Europe is the world’s fastest warming continent and the year 2024 was its warmest on record.

Europe is the world’s fastest-warming continent and 2024 was the warmest year on record, with record temperatures in the central, eastern and southeastern regions, according to the latest European State of the Climate 2024 report published jointly by the World Meteorological Organization (WMO) and Copernicus Climate Change Service (C3S).

Severe storms and flooding claimed 335 lives last year and affected around 413,000 people. Scientists also reported that the east was extremely dry, while the west witnessed warm and wet conditions.

“This report highlights that Europe is the fastest-warming continent and is experiencing serious impacts from extreme weather and climate change. Every additional fraction of a degree of temperature rise matters because it accentuates the risks to our lives, to economies and to the planet. Adaptation is a must,” WMO Secretary-General Celeste Saulo said in a press statement.

The report has a silver lining. The proportion of electricity generation by renewables in Europe reached a record high in 2024, and now stands at 45%.

This is the eighth annual report, released in April every year, and the second that has been published jointly with Copernicus, the European Union’s earth observation program.

Climate change hotspots

In 2024 Europe saw climate impacts ranging from heatwaves to wildfires.

Europe experienced the most widespread flooding since 2013. Almost one-third of the continent’s river network experienced flooding that exceeded the ‘high’ flood threshold.

The continent saw both hot and cold extremes. The numbers of days with ‘strong’, ‘very strong’ and ‘extreme heat stress’ were all the second highest on record.

Nearly 60% of Europe saw more days than average with at least ‘strong heat stress’. But there was a record low number of days with at least ‘strong cold stress’ too.

“These extreme events led to an estimated 18 billion euros of damages, 85% of which is attributed to flooding,” said Samantha Burgess, deputy Director of C3S during a press conference to discuss the report’s key findings.

Last year was the warmest ever for Europe with record-high annual temperatures in almost half of the continent.

All European regions saw a loss of ice due to record temperatures. Glaciers in Scandinavia and Svalbard saw their highest rates of mass loss on record. In September, fires in Portugal burned around 110,000 ha (1100 km2) in one week, representing around a quarter of Europe’s total annual burnt area. An estimated 42,000 people were affected by wildfires in Europe.

“We observed the longest heatwave in southeastern Europe and record glacier mass loss in Scandinavia and Svalbard, an archipelago between Norway and the North Pole. But 2024 was also a year of marked climate contrasts between eastern and western Europe,” Carlo Buontempo, C3S director said during the press conference.

While the entire continent is not a climate change hotspot, experts said that some areas within Europe do fit those criteria.

“A good example of this is the Mediterranean region, which is widely recognized as a climate change hotspot with above average warming, a projected decrease in precipitation, rising drought, risk wildfires and strong socio economic and ecological vulnerabilities. Similarly, the alpine region in Europe is also experiencing above average warming and sensitive changes in the cryosphere,” Burgess said.

Impact of funding cuts to NOAA now visible

In recent months the United States government has cut funding to the country’s climate monitoring system, the National Oceanic and Atmospheric Administration (NOAA).

This has affected scientists who have been laid off from their jobs and has also limited the number of observations NOAA makes around the world. Scientists acknowledged that this has affected the quality of the report that uses data from multiple data sources.

“Observations are absolutely fundamental to monitor what we’re doing, and NOAA is providing a lot of observations. What we’ve seen since March is that there has been a drop in the number of observations delivered by NOAA due to funding cuts,” said Florence Rabier, Director-General of European Centre for Medium-Range Weather Forecasts or ECMWF.

“Any observation loss is a loss for climate monitoring, for calibration of satellite, for verification of forecasts. So, in terms of both science and observations for weather and climate, I think it would indeed have an impact on the whole community,” she told the press conference.

Progress on some fronts

Cities across Europe have been focusing on initiatives to respond to climate change.

The report spotlighted some progress that was made by cities and countries. In 2024, Europe generated 45% of its electricity needs from renewables, up from 43% in 2023.

The number of EU countries where renewables generate more electricity than fossil fuels has nearly doubled since 2019, rising from 12 to 20, according to reports.

In addition, around 51% of European cities have adopted climate adaptation plans, which is almost double the 26% in 2018. Urban areas are responsible for 70% of all carbon emissions globally and the United Nations has pushed for cities to take action as they can play a big role in our response to the climate crisis.

Around 100 scientists in Europe and around the world worked on this report, and WMO head Saulo emphasized the need for continued action: “Every fraction of a degree matters. Climate adaptation is not the future option. It’s a very real necessity now, today, not tomorrow.”

Image Credits: Unsplash, European State of the Climate 2024 report.

US Health Secretary Robert F Kennedy Jr.

The United States federal government’s response to the rapidly spreading measles outbreak has faced steep criticism after Health and Human Services (HHS) Secretary Robert F Kennedy Jr (RFK Jr) falsely claimed the vaccine’s protection “waned quickly” and hasn’t been “safely tested.” 

While Kennedy endorsed the measles vaccine as the most effective way to protect against the disease, he has simultaneously sowed doubt in multiple statements. 

Meanwhile, a second unvaccinated US child has died from measles, a highly contagious but vaccine-preventable virus. 

More than 712 patients have been affected as of 10 April, according to the Centers for Disease Control and Prevention (CDC). 

The outbreak is quickly becoming the largest, and deadliest, in recent US history, threatening the country’s measles elimination status, which it has enjoyed since 2000.

Since then, slipping vaccination rates have meant communities have lost the herd protection needed (a vaccination rate of at least 95%) to keep cases from spiraling out of control. Prior to this outbreak, a child hadn’t died from measles since 2003 in the US.

Public health experts – pediatricians, epidemiologists, and government officials -– and Kennedy’s anti-vaccine supporters have criticized HHS for its contradictory and misleading statements.

“RFK Jr has stated that the measles vaccination routinely causes deaths, which is not true. The truth is that measles vaccination has prevented more than 60 million deaths globally. Vaccinating your children not only protects them, but also entire communities,” said Dr Tom Frieden, former CDC Director during the Obama administration and CEO of Resolve to Save Lives.

 “Measles has historically killed between one and three people per 1,000 cases, and those that died were usually immunocompromised. This year is different: two of the three deaths have occurred in healthy children,” noted W Brian Byrd, Public Health Director in Tarrant County, Texas, in a social media post.

“Most of us believe this outbreak is larger than what is being reported.”

Cases spread to Oklahoma, Ohio, Pennsylvania, Indiana, Arkansas

The US measles outbreak began in West Texas in late January, concentrated in unvaccinated children and adolescents. Three measles-related deaths have been reported – two unvaccinated children and one unvaccinated adult.

Since the outbreak began, 11% of the 712 cases have been hospitalized, according to the CDC. The World Health Organization (WHO) reported a 17% hospitalization rate. 

Measles is the most contagious infectious disease, causing high fever, runny nose, and a full-body rash. There is no specific treatment for measles. 

While the epicenter of the outbreak remains Western Texas and New Mexico (90% of cases combined), a total of 25 jurisdictions – including Indiana, Ohio, Michigan, Pennsylvania, and Arkansas – have reported cases, some for the first time in years.

Measles in the US, 9 April 2025

Across the country, childhood vaccination rates have dipped to 92.7%, several points lower than the 95% threshold the WHO stipulates will maintain herd immunity. 

In Gaines County, Texas, the epicenter of the outbreak, the vaccination rate is around 82%.

The measles, mumps, and rubella (MMR) vaccine is proven safe and effective, according to the CDC, with rare side effects. Despite this, counties across the country have struggled with falling vaccination rates.

“Talking to the community, they really stopped vaccinating about 20 years ago, which is in line with what we’ve seen in other communities across the United States,” said Katherine Wells, director of public health of a West Texas city.

Mixed messages and mass lay-offs hamstring response

Entire disease communication teams were dismantled during the HHS’s recent sweeping purge of scientists, regulators and public health experts. 

The “reduction in force” (RIF) notices terminated over 10,000 HHS employees across divisions and agencies, including those responsible for communicating with the public about health emergencies. All agency press officers were fired.

In addition, scientists studying vaccine hesitancy recently lost their National Institutes of Health (NIH) funding.

“Eliminating communications staff from CDC means we all have less information on how to protect ourselves from health threats,” said Friedan. 

Jeremy Kahn, Food and Drug Administration (FDA) media relations director, was one of the many communications personnel removed. 

“Whether explaining the nuances of a medication recall or providing guidance during emerging health concerns, our communications helped Americans make informed decisions based on facts rather than fear. There is no question that this delicate balance of transparency and reassurance made tangible differences in public health outcomes,” he said in a LinkedIn post.

In the meantime, Kennedy appeared on several media platforms to discuss his department’s response.

This included claiming that the US’s response should be the “model for the rest of the world,” incorrectly comparing the US’s number of cases to the total cases from Europe’s 44 countries.

Kennedy also claimed that cases were slowing, directly contradicting Texas health officials’ projections that the surge in cases would probably last until the end of the year.

“We think these cases are undercounted,” Dr Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security said at a press conference with Texas health officials, as reported by Politico. “So, you can’t say something is flattening if you don’t know the denominator of cases.”

In a CBS interview, Kennedy made several other claims that have been debunked by health experts: that vaccines were developed without placebos and that they were tested for “three or four days.” Both statements are misleading, according to vaccine experts.

MAHA backlash

Not only has Kennedy’s comments sparked backlash from the public health community, but also from his own ardent anti-vaccine “Make America Healthy Again” (MAHA) following.

After Kennedy posted that vaccines were the most effective way to prevent disease, Del Bigtree, the communications head of his presidential campaign and anti-vaxx advocate wrote on X: “Your post got cut off. The MMR is also one of the most effective ways to cause autism.” 

However, numerous studies have debunked the claim that the vaccine causes autism. 

“Health freedom” advocate Dr Mary Talley Bowden, who gained a following over her support of ivermectin, replied to the post with “I’m sorry, but we voted for challenging the medical establishment, not parroting it.” Ivermectin is a treatment for parasites that was promoted by anti-vaxxers and alternative health advocates as a treatment for COVID-19, although studies have found has little effect on the virus.

But Kennedy’s fluctuating position and mixed messaging appear to be jeopardizing the response to the outbreak, especially in getting more children vaccinated. 

“That’s the way to stop it. This only ends with immunity,” said Jennifer Nuzzo, director of the Pandemic Center at The Brown University School of Public Health, in a statement to NPR. 

Funding chaos shutters disease surveillance labs

Health professionals – including those working on outbreak investigation, maternal mortality, and vector-borne disease – across HHS’s 13 divisions saw mass layoffs as the Trump administration attempts to reduce the size of the federal workforce.

Measles surveillance and messaging were not the only HHS functions crippled in the past weeks.Part of HHS’s unprecedented purge of employees was the closure of the preeminent CDC laboratory dedicated to tracking sexually transmitted diseases (STDs) which affect one in five Americans.

The CDC lab was only one of three globally that tracks particularly notorious drug-resistant STDs.

Leading STD experts, including David C. Harvey,, executive director of the National Coalition of STD Directors, called the lab closure “alarming” and a “critical loss of an essential health function that the federal government should be providing to protect the health of all Americans.”

“The lab closure removes one of the critical tools we use to protect people from drug-resistant infections at the same time our ability to prevent STIs has been set back by massive cuts and layoffs,” Harvey told the news site Healio. 

“We are urging Secretary Kennedy to reinstate these labs and staff in order to protect the public against the ongoing STI epidemic and other infectious diseases.”

It’s not only the US that will be forced to limp its way through outbreaks.

The US was the sole funder of the World Health Organization’s global measles and rubella network of more than 700 laboratories. These key labs face “imminent shutdown” in the wake of US funding cuts, the WHO director general  said to the media last month. Without “Gremlin,” the global surveillance network, outbreaks would not be detected, said Dr Kate O’Brien, WHO director at the department of immunization, vaccines and biologicals.

Surveillance plays a crucial role in understanding disease burden and trends – as well as in identifying outbreaks, like measles. Without public health laboratories, and the staff to communicate during an outbreak, “we are flying blind,” said Dr Tom Frieden, during a podcast interview. 

Image Credits: CBS, CDC.

The ten division heads currently in WHO Director General Dr Tedros Adhanom Ghebreyesus’ Senior Leadership Team could soon be reduced to just five.

The number of WHO programme divisions would be reduced from 10 to just five and the number of directors in headquarters would shrink from nearly 80 to around 30 in an emergency reorganisation plan reviewed by the agency’s executive management group at a closed-door retreat on Saturday.   

The plan, to be presented to member states this week, also proposes to move some departments housed in Geneva to WHO’s Regional Offices, where costs are far less, or HQ outposts away from Geneva even if the operations remain associated with headquarters. 

Examples include a possible move of WHO’s entire polio operation to the Eastern Mediterranean Regional Office in Cairo; the region is responsible for Afghanistan and Pakistan which are the only countries where transmissions of wild poliovirus still continues. Similarly, there are discussions about moving WHO’s Department of Traditional Medicine to India, a leader in the field, and so on. 

Other core functions or departments might be moved out of Geneva to satellite offices elsewhere in Europe, so that they can remain in proximity to headquarters, without the associated costs. Along with its regional office in Bonn, WHO already has offices or research centres in Lyon, Germany, Italy, and Denmark. Other venues could also be considered, sources told Health Policy Watch. 

But even these dramatic steps, informed observers say, will not be enough to generate the savings required to cover an expected $600 million budget deficit for 2025, along with a projected $1.9 billion gap for the upcoming budget biennium of 2026-2027 triggered by the United States’ withdrawal from the organisation in January.  

And given that the lion’s share of the WHO deficit is in its Geneva headquarters, it’s expected that staff there will likely have to be reduced by some 40% or more, from more than 2,600 people today to around 1,400-1,500 employees – some of whom may also be re-assigned to satellite offices.  

Perform, Power, Promote, Provide and Protect

One of two options for WHO’s reorganization, considered at a WHO senior executive meeting Saturday.

The latest iterations of the WHO “straw draft” organigram, seen by Health Policy Watch on Friday, included two highly similar options presented to Saturday’s meeting of WHO’s executive leadership. The leadership will fine-tune a final option prior to the presentation of the plan to member states, in a meeting set for this week.  

Both options model WHO’s new organisation around five “P’s” said to embody the agency’s internal functions and external mission. They include: perform, power, promote, provide and protect.

The focus of each WHO division, follows intuitively from those keywords. Science, data and medical product standard-setting is centred in the “power” division; environment, nutrition, sexual and reproductive health, and health promotion fall under “promote. Communicable and non-communicable diseases, as well as the health systems and workforce are clustered in “Provide”, while health and humanitarian emergencies fall under “protect.”

The reorganisation would roll back WHO’s lumbering bureaucracy from today’s nearly 60 programme departments to about 32, slashing the number of directors as well. In the January 2025 organigram directors of departments and special programmes housed at Headquarters numbered 63. According to the last WHO Workforce Data report, of July 2024, however, there were around 80 D1 and D2 directors based at headquarters – more than the number of departments and programmes to be managed.

As of Juy 2024 there were nearly 80 directors (D1,D2) at WHO Headquarters – more than the number of departments. [Note, one director would be attributable to the Global Services Center in Kuala Lumpur].
On a global level, the swollen number of senior directors together with even higher-earning division heads, regional directors, and the director general and his deputy, have been costing the organisation nearly $100 million a year, a 10 March Health Policy Watch investigation found.

EXCLUSIVE: Number of WHO Senior Directors Nearly Doubled since 2017, Costs Approach $100 million

Back to basics?

WHO Organization as of January 2025 boasted 10 divisions, and nearly 60 departments, not including the Director General’s Office.

The new reorganisation, while seemingly radical, would in fact bring the agency’s core functions back to a template similar to the one that was left by WHO’s previous Director General Dr Margaret Chan, when she finished her 10-year tenure as head of the agency in July 2017. 

During her second five-year term in office, Chan, who ran a fiscally conservative administration, pared down operations at headquarters from eight to five divisions in a model that is not dissimilar to those featured on the “straw drafts” circulating over the past two weeks. 

After July 2017, the agency swelled in numbers of directors, departments and divisions – as well as staff and consultants – during the “Transformation” initiated by  Chan’s successor, Dr Tedros Adhanom Ghebreyesus.  

Ostensibly, that transformation aimed to shift more resources in countries and regions. It also created a new Science division, welcomed by many as a forward-looking measure that could consolidate many of WHO’s standard-setting functions with new challenges in digital health and AI. 

But as per the Health Policy Watch assessment in March, the transformation also saw the multiplication of departments and divisions at headquarters, adding costs to WHO’s uppermost layers. 

The number of WHO’s top-ranked directors (D2), nearly doubled to 75, with most of those costs associated with new or upgraded posts at headquarters. 

Sources: WHO bi-annual HR reports, and UN salary scales, in comparison to proportion of costs attributable to entitlements and benefits. Note: Costs of P6 positions, while comparable to D1, are included in the P- category, not D category.

Along with being expensive, WHO’s new organisation turned out to be a rather cumbersome  beast, neither easy to grasp or entirely logical. WHO staff themselves often stumble over both the names and the focus of three core divisions, all bearing mutations of “Universal Health Coverage (UHC)” in their titles.  There were fears that the broad distribution of divisions and departments fostered more siloed functions, as compared to a more interdisciplinary approach to global health challenges.   

Embedded within the large and complex structure, whole new teams were created, such as the Office of the Deputy Director General, which were then equipped with significant staff – over two dozen people, according to the last detailed organigram of the DDG’s office published in 2019.   

Staff protests and discontent?

Salary gap by region for 2025 as presented to WHO member states in March, shows more than half of the deficit is in headquarters.

The draft new organisational mapping, while simpler, may also correct some of those knock-on effects, although it will have big political ramifications, as well, if adopted.

For instance, the deputy director general and his office is not mentioned at all in the latest iterations. Does that mean the current DDG, Mike Ryan, might even return to his previous position as executive director of health emergencies, should the new plan be implemented? Or will he possibly retire as he was rumoured to be planning two years ago?  That remains to be seen.   

What’s clear is that the tremors will be felt well beyond the senior leadership of the organisation as the cuts that Tedros pledged would “start” at the top and ripple downwards into the staff rank and file. 

A WHO Staff Association Open House is planned for Thursday to take up the issue of the pending changes, none of which have yet been discussed with Staff Association representatives. 

The Staff Association also is considering a pre-emptive, class action suit to ensure that staff rights are protected, one insider told Health Policy Watch. In 2018, staff pursued a similar action to protest a planned 7% reduction in take-home pay based on what they contended was an erroneous cost-of-living adjustment for Geneva based professional staff – and were successful.  UN-wide revisions in cost of living scales that were subsequently made, and approved by WHO’s Executive Board in February, did not result in any net loss in pay.

“Tedros, in his Town Hall presentation to staff [2 April], promised to make cuts based on functions, not based on contracts,” the source explained. “OK, you can cut the functions, but at the end of the day, WHO staff on long-term (continuing) contracts should get the first priority for the jobs that are left; those on fixed term (1-2 years), come next; then temporary staff (less than one year); and then consultants – who should go altogether. 

“The main issue is that there still is no transparency,” one WHO staff member complained. “So many people are going to lose jobs. And there are a lot of eyes on Tedros. At the end of the day, the buck stops with him.” 

–Updated 14.04.2025 to note that a member state meeting on the reorganization is expected to be held this week.

Image Credits: Wikipedia , WHO , WHO , WHO, 2025.

Jubilant and exhausted members of the INB pose after marathon pandemic agreement talks finally result in unity.

World Health Organization (WHO) member states are very close to agreeing on the entire pandemic agreement – and may even have been able to clinch a deal on Saturday had they not been exhausted after negotiating from Friday morning right through until  9am on Saturday morning, according to sources.

Anne-Claire Amprou, co-chair of the Intergovernmental Negotiating Body (INB), told Associated Press  that “we have an accord in principle” – and indeed they almost do.

By sunrise on Saturday morning, the entire draft pandemic agreement had been agreed on – bar the vexing question of whether technology transfer related to the production of pandemic products should always be voluntary, reported by Health Policy Watch.

Several negotiators also need to get new mandates from their principles before they regroup at the final formal talks on Tuesday where the text expected to be approved for presentation at the World Health Assemby (WHA) next month.

The one outstanding issue involves whether technology transfer for producing pandemic-related health products shall be both “voluntary” and on “mutually agreed terms”, according to a footnote in Article 11.

Thirty legal experts argue in a letter sent to negotiators earlier in the week that the use of “voluntary” will undermine countries’ “sovereign right … to implement legislation within their jurisdiction, and equity in pandemic preparedness and response”.

Several countries have laws allowing non-voluntary measures under exceptional circumstances, including the United States Defense Production Act, and Germany’s Act on the Protection of the Population in Case of an Epidemic Situation of National Significance, passed in 2020 in response to the COVID-19 pandemic.

The INB Bureau proposed on Wednesday that the footnote should read: “For the purposes of this Agreement, transfer of technology refers to an agreed process where technology is transferred on mutually agreed terms. This understanding is without prejudice to and does not affect the measures that Parties may take in accordance with their domestic or national laws and regulations, and compliant with their international obligations”.

Brazil has since proposed a compromise, which reads:  “For the purposes of this agreement, ‘as mutually agreed’ means willingly undertaken and on mutually agreed terms, without prejudice to the rights and obligations of the Parties under other international agreements.”

This compromise appears likely to have struck the right note with member states and it looks as if Tuesday will see text of the entire agreement “greened” to show total agreement – positive news for global pandemic prevention, preparedness and response after three long and tough years of negotiations.

Image Credits: Thiru Balasubramaniam.

Half of the world’s population has no access to any kind of oral care and lives with untreated oral disease every day, according to Dr. Habib Benzian, a dentist and professor of epidemiology and health promotion at New York University.

“There’s no other disease group that affects so many people,” Benzian said.

In fact, oral health issues impact 3.5 billion people globally.

Benzian spoke on the most recent episode of Global Health Matters with Dr. Garry Aslanyan, alongside Bulela Vava, a dentist and president of the Public Oral Health Forum in South Africa. The discussion centred around the World Health Organization’s new global oral health strategy and action plan for 2023 to 2030. The plan calls for everyone to have access to essential oral health services—prevention, care, and rehabilitation—by 2030. However, the vision remains far from being realised.

Why the gap?

Benzian and Vava pointed to several barriers. One is the historical professionalisation of oral health as a separate field, which has led to its exclusion from broader health systems. Another is the framing of oral health as a private responsibility rather than a public health issue, keeping it out of many government-funded healthcare programs. There is also a widespread complacency and a lack of awareness that oral diseases affect overall health and should be taken seriously.

What needs to change?

Advocacy, the speakers agreed. Benzian noted that oral health professionals are often trained in clinical settings and focus on treating individual patients rather than driving systemic change. Yet, as Aslanyan said, the real challenge is for “us all to see our role not only as providers of care, but as mobilisers of community agency.”

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: TDR Global Health Matters.

Negotiators pose at the final meeting of the Intergovernmental Negotiating Body in Geneva

By sunrise on Saturday morning, the entire draft pandemic agreement had been agreed on – bar the vexing question of whether technology transfer related to the production of pandemic products should always be voluntary.

Negotiators talked into the early hours of Saturday morning, trying to find a way around the deadlock, according to sources close to the process.

Formal talks at the 13th meeting of the Intergovernmental Negotiating Body (INB) will resume on Tuesday, according to the World Health Organization (WHO).

“INB13 ends on Tuesday with several pieces to resolve. Several members states  have to clarify various positions with the capitals,” a WHO spokesperson told Health Policy Watch.

The negotiations were due to finish on Friday in time for a draft agreement to be prepared for the World Health Assembly (WHA) next month.

The standoff involves whether technology transfer for producing pandemic-related health products shall be both “voluntary” and on “mutually agreed terms”, according to a footnote in Article 11. 

Thirty legal experts argue in a letter sent to negotiators earlier in the week that the use of “voluntary” will undermine countries’ “sovereign right … to implement legislation within their jurisdiction, and equity in pandemic preparedness and response”.

Several countries have laws allowing non-voluntary measures under exceptional circumstances, including the United States Defense Production Act, and Germany’s Act on the Protection of the Population in Case of an Epidemic Situation of National Significance, passed in 2020 in response to the COVID-19 pandemic.

Insisting solely on voluntary measures will “defeat two principles that guide the Pandemic Agreement’s core objective: respect for the sovereign right of States to implement legislation within their jurisdiction, and equity in pandemic preparedness and response”, the experts note.

‘Voluntary’ – or bust?

However, the pharmaceutical industry has said that dropping “voluntary” is a no-no for them, and European nations that host large pharma companies – most notably Germany and Switzerland – have also dug in their heels on this issue.

The European pharmaceutical industry is facing tariff threats from the United States, and earlier this week, the European Federation of Pharmaceutical Industries and Associations (EFPIA) issued a “stark warning” to European Commission President Ursula von der Leyen that, “unless Europe delivers rapid, radical policy change then pharmaceutical research, development and manufacturing is increasingly likely to be directed towards the US”.

Knowledge Ecology International’s Jamie Love proposes using a caveat “without prejudice” to overcome the deadlock.

Various proposals have been made to accommodate differing positions. Knowledge Ecology International’s Jamie Love told negotiators on Friday morning that it “would make sense to say [Article 11] is without prejudice”, and does not affect the measures that parties may take in accordance with their own laws.

This is in line with what the INB Bureau proposed on Wednesday, namely that the footnote should read: “For the purposes of this Agreement, transfer of technology refers to an agreed process where technology is transferred on mutually agreed terms. This understanding is without prejudice to and does not affect the measures that Parties may take in accordance with their domestic or national laws and regulations, and compliant with their international obligations”.

However, there are other proposals on the table too, according to Third World Network. These involve:

  • Modifying the footnote;
  • Removing the footnote and using language from the Framework Convention on Tobacco Control (FCTC), Article 22 “as mutually agreed” after each mention of “transfer of technology” in the text;
  • Removing the footnote and using the whole FCTC text from Article 22, with slight adjustment for clarity;
  • Removing both the footnote and “as mutually agreed”, and using “consensual” and “reporting procedure”:
  • Removing the footnote and rephrasing.

Hopefully, negotiators will find a way to agree on one of these options to enable an agreement by Tuesday.

Racing against time

WHO Deputy Director-General Dr Mike Ryan said that the WHO Secretariat “will do whatever it takes to get them more time”.

“The reality is we’re against that time now if you consider that many member states will have to consult their capitals … before the [WHA] meeting in May,” Ryan told the WHO’s global media briefing on Thursday.

“The Assembly is, classically, a meeting of ministers of health and it often involves heads of state… so the people who will make the agreement at the Assembly are at a higher level. So the sooner negotiations can be concluded, the sooner we can prepare that process.” 

While negotiators “don’t have to have every ‘i’ dotted, they don’t have to have every comma agreed”, the text still needs to be subjected ao a legal scope, Ryan explained. 

“The member states will have to make a judgement themselves of how close they are. The negotiators downstairs [in the WHO headquarters in Geneva] are not WHO negotiators. The negotiators are … 192 sovereign states [excluding the US, which pulled out of the talks], and they will decide what happens next, and we will facilitate whatever they wish. 

“We will obviously offer them advice around timelines and what’s realistic and what can be done in advance of the Assembly. I’m always someone who’s very reticent to admit that you won’t make it and then add on more time, because in my world, work fills time, and if you make more time, the work will just stretch out to fill that time.”

However, he acknowledged that “there are real issues”, with single words having political, ideological and legal meanings. 

“The great thing we should celebrate is that there are currently over 190 member states in a basement, trying to find a way to work together, trying to find language that will protect eight and a half billion people from the next pandemic. 

“We should be celebrating the very fact that they’re in the room, given everything else that’s happening around the world, geopolitically and geo-economically.”

Image Credits: WHO.

The US Environmental Protection Agency is set to halt requirements for a majority of major polluters to report their emissions.

The federal agency responsible for protecting the environment in the United States will stop requiring most polluters to report their emissions of carbon dioxide, methane and other greenhouse gases that cause climate change.

The upcoming policy shift by the Environmental Protection Agency (EPA), first reported by ProPublica on Thursday, will effectively render the second-largest greenhouse gas emitter in the world, and largest historical emitter, blind to the pollution caused by its factories, fossil fuel industry and chemical plants.

The Greenhouse Gas Reporting Program, a publicly accessible database tracking US emissions since 2010, is widely used by lawmakers across the country to make policy decisions on health and environmental considerations of polluting facilities in local communities and to hold companies accountable for damages. The program currently tracks an estimated 90% of US emissions.

The EPA will cut reporting requirements for 40 out of 41 sectors currently required to submit emissions data, according to documents reviewed by ProPublica. The single sector that will remain under reporting obligations is known as Subpart W, and covers facilities involved in onshore and offshore production, processing, transmission, storage, and distribution of oil and natural gas products.

Only 2,300 of the 8,000 facilities currently required to report emissions will still be subject to the reporting requirements after the rule change. The rollback will make public scrutiny of heavy polluters more difficult as emissions that are not tracked cannot be regulated. It is likely to primarily benefit the petrochemical and energy-intensive manufacturing industries, such as cement, glass, iron and steel, by reducing compliance costs.

The program is also the source of a vast majority of the data submitted by the US to the United Nations on its emissions trajectory required under the Paris Climate Agreement, which Trump exited on his first day in office. 

The move comes as countries around the world try to move in the opposite direction and reduce emissions as weather threats intensified by climate change drive increasingly severe floods, storms and droughts globally. Trump’s withdrawal from the Paris agreement saw the US  join Iran, Libya and Yemen as the only countries on the planet that are not part of the accord. 

Why?

Lee Zeldin, Trump’s EPA chief, has declared that his agency is “driving a dagger straight into the heart of the climate change religion.”

The motivation for the move, while reflecting the Trump administration’s position that the federal government should not be involved in fighting or studying the effects of climate change on the US and the world, is not immediately clear. The primary beneficiaries, however, will be large industrial polluters.

The move was first hinted at in a press release posted by the EPA on 12 March, when Lee Zeldin, the agency’s administrator, announced that his agency was “reconsidering” the emissions reporting programme as part of a set of 31 policy reviews in “the greatest and most consequential day of deregulation in the history of the United States.”

“The Greenhouse Gas Reporting Program is another example of a bureaucratic government program that does not improve air quality,” Zeldin said at the time. “Instead, it costs American businesses and manufacturing millions of dollars, hurting small businesses and the ability to achieve the American Dream.”

The move to gut emissions reporting is directly referenced in Project 2025, the behemoth 900-page far-right policy blueprint underpinning many actions taken by the Trump administration in its early months. The document echoes Zeldin’s critique that it is a burden on small businesses, advising the EPA to “remove” it.

Yet to qualify for mandatory reporting requirements, businesses must emit at least 25,000 metric tons of carbon dioxide equivalents per year – a high threshold that excludes the vast majority of what may be considered “small businesses.”

This is equivalent to 58,000 barrels of oil consumed or nearly 14,000 tonnes of coal burned, according to the EPA’s own Greenhouse Gas Equivalencies Calculator. At the average price of $80.53 per barrel for Brent crude oil in 2024, those barrels would be worth about $4.7 million.

The regulation was designed with this high threshold specifically to protect small businesses from onerous reporting requirements. 

Eliminating reporting as emissions rise

A Carbon Brief analysis of President Trump’s climate and energy policies estimated his re-election would add new emissions equivalent to the annual output of the world’s 140 least polluting nations by the end of the decade.

One plausible benefit of the elimination of the programme is to limit public scrutiny of emissions amid plans by the Trump administration and Project 2025’s policy paper to vastly increase US emissions.

An analysis of plans published by the Trump administration conducted by Carbon Brief found his re-election was likely to add four billion tonnes of US emissions by 2030, equivalent to the combined annual emissions of the European Union’s 27 member-states and Japan, or 140 of the world’s smallest emitter nations.

“Put another way, the extra 4GtCO2e from a second Trump term would negate – twice over – all of the savings from deploying wind, solar and other clean technologies around the world over the past five years,” the analysis found.

Project 2025 meanwhile proposes a similar trajectory. A separate analysis found the policy proposals outlined would increase US emissions by 2.7 billion tonnes above its current trajectory by 2030. Ross Vought, the architect of Project 2025, is in Trump’s cabinet and leads the Office of Personnel Management (OPM).

An analysis by Energy Innovation Policy & Technology, a non-partisan energy and climate policy think tank, found Project 2025’s policies would “significantly increase” US emissions.

Regardless of the stated justifications, the policy shift clearly aligns with the broader agenda of the administration that the federal government should have nothing to do with studying or funding climate change initiatives.

In what Zeldin termed the “most momentous day in the history of the EPA” in March when he first mentioned eliminating the GHG Reporting Program, his agency announced the rollback of 31 separate regulations on climate.

These included revising measures “throttling the oil and gas industry,” safety standards for mercury and toxic air that “improperly targeted coal-fired power plants,” and slashing national standards set by the EPA that control the discharge of pollutants in wastewater from industrial facilities produced during extraction operations like drilling, fracking, and production, among an array of other measures softening rules on pollution of all kinds.

“We are driving a dagger straight into the heart of the climate change religion,” Zeldin said in March. “We are living up to our promises to unleash American energy, lower costs for Americans, revitalize the American auto industry.”

The EPA has not responded to a request for comment from Health Policy Watch at the time of publication. 

Lobbyists in control

An ExxonMobil plant towers over the landscape outside Chicago, Illinois. Lobbyists who recently represented the fossil fuel giant are now key figures gutting the Trump era EPA.

The political appointees who have tasked the EPA with rolling back reporting requirements have direct and recent ties to America’s petrochemical industry, public records show.

Abigale Tardif, the Principal Deputy Assistant Administrator at the EPA’s Air and Radiation Office, was identified by ProPublica as the appointee who instructed the agency’s staff to draft the regulation that would eliminate emissions reporting.

Tardif was still listed as a lobbyist on the website of the American Fuel and Petrochemical Manufacturers (AFPM) – an industry group including Chevron, ExxonMobil, and Koch Industries that spent over $27 million lobbying in 2024 – when her appointment was announced.

She previously worked as a lobbyist for the Ohio-based Marathon Petroleum, which is a member of AFPM, according to public records. Her lobbying portfolio included pushing for the repeal of Biden-era tailpipe emissions standards as well as “unspecified air regulations on refineries and petrochemical plants along with vehicle fuel economy standards,” according to public quarterly disclosure reports seen by Politico.

Aaron Szabo, who is awaiting confirmation as assistant administrator to the office, was also confirmed to be present at the meeting by ProPublica. His recent work includes lobbying for the American Chemistry Council, which includes fossil fuel titans such as Chevron, ExxonMobil and Shell, and the American Petroleum Institute, among others, public records show.

Combined, just three of the clients represented by Tardif and Szabo – the American Petroleum Institute (API), American Chemistry Council (ACC) and American Fuel and Petrochemical Manufacturers (AFPM) – spent over $56 million on lobbying in 2024 alone.

Zeldin, the EPA chief, received over $410,000 from the oil and gas industry during his runs for Congress and governor of New York, public records show. He was a frequent opponent of all types of climate action during his time in Congress.

On Tuesday, Zeldin said his EPA supports “clean beautiful coal” following a Trump administration executive order prohibiting federal agencies “discriminate” against coal and waiving crucial air-pollution regulations on plants across the country – effectively granting the industry both increased pollution rights and freedom from public scrutiny.

Climate purge across US government 

Trump is cutting $4 million in federal funding for climate change research at Princeton University, saying the work promoted “exaggerated and implausible climate threats” and increased “climate anxiety” among young Americans.#HeadInTheSandwww.bostonglobe.com/2025/04/09/n…

— Climate Risk Economics (@climateeconomics.bsky.social) 2025-04-10T08:10:42.362Z

The plan to stop tracking emissions that cause climate change is part of a wider assault on climate science and discourse that began the day Trump retook the White House.

Beyond the EPA, mentions of climate are being targeted across every government website, grant program and policy.

The Trump administration has gutted government support for scientific research in the US and abroad that contains the word “climate” at all. This ban on referencing the climate crisis in research includes grants issued by federal agencies, research within those agencies, as well as outside academic institutions.

One environmental scientist who did not want to be named told The Guardian their previously awarded grant from the Department of Transportation for climate-adaptation research had been withdrawn, until they renamed it to remove the word “climate.”

“I still have the grant because I changed the title,” the scientist said. “I was told that I needed to do so before the title of the grant was published on the US DoT website in order to keep it. The explanation was that the priorities of the current administration don’t include climate change.”

Over $20 billion in grants for climate research have been terminated, including $4 million to Princeton University cancelled on Monday, which the White House accused of promoting “exaggerated and implausible climate threats” that increase “climate anxiety” in young Americans. 

Princeton was running programs with the National Oceanic and Atmospheric Administration (NOAA) focused on forecasting weather models for water access and extreme weather events, modeling climate risks and predictions to advance adaptation strategies for a world on track for 3.1C warming by 2100 – catastrophic warming by all model predictions.

“Its focus on alarming climate scenarios fosters fear rather than rational, balanced discussion,” the Department of Commerce said in a press release announcing the funding cuts to Princeton. 

It added one of the research programs “suggests that the Earth will have a significant fluctuation in its water availability as a result of global warming. Using federal funds to perpetuate these narratives does not align with the priorities of this Administration and such time and resources can be better utilized elsewhere.”

US military drops ‘climate change crap’

The Pentagon has seen a similar purge despite its long history of climate security planning. The US military has cancelled more than 90 studies related to climate change impacts on national security in the US and abroad. 

“The Department of Defense does not do climate change crap,” US Defense Secretary Pete Hegseth declared on social media, a statement later confirmed as “Fact check true” by an official Pentagon account.

This dramatic shift contradicts the military’s own long-standing position. The Department of Defense has officially recognized climate change as a “threat multiplier” since at least 2010, noting it can exacerbate existing security threats. In 2014, the Pentagon released a Climate Change Adaptation Roadmap that called climate change an “immediate risk to national security.”

“Today, no nation can find lasting security without addressing the climate crisis. We face all kinds of threats in our line of work, but few of them truly deserve to be called existential. The climate crisis does,” then-Secretary of Defense Lloyd Austin stated in 2021.

US lobbying efforts have historically resulted in military activities being exempted from landmark UN climate agreements. The Kyoto Protocol contained no requirements for military emissions reporting, and the 2015 Paris Agreement makes armed forces emissions reporting optional – exemptions that have also benefited other major military powers like China and Russia.

Meanwhile, the US Department of Defense has become by far the world’s largest single institutional consumer of fossil fuels. A 2023 report found the United States and United Kingdom armed forces emitted at least 430 million tons of CO₂ since the Paris accord was signed — more than the UK’s total emissions in 2022. Ninety percent of those emissions were attributed to the US military.

If the planet’s militaries were a country, they would have the fourth-largest national carbon footprint, exceeding that of Russia. 

“We are stripping away support for these studies to restore the warrior ethos and refocus our military on its core mission of deterring, fighting and winning wars,” Pentagon spokesperson John Ullyot said in a statement. “Climate zealotry and other woke chimeras of the Left are not part of that core mission.”

Image Credits: Gadge Skilmore, Richard Hurd.

Africa CDC headquarters
Africa CDC’s head office in Addis Ababa, Ethiopia.

Amid bleak global economic and development aid trends, Africa’s Centres for Disease Control and Prevention (Africa CDC) is piloting innovative financing solutions and doubling down on efforts to get member states to invest more domestic funds in health.

A week ago, Africa CDC launched a new financing guide for member states and on Friday the continental body announced that it was starting to implement the first phase, which will focus on “updating national health financing plans in 30 countries, piloting innovative revenue mechanisms, and launching transparency dashboards”. 

The strategy urges governments to allocate at least 15% of national budgets to health, as agreed by the 2001 Abuja Declaration, which was adopted during another crisis: the HIV and tuberculosis pandemics.

Its proposals on innovative financing include “solidarity levies on airline tickets, alcohol, and mobile services, while exploring how Africa’s US$95 billion in annual diaspora remittances can support national health priorities”, according to the body. 

Finally, it proposes blended financing to “unlock public and private capital for critical investments in infrastructure, digital health, and local production of vaccines and medical supplies”.

Phase 2 (2026–2030) will scale successful approaches and aims to ensure that at least 20 countries can finance 50% or more of their health budgets through sustainable domestic sources.

“Africa cannot continue outsourcing its health security,” said Dr. Jean Kaseya, Director General of Africa CDC. “This strategy is not about aid—it’s about ownership. We are building a future where Africa invests in its people, drives its own health agenda, and responds to crises with speed, strength, and self-reliance.”

Mpox continues to rise

Professor Yap Boum of the Incident Management Support Team

Meanwhile, at the Africa CDC briefing on Thursday, Professor Yap Boum, the Africa CDC’s deputy head of the Incident Management Support Team, reported that Uganda’s mpox outbreak is continuing to spread, increasing by 30% in the past week (from 190 to 247 confirmed cases).

Boum attributed the spread of Clade 1b to complex sexual networks, including sex workers with multiple daily clients.

“Mpox, specifically the Clade 1b strain, is sexually transmissible. Yesterday, Uganda’s incident manager informed us that there are sex workers who have up to 10 clients per day,” said Boum.

“Sexual networks remain the key driver of the outbreak [in Uganda], with cases spreading in slums, semi-urban, and urban areas. Last week, Mbarara City and Masaka City accounted for 50% of daily incidence,” Boum noted.

Unlike the Democratic Republic of Congo (DRC), however, Uganda is managing to test all its suspected mpox cases, 60% of which have been positive.

Uganda has also faced Ebola and Crimean-Congo hemorrhagic fever (CCHF) outbreaks in the past month.

While mpox cases in the DRC decreased slightly over the past week, the burden is likely underestimated because of challenges with testing, which has been adversely affected by the withdrawal of US funding and conflict in North and South Kivu.

Kinshasa was also affected by torrential rains in the past week that resulted in the Limete Health Center and other health facilities being submerged under water, damaged roads and power and water outages across multiple health facilities in Kinshasa.

However, testing in the DRC has risen over the past week from 18.4% of suspected cases to 21.7%, largely as a result of decentralised laboratory services. Three new Gene Xpert testing machines have been deployed and 26 laboratories are now functional.

Image Credits: Africa CDC .

Dr Tedros Adhanom Ghebreyessus

Health services worldwide have been “severely disrupted” by the United States slashing aid, and the World Health Organisation (WHO) is radically reducing its operations following the US withdrawal from the global body – but there has been no formal engagement between the WHO and the White House.

WHO Director-General Dr Tedros Adhanom Ghebreyessus revealed this at a press conference on Thursday, reporting that three-quarters of the over 100 countries had reported “severely disrupted” services, a quarter had closed health facilities and a quarter were charging patients more for services.

The US owes the WHO $260 million in membership fees for 2024-25. The Biden administration failed to pay fees last year and the US is liable for this year’s fees as it is obliged to give a year’s notice of its withdrawal form the body. 

But there has been no formal engagement between the WHO and the White House since Trump issued an executive order on 20 January withdrawing from the WHO, said Tedros.

“I hope there will be some formal engagement, or a very honest and candid dialogue for the US to come back to the World Health Organisation. It’s in the best interest of the US to stay in WHO. It’s a health security that keeps the US safe and the rest of the world safe,” he added.

Ongoing talks between the remaining 192 WHO member states on a pandemic agreement, expected to conclude this week, would “set the rules of the game” in a future pandemic to ensure that the world is safer, added WHO Deputy Director-General Dr Mike Ryan.

“The great thing about an international rules-based system is we all agree how the game is played, and we really do need to play a better game in the next pandemic, and this is the way to do it,” added Ryan.

The US has pointedly removed itself from the pandemic agreement negotiations, erroneously claiming that a pandemic agreement will infringe on its soverignty.

Prioritise the poorest

In response to the loss of US aid, countries are “revising budgets, cutting costs and strengthening fundraising and partnerships,” said Tedros, reporting on efforts by South Africa, Nigeria and Kenya to increase their domestic allocations to health.

He advised countries to prioritise their poorest citizens, protecting them from being impoverished by additional health spending, and to resist cutting public health spending, instead improving efficiency.

“Absorb as much of the impact as possible through efficiency gains in health systems, including.. improving procurement, minimising overheads, pooling purchasing of goods and services, and using health technology assessment to guide decisions on which services and products provide the biggest health gains,” Tedros advised.

Countries can also increase revenue by introducing or increasing taxes on products that harm health, including tobacco, alcohol and sugary drinks, he added.

Unpaid WHO membership fees

Dr Mike Ryan

The WHO is in the midst of intense reprioritisation following the loss of around a quarter of its budget. It faces a gap of $2,5 billion for the 2025/27 period, according to a recent Health Policy Watch report.

Ryan, who chairs the WHO prioritisation committee, said that the pain being experienced at WHO was a “ha’penny space” in “the hierarchy of suffering”.

“However, we recognise that we’re in a situation where, with the advice and with cooperation with our member states, we need to contract the amount of money we absorb as an organisation to do the work we do,” said Ryan.

“We’re approaching that very, very responsibly in terms of cost containment, resource mobilisation” and prioritisation of activities, he said.

“We have to have a new budget on the table for the World Health Assembly [next month]… and there will have to be a new set of priorities, and obviously an organisational design that can deliver that.”

Aside from $260 million hole left by the US withdrawal, other member states owe the WHO $193 million in unpaid membership fees (called “assessed contributions”), according to a report compiled for the World Health Assembly next month.

The voting privileges of Afghanistan, Central African Republic, Comoros, Dominica, Lebanon, Sierra Leone, Somalia, South Sudan, Sudan, Venezuela and Yemen remain suspended as a result of unpaid fees.

Algeria, Bolivia, Cameroon, Grenada, Iran, Myanmar, Panama and Saint Lucia may also lose their voting rights as a result of unpaid fees for 2024 and 2025.

Gaza blockade

A child forages in Gaza rubble.

Tedros also condemned Israel’s “complete blockade” of Gaza since the breakdown of the ceasefire on 2 March, in which it has prevented all food and medicine from entering into Gaza.

“In the past week, 75% of UN missions within Gaza have been denied or impeded. This blockade is leaving families hungry, malnourished, without clean water, shelter and adequate health care, and increasing the risk of disease and death,” said Tedros.

During the ceasefire, WHO had been able to resupply the health system and its warehouses but those supplies “will run out in two to four weeks unless the siege is lifted”, he added.

“Some 180,000 doses of routine childhood vaccines, enough to protect 60,000 children under the age of two, have not been allowed to enter leaving newborns and young children at risk,” said Tedros.

“Since the breakdown of the ceasefire, almost 400,000 people are estimated to have been displaced again with no safe place to go, and almost 1500 people have been killed, including 500 children,” said Tedros.

“The health system is only functioning partially and is overwhelmed. Meanwhile, healthcare continues to be attacked. On the 23 March, the Israeli army attacked a medical and emergency convoy, killing 15 health and humanitarian workers.”

On Wednesday, WHO assisted in evacuating 18 patients and 29 companions to Norway, Malta, Luxembourg and Romania but “more than 10,000 other patients are still awaiting evacuation” for medical treatment.

“WHO calls for the urgent lifting of the aid blockade, the protection of healthcare and embedded humanitarian access across Gaza, the immediate resumption of daily medical evacuations, the release of hostages still detained in Gaza, and above all, a ceasefire,” Tedros concluded.

Image Credits: UNICEF/UNI501989/Al-Qattaa.

A technician works on production of medicines.

Patients will face costlier medicine and European and Indian drug companies face billion-dollar losses if US President Donald Trump’s threat issued late Tuesday of “a major tariff on pharmaceuticals” produced outside his country is realised.

However, amid chaos on the financial markets, Trump back-pedalled on Wednesday and announced a 90-day pause on all tariffs except for China – where he announced a 125% tariff on Chinese goods.

Trump’s threat was made a few hours after major European pharmaceutical companies met with European Commission (EC) President Ursula von den Leyen, urging her to negotiate with the US or they would face supply chain issues, according to Euro News.

The European Federation of Pharmaceutical Industries and Associations (EFPIA) issued a “stark warning to President von der Leyen that unless Europe delivers rapid, radical policy change then pharmaceutical research, development and manufacturing is increasingly likely to be directed towards the US,” in a statement on Tuesday.

Eighteen EFPIA member companies identified “as much as 85% of capital expenditure investments (approximately €50.6 billion) and as much as 50% of R&D expenditure (approximately €52.6 billion) potentially at risk” in an industry survey. 

“This is out of a current combined total of €164.8 billion in investments planned for the period 2025-2029 in the EU-27 territory. Over the next three months, companies that responded estimate that a total of €16.5 billion ie. 10% of the total investment plans is at risk,” the federation noted.

‘Little incentive to invest in Europe’

“In addition to the uncertainty created by the threat of tariffs, there is little incentive to invest in the EU and significant drivers to relocate to the US,” the federation warned, noting that the US “now leads Europe on every investor metric from availability of capital, intellectual property, speed of approval to rewards for innovation.

They called on von der Leyen to develop a competitive EU market that “rewards innovation”, stronger intellectual property provisions, and “policy coherence across environmental and chemical legislation to secure a resilient manufacturing and supply chain of medicines in Europe”.

“Europe needs to make a serious commitment to invest in a world-class pharmaceutical ecosystem, or at best, risk being reduced to a consumer of other region’s innovation.”

Pharma giants Bayer, Novartis, Novo Nordisk, Roche and Sanofi are based in Europe. Their shares all tumbled by around 5%, while US pharma companies’ shares fell by 3-6 %, according to Reuters. Shares in the UK-based AstraZeneca and GSK also lost value.

Costly to relocate

The share price of US pharmaceutical giants including Pfizer, Johnson & Johnson, Eli Lilly, Bristol-Myers Squibb, Gilead and AbbVie also lost value. These have significant European manufacturing capacity, based primarily in Ireland and it would be costly to relocate.

Han Steutel, head of the German Association of Research-Based Pharmaceutical Companies (VFA), said that moving production to the US could cost billions of dollars and take five to 10 years to set up.

“It will be devastating for patients if medication is no longer available as they cannot easily switch from one drug to another, like with other commodities,” Steutel told CNBC.

‘We are a global industry in terms of research and development and production,” said Steutel. “Unlike with generic companies, the active [pharmaceutical] ingredients for patented drugs are solely produced in Europe or the US,” he said.

“If a company has a plant producing this in Europe it’s not going to set up another plant in the US or vice versa because it would just make the production process inefficient,” he noted.

Huge losses for Indian companies

​​However, 90% of API for US medicines are manufactured outside that country – by 2021, mostly in India (48%), followed by Europe (22%) and China (13%). 

Indian companies face potentially huge cost increases from tariffs on pharmaceutical products as the US is their biggest market – worth $8.7 billion in 2024, according to the Pharmaceuticals Export Promotion Council of India.

Some 45% of US generics are made in India and tariffs would cause price hikes that would affect both patients and companies outside the US.

However, given Trump’s last-minute flip-flop on tariffs, uncertainty is only certain element of the US’s global trade war.

Image Credits: AMR Industry Alliance.