Midwife Neha Mankani attends to a mother and her newborn in a flood affected community in Pakistan.

In 2024, the world reached an alarming milestone: the hottest global temperatures ever recorded. Floods, heat waves, tropical storms, hurricanes, droughts, and wildfires are affecting everyone, everywhere, with devastating consequences. 

But behind the headlines of environmental catastrophe lies a quieter crisis: the health impacts of climate change on women, families and newborns, and the health providers at the forefront of this crisis.

Sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) needs don’t pause during crises. Babies are still being born, and women and girls can’t wait for care – whether it’s for contraception, treatment for a sexually transmitted infection (STI), or comprehensive abortion care. 

Midwives can provide up to 90% of essential SRMNAH services, even in the most challenging circumstances. Yet their voices are often left out of global climate discussions, and their potential as climate resilience leaders is overlooked.

Minimal infrastructure

“As the world becomes progressively more unstable over time, which it will, having care providers who can operate with minimal infrastructure to deliver care to clients will become increasingly important,” said a Canadian midwife in a new report by the International Confederation of Midwives (ICM). 

“Midwives are ideally positioned to provide flexible sexual and reproductive health and perinatal care to vulnerable populations. We are the face of climate mitigation.”

The report highlights the far-reaching health impacts of climate change and the critical role midwives are already playing in addressing them. It also showcases their vision for building climate-resilient health systems and calls on governments and policymakers to recognise midwives as integral to climate resilience.

A midwife checking a pregnant woman in a rural community clinic in Guatemala.

Impact of extreme heat

Midwives are experiencing first-hand the effect of heatwaves, floods, and other disasters on their patients, with increasing risks of preterm births, stillbirths, and maternal complications like dehydration and postpartum haemorrhage.

“Extreme heat is contributing to increased stillbirth rates, postpartum haemorrhage, and stunting,” shared a midwife from Ethiopia.

Three-quarters of respondents agreed that climate change is harming the communities they serve. These challenges hit marginalised and low-income populations hardest, where access to healthcare is already limited. 

“Low-income communities are more severely affected when there are heat waves. And women are at higher risk of dehydration and preterm labour as a result,” shared one respondent.

Displacement caused by climate disasters adds another layer of inequity. 

A midwife from Ontario, Canada, noted: “Forest fires in my country have displaced Indigenous people from their land. They already face removal from their community to give birth and access care.”

Midwives are already responding

Midwives are not passive observers of the climate crisis; they are active responders. From delivering care during floods and heatwaves to educating families about health risks, midwives are already adapting to the challenges posed by climate change.

“Midwives are vital agents of change in building climate resilience in vulnerable communities. Their multifaceted contributions are critical … they tirelessly educate communities about the health risks of climate change, promote adaptation strategies, provide emergency care during disasters, and integrate sustainable practices within healthcare facilities,” said a midwife from Kenya.

Respondents often reported using their time with clients to discuss environmental health, with 39% doing so regularly. However, 31% expressed a desire to engage in these conversations but felt they lacked the necessary information to do so effectively.

This vital work often comes at a personal cost. The report revealed that 76% of midwives said the climate crisis negatively impacts their work, leading to stress, burnout, and displacement. 

As one Ugandan midwife shared, “I am not able to provide services as I want, and this has affected me psychologically.” 

Jane Mpanga, a midwife checks on an expectant mother at her clinic in Kampala.

A sustainable model of care

Continuity of midwife care offers a sustainable model of care that aligns with global climate goals. Unlike resource-heavy obstetric models, midwifery puts women at the centre of care, while relying on fewer interventions, producing less medical waste, and being inherently community-focused.

“As midwives, we are low tech, high touch,” said a midwife from Australia. “We should continue to advance midwifery as climate activists because [midwifery is] good for the environment.”

Midwives are resourceful in their approach. “Midwives are judicious with their use of resources and resilient and resourceful with limited equipment and facilities,” noted a midwife from Australia. 

“Midwife-attended births at home, for example, generate significantly less waste than a similar birth in a hospital setting and are therefore much better from an environmental perspective.” 

Midwife Farhana Jany with Rohingya mothers at Hope Hospital in Cox’s Bazar, Bangladesh.

There is an extensive body of research that shows that in health systems where midwives are enabled and integrated, this type of care gives excellent outcomes.

Midwives also empower women to build their resilience. Through education and support, midwives help women make informed decisions about their health, fostering long-term stability for their families and communities.

An Ethiopian midwife noted, “Midwifery care offers a unique approach to supporting women and families in a climate-changing world. Their focus on community, resilience, and holistic care positions them as key players in ensuring healthy pregnancies and births even amidst growing instability.” 

Call to action

Midwives are key to addressing the health challenges of climate change and building sustainable, climate-resilient health systems. Yet, they remain excluded from most national climate strategies. 

Governments and policymakers must urgently integrate midwives into climate preparedness and response planning processes. This includes ensuring midwives are part of the process, and that when crisis strikes, they have the training, tools, and resources they need to address climate-related health risks and establish referral pathways and transport systems to use when needed.

The climate crisis is a public health emergency that demands immediate, coordinated action. National health strategies, especially those addressing climate resilience, cannot succeed without recognising the vital role of midwives.

The stakes couldn’t be higher. As one Canadian midwife aptly said: “It is hard to remain hopeful in a context where science demonstrates that we have a tiny window to act, but our leaders are not taking the necessary action.”

The time to act is now – for midwives, for the women and families they serve, and for a healthier, more resilient future.

Sandra Oyarzo Torrez is President of the International Confederation of Midwives

Ana Gutierrez is Communications Lead at the International Confederation of Midwives

Image Credits: International Confederation of Midwives.

Sugary drinks have become popular in Africa, driving type 2 diabetes and cardiovascular disease.

Sugary drinks are driving new cases of diabetes and cardiovascular disease, particularly in sub-Saharan Africa, Latin America and the Caribbean, according to a study published in Nature this week.

One in five new type 2 diabetes cases in Sub-Saharan Africa and a quarter of those in Latin America and the Caribbean are attributable to sugary drinks, according to researchers from Tufts University’s School of Nutrition Science and Policy.

They estimate that 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease occur globally each year due to the consumption of sugary beverages.

Around 11% of new cardiovascular diseases in the Caribbean and over 10% in sub-Saharan Africa are also the result of these drinks. 

The researchers compiled data about 184 countries between 1990 and 2020 using the Global Dietary Database, including 450 surveys with data on sugary drinks totaling 2.9 million individuals from 118 countries.

Biggest increase in sub-Saharan Africa

The biggest increases in diabetes and CVD occurred in sub-Saharan Africa, reflecting changes in the consumption patterns of the region.

Colombia, Mexico, and South Africa have been particularly hard hit.  Almost half (48%) of Colombia’s new diabetes cases, 30% of Mexico’s cases and 27.6% of South Africa’s cases were attributable to sugary drinks.

Meanwhile, sugary drinks were to blame for 23% of Colombia’s CVD cases, 14,6% of those in South Africa and 13,5% of Mexico’s cases. 

“Sugar-sweetened beverages are heavily marketed and sold in low- and middle-income nations. Not only are these communities consuming harmful products, but they are also often less well equipped to deal with the long-term health consequences,” says Professor Dariush Mozaffarian, senior author on the paper and director of Tufts’ Food is Medicine Institute.

‘Clarion call’ to cut consumption

The study describes its findings as “a clarion call that the ‘nutrition transition’ from traditional toward Western diets has already occurred in much of the [sub-Saharan] region”, yet most African nations have not implemented any measures to curb sugary drinks intakes, “perhaps owing to both industry opposition and previous lack of credible country-specific data”.

Those most at risk varied from region to region. In Latin America, the Caribbean, South Asia and sub-Saharan Africa better educated people were most at risk. But in the Middle East and North Africa, lower educated people consumed more sugary drinks. Younger people and men were also more at risk.

There were “modest decreases” in cardio-metabolic burdens related to sugary drinks in Latin America and the Caribbean, which is consistent with slowly decreasing consumption of sugary drinks.

“Nations in this region have implemented several policy efforts targeting sugar-sweetened beverages, including taxes, marketing regulations, front-of-package warnings and education campaigns,” the researchers note.

However, the impact of sugary drinks on health remains high and absolute burdens per million adults continue to rise “owing to continuing increased rates in obesity, type 2 diabetes and CVD” as well as other risks such as high consumption of refined grain and physical inactivity.

Taxes on sugary drinks

South Africans campaign in favour of a tax on sugary drinks in 2017

The authors call for public health campaigns, regulation of sugary drink advertising, and taxes on sugar-sweetened beverages.  

Mexico, which has one of the highest per capita rates of sugary drink consumption in the world, introduced a tax on the beverages in 2014. 

South Africa followed suit with a tax called a Health Promotion Levy in April 2018, taxing all sugary drinks with over 4 grams of sugar per 100 millilitres. 

Colombia’s tax on sugary drinks, which took effect on November 1, 2023, also varies according to the amount of added sugar in the drink:

“Much more needs to be done, especially in countries in Latin America and Africa where consumption is high and the health consequence severe,” says Mozaffarian, who is also Professor of Nutrition. 

Due to their liquid form, sugary drinks are “rapidly consumed and digested, resulting in lower satiety, higher caloric intake and weight gain”, according to the study.

“High doses of rapidly digested glucose also activate insulin and other regulatory pathways, which can result in visceral fat production, hepatic and skeletal muscle insulin resistance and weight gain.”

Image Credits: Heala_SA/Twitter, Kerry Cullinan.

Chinese doctors perform remote surgeries on patients thousands of kilometres away.

Chinese surgeons have used a surgical robotic system and a high-speed satellite to perform five operations on patients thousands of kilometres away from them, according to China Global Television Network (CGTN), China’s global news  broadcaster.

The surgeons, who were based in the Chinese cities of Lhasa, Dali and Sanya, performed procedures on the Beijing patients’ liver, pancreas and gallbladder.

“The surgeon’s movements would be translated into data, which would be sent up to the satellite, then down to the robotic system working on the patient,” according to CGTN.

“Feedback data would then be sent in the opposite direction. All in all, the data would travel nearly 150,000 kilometers, and yet the surgeons could do their jobs as if they were in the same room as their patients.”

The Apstar-6D broadband communication satellite was the conduit for the surgeons’ movements. Satellites are faster and more stable than ground-based systems.

“This series of remote surgeries spanned China’s mountains and straits, demonstrating the feasibility, safety and effectiveness of performing complex long-distance operations using home-grown satellite technologies and robotic systems,” according to CGTN.

China has raised the possibility that such technology can be used to operate on people in dangerous conflict zones.

“The technology could connect patients with surgeons in ways we’ve never seen before. For example, it’s possible that doctors could treat injured soldiers without going anywhere near the front line,” the CGTN report noted.

However, patients still need to be in a health facility with sophisticated infrastructure including the surgical robotic systems. 

“There may be some way to go, but these operations suggest that one day, a satellite surgeon could save someone’s life.”

Image Credits: China Global Television Network (CGTN).

Evidence of the links between alcohol and cancer is “extensive”.

Alcohol is the third leading cause of cancer in the United States, yet less than half of US citizens polled are aware of its link to cancer, according to the US Surgeon General.

To mitigate this, the warning labels on alcoholic beverages should be updated to include the risk of cancer, advised Surgeon General Dr Vivek Murthy this week.

By 2019, almost 100,000 cancer cases in the country “were related to alcohol consumption including 42,400 in men and 54,330 in women”, according to the Surgeon General’s advisory on alcohol and cancer issued this week. 

Breast cancer accounted for the “largest burden of alcohol-related cancer in the US”, with an estimated 44,180 cases in 2019, according to the advisory. This was 16.4% of the total breast cancer cases for women that year.

Cancer of the colorectum, oesophagus, liver, mouth (oral cavity), throat (pharynx), and voice box (larynx) are also linked to alcohol consumption. 

At least seven cancers are associated with alcohol

There are around 20,000 annual alcohol-related cancer deaths – significantly higher than the approximately 13,500 alcohol-associated traffic crash deaths. Only tobacco consumption and obesity cause more cancer than alcohol.

“The more alcohol consumed, the greater the risk of cancer. For certain cancers, like breast, mouth, and throat cancers, evidence shows that this risk may start to increase around one or fewer drinks per day,” the advisory notes.

Almost three-quarters of US citizens (72%) reported having at least one alcoholic drink a week (2019-2020).

According to the World Health Organization’s (WHO) global status report on alcohol and substance use disorders, based on 2019 data from 154 countries, in the region of the Americas, Canada (21.5) and the USA (20.8) topped the list of alcohol consumption.

Those living in the vast WHO European region, which includes Russia, consumed the most alcohol – 9.2 litres of pure alcohol per person annually. The Region of the Americas, which includes North and South America and the Caribbean, followed with 7.5 litres.

But in a 2019 survey, only 45% of people in the US were aware of the relationship between alcohol consumption and cancer risk.

Only 45% of US citizens were aware of the link between alcohol and cancer

‘Extensive evidence’

There is extensive evidence from biological studies that ethanol (the pure alcohol found in all alcohol-containing beverages) causes cancer in at least four distinct ways, according to the advisory.

First, alcohol breaks down into acetaldehyde in the body. This causes cancer by binding to DNA and damaging it. 

Alcohol also generates “reactive oxygen specie”s, which increase inflammation and can damage DNA, proteins, and lipids in the body through a process called oxidation. 

Third, alcohol alters hormone levels (including estrogen), which can play a role in the development of breast cancer. 

Fourth, carcinogens from other sources, especially particles of tobacco smoke, can dissolve in alcohol, making it easier for them to be absorbed into the body, increasing the risk for mouth and throat cancers. 

The World Health Organization (WHO) has said that there is no safe level of alcohol consumption, calling for global action to combat the consumption of alcohol and and narcotic drugs.

Mitigation of risk

In  order to reduce alcohol-related cancers in the US, the Surgeon General recommends updating the warning labels on alcoholic beverages to include the risk of cancer and making the labels “more visible, prominent, and effective”.

He also suggests reassessing recommended limits for alcohol consumption based on the latest evidence on alcohol consumption and cancer risk.

Other suggestions include stronger and more educational efforts to increase general awareness that alcohol consumption causes cancer, informing patients of their risks and promoting alcohol screening, intervention and treatment referral.

Image Credits: Stanislav Ivanitskiy/ Unsplash, US Surgeon General, US Surgeon-General.

Nigerian veterinary paraprofessionals on an animal health training course; good livestock management practices can help reduce antibiotic use and drug resistance (AMR).

Antimicrobial resistance (AMR), or “superbugs,” is known as one of the most urgent global health threats, killing more than 700,000 people every year, a number that may rise significantly if we fail to address this crisis. Conversations about how to stop it do not focus enough on addressing the overuse of antibiotics in the animal farming sector, which accounts for between 70 and 80% of worldwide antibiotic consumption. Global attempts to curb it have made little progress, as evidenced by the recently adopted declaration at the last UN General Assembly, where language around animal use was weakened in negotiations leading up to the High-Level Meeting where the declaration was approved.

Still, countries can and should do a lot to improve antibiotic use in agriculture.

In response to this growing crisis, the Nigerian government and the Arlington, Virginia-based Management Sciences for Health, have been working to strengthen policies and improve appropriate use of antibiotics in collaboration with stakeholders from both the human and animal health sectors.

Our experience in Nigeria – one of a number of countries in Africa which MSH has supported – illustrates some challenges and opportunities, and where countries might begin their work.

Protecting livestock

Farmers typically turn to antibiotics to protect their livestock. But in many low-and middle-income countries they may do so without professional guidance or in inappropriate doses. They may administer the wrong drugs or for the wrong reasons  – not in response to a specific, lab-identified pathogen and drug susceptibility test, but for widespread disease prevention and growth promotion.

Awareness raising amongst communities, veterinarians and farmers is key – course for veterinary paraprofessionals in Nigeria, sponsored by the FAO.

The problem is exacerbated by the fact that antibiotics are readily available over the counter in local markets, sold by untrained vendors without capacity to guide farmers. In Nigeria, many regions lack effective government regulatory oversight. Public awareness of the AMR risks associated with excessive antibiotic use amongst animals remains low. Farmers who have not been fully educated on the risks will often continue to use antibiotics indiscriminately.

Insofar as the health of animals, humans, and the environment is interconnected, and efforts to address AMR should be too.

Veterinarians, medical professionals, government agencies, farmers, and civil society must work together to develop and implement comprehensive AMR strategies. Several key areas are crucial to these efforts. They include: a) strengthened government policies and regulatory frameworks; b) increased public awareness, particularly among the farmers themselves; and c) promotion of a ‘One Health’ approach that recognizes the linkages between animal and human antibiotic use – and associated health benefits as well as risks.

Strengthening government regulatory efforts

Governments need to build on the regulatory frameworks that exist and ensure that they are enforced effectively. Antibiotics should cease to be sold freely in open markets, and farmers should only have access to antibiotics under the guidance of trained veterinarians. Regulatory bodies must take stronger action to control the distribution of antibiotics, ensuring that they are used in accordance with established World Health Organization guidelines. Laboratories need to be strengthened, ensuring that facilities are equipped with reagents to test for resistant organisms.

Governments should also support farmers to help them reduce AMR. Right now, the cost of testing and treating sick animals is borne by farmers in Nigeria and many other countries. Can the government subsidize some of that cost? What about insurance for farmers who experience losses due to illness among their livestock? Investing in research into effective alternatives to antibiotic use, and enhancing implementation of basic biosecurity measures and animal health services are other areas to which governments could contribute to reduce the need for antibiotics for otherwise healthy animals and herds.

Chicken vendors in Dar es Salaam, Tanzania; meat laced with antibiotics from excessive animal use can lead to more antibiotic resistance in people as well as animals.

Public awareness: education of farmers, veterinarians and communities

The public, veterinarians, and farmers alike must understand the risks of overusing antibiotics and the long-term consequences of antibiotic resistance – for animals as well as people.

For instance, in Nigeria, many of our activities will involve supporting the Federal Ministry of Agriculture and Food Security initiatives on social and behavioural change. This includes activities such as: hosting town hall educational meetings with farmers and suppliers; working with secondary school clubs to promote AMR awareness; educating members of the media; and developing radio jingles to talk about the dangers and promote alternatives to antibiotics and other antimicrobial agents.

Civil society organizations (CSOs) can help bridge the knowledge gap by promoting education to farmers and local communities, particularly in hard-to-reach areas, helping them understand why reducing antibiotic use is so crucial, and encouraging hygienic, responsible, and more sustainable farming practices. With a nuanced understanding of cultural contexts and resource availability at the community level, they can help explain biosecurity measures and why they work and dispel myths that might foster resistance to implementing such measures.

CSOs can continue to advocate for stronger policies and help build public support for AMR-related initiatives. They should engage with policymakers to ensure that AMR remains high on the national agenda and pressure governments for more stringent regulations to control antibiotic use. CSOs provide an important voice to advocate for national governments to fund AMR prevention measures, which are currently funded most often by external donors.

Promoting a One Health Approach

WHO:One Health means “designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes”.

A One Health approach to AMR recognizes that the health of humans, animals, plants, and the environment is interconnected. Global health professionals can help break down the silos between human health and animal health professionals and promote working together toward common goals. Farmers need access to training and resources that can help them manage animal health challenges without over-relying on antibiotics. These include better sanitation practices, the use of vaccines, and effective methods for managing livestock health that don’t require the routine use of antibiotics.

Collaboration across sectors is essential to understand the full scope of AMR and to implement policies that address it comprehensively. In Nigeria, we hold quarterly meetings with stakeholders from the government and the various sectors to share lessons, progress we have made, and how we can coordinate activities based on the data we’re seeing.

AMR is a complex and global problem, but it is not insurmountable. The role of the animal farming sector in reducing antibiotic use is critical, and Nigeria’s experience highlights the importance of coordinated efforts among the government, farmers, veterinary professionals, and civil society. Through stronger regulations, better education, and collaborative approaches, we can contain AMR, prevent the rise of superbugs, and ensure that antibiotics remain effective for future generations—both for the health of our animals and the well-being of all people.

Babatunde Akinola, FAPH, is a director with Management Sciences for Health in Nigeria. A trained pharmacist, he has more than 20 years of experience across the pharmaceutical manufacturing sector, medicines regulatory agencies, multinational corporations, and the public health space.

 

 

Dr Columba Teru Vakuru is Nigeria’s Chief Veterinary Officer in the Federal Ministry of Agriculture and Food Security.

 

 

 

Image Credits: FAO, Peter Mgongo, WHO .

Extreme weather events reached dangerous levels in 2024 due to record-breaking temperatures.

The year 2024 is set to be the warmest year on record, the United Nations’ (UN) weather agency, the World Meteorological Organization (WMO), said in an end-year statement on 30 December. This year caps a decade of unprecedented heat fuelled by human activities, the WMO said.

“In my first year as WMO Secretary-General, I have issued repeated Red Alerts about the state of the climate,” said WMO Secretary-General Celeste Saulo.

“This year we saw record-breaking rainfall and flooding events and terrible loss of life in so many countries, causing heartbreak to communities on every continent. Tropical cyclones caused a terrible human and economic toll, most recently in the French overseas department of Mayotte in the Indian Ocean. Intense heat scorched dozens of countries, with temperatures topping 50°C on a number of occasions. Wildfires wreaked devastation,” Saulo said.

Her comments foreshadowed the expected findings of WMO’s formal consolidated global temperatures report for 2024, due to be published in early January.

In a close-up look at just 26 of the 219 major weather events of 2024, climate change-related extremes contributed to the deaths of at least 3,700 people in floods, typhoons, hurricanes, heat waves and wildfires, while leading to the displacement of millions.

This, according to a separate report by World Weather Attribution (WWA), an international consortium of scientists.

“It’s likely the total number of people killed in extreme weather events intensified by climate change this year is in the tens, or hundreds of thousands,” the report stated.

Extreme heat more and more devastating

Climate change also was responsible for an additional 41 days of dangerous heat exposure, per person, on average, in 2024 as compared to pre-industrial exposure levels, the WWA scientists found.

World Weather Attribution studied 26 weather events closely out of the 219 events in 2024.

What is worse is that the countries that experienced the highest number of dangerous heat days are overwhelmingly small islands and developing states that tend to have limited resources to cope.

“Today I can officially report that we have just endured a decade of deadly heat. The top ten hottest years on record have happened in the last ten years, including 2024,” said UN Secretary-General António Guterres in his own New Year message.

“This is climate breakdown – in real time. We must exit this road to ruin – and we have no time to lose. In 2025, countries must put the world on a safer path by dramatically slashing emissions, and supporting the transition to a renewable future,” Guterres said.

Runaway emissions locking in even more heat

Trends are only getting worse, according to the WMO. Currently, the world is at 1.3°C of human-induced warming. In the next five years the annual global temperature is very likely to temporarily breach the 1.5°C target above pre-industrial era that was the target set as a part of the Paris agreement.

And with the most recent UN climate conference COP in Azerbaijan’s capital Baku this November failing to set any new targets for reining in record high fossil fuel burning and emissions, while delivering only $300 billion annually of the $1trillion in climate finance demanded by the poor countries to make a green energy transition, the chances of halting and reversing those trends any time soon looked grim at year’s end.

“Every fraction of a degree of warming matters, and increases climate extremes, impacts and risks,” WMO’s Saulo also said in her a chilling warning. “Temperatures are only part of the picture. Climate change plays out before our eyes on an almost daily basis in the form of increased occurrence and impact of extreme weather events,” she said.

Better monitoring of GHG concentrations 

WMO is in the process of rolling out the Global Greenhouse Gas Watch initiative that will track the GHG concentrations and monthly net fluxes in the atmosphere, for carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) at a 1° × 1° geographic latitude-longitude grid resolution (about 100×100 km spatial resolution).

The aim is to “reduce uncertainties and improve the reliability of GHG monitoring,” the organization said, thus helping countries track the atmospheric impacts of greenhouse gas emissions, while addressing data gaps.

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

Push for early warning systems, more data

The UN also is pushing countries to ramp up their own early warning extreme weather systems. Under the Early Warnings for All initiative, WMO plans to support countries in developing their climate services and delivery programmes.

Other multilateral agencies are also doing the same. In Asia, the Asian Development Bank Institute is pushing countries in the Asia and Pacific region to collect more climate data that could  help prioritize vulnerable communities and respond effectively.

Image Credits: WMO, WWA, WMO.

WHO Emergency team outside Kamal Adwan Hospital on 20 December, the last such convoy before Israel stormed the building and closed it down.

WHO’s Director General Dr Tedros Adhanom Ghebreyesus issued a stiff rebuke to Israel for its military occupation of Kamal Adwan Hospital – the only hospital left operating in Gaza’s northernmost band of territory – which is now largely depopulated after months of bitter warfare.  

In a post on X, Tedros also called for the release of the Hospital’s director, Dr Hussam Abu Safiya, who was taken into custody by Israel over the weekend of 27-29 December. 

“Kamal Adwan Hospital in northern #Gaza is out of service — following the raid, forced patient and staff evacuation and the detention of its director, Dr Hussam Abu Safiya two days ago. His whereabouts are unknown. We call for his immediate release,” Tedros said in a 30 December post. His appeal was repeated again on Saturday, 4 January, as Abu Safiya’s whereabouts remained unknown.   

The WHO director’s calls for the release of the hospital director were echoed by Amnesty International and the UN Special Rapporteur for the Occupied Territories Francesca Albanese, who also called for a worldwide boycott of Israeli medical professionals. 

The Israeli Defense Forces (IDF) moved into the hospital compound during the last week of December, for the third time in a year. The IDF confirmed it had arrested Abu Safiya as well as some 240 other people suspected of being Hamas fighters, while evacuating patients and health workers deemed to be civilians.   

In his post on 30 December, Tedros said that while critically ill patients had been moved to the Indonesian Hospital, in Beit Lahiya, treatment for critically ill patients was unavailable there, at the severely damaged hospital.  

“Amid ongoing chaos in northern Gaza, @WHO and partners today delivered basic medical and hygiene supplies, food and water to Indonesian Hospital and transferred 10 critical patients to Al-Shifa Hospital. Four patients were detained during the transfer. We urge Israel to ensure their health care needs and rights are upheld,” he said. 

On Saturday 4 January, the Hamas-controlled Gaza Health Ministry said that the Indonesian Hospital had been forced to close as well, as Israel drives the remaining civilians out of the northernmost Gaza neighborhoods, which lie adjacent to its border, and where plans are underway to create a “security perimeter”. The hospital was the last functioning facility north of Gaza City.

Israel says it facilitated evacuation of civilians from the hospital

IDF footage of civilians evacuating Kamal Adwan hospital over the weekend.

In a sharply different account of the hospital’s occupation, Israel’s military said that it had facilitated the evacuation of dozens of civilian patients and health care staff from the Kamal Adwan hospital premises – displaying video footage of  people lining up at night to leave in ambulances, and conducted “precise activities inside the hospital, locating and confiscating weapons in the area, including grenades, guns, munitions, and military equipment.”  

The arrest of some 240 suspected Hamas operatives included 15 men alleged to have participated in the 7 October 2023 Hamas invasion of Israeli communities near the Gaza enclave, which triggered the 14-month war.   Hospital Director Abu Safiya was arrested because he was “suspected of being a Hamas terrorist operative,” the army said.  Israeli and Palestinian media reported he was being held in Israel’s notorious Sde Teiman facility, although that remains unconfirmed. 

While human rights activists worldwide began to clamour for Abu Safiya’s release in a virtual campaign, Israeli media cited published statements by the Hamas-controlled Gaza government referring to Abu Safiya as a ‘’colonel’. Abu Safiya’s Facebook posts from October 2023, also praised the 7 October Hamas attacks on Gaza-area Israeli communities – although some of the most explicit posts cited by critics were no longer not available online.

Allegations of Hamas use of Gaza health facilities

WHO health supplies delivered to Al Nasser Medical complex, Khan Younis on 23 October, 2023.

Throughout the war, Israel has contended Hamas combatants and leaders have regularly used health facilities as bases for combatants and hiding places for Hamas leaders – as well as concealing Israeli hostages, at times, as well. 

WHO has sidestepped the issue, saying it has no means to investigate the veracity of such allegations, while calling periodically on both sides to refrain from militarizing health facilities. No foreign media have been allowed by Israel to enter Gaza since the war began. 

Some former Israeli hostages such as Sharon Aloni Cunio, have spoken in detail about spending extensive time in captivity in Gaza’s Al Nasser Hospital with 30 other captives. 

CCTV footage, confiscated by Israel and later aired by global media, also showed some hostages in the corridors of Al Shifa hospital shortly after their capture – while other freed hostages have related how they underwent procedures at hospitals for injuries sustained during their abduction.  

Forced to undergo procedures without anesthesia

A report to be submitted by Israel this week to the UN Special Rapporteur on Torture, also describes Israeli hostages being denied treatment for injuries, or forced to undergo painful procedures for acute injuries without anesthesia, as among the various forms of physical and sexual “torture” endured by the 100 captives who were among the more than 240 abducted by Hamas on 7 October, and since released.

But the report, Israel’s first official submission on the subject to the UN, doesn’t explicitly call out a hospital role, per se, in the reports of abuse – which included some women sexually assaulted at gunpoint, and a report of two teens forced to perform sexual acts on each other, as well as men who were beaten and branded.

Independent eyewitness reports have, on rare occasions, confirmed at least some of the Israeli allegations about the use of hospitals by Hamas leaders and combatants. In one such testimony, a Kurdish-born doctor from Denmark, described to Rudaw, a Kurdish TV network based in Iraq how foreign humanitarian volunteers like himself had to turn a blind eye to Hamas activities at hospitals in the northern Gaza where he worked – or risk being labelled as spies. 

“Hamas as a political, military organization needs to exploit all places to maintain it’s survival and strategic position,” said Baram, noting that on one or two occasions, he sat down with an official that he thought was a part of the hospital administration, only to find out later that he was meeting a senior Hamas official.

“It is unfortunate that I have to say, I have seen it with my eyes, that the hsopitals have been used for hiding Hamas leaders.  “It is a reality that exists. There are some realities that you cannot resist…. if you make such attempts you would be labelled as a troublemaker, a spy, or any other thing,” said the orthopedist, who said he was in Gaza on behalf of the Norwegian aid committee, NORWAC, in April and May of 2024. “Our job basically was not even to see them at all.”

WHO says positions anchored in international humanitarian law

Responding to a query from Health Policy Watch,  a WHO spokesman cited a statement from 21 February, 2024 by the agency’s principle legal officer, Steven Solomon, which stated:

“The International Humanitarian Law is very clear. Healthcare workers and healthcare facilities are off limits. They must not be attacked. They must not be used for military purposes. They must be protected at all times. The point is both to protect civilians, as well as to protect the health systems and infrastructure that communities depend on for life-giving care and continuity of services.

“Failure to protect and respect healthcare devastates twice. First, in the initial harm, and then again for the months or years it takes to rebuild the health systems.

“The protection of healthcare also includes the prohibition against combatants using health facilities for military purposes. IHL is also clear that even if healthcare facilities are being used for military purposes, there are stringent conditions which apply to taking action against them, including a duty to warn and to wait after warning and even then, disproportionate attacks are strictly prohibited.” The spokesman added, “WHO consistently calls for hostages to be given access to health care, and to be released.”

Tedros criticises slow pace of Israeli approvals for Palestinian medical evacuations from Gaza

In a separate statement, the WHO Director General also also criticised the slow pace of Israeli permissions facilitating the medical evacuations of wounded Palestinians from Gaza.

Of the 5383 patients evacuated by WHO since the war began, only 436 have been permitted to leave via Israel since Gaza’s southernmost Rafah crossing into Egypt was closed in May 2024, Tedros said, including 55 patients and companions on 31 December.

Over 12,000 people are awaiting medical evacuation, according to the WHO DG, who exclaimed in an X post: “At this rate, it would take 5-10 years to evacuate all these critically ill patients, including thousands of children. In the meantime, their conditions get worse and some die.”

–Updated 5.1.2024 with news of the Indonesian hospital closing, new WHO statements and the statement by the UN Special Rapporteur, Francesca Albanese. 

Image Credits: @DrTedros/X, IDF .

Israeli air strike at Yemen’s Sana’a International Airport, Thursday narrowly missed WHO Director General waiting to board a flight.

WHO’s Director General Dr Tedros Adhanom Ghebreyesus was back in Geneva this week, after surviving a near miss from an Israeli Air Force strike on Sana’a International Airport, Thursday.

Airport TV footage aired Monday by the DG on X showed his entourage fleeing the VIP departures hall, where they had been waiting to board a UN flight, as the attack began.  A missile aimed at the airport’s air traffic control tower then sent shrapnel flying in the direction of the passenger terminal.

At least three people were killed while a crew member of the waiting UN plane was injured in the Israeli air strike, the largest to date. It came in response to months of Houthi missile fire into Israel, some 2200 kilometers away, including two strikes on Tel Aviv in the past ten days, which injured over a dozen people and destroyed a school.

Israel – ‘UN assets and staff not a target’

In a first-ever response to the incident on Monday, Israel’s UN Mission in Geneva declared in an X post that “UN assets and UN staff are not a target”. But Israel defended the strike saying it was aimed at “military infrastructure used by the Houthis for their terror activities, including in the Sana’a International Airport….

“Terrorist organizations must stop using civilian infrastructure to cover their terror activities,” the Israeli Mission continued. “The UN and the WHO should recognise terrorist organizations as such, stop justifying their activities, and address the regional situation in a fair and unbiased way. One-state-to-blame policy has never worked out, and never will.”

UN Security Council debate on escalating conflict

In a UN Security Council debate Monday, Khaled Khiari, UN Assistant Secretary-General for Middle East, Asia and the Pacific, warned about the new escalation of regional tensions, saying that attacks “originating from Houthi-controlled areas in Yemen must stop.”  But he also appealed to all sides “to respect and protect civilians and civilian infrastructure. Humanitarian workers must be protected at all times.

“The risks of disruption to vital humanitarian operations at a time when millions of people in Yemen are in need of life-saving assistance are of grave concern,” said Khiari.

But there was no sign that either the UN statements or the Israeli military reprisals would halt the strikes by the ad hoc regime, which is funded by Iran and has pledged to continue its attacks until the declared goal of an  Israeli ceasefire with Gaza is reached.

Late Monday evening, a Houthi missile aimed at Israel’s Tel Aviv and central region sent millions of people scurrying to shelters before it was intercepted, with some fragments showering down on a busy highway. That followed another ballistic missle strike early Saturday morning, aimed at the Negev and Jerusalem regions, and also intercepted.  Unlike the Islamic Hizbullah militia in Lebanon, which operated at close range to Israel’s border, the Houthi forces command vast swathes of distant desert from which they can launch projectiles, and remain unhindered by any other countervailing government force, observers said.

Tedros describes his ordeal

Thursday’s Israeli attack on Yemen targeted Houthi positions in and around the capital, including Hodeidah Port, power and fuel stations, and the airport’s runway and air traffic control tower – rendering the later inoperable.

Sana’a Airport control tower after the Israeli strike Thursday evening.

In his first X post that evening, the WHO Director General described the ordeal tersely, saying only, “As we were about to board our flight from Sana’a, about two hours ago, the airport came under aerial bombardment. One of our plane’s crew members was injured. At least two people were reported killed at the airport. The air traffic control tower, the departure lounge — just a few meters from where we were — and the runway were damaged. We will need to wait for the damage to the airport to be repaired before we can leave.

“My UN and @WHO colleagues and I are safe.”

Evacuated safely to Jordan on Friday

On Friday evening, after the WHO DG was evacuated to Amman, Jordan, accompanying the wounded crew member, a member of the UN Humanitarian Air Service (UNHAS), he spoke about the experience in more emotional terms, telling BBC Radio:

“It’s a matter of luck, if the missile deviated just slightly it could have been on our head.”

In Sana’a to negotiate with Houthi’s over release of UN workers being held hostage

The WHO DG had been in Sana’a with a United Nations team to negotiate with the Houthis over the release of more than a dozen UN workers who are being held as hostages by the rebel force.

Six staff of the Office of the High Commission of Human Rights (OHCHR) – one woman and five men – were arbitrarily arrested by the de facto Houthi authorities in June together with seven other UN personnel. A further two OHCHR staffers and two colleagues from other UN agencies have been detained and held “incommunicado” since 2021 and 2023 respectively.

The Houthis, a Shia movement aligned with Iran, took over the Yemenite capital of Sana’a in 2015, deposing the president who fled with Yemen’s UN-recognized government to Aden.

Since 7 October 2023, Houthi forces have been firing missiles intermittently at Israel, in support of the Palestinian Hamas fighting Israel in Gaza, as well as interrupting international shipping lines. On December 21, a Houthi ballistic missile fell in a Tel Aviv city park injuring some 16 people after Israel’s much-vaunted Iron Dome anti-missile system failed to intercept the projectile.  Two days earlier, another missile destroyed a school in the Tel Aviv suburb of Ramat Gan, although there were no injuries because structure was empty at the time.

Israeli media said the attack Thursday evening was the largest ever and included some 100 Air Force aircraft.

Speaking in a video statement, Prime Minister Benjamin Netanyahu of Israel said: “A short while ago, the Air Force attacked targets of the Houthi terrorist organization in Yemen, both along the coast and in Sana. We are determined to cut off this terrorist arm of Iran’s axis of evil. We will persist until we get the job done.”

Updated Monday 30.12.24

Image Credits: YNet/Yemenite TV , Al-Estiklal .

Filling up with water at a displaced persons’ camp in the war-torn Darfur region, where famine is prevalent.

More than 24.6 million people – one half of Sudan’s population – are experiencing high levels of acute food insecurity, according to the latest report of the Integrated Food Security Phase Classification (IPC), which tracks hunger risks and extreme hunger spots globally.

And famine (IPC phase 5) is present in at least five Sudanese areas in North Darfur and parts of the Western Nuba Mountains, according to the IPC’s Famine Review Committee, in its latest analysis, released on Tuesday, 24 December.

Without further access to aid in the conflict-wracked country, even more North Darfur areas will also face famine over the coming five months, the IPC predicted. And 17 other areas in North and South Darfur, Khartoum, and Al Jazirah states are at risk of famine, particularly in areas with high rates of internally displaced persons (IDPs), the review stated.

‘Famine is the most extreme manifestation of human suffering’

Large parts of Sudan face extreme food insecurity, with risk of famine in some places.

“Twenty months into the conflict, Sudan continues to slide into a widening Famine crisis characterized by widespread starvation and a significant surge in acute malnutrition,” the IPC Famine Review Committee (FRC) analysis stated. “This marks an unprecedented deepening and widening of the food and nutrition crisis, driven by the devastating conflict, which has triggered unprecedented mass displacement, a collapsing economy, the breakdown of essential social services, and severe societal disruptions, and poor humanitarian access.”

“Famine is the most extreme manifestation of human suffering, representing a catastrophic collapse of the systems and resources essential for survival,” the IPC  added. “It is not merely a lack of food but a profound breakdown of health, livelihoods, and social structures, leaving entire communities in a state of desperation.”

Famine (IPC Phase 5) first detected in August 2024 in Zamzam camp, North Darfur state, has not only persisted but also expanded to Al Salam and Abu Shouk camps and the Western Nuba Mountains for the period October to November 2024, the IPC committee found.

“Between December 2024 and May 2025, Famine is projected to expand in North Darfur localities including Um Kadadah, Melit, El Fasher, At Tawisha, and Al Lait,” they stated.  “There is a risk of famine in the Central Nuba Mountains (including in Delami, Western Kadugli, Um Durein, and Al Buram localities), and in areas likely to experience high influxes of IDPs in North and South Darfur,” as well as in Khartoum and Al Jazirah states.

Above-average rainfall during the May-October rainy season did provide relief in some areas of Sudan, allowing for more food production in areas where security conditions allowed, the report found. But the ongoing conflict has severely disrupted farming activities across vast swathes of the most affected regions.

Farmers were forced to abandon fields, and crops were looted or destroyed. Displaced families, particularly those in settlements and public buildings, are unable to access harvested foods.

UN Secretary General calls for warring parties to grant aid groups humanitarian access

UN agencies and partners are scaling up food assistance and other essential support programmes, said UN Secretary-General António Guterres.

However, ongoing fighting and restrictions on the movement of relief supplies and personnel continue to jeopardize aid operations.

“The Secretary-General reiterates his call for the parties to facilitate rapid, safe, unhindered and sustained access so that humanitarian assistance and staff can reach people in need wherever they are,” a statement by the SG’s spokesman warned.

RSF enjoys support from the UAE and Wagner group

The brutal civil war first erupted in April 2023 between the Sudanese Armed Forces, and the Rapid Support Forces, a paramilitary group previously operating under the auspices of the government of Sudan.

Built upon an association of tribal militias, the RSF has long wielded control over Sudanese gold mines in the Darfur area, with the precious metal exported to the United Arab Emirates where it was used to fund the RSF leader Mohamed Hamdan Dagalo (Hemedti) and the militia’s activities. The UAE is reportedly a key backer of the military force, with western countries as well as the UN largely turning a blind eye to the relationship, which has been condemned by Human Rights Watch and other humanitarian groups.  The RSF and its leadership also reportedly has connections with the Russian paramilitary Wagner group, which allegedly provided training and equipment to the fighters.

The conflict has claimed more than 20,000 lives and driven over 12 million people – nearly a quarter of Sudan’s population – from their homes. Fighting continues to rage, including in densely populated areas, with widespread reports of humanitarian law violations, as well as sexual violence, on the part of both the RSF and the Sudanese Armed Forces (SAF). On 19 December, three World Food Programme field officers were killed in an aerial bombardment of the WFP Field Office Compound in Yabus, Blue Nile State. The SAF denounced the attack, saying that it had no military activities in the area, while the RSF did not comment.


Health and education infrastructure lies in ruins while deadly diseases such as cholera are spreading, due to the lack of access to clean water and sanitation.

“Only a ceasefire can reduce the risk of famine spreading further and contain the already high levels of acute food insecurity,” the IPC report concluded.

Image Credits: IPC, UNICEF , IPC .

They reached out for a dialogue at the height of the COVID pandemic: Michelle Williams, then dean of Harvard’s School of Public Health, and Margaret Chan, dean of China’s Vanke’s School – face to face in  Geneva in May 2024.

In April 2022, amidst the continuing uproar of the COVID pandemic, four deans of schools of public health from the USA, China, Switzerland and Singapore, first got on a call with each other to see how they could ramp up cooperation – remotely.

Barred by lockdowns from the usual academic meetings and conferences, the urge to link up was stronger than ever.

Co-founders of the high-powered group were Michelle Williams, then dean of Harvard’s School of Public Health, and former WHO Director General  Margaret Chan, now dean of Beijing’s brand-new Vanke School of Public Health.

“At the height of the pandemic, my good friend here, Margaret and several others amongst us, decided that we needed to come together with deans of schools of public health, to promote solidarity, and to continue to be assertive about what global health diplomacy means for all of us,” said Williams at the first face-to-face Coalition meeting in May 2024.

“We were surprised at the lack of dialogue, the lack of cooperation and collaboration worldwide,” said Chan, of that difficult pandemic period. So, she was delighted when Williams reached out about a conferring virtually. “We felt that change is necessary, and we can make a contribution as universities – which represent the creation and translation of knowledge, through science, to policymaking.”

Other founding members included Antoine Flahault, director of the Zurich-based Swiss School of Public Health and long-time actor in Geneva, the world’s “global health hub”. And the deans of public health schools at the University of Cape Town; Mahidol University, Thailand. Heads of public health institutes in Huazhong, China, Mexico, Sydney, Chile and Singapore.

Online hosted by China

Vanke School of Public Health, Tsinghua University, China.

 That first encounter, organized online by Chan at the Vanke School, was naturally focused on health issues related to the COVID crisis – but with an eye beyond the immediate issues of vaccines, travel restrictions and lockdowns to the long-term challenges that everyone knew lay ahead.

Challenges like the need for countries to come together on the all-important task of building more resilient health systems, better prepared for the next pandemic.

“Working with Dr. Margaret Chan to co-create the Coalition was one of the few bright spots during the early part of the pandemic,” Williams, who recently stepped down as dean, told Health Policy Watch by email from California, where she is currently on sabbatical.

“I was delighted that Margaret, and I joined forces and then had other deans join us. I felt it was important that we academic leaders needed to redouble our efforts to break down real and perceived barriers to global health collaboration, cooperation and diplomacy.

“All around us, in political and public health practice spaces, I observed decision makers looking inward and sometimes missing the important imperatives and values of global public health,” Williams said.

“Vaccine nationalism, unthoughtful border closings and some other policies ran counter to public health, global health diplomacy and practice.  This was disheartening especially as pandemic threats, threats from climate change and other threats like antimicrobial resistance are global threats that require global cooperation.”

Linking academia’s public health leadership

‘Our aim is not to duplicate’, Antoine Flahault, dean of the Swiss School of Public Health (on left), with Geneva University’s Alexandra Calmy at a meeting of the Coalition in May, 2024

Indeed, while there are other established coalitions of Public Health Schools, mostly US-based, such as the American Association of Schools of Public Health, the World Federation of Schools of Public Health, and the Consortium of Universities for Global Health, one unique aspect of the GHF-based Coalition of Deans has been the way it links public health leaders, and not only the institutions, says Flahault.

“Our aim is not to duplicate, but to be complementary to all of these groups, with which we coordinate,” he said.

The loosely-knit group now includes about a dozen institutions, as well as the leading European and American associations or federations of Public Health universities and schools.

“Our vision is that this Global Coalition will allow us to learn more from each other, sharing our experiences, facilitating exchanges of students and faculty among schools and fostering joint research programs,” Flahault observed.

Adds Michel Kazatchkine, a physician, academic and former French diplomat, who also spoke at the group’s last meeting on the margins of the World Health Assembly:

‘Increasing interest in health diplomacy’: Michel Kazatchkine, physician and former diplomat.

“We’re now seeing an increasing interest in health diplomacy. But in this context, academia is particularly important because science is essential in evaluating the impact of policies and providing feedback analysis to politicians so that they can correct trajectories if needed.

“And academia provides the freedom to do research on any topic, even the most sensitive – to collect, analyze and speak about the findings of your data. So, we should not underestimate the role of academia as a fundamental pillar of knowledge-based, democratic societies.”

Focusing on planetary health and other neglected topics

The Sydney School of Public Health’s Flagship planetary health initiative in Fiji was one example featured at the Geneva Health Forum. A study of watershed interventions, it aims to reduce incidence of typhoid, dengue and other deadly diseases in Pacific Island countries.

This year, after two years of remote meetings organized by the Vanke School and Harvard in succession, members of the coalition convened face-to-face, for the first time in Geneva, on the margins of the World Health Assembly, hosted by the Geneva Health Forum and the University of Geneva.

The group focused on planetary health as their principal topic.

“We shared experiences from Australia, China, and the USA about academic programmes dedicated to this issue – and asked the question: how do schools of public health integrate planetary health into their curriculum?” Flahault said. Doctoral and masters’ students from selected schools were also invited to speak along with faculty about lessons learned, he noted.

The discussions continued a thread from the 2023 remote meeting, which examined climate-driven food insecurity in the global health context – another cutting- edge issue that rarely gets much attention in classic public health school textbooks or classrooms.

“The Coalition of Deans have already been instrumental insofar as bringing attention to the importance of creating multi-national and interdisciplinary collaboration to bring multiple perspectives into designing curriculum,” reflected Williams.

“We’ve also provided a platform (as seen in the meeting hosted by Prof Flahault last spring) for showcasing junior faculty members and graduate students working in the fields of global planetary health and environmental justice,” Williams pointed out.

The effort is all the more topical insofar as Harvard’s Chan School of Public Health just launched a concentration in climate and planetary health in 2024.

In China, the Vanke School is also planning to pilot a planetary health course in 2025. That course will bring together students of public health with those in students from economics, urban design, environmental health sciences and engineering to examine multi-sectoral challenges and design solutions, said Chan, speaking with Health Policy Watch.

Chan: Vanke’s new planetary health course will bring together students of diverse disciplines.

“Everyone knows about how John Snow stopped the cholera epidemic [by breaking the pump on a contaminated water cistern], but what about the sanitary engineer who helps to renovate and overhaul the London sewage system,” Chan said.

Tsinghua University, where the Vanke School is located, is world famous for its engineering school, she observes.  “So. this will train future decision-makers to bridge between disciplines such as engineering and health.”

Indoor air pollution and wastewater epidemiology

Along with partners in the WHO, the GHF and European Universities, Coalition members have also supported the development of a series of events on other interdisciplinary health topics over the past year.

These included a conference on Indoor Air Pollution, in September 2023 in Berne, as well as a recent Conference in Paris on Wastewater-based Epidemiology. See related story:

Post Pandemic: Wastewater-based Surveillance of Diseases Comes of Age 

 

“Of course we have moved on from the pandemic to other topics,” noted Chan, speaking with Health Policy Watch recently in a phone interview. “The change in the conversation is a reflection of the changes in the current trends in Public Health. And it’s going to be more diverse as we move along.

One topic she’d like to see the Coalition tackle at some point would be the challenges of harnessing AI for good in the broad context of public health research and policymaking.

“There is a lot of talk about AI in clinical work, but what about AI in public health?” she asks. “Patient confidentiality is important. But we also need policies in place to enable the use of AI in research and outreach, but also to protect people’s privacy.”

Whatever the theme may be, the approach is the same, says Williams, who was instrumental in establishing a student exchange programme between Harvard and the Vanke School in 2021.

“Sharing of teaching materials and experiences related to launching new courses and concentrations are ways we can facilitate the spread of ideas across other universities.

“Developing and supporting annual workshops, and supporting student and faculty exchanges, are another. It is hoped that the Deans can secure resources to help operationalize these collaborative initiatives.”

Looking forward to 2025

Cabo Verde's Minister of Health, Filomena Mendes Gonçalves.
Geneva Health Forum 2024 session on malaria elimination with Cabo Verde’s Minister of Health, Filomena Mendes Gonçalves.

Looking forward, Flahault says the group aims to maintain its informal modus operandi, to facilitate exchange across borders – and keep the focus on meaningful meetings and liaisons.

“We are a lean organization without any budget and staff and not competing with any other organizations,” Flahault said.

At the same time, he envisions the Coalition playing an advisory role in a soon-to-be-formed Think Tank that aims to continue dialogue and problem-solving around the themes of the Geneva Health Forum throughout the year. “One major fruit or byproduct of this will be the GHF Think Tank, which we are launching this spring, and will tap the academic network the Global Coalition assembles,” he said.

That, in addition to their annual meetings, on the margins of the Geneva Health Forum’s annual conference during the World Health Assembly – with the next event organized by Teo Yik-Ying, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.

Now that face-to-face meetings are once more feasible, working from the Geneva axis offers a unique vantage point that can transcend some of the sharp geopolitical divides that academic leaders face in dialogues at other venues, Flahault also points out.

Says Chan, who served as WHO Director General from 2006-2017, “I’m very biased – to me, Geneva is the capital of public health. And all countries come to the World Health Assembly. So, it’s natural that all of us in the Coalition would meet here, to make our voices heard.”

Returning to basics of infectious disease elimination

A child paralyzed by polio breathes in an iron lung – the best available intervention before the polio vaccine’s discovery in 1955.

Along with emerging global health issues around climate and planetary health – Flahault sees a future role for the group in reviving interest around some of the world’s longstanding, and unsolved public health challenges – such as elimination of polio, cholera and other preventable infectious diseases.

“Personally, I would love to see a WHA resolution against the three major diseases, polio malaria and cholera – with the same sense of determination we displaced against smallpox in the 1950s and 60s, with the same sharp formulation, we want to eradicate these diseases as soon as possible,” he said in a recent interview.

 “All of the major actors would push and row together to make this successful. For polio it’s already done but we have to say we have to end the job.

“We need to be modest and realistic,” Flahault admitted. “Surely, eradicating cholera from the planet, which has already been the subject of one WHA resolution, needs a huge political commitment. This is not in the portfolio of the Global Coalition or schools of public health.

“But we could still play a role. With players in the media ..we could try to mobilize political leadership which is lacking today. We don’t have many political leaders embracing global health issues, as happened during the pandemic, but today global health issues remain a source of power for promoting multilateral commitments.

“And in the coalition, we have a great opportunity for liaison between China, the USA and Europe and all of the other constituencies that are in the room, which give us an opportunity to push public health as a form of ‘soft power’ to move forward agendas.

After all, we succeeded in the 20th century to eliminate smallpox at the height of the cold war between the USSR and the USA.  It was not easy, but we succeeded thanks to a shared commitment to health.”

–Written as part of a Health Policy Watch collaboration with the Geneva Health Forum.

Image Credits: Vanke School of Public Health , Aaron Jenkins, Sydney School of Public Health, Geneva Health Forum, Paul Palmer/ WHO.