humanitarian , Instagram/AFP .

Rock icon Elvis Presley getting his polio vaccination in 1956, as New York City Commissioner of Health Leona Baumgartner (right) held his arm and Assistant Commissioner Harold Fuerst administered the vaccine. His public vaccination massively boosted polio immunisation.

Public health ended 2025 in one of its weakest positions in living memory – not because of a surge in disease, but because of a collapse in political, financial, and cultural support. 

Vaccination policies long considered settled science are being reversed, and industry-backed “junk science” is shaping legislation to derail proven nutrition policies. 

Even as storied public health entities are being dismantled, the tobacco industry – still responsible for eight million deaths each year – faces little resistance in its cynical PR effort to reposition itself as a champion for health. These are not isolated policy defeats. They are symptoms of a deeper problem: public health has lost its relevance in the public narrative.

For decades, harmful industries have poured billions into persuasion, addicting people to sugar, alcohol, and tobacco. Public health, meanwhile, has organized around the assumption that evidence alone can carry policy goals. 

That may have worked in an era dominated by elite opinion makers driving consensus through limited broadcast media channels and operating with institutional trust. But today’s media landscape—driven by algorithms, influencers, and coordinated narrative warfare – requires something different. 

The field isn’t losing because the science is weak; it is losing because it has treated communications as a garnish rather than as an engine for impact. While our opponents invest in persuasion as a primary tool, public health has largely disinvested in communication as a core infrastructure.

This wasn’t inevitable. Public health’s greatest victories once depended on grassroots education and mass mobilization that shaped the cultural conversation. 

In 1956, Elvis Presley’s televised polio vaccination helped skyrocket teen uptake from nearly zero to 80%. In the 1980s and ’90s, “Silence=Death” graphics and the art of Keith Haring transformed the HIV/AIDS crisis into a global movement for human rights. 

Keith Haring’s Ignorance = Fear artwork.

These moments proved that narrative power is as essential to public health as any laboratory breakthrough. And they can be again; the field of public health is poised for realignment. Here’s how it can happen:

The power of culture and influence

Evidence does not “speak” on its own; it requires a deliberate strategy to compete for attention. Industries that profit from harmful products use real-time social listening, test narrative frames the way pharmaceutical companies test molecules, and deploy influencers who reach audiences no government agency can reach. 

They communicate emotionally and strategically, aided by an unregulated attention economy in which algorithms reward outrage and accelerate falsehoods.

Public health must recognize that population health and policy follow culture, not evidence. Today, the main battleground is the “content creator economy.” 

Remarkable voices, from doctors debunking junk science to creators sharing lived experiences, are proving that health can gain traction there. These talented communicators are the modern heirs to the activist-artists of the past; with support, they could help truth compete at the scale of weaponized disinformation of both industry and grifter economy.

Communication as essential infrastructure

The path forward requires a fundamental shift in how we define public health “work.” Leaders must decide to fund communication as essential infrastructure, positioned alongside epidemiology, policy development and providing equitable access to high-quality care. This is not about one-off marketing budgets, but about building a core capability that is permanent and professionalized.

Financing is often cited as a barrier, but it is political will that is the most important resource. Many countries, cities, and states have already found practical ways to sustain this work, and these could be scaled and more explicitly tied to health. 

From health foundations and taxes on alcohol and tobacco, to reclaiming public airwaves or redirecting settlement agreements from industry litigation, mechanisms for significant funding exist.

The challenge is ensuring these resources are used to strengthen health infrastructure – including public engagement systems needed to address the harms caused by these industries. Ironically, more public visibility and engagement are win/win competencies in the battle to secure resources to better engage the public. 

Los Angeles County in the US is using some of the people they have helped to overcome health challenges to humanize health policy.

What would it look like to treat communication as core infrastructure—on par with labs, data systems, or clinical delivery? Three priorities would define the work ahead:

1. Building professional communication and community engagement capacity within health departments.

Modern public health requires full-time professional teams with the budget and authority to run campaigns at scale – comparable to the capacity currently reserved for disease surveillance. Health departments hold a unique strategic advantage: access to the authentic, local stories that humanize policy. Experience in jurisdictions like Los Angeles County shows that when health departments move beyond data dissemination and integrate narrative storytelling, they can successfully reclaim the local conversation from digital noise.

2. Integrating public health with the creator economy.

Since many of the most trusted messengers now exist outside of government, public health must develop the infrastructure to collaborate with digital creators while maintaining scientific integrity. Success in this area depends on meeting audiences where they already are. For instance, we see young people leveraging lifestyle themes, using fashion TikToks or travel videos on Instagram to effectively communicate the risks of nicotine to younger audiences who are otherwise unreachable through traditional channels.

3. Shifting from dissemination to community co-creation.

Trust is not built through top-down messaging, but through genuine dialogue. The next generation of public health initiatives must move from “targeting” communities to “shaping” work with them. This shift ensures that campaigns are not only culturally grounded but also community-owned, turning a passive audience into active participants in their own health outcomes.

Vital Strategies collaborated with the US National Black Harm Reduction Network on a campaign to make naxolone, a spray that can reverse drug overdoses, widely available.

Reclaiming the ‘public’ in public health

The fundamental truth of 2025 is that for too long public health has retreated into technical, cautious communication – messages optimized for scientific accuracy rather than for the anxieties and daily realities that shape people’s lives. 

As institutions grew quieter and more inscrutable, a communication vacuum emerged – one that the public naturally filled by turning to more responsive voices, often belonging to industries and ideologues and supercharged by platforms that reward attention and disregard truth.

Public health is facing existential challenges, and it may seem far-fetched to include prioritizing communications and public engagement among them. With a desperate shortage of resources, many argue that public health needs to trim back to what is “essential,” rather than think about doing things differently. 

There are worthy arguments about what public health must focus on delivering – global health security, universal health coverage, stronger lab systems – but none of these efforts can succeed without public approval, attention, and trust. 

Public health’s next iteration must respond to the new reality that health, social, and policy change are fundamentally rooted in public attention in a way that they never have been before.

Reversing this trajectory requires reorientation. Public health must reclaim its identity not just as a scientific enterprise, but as a mobilizing one. It must participate in shaping culture and policy – not as a byproduct of producing evidence, but as a deliberate act. 

That responsibility falls not just to governments, but to institutions, funders, and organizations committed to protecting health in the 21st century. If we want a healthier future, we must begin with a simple truth: We need to put the public back in public health.

Steve Hamill is Vice President of Policy Advocacy and Communication at Vital Strategies

Image Credits: Department of Health Collection, New York City, The Haring Foundation, LA County, You Can Save Lives.