Village Health Team member Fenehasi Bazimbana recording data after testing a household for malaria.

KAMPALA, Uganda – After five years of focusing on malaria prevention through Seasonal Malaria Chemoprevention (SMC) in the Karamoja region in northeastern Uganda for children under the age of five, Uganda’s Health Ministry has decided to extend the intervention to children up to the age of 10.

SMC is the intermittent administration of a curative dose of antimalarial medicine to children at high risk of severe malaria living in areas with seasonal transmission, regardless of whether they are infected with malaria. 

Since it was introduced, there has been a modest 13% reduction in malaria cases in children aged three to 59 months, according to the Uganda Ministry of Health’s National Malaria Control Division.

Uganda is one of the worst-affected countries in Africa for malaria.

Dr André-Marie Tchouatieu, senior director of medical affairs at the Medicines for Malaria Venture (MMV), described the extension of SMC to children older than five years old in Uganda as “one of the most impactful, evidence-backed strategies available to reduce the country’s malaria burden”. 

“By reducing the parasite reservoir, closing the immunity gap in older children and protecting this high-risk group, age-extended SMC could dramatically accelerate Uganda’s progress toward malaria control, and potentially elimination, in seasonal transmission zones,” said Tchouatieu.

“The combination of strong clinical evidence, WHO’s updated guidance on SMC and Uganda’s existing infrastructure makes this scale-up both feasible and urgently needed.

The first-ever joint annual meeting of the SMC Alliance and the Alliance for Malaria Prevention (AMP) was held in Kampala last week.

Lives saved

“Since SMC was introduced, many children’s lives have been saved in my region,” Lotee Paul Komol, chairperson of Kotido district, told the first-ever joint annual meeting of the SMC Alliance and the Alliance for Malaria Prevention (AMP) held in Kampala last week.

 In Africa, SMC has already been implemented at scale in 20 countries, 14 of which are in the Sahel region, according to the World Malaria Report 2025.

 “This intervention was delivered at the right time, and it has significantly reduced malaria deaths among children under five,” Komol told Health Policy Watch. 

“As leaders from Karamoja, we are extremely proud that we were prioritized and it was implemented in our region. We no longer see parents flooding health facilities with children suffering from malaria, as was once the case. SMC has put a smile on the faces of many mothers,” he said.

 In 2013, about a million children received SMC, but by 2024, this had risen to around 54 million. The success of SMC led WHO to recommend its expanded use for any child at high risk of severe malaria in Africa, irrespective of age and geography.  

In Uganda, the SMC program started in 2021 in Moroto and Kotido, with Nabilatuk serving as a control during the evaluation phase. Once the government saw that it was feasible, the program was expanded to nine districts in the Karamoja region, including Moroto, Kotido, Nakapiripirit, Amudat, Abim, Napak, Karenga and Kaabong by 2023.

Since then, some districts in Acholi and Lango regions have also met the SMC criteria, so SMC is now being expanding to 18 of its 146 districts. The Malaria Consortium is the implementing partner, with funding from GiveWell and the Global Fund.

 “When we realized that it was feasible, we mobilized resources and began to scale up,” said Dr Jane Nabakooza, a senior medical officer and technical lead for Malaria Chemoprevention and Vaccines at the Uganda Ministry of Health’s National Malaria Control Division.

Uganda is one of the three worst affected countries in Africa for malaria, recording almost 11 million cases in 2024.

Integrated approach

The Uganda SMC programme also realised that the intervention could not be delivered in isolation, so it was included in the integrated Community Case Management (iCCM) being implemented by the Village Health Teams (VHTs). These had a strong module on referral.

“SMC is not a stand-alone,” Nabakooza said. “It has to be done with other methods.” For instance, VHTs under SMC were cautioned not to dispense medicines until they established that the children had no malaria.

“If they were infected, medicines were withheld until treatment was initiated. If they had malaria signs, referral to the nearest health centre was done,” said Nabakooza. As such, the relationship between VHTs and health facilities deepened.

“If you do not plan with the VHTs, you miss a lot because they have the solutions to most of the problems and their lived experiences shape how malaria interventions succeed or fail,” she explained.

At the community level, SMC teams confirmed that households had bed nets, were using them properly, and identified children who had missed routine vaccines.

They were referred to health facilities, but many did not follow through and visit the facilities. 

“Subsequently, the SMC teamed up with vaccination teams, not only for malaria but for all childhood vaccines,” Nabakooza said.

But as the project was rolling out, weaknesses quickly became visible. VHTs could identify sick children, yet stock-outs meant they often had no medicines. Reporting was weak, and their contributions went undocumented.

“This was solved by strengthening supply chains, improving supervision, and tightening reporting systems,” said Nabakooza. 

But still, the results were not good. Data appeared weak, partly because reporting tools were not robust enough and some health workers struggled with documentation. 

Uganda’s decision to extend Seasonal Malaria Chemoprevention to older children can save many lives.

Digital dashboards

Digitisation was also introduced into SMC and staff were retrained and supplied with new tools and a robust surveillance system to identify problems and act accordingly.

Brenden Williams, co-chair of the Humanitarian and At-Risk Populations (HARP) Working Group, said national malaria programmes are leading the use of real-time digital dashboards to identify and correct registration errors mid-campaign, ensuring accurate data-driven decisions that were previously impossible with paper reporting.

Williams presented the meeting with data from national malaria programmes and partners in Burundi, Chad, Mali, Nigeria, Pakistan, Somalia, and South Sudan.

In Ghana, an electronic data system for all interventions – Insecticide Treated Nets (ITN) mass campaigns, SMC, and larviciding (killing mosquito larvae) – has been developed. All electronic community intervention data systems are in the process of being harmonised into one platform called the Ghana Malaria Interventions System (GMIS).

Moving to digital platforms generates long-term savings by reducing logistical costs and preventing over-procurement through more accurate population estimates, said Williams.

It also fosters national ownership by training local government staff to manage technical operations, reducing reliance on external support and improving the user experience for field volunteers.

But while SMC is designed for highly seasonal settings, Uganda wants to expand it beyond Karamoja’s single rainy season to regions like Lango and Acholi that have two rainy seasons and are more densely populated regions. This would mean reaching more children and lowering the cost of intervention per chil

The rationale is that children who survived malaria often carried infections that re-exposed younger children. So in 2025, SMC was extended to children aged five to 10 in Napak, Abim, Karenga and Kaabong.

While the results are still being analyzed, one outcome is already clear. “We reduced the cost per child from $4 to $1.71 over five years,” said Nabakooza.

In the Gambia, they also want to implement SMC for children up to 10 years old because they think it will enable them achieve elimination.

Peter Olumese, the World Health Organisation (WHO) technical Lead of malaria case management in the Malaria and NTD Department

But Peter Olumese, the World Health Organisation (WHO) technical Lead of malaria case management in the Malaria and NTD Department, is sceptical.

“SMC has to be done in areas where the transmission is seasonal. In most parts of Uganda, you have perennial seasons. That means transmission happens all year,” he told Health Policy Watch. 

“During the rainy season, malaria cases go up. That is not seasonal transmission. That is perennial transmission with seasonal variation, which is different from the Sahel region, where you have malaria during the months of July to October, and after that, there is little or no malaria. Even when children have a fever, you do not think about malaria. So that is where you should be doing SMC,” he said.

“Technically, speaking from a WHO perspective, [Uganda] should not be implementing this, but a country has a right to choose to do what they want to do,” he said.

The meeting also served as a shared platform for countries and implementing partners to exchange experiences, innovations and best practices, particularly in light of the revised WHO malaria guidelines and the shifting funding landscape as nations prepare for Global Fund Grant Cycle 8.

“The beauty of it is having 29 African countries and combining the two meetings.  At the end of the day, country programs here are hearing from each other and learning, plus exchanging ideas. That is one of the best things,” said Olumese.

Image Credits: UNICEF.

The US has seen record-breaking outbreaks of measles in the past year. Experts point to falling vaccination rates.

The World Health Organization (WHO) has pushed back against speculation that a critical review of the US measles elimination status was delayed until November for political reasons. Rather, the WHO said that there were strong technical reasons for postponing the review from April until November so that more data could be collected.

This came as US health officials asked an independent panel to delay its review of the country’s measles elimination status until later this year. 

The review of the measles elimination status is now set to happen after the US midterm elections, reportedly sparking concerns over political motives. However, authorities strongly insist that the extensive delay is necessary to guarantee an uncompromising and exhaustive epidemiological review of recent circulation data. 

It is essential that “all of the data, all of the evidence, all of the analysis has been done and scrupulously done,” noted Kate O’Brien, WHO director of the Department of Immunization, Vaccines, and Biologicals.

The review, which is to be led by the Pan American Health Organization (PAHO), WHO’s regional arm in the Americas, could lead to the embarrassing loss of the US status as a country that has eliminated measles, due to the multiple outbreaks that have occurred there over the past year.  

It comes at a time when PAHO, a semi-autonomous entity, is keen to retain the US as a partner – even after the US pulled out of the WHO as a global entity.

Last November, PAHO’s Measles, Rubella, and Congenital Rubella Syndrome Elimination Regional Monitoring and Re-Verification Commission resolved that Canada had lost its measles elimination status after 12 months of continuous transmission.

The US has seen record-breaking outbreaks concentrated in Texas and South Carolina in the past year, with the most recent outbreak exceeding 1,000 cases. Experts point to waning vaccination rates and community transmission.

The US achieved elimination status in 2000, marking a victory over a disease that once infected nearly every child and claimed 500 deaths per year before widespread vaccination. 

PAHO points to technical reasons for postponement

map world measles elimination status
The number of reported measles cases in the last 6 months of 2025.

The WHO carries out routine elimination verification of its member states every year, assessing whether a country had no local transmission of the same strain within the past 12 months. 

PAHO initially invited both Mexico and the US to meet in April to review their elimination statuses following recent outbreaks. Under the organization’s frameworks, the panel meets annually, but may “also convene at other times as needed to carry out its mandate.”

“The meeting date has been set to give national health authorities and national sustainability committees sufficient time to prepare comprehensive reports, including descriptions and analyses with detailed epidemiological and laboratory evidence, for review by the commission,” the announcement read.

Now, though, PAHO has said they want to “harmonize” the commission’s schedule.

The WHO defended the rationale for postponing the review: “The [status review] meeting normally takes place in the fourth quarter of the year,” said O’Brien, responding to questions during a WHO press briefing. 

“That is when the review of the evidence will take place by that committee to determine whether [countries] retain or do not retain their elimination status.”

Another reason that the meeting wasn’t held earlier was to ensure all data and analysis were completed with the necessary rigor and depth, she explained. This preparation would ensure that external committee members have every piece of information required to reach their conclusions.

US could join UK, others, in losing elimination status

measles elimination vaccines map US
The percentage of American kindergarten children who have been vaccinated against measles has declined in the past two decades.

In January, the UK, Spain, Armenia, Azerbaijan, and Uzbekistan also lost their measles elimination status after the Europe and Central Asia regional committee met to review the status.

The Region of the Americas has historically maintained the most countries to reach elimination status.

But outbreaks across the region – notably the US, Canada, and Mexico – threaten the region’s reputation as the only group that has achieved total measles elimination. 

Slipping vaccination rates in higher-income countries help explain a resurgence of infections. In the last school year, 13 US states had vaccination rates below 90%. In 2010, only six states fell below 90%, according to CDC data.

And when using the WHO’s threshold for herd immunity – 95% – only 10 states currently meet that criteria. 

Nearly 100,000 deaths a year among unvaccinated

Globally, 95,000 measles deaths occur each year, mostly among unvaccinated or under-vaccinated children under the age of five. 

Cases and deaths are mostly concentrated in low- and middle-income countries and in low-resource or conflict settings.

Yemen, Indonesia, India, Pakistan, and Angola accounted for the majority of the disease burden in 2025. 

The disease is one of the most contagious viruses that can lead to severe complications and death, according to the WHO. Vaccination, though, averted nearly 59 million deaths in the past quarter-century.

The measles virus infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body, per the WHO.

Image Credits: WHO, WHO, CDC.

Residents of Kakola–Ombaka being evacuated after their homes were flooded.

For decades, residents of Kakola-Ombaka village in Western Kenya lived through cycles of seasonal heatwaves and droughts on the shores of Lake Victoria without significant harm. 

That changed in 2019, when heavy rainfall of unprecedented intensity struck the area. The entire village and surrounding communities were inundated. The lake swelled, water levels rose steadily, banks eroded, and backflows spread across the land. Many residents were forced to flee to higher ground. 

For over a month, much of the village remained submerged. Families camped at local schools until those, too, were overtaken by water. Canoes and boats became the primary means of transport, though many residents with insufficient access to vessels continued to wade through the floodwaters on foot.

When the water eventually receded, families returned home. But the following year, the flooding returned, and then again, with increasing frequency. Historically, the area experienced a single rainy season. 

In recent years, two have become the norm — one from March to May and another from October to December. Residents have barely recovered from one episode before the next begins. Today, four camps of permanently displaced people remain in the area.

Water contaminated by pit latrines

Carren Onjala, a local community health promoter (CHP), said that almost all the pit latrines were submerged in the floods.

Many homes in this impoverished area rely on pit latrines, most of which were in a state of disrepair. When the floods came, virtually all of these were submerged. 

Carren Onjala, a local community health promoter, explained that faeces-filled stagnant water quickly became a breeding ground for snails, worms, and mosquitoes. Water and sanitation systems were seriously disrupted across the entire community.

The warmer, wetter conditions also accelerated the life cycle of parasites. The result has been a marked increase in cases of Schistosomiasis (commonly known as bilharzia) and other diseases transmitted by parasitic worms, known as helminths.

Dr Martin Mutuku, a neglected tropical disease expert from the Kenya Medical Research Institute (KEMRI), explained that rising temperatures combined with unpredictable rainfall create ideal conditions for the breeding of the snails that serve as intermediate hosts for the Schistosomiasis parasite. Many communities in Western Kenya, particularly those living along the shores of Lake Victoria, have been affected.

Children most affected

A school girl collecting water fetching water for domestic use in Kakola- Ombaka.

Schoolchildren were particularly vulnerable. Many were required to walk through floodwaters twice a day to attend school and collect water for their families, making prolonged contact with contaminated water unavoidable. 

Prisca Awuor Aende, a teacher at Nyamasao Primary School in Kakola-Ombaka village, recalled seeing children playing in stagnant water. 

Many stopped attending school altogether as a result of bilharzia infections. Younger children stayed away for fear of the rising water. Others lost their books in the floods, and academic performance across the school declined sharply.

The broader economic toll on the community has also been severe. Families have lost livestock, household goods, and property. Some have suffered damage to their homes; others have lost their land entirely, driving a rise in poverty across the area.

Neglected Tropical Diseases and climate

Neglected Tropical Diseases (NTDs) are a broad group of conditions caused by a range of pathogens, including parasites, bacteria, viruses, and fungi. 

According to the World Health Organization (WHO), more than one billion people are affected by NTDs globally, and approximately 200,000 die from them each year. 

In rural Western Kenya, the twin pressures of rising temperatures and shifting rainfall patterns are emerging as significant drivers of NTD spread, with Schistosomiasis and soil-transmitted helminths (STHs) finding new footholds as ecological changes bring parasites closer to vulnerable communities.

These climate-related risks were anticipated long before the 2019 floods. The Nyando and Kadibo sub-counties rank among the worst affected by climate change in Kisumu County, according to the county’s Special Programme and Disaster Management data. 

As early as 1966, the Kenyan government had predicted that changing weather patterns and lake flooding would place residents of Kadibo sub-county at risk. In response, the government purchased land in the Muhoroni Scheme and resettled affected communities. But after years passed without major flooding, many residents returned to their original homes and lived without incident — until 2019.

Ombaka Dispensary in Kakola –Ombaka submerged in flooded water.

The first indications that community members were suffering from bilharzia came when men and male children began presenting with swollen abdomens, an unusual symptom for their demographic. 

Those affected were taken to Ahero Sub-County Hospital, where they were diagnosed. In response, the Ministry of Health, various NGOs, UNICEF, and the Red Cross intervened with food, sanitary products, clothing, water containers, books, and medication, including Praziquantel, the primary drug used to treat Schistosomiasis.

But the delivery of these supplies was complicated by the fact that the nearby dispensary was also flooded, requiring health workers to distribute medicine and mosquito nets by boat and canoe.

Despite annual deworming programmes conducted by the Ministry of Health, re-infection rates remained high., said Maurice Murithi, the area’s Disease Surveillance Officer. 

Residents continued to wade through floodwaters to check on their submerged homes, exposing themselves repeatedly to contaminated water. The area also lacked reliable access to clean water, leaving residents with little alternative but to use what was available.

The deputy county director for special programmes, Migosi Oluoch, pointed to another contributing factor: the chronic contamination of the lake, rivers, and streams.

Waste discharged without adequate treatment from nearby industries and hotels enters the water system, creating a persistent snail habitat. When rains or lake backflows occur, this contaminated water spreads into surrounding communities, increasing exposure to both bilharzia and soil helminths.

 Mutuku highlighted structural reasons why NTDs persist despite intervention. Mass drug administration and deworming programmes are typically conducted in schools, leaving adults at home without treatment and resulting in poor overall coverage. 

Pharmaceutical companies also have limited commercial incentive to manufacture NTD drugs, as these are diseases that predominantly affect people living in poverty. This dynamic has led to a scarcity of bilharzia medication. 

Without reliable access to safe water, communities will continue to have unavoidable contact with contaminated sources. 

Flood mitigation 

Oluoch confirmed that flooding is the foremost climate-related disaster facing Kisumu County, with Kadibo among the most severely affected.

The county government has responded by opening water channels and canals to direct floodwater back towards the lake,while a Disaster Management Committee, co-chaired by the Governor and the County Commissioner, has been established to coordinate the response at the county level.

Residents of Kakola-Ombaka and the wider Kadibo and Nyando sub-counties have called for the construction of dykes, a recommendation that Oluoch supports.

He also urged the national government to accelerate the completion of the Koru-Soin Dam, which could help regulate water levels significantly.

He further proposed that vacant land rendered unusable by flooding – including the sites of former institutions such as Ombaka High School and several other abandoned settlements – be repurposed for a research centre or university.

Simultaneous actions

The situation in Kakola-Ombaka illustrates the relationship between climate change and neglected tropical diseases.

Controlling the spread of Schistosomiasis and soil helminths in Western Kenya will require action on several fronts simultaneously.

Infrastructure investment – including dams, dykes, and improved water and sanitation systems – is essential to reduce flooding and the contamination it brings. 

So too is the elimination of industrial and commercial waste entering the lake. Community-wide mass drug administration, rather than school-focused programmes alone, would improve treatment coverage. And sustained public education remains critical to equipping communities with the knowledge to protect themselves.

As Mutuku noted, vector-borne diseases that were once controlled can re-emerge whenever climate change raises temperatures and disrupts rainfall patterns. In Kakola-Ombaka, that re-emergence is already well underway

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

The US-Israeli war with Iran, which has paralyzed air travel across the Middle East, has also frozen deliveries of vital medical supplies from the world’s largest humanitarian supply hub in Dubai to conflict-wracked countries from Afghanistan to Lebanon, said the World Health Organization on Thursday. 

“Operations at WHO’s logistics hub for global health emergencies in Dubai, are currently on hold due to insecurity,” said WHO Director General Dr Tedros Adhanom Ghebreyesus at a WHO press briefing in Geneva.

WHO Director General Dr Tedros Adhanom Ghebreyesus speaks about the Iran war’s domino effect on medical supply routes throughout the region.

The airspace closures as well as restrictions on cargo traffic through the Straits of Hormuz have put the hub’s operations “temporarily on hold,” echoed Hanan Balkhy, WHO Regional Director of the Eastern Mediterranean Regional Office  (EMRO), at the briefing. 

She said that the disruption is preventing access to some $18 million in humanitarian health supplies, while another $8 million in shipments has been stranded and unable to reach the hub in Dubai. 

“More than 50 emergency supply requests from 25 countries are currently affected. And $6 million in medicines for Gaza as well as $1.6 million in polio laboratory supplies are also held up,” Balkhy said. WHO’s emergency operations across the region currently face a 70% funding gap, she added. “Without urgent financial support, essential services will cease and preventable suffering will deepen.” 

One-half of world’s humanitarian needs are in Eastern Mediterranean Region

Hanan Balkhy, WHO Director of the Eastern Mediterranean Regional Office.

The airspace and sea lane closures have had broad repercussions insofar as one-half of global humanitarian needs are concentrated in the eastern Mediterranean region – which extends from Pakistan all the way to Tunisia. 

The Dubai hub, alongside one of the world’s busiest airports, also serves as a logistics junction for WHO-supported medical supplies traveling to Africa, South-East Asia and beyond. 

“Last year, WHO’s global health emergencies logistics hub in Dubai fulfilled more than 500 emergency orders for 75 countries across all six WHO regions. However, humanitarian health supply chains are now being jeopardized,” said Balkhy.  

Deepening humanitarian crisis

The crisis comes just as WHO and other humanitarian partners are attempting to pre-position trauma supplies and essential medicines in vulnerable regions, like southern Lebanon, in preparation for potential mass casualties -as well as population displacement. 

Israel on Wednesday ordered the evacuation of some 300,000 people from southern Lebanon and on Thursday evening called for the evacuation of all of Beirut’s southern suburbs – moves that will almost certainly lead to an even wider humanitarian crisis in the region.

The Israeli  moves on Lebanon came after Iran’s ally, the Shi’ite Hizbullah militia, entered the war earlier this week pounding northern and central Israel with repeated volleys of rocket fire.

The war began last Saturday morning, when Israel and the US launched a surprise attack on Iranian military and missile sites – after negotiations to curb Iran’s nuclear ambitions and missile arsenal faltered. Iran then  sent missiles flying across the region, hitting not only Israel but Dubai’s airport, as well as military and civilian sites across the Gulf and as far away as Jordan. That has paralyzed air traffic, stranding hundreds of thousands of tourists and travelers in a widening arc of conflict.    

There are also concerns over a potential nuclear event as Israel and the United States target Iran’s nuclear facilities and Iran threatens retaliation against Israel’s nuclear facility in the Negev Desert region of Dimona, WHO’s Director General warned.  

“The threat of nuclear facilities being impacted is also concerning,” said Tedros. “Any compromise to nuclear safety could have serious public health consequences.” 

Efforts to carve out alternative supply routes

Annette Heinzelmann

As the arc of the war extends across most of the region’s air space,  WHO is exploring alternative overland supply routes as an alternative to air transport together with UNICEF and the World Food Programme, said Annette Heinzelmann – EMRO emergency director 

“We are assessing the possibility of working through our other UN logistic hubs, notably in Nairobi and in Brindisi, which are close to the region… we are also working with our logistics hub in Dakar to look into alternative shipment routes,” Heinzelmann said 

“And there is the potential of local supply sources, as well as shipments through land routes,”  she said, noting that the opportunities and barriers vary widely country by country – citing Afghanistan as an example where alternative routes of access are “highly complex.”. 

Impacts on Gaza 

Gaza tent camp amidst rain and rubble in January 2026. WHO describes progress in rehabilitation since the October 2025 cease-fire as ‘marginal.’

For Gaza, already devastated by two-years of war with Israel, the fresh conflict with Iran and Lebanon is a huge setback in an “extremely fragile situation,” she added. 

For the first few days of the war, Israel also closed key humanitarian aid corridors.  Those have since been partially reopened, “but there is really not enough humanitarian aid going in.  

“And we still do not have enough patients [able to] leave Gaza to seek medical care outside. 

Tedros described the progress in Gaza since the October cease-fire as “marginal,” saying “we need 600 trucks to cross into Gaza every single day. But currently it’s not more than 100 between 100 or 150 – and some of those tracks are actually commercial, and that doesn’t really help with humanitarian services.”

He also renewed an appeal to Israel to allow Gaza patients who can’t be treated properly in the enclave to access more specialized medical care in East Jerusalem. This, in light of the dearth of countries willing to take in the more than 10,000 Palestinians awaiting medical treatment abroad. 

“I’d like to use this opportunity to ask Israel to allow us to take patients to East Jerusalem and West Bank,” Tedros said.. 

Casualties and attacks on health facilities 

Since the war began in an early morning surprise attack by Israel and the United States on Saturday, 28 February, some 1000 people have been reportedly killed in Iran, according to the Islamic regime; 50 in Lebanon, 13 people in Israel and eleven in other countries, WHO said.

In addition, WHO has verified 13 attacks on health care in Iran and one in Lebanon, according to Balkhy, citing data culled from WHO’s  dashboard on attacks on healthcare facilities or health workers. 

The WHO dashboard, however, contains only data provided by the Islamic Regime. It has no records of the many reported regime attacks on health workers and hospitals during the month of January unrest. In that period, there were multiple, credible reports of heavily armed forces bursting into hospital emergency wards to obstruct care, arrest or kill injured patients as well as health care workers. 

Over the course of that month, the Iranian regime’s systematic killing of protestors led to an estimated 10,000 to 30,000 deaths – a death toll that the regime went to great extremes to conceal.

During the current war, members of its Islamic Revolutionary Guard Corps (IRGC)  and its affiliated Basij paramilitary volunteers, are reportedly being embedded in schools, mosques and hospitals, making them targets of attack, according to independent news reports.

KurdPa Human Rights news agency Instagram post Wednesday: Sanandaj – Forced evacuation of the Seyyed al-Shuhada private hospital and deployment of Revolutionary Guard forces.

Speaking at the WHO press briefing, Heinzelmann said that she had no information about the incursion of armed forces in health facilities. 

Reached by Health Policy Watch, a WHO spokesperson did not explain why the January attacks on health facilities by regime forces were not included in the WHO dashboard of attacks on health care. However, the spokeperson noted that the Director General had posted a remark on X about some of the reported incidents.     

Image Credits: Dubai Humanitarian , Palestinian Water Authority , Instagram/Kurdpafarsi news agency.

India’s school-based HPV vaccination initiative is a critical gateway for reaching 12 million girls with the life-saving jab to prevent cervical cancer.
India’s school-based HPV vaccination initiative is a critical gateway for reaching 12 million girls with the life-saving jab to prevent cervical cancer.

India launched the most extensive free Human Papillomavirus (HPV) vaccination initiative in history to systematically combat the rising toll of cervical cancer. This ambitious 90-day campaign aims to inoculate nearly 12 million 14-year-old girls before the preventative shot is permanently integrated into the country’s universal immunization schedule.

Indian Minister of Health Jagat Prakash Nadda addresses the WHO press briefing on the global fight against cervical cancer.
Indian Minister of Health Jagat Prakash Nadda addresses the WHO press briefing on the global fight against cervical cancer.

“India has joined the community of 160 countries in the global fight against cervical cancer,” stated India’s Minister of Health Jagat Prakash Nadda at a World Health Organization (WHO) press briefing on Thursday.

WHO Director-General Dr Tedros Adhanom Ghebreyesus commended the Indian government’s leadership and congratulated their progress toward the WHO’s ambitious 90-70-90 elimination targets. This global strategy states that by the year 2030, 90% of girls must be vaccinated, 70% of women must be screened, and 90% of women with cervical cancer or precancerous lesions must receive treatment.

HPV is a prevalent family of viruses that remains the leading cause of cervical cancer globally. Because of this direct viral link, administering the targeted HPV vaccine to young girls before they become sexually active is a highly effective clinical strategy proven to reduce cervical cancer cases by almost 90%.

With its HPV vaccination campaign, India is combating an immense localized crisis, with over 127,000 women diagnosed with the cancer annually, leading to approximately 80,000 deaths. To address this, the government has already screened 86 million women across 181,000 specialized health and wellness centres nationwide.

The massive logistics behind the immunization campaign is managed through India’s proprietary U-WIN digital platform, capturing end-to-end records of all immunizations and monitoring vaccine stocks to prevent critical supply shortages.

African leadership in global HPV vaccination rates

The WHO African region achieved a 47% first-dose HPV vaccination coverage rate for females in 2024, overtaking the European region.
The WHO African region achieved a 47% first-dose HPV vaccination coverage rate for females in 2024, overtaking the European region.

Concurrently, South Africa is drastically elevating its own historical battle against the devastating disease through high-level political intervention. A massive new national push to completely eliminate cervical cancer will be officially inaugurated by the country’s highest office in the coming weeks.

“It is no longer the minister of health who is going to launch this campaign to end cervical cancer, it will be the president himself,” confirmed South African Minister of Health Aaron Motsoaledi.

According to the WHO immunization dashboard, The African region has made spectacular strides in localized coverage, officially overtaking Europe to claim the second-highest first-dose HPV vaccination rate globally. Following setbacks in countries like Malawi, the African region’s trajectory – climbing from 9% in 2016 to 40% in 2023 and reaching 47% in 2024 – stands in stark contrast to Europe’s stagnation at 41%.

For years, the South-East Asia region hovered around a staggering 3% coverage rate for females from 2016 to 2022. The region broke double digits in 2024 by reaching 14% coverage, and India’s newly announced campaign targeting 14-year-old girls guarantees this upward trajectory will continue swiftly.

WHO Director of Immunization, Vaccines, and Biologicals Kate O'Brien speaks to major achievements in HPV immunization.
WHO Director of Immunization, Vaccines, and Biologicals Kate O’Brien speaks to major achievements in HPV immunization.

This progress is largely attributed to the transition toward simplified, single-shot immunization regimens worldwide. “It makes the way of administering a vaccine so much easier,” explained WHO Director of Immunization, Vaccines, and Biologicals, Kate O’Brien.

“We have some estimates that as a result of countries switching to the one dose schedule, something in excess of 30 million additional girls have been able to be vaccinated.”

Community-driven strategies power South Africa’s rollout

While financial constraints previously limited this life-saving intervention exclusively to public institutions, the official adoption of a single-dose regimen has fundamentally transformed the economic maths in South-Africa’s immunization efforts.

This crucial shift allows South Africa to stretch its self-funded resources and expand its protective network into private and independent schools, which serve roughly 5% of the student population.

Another key to success is South Africa’s distribution model that relies heavily on a collaborative framework between the health and basic education ministries. The ‘Integrated School Health Program’ utilizes dedicated school nurses to administer the HPV vaccine and engages with both parents and local school governing bodies.

Nothemba Simelela, adviser to the South African Minister of Health, highlights the importance of a community-driven approach.
Nothemba Simelela, adviser to the South African Minister of Health, highlights the importance of a community-driven approach.

Securing parental consent is a fundamental pillar of the rollout, with officials strategically bundling permission slips with annual school registration forms to maximize compliance.

“Some of the nurses have given us feedback that they [the girls] just join the queue because they don’t want to be left behind by their peers, and it’s quite difficult to refuse to give such young girls the vaccination,” stated Nothemba (Nono) Simelela, adviser to the South African Minister of Health.

Innovating HIV medication to tackle overlapping threats

WHO Director-General Dr Tedros Adhanom Ghebreyesus commended India's leadership in the global fight against cervical cancer.
WHO Director-General Dr Tedros Adhanom Ghebreyesus commended India’s leadership in the global fight against cervical cancer.

The underlying urgency to protect these vulnerable populations is driven by stark epidemiological realities regarding overlapping threats. Women living with HIV are six times more likely to develop cervical cancer compared to women without HIV, according to the WHO.

Recognizing that overcoming this deadly coinfection crisis requires a two-front defence, South Africa is confronting its staggering HIV burden with groundbreaking pharmaceutical developments. Just today, the state announced its intention to begin locally manufacturing Lenacapavir, a highly preventative medication.

This pharmaceutical is technically not a vaccine, but it operates as a long-acting antiretroviral injection administered every six months to high-risk individuals. In recent clinical trials, the preventative treatment has been shown to block almost all cases of HIV transmission among vulnerable demographics, Dr Tedros explained.

Global health authorities have fast-tracked the drug’s approval process to ensure equitable international distribution as quickly as possible. “It’s the first time WHO has developed pre-qualification and guidelines in parallel not in sequence to speed up equitable access to innovative new tools,” announced the WHO Director-General.

South Africa previously became the first nation in Africa to officially approve the preventative medication back in October last year. The planned massive rollout of this drug represents a fundamental shift in how the continent approaches its long-standing battle against the devastating HIV epidemic.

Image Credits: Felix Sassmannshausen, Pravin via Canva.

Intensified climate-health risks such as prolonged droughts are placing a strain on public health systems.
Intensified climate-health risks such as prolonged droughts are placing a strain on public health systems in Africa.

Two regional research hubs that aim to develop climate adaptation strategies that reduce health impacts are to be established in Ghana and South Africa under the terms of a new £40 million climate-health initiative led by African universities and the Wellcome Trust, announced on Thursday.

Along with the two hubs in South Africa and Ghana, an additional £20 million has been earmarked for a third hub in East Africa, with the site yet to be determined.

The aim is to develop provide policymakers on the continent with tailor-made scientific data and strategies for shielding vulnerable populations from the intensifying health threats of extreme heat, flooding, air pollution and worsening nutrition – which already kill millions of people every year.

“Africa is on the frontline of climate change, with women and marginalized communities already suffering the worst health impacts,” stressed Charlotte Watts, Executive Director of Solutions at the Wellcome Trust, in Thursday’s statement.

The hubs will link scientists across diverse disciplines along with policymakers, and community partners, to generate effective strategies protecting human health.

The South African hub, anchored at the University of the Witwatersrand, will address extreme heat in South Africa and Zimbabwe, alongside issues like devastating flooding in Malawi. The goal is to overcome the knowledge and financial barriers constraining essential care for affected communities, according to consortium lead Matthew Chersich, Professor at the Wits Planetary Health Research Division.

Meanwhile, the Western Africa consortium anchored at Ghana’s Kwame Nkrumah University of Science and Technology, will tackle environmental hazards that are characteristic of that region, such as intense dust storms and prolonged droughts along with heat waves. Intensifying climate risks are straining fragile public health systems and disrupting livelihoods across the region, warned the Western Africa lead Philip Antwi-Agyei, Professor of Climate Change and Sustainability Science.

Adelheid Onyango, Director of the Health Systems and Services Cluster at the WHO Regional Office for Africa, emphasizes the critical need for rigorous data to support health leaders making vital decisions with limited resources.
Adelheid Onyango (WHO) emphasizes the need for rigorous data to support health leaders making vital decisions.

Currently, uncoordinated policies pose a massive challenge to protecting vulnerable populations in nations like Ghana and Senegal, Antwi-Agyei argued.

“Health leaders across Africa make vital decisions with limited resources, so having access to rigorous, context-relevant evidence is essential,” added Adelheid Onyango, Director of the Health Systems and Services Cluster at the World Health Organization (WHO) Regional Office for Africa.

A continent bearing a disproportionate climate-health burden

12 of 20 climate-health indicators are now at catastrophic levels, including a sharp rise in heat-related deaths globally.
Lancet Countdown 2025: 12 of 20 climate-health indicators are now at catastrophic levels, including a sharp rise in heat-related deaths globally.

This African initiative arrives against a grim global backdrop, as the 2025 Lancet Countdown report recently revealed that 12 out of 20 key climate-health indicators have hit catastrophic records. Extreme heat exposure alone claimed an estimated 546,000 lives annually over the last decade. Some 2.5 million people are estimated to die every year from air pollution generated by fossil fuel use.

While Africa contributes minimally to global emissions, it bears the greatest burden of climate change.

Compounding these health vulnerabilities is a massive infrastructure deficit, with roughly 600 million Africans still lacking basic access to electricity. Consequently, about half of the health centres in sub-Saharan Africa suffer from unreliable power, severely disrupting emergency care and vaccine refrigeration capabilities.

Furthermore, the world’s poorest countries are now spending more on debt service than on healthcare, education, and infrastructure combined. This ongoing debt trap leaves health systems chronically underfunded and unable to cope with rising climate-health disease burdens.

African member states fought hard to support the full adoption of a new WHO action plan on climate change and health, approved by the World Health Assembly in May 2025 The initiative actively encourages countries to transition their critical health facilities toward reliable, renewable energy sources to boost overall climate-health resilience.

Building a climate-health fortress of evidence

According to Modi Mwatsama, the new African-led consortiums have the potential to drive essential innovation in climate-health policy across the continent.
Modi Mwatsama, Wellcome.

Ensuring African communities possess the necessary expertise to navigate the complex challenges of climate change is a pillar of Wellcome’s climate and health strategy. The new consortiums hold massive potential to foster essential innovation, Modi Mwatsama, Head of Capacity and Field Development at Wellcome stated.

Looking ahead, the hubs also will pioneer health-centred approaches to reducing carbon emissions – building more stakeholder support for climate mitigation and the carbon transition. And they will also prioritize delivering specialized care solutions for the most at-risk demographic groups, including pregnant women, children, and older individuals.

Advocates view the integration of scientific rigour and local policymaking as a crucial step toward achieving more robust climate-health policies and broader climate justice for the global South.

The funding will help build a stronger “fortress of evidence” that the world urgently requires right now, said Philip Kilonzo, of the PanAfrican Climate Justice Alliance.

Image Credits: piyaset/Getty Images via Canva, WHO, Felix Sassmannshausen, Wellcome Trust.

obesity
Most people with obesity now live in low and middle-income countries.

WORLD OBESITY DAY – Most people living with obesity are now in low and middle-income countries (LMICs), according to the World Obesity Federation (WOF) – yet people living in these countries are least likely to have access to the Glucagon-Like Peptide-1 (GLP-1) medicine that is transforming treatment outcomes in wealthier countries.

Around one billion people are currently living with obesity, and four billion people – almost half the world’s population – are projected to be overweight or obese by 2035. Obesity in children has risen from 4% in 1975 to 20% by 2025.

People with obesity are at greater risk of non-communicable diseases (NCDs), particularly heart disease, stroke, high blood pressure and diabetes.

The GLP-1 drugs are transforming obesity treatment after years of behaviour-based policy interventions have failed to stop the rise of obesity.

In clinical trials of newer GLP-1 drugs such as semaglutide (Wegovy), obese patients without diabetes lose 15%–25% of their body weight over 12 to 18 months.

The World Health Organization (WHO) issued its first guidelines for their use to address obesity last December. (Several have already been approved as essential drugs to treat type 2 diabetes).

Around 10 million people in the US were estimated to be on GLP-1 drugs in 2025, and this is projected to rise to 25 million by 2030. Australians, New Zealanders and Europeans are also embracing the drugs.

Scarce and expensive

But these medicines are scarce in LMICs despite the growing need. Between 2010 and 2022, obesity more than doubled across all LMICs and tripled in low-income countries, according to the WOF.

In South Africa, for example, the prevalence of obesity in adults rose by 38% between 1998 and 2017, affecting 28% of the adult population, with women having double the rate of men.

But GLP-1 drugs are “currently prohibitively expensive, prone to massive repeated supply shortages, and unavailable from state clinics and most medical aids”, according to South African clinicians Dr Francois Venter and Dr Nomathemba Chandiwana.

The monthly cost of the medication varies from around $100 to $300, way out of the reach of the vast majority of South Africans.

Only four of the 20 countries most impacted or projected to be most impacted by rising obesity rates cover obesity medicine in their public health systems, according to the Economist Impact’s Global Obesity Response Index.

Only the UK covers all four forms of evidence-based obesity care – nutrition counselling, intensive behavioural therapy, medications, and metabolic and bariatric surgery –through public insurance.

Canada, China, Mexico, Nigeria, Rwanda and South Africa offer no national-level coverage of any of these interventions.

“Without deep price reductions and scalable care systems, obesity treatment will remain out of reach, and health systems will continue to absorb the far higher costs of untreated disease,” according to the Medicines Patent Pool this week.

However, access to GLP-1 medicine should improve as the key compound patents for semaglutide (Wegovy) expire within the next few months, with generic medicine poised to enter the market.

Curbing ultra-processed food

Unhealthy food habits drive obesity

While medicine is key to reducing obesity, so too are policy measures to rein in the industries that promote ultra-processed food that drives the condition.

Key interventions are high taxes on ultra-processed food and sugary drinks; front-of-package warning labels on food high in sugar, salt and fat; and restrictions on marketing these products to children.

However, of the 20 most affected countries, only one – Mexico – taxes both unhealthy foods and drinks, according to the Global Obesity Response Index.

Only three – Brazil, Canada, and Mexico – require front-of-package nutrition labelling.

 

Image Credits: Flip.

A UNICEF-supported mobile clinic provides healthcare to people displaced by violence in Darfur, Sudan.

The first vaccines to reach Sudan’s South Kordofan state in nearly three years were delivered this week, according to Save the Children.

South Kordofan has not received any vaccines since July 2023 due to a siege by the Rapid Support Forces (RSF),which has blocked medical and humanitarian supplies. 

“This left thousands of children without protection from preventable disease at a time when malnutrition and displacement were putting them at heightened risk,” said Save the Children.

The organisation delivered two truckloads containing 18 metric tons of routine vaccines to Kadugli town in the south-central state over the past few days. 

The shipment includes the tuberculosis BCG vaccine, oral polio vaccine (OPV) and pentavalent vaccine (against diphtheria, tetanus, hepatitis B, whooping cough and Hib), as well as vaccines for rotavirus, pneumococcal, measles, meningococcal A, inactivated and Yellow Fever.

The vaccines, funded by Gavi, will support immunisation in five localities, including Kadugli where famine was confirmed in September 2025. 

Families in Al Reif Alshargi, Aldalang, Habila and Al Goos will also benefit, with more than 24,500 children set to receive routine vaccinations this year. In addition, nearly 6,000 women will receive the tetanus vaccine.

“Vaccines are one of the simplest and most effective tools we have to prevent child deaths,” said Dr Bashir Kamal Eldin, Save the Children’s health and nutrition director in Sudan.

“This vaccine delivery is a breakthrough for thousands of children and mothers who have endured months without reliable access to food and basic health services, conditions that have put their lives at serious risk.”

However, Eldin warned that the situation remains extremely fragile: “Without sustained peace and guaranteed humanitarian access, these gains could quickly be reversed.”

‘Humanitarian catastrophe’

The World Health Organization (WHO) has described the situation in Sudan as a “humanitarian catastrophe of staggering dimensions” in its latest report on the conflict.

The WHO estimates that 33,7 million people require assistance.  Some 11.5 million people have been forcibly displaced, with over 4.2 million fleeing into neighbouring countries. Chad recently closed its border with Sudan as it cannot cope with the influx of refugees.

“More than 21.2 million people are experiencing acute food insecurity,” said the WHO, with violence disrupting food and aid supply chains and agricultural production.

Some areas, including El Fasher (North Darfur) and Kadugli (South Kordofan), are facing famine, categorised as “Integrated Phase Classification Phase 5 (IPC Phase 5)”, when over 20% of households face an extreme lack of food and over 30% of children face acute malnutrition.

“The latest nutrition survey in Um Baru (North Darfur) recorded a Global Acute Malnutrition rate of 53%, of which 35% were classified as Severe Acute Malnutrition. Coupled with high rates of malnutrition, an overstretched health system and low immunisation coverage, this increases the risk of disease outbreaks and their catastrophic impacts,” said the WHO.

“Multiple disease outbreaks are occurring simultaneously, including cholera, dengue, malaria, measles, hepatitis E, and diphtheria.

“Over 40 000 injuries have been reported amid the ongoing conflict. Civilians continue to be killed, injured and displaced in ongoing attacks in the Darfur and Kordofan regions. Sexual violence remains pervasive.”

Between 15 April 2023 and 31 December 2025, the WHO has formally validated 201 attacks on health care, 1,858 deaths and 490 injuries.

“Many health facilities have been destroyed, looted, or are functioning with severe shortages of staff, medicines, vaccines, equipment, and supplies,” the WHO concludes.

Image Credits: Mohammed Jamal / UNICEF.

Senegal’s President Ousmane Sonko.

The Parliaments of both Ghana and Senegal are considering harsher penalties for same-sex relationships.

Last month, Ghana’s Parliament had its first reading of an anti-LGBTQ Bill, which is now being considered by its Committee on Constitutional, Legal and Parliamentary Affairs.

Meanwhile, Senegal’s Cabinet approved a Bill for its Parliament last month that will double the maximum penalty for same sex relationships – up to 10 years in prison.

Ghana passed an anti-LGBTQ bill in 2024, but it was not signed into law by the country’s then-president, Nana Akufo-Addo. The current president, John Mahama, was elected in 2024 and has stated his readiness to pass anti-LGBTQ laws.

Ghana’s Human Sexual Rights and Family Values Bill is similar to the one passed in 2024, and contains some of the most wide-ranging legal restrictions on human sexuality.

First off, the Bill aims to criminalise LGBTTQAP+ people. This applies to “a lesbian, gay, bisexual, transgender, transsexual, queer, ally, pansexual or a person of any other sexual orientation that is contrary to the sociocultural relationship between a male and a female”.

Any sexual activities by LGBTTQAP+ people will get a prison sentence of between two months and three years.

Meanwhile, “gross indecency” – defined as a “public show of romantic relations” or “cross-dressing” can get six to 12 months in prison.

LGBTTQAP+ organisations are also banned.

Ghanaians have a duty to report transgressions. The Bill also requires “parents, teachers, religious bodies, media and state institutions” to “promote and protect… human sexual rights and family values” and ensure they are “preserved and integrated into the fabric of national life.” 

Senegal’s Prime Minister Ousmane Sonko, who also came to power in 2024, told his Parliament that the Bill will punish “acts against nature” with prison sentences from five to 10 years.

DRC Health Minister Dr Roger Kamba, US Charge D’Affaires in DRC, Ian McCary, DRC Prime Minister Judith Tuluka Suminwa and Finance Minister Doudou Fwamba, at the signing of the health MOU last week.

The United States has moved at speed to secure several new bilateral health Memoranda of Understanding (MOUs) in the past week, including, for the first time, four in Latin America – with the Dominican Republic, El Salvador, Guatemala and Panama.

To date (2 March), the US has signed 24 bilateral health MOUs in terms of the Trump administration’s America First Global Health Strategy.

Announcing its agreement with Panama, the first MOU within Latin America, the US State Department described it as “strengthening Western hemisphere health security”, which it added is “a priority”.

The four Latin American agreements involve smaller grants and are almost wholly focused on disease surveillance.

The other 20 bilateral agreements are all with African countries – mostly previous recipients of health grants via the now disbanded US Agency for International Development (USAID) and decimated US President’s Emergency Fund for AIDS Relief (PEPFAR).

Several of these countries are facing dire shortages of medicines for HIV, tuberculosis, and maternal and child health as a result of the US withdrawal of funds.

The five-year MOUs are aimed at rapidly transferring financial responsibility for these key health services to countries themselves – as some, such as Kenya, Uganda and the Democratic Republic of Congo (DRC) – derived over half their HIV budgets from donors, particularly the US. In the DRC, for example, at least half the antiretroviral medication it used was covered by the US.

High parting price

However, the parting price for these transitional MOUs includes extensive investment in infectious disease surveillance networks. The aim is to supply the US with pathogen information within a week of any outbreak to not only “keep America safe” but to give US firms exclusive access to pathogen information, which will enable them to make vaccines, medicines and diagnostics to combat these.

The US-DRC MOU, signed on 26 February, focuses extensively on “strengthening the DRC’s capacity to detect and contain infectious disease outbreaks before they spread internationally”, according to a US State Department statement.

The DRC has experienced recent Ebola outbreaks and, for the past year, the biggest mpox outbreak in the world.

According to the MOU, the US commits to investing up to $900 million over five years and the DRC commits to increasing its health expenditure by $300 million.

The bulk of the money will go into “a national integrated surveillance and outbreak response system, including a high-quality laboratory network capable of detecting and investigating infectious disease outbreaks within seven days”. 

“Under this system, relevant authorities, including the United States and other partners, will coordinate epidemic preparedness and rapid response measures to contain outbreaks and prevent their spread to neighboring areas,” according to the statement.

The MOU also aims to modernise data and disease surveillance systems with “enhanced electronic medical records and interoperable platforms”, professionalise community health workers and “expand integrated delivery of essential health services for HIV, tuberculosis, malaria, polio, and maternal and child health”. 

First, the minerals…

Guinea and the US signed a minerals MOU before the health MOU.

The US held off signing an MOU with the DRC in terms of its “America First Global Health Strategy” on 5 December, when it signed deals with Rwanda and Kenya on the sidelines of the signing of a peace accord between Rwanda and the DRC.

Instead, the US and the DRC signed a “strategic partnership agreement” to  “promote secure, reliable, and mutually beneficial critical mineral flows for commercial and defense purposes”. 

The DRC is one of the world’s most important sources of rare earth minerals, but China has dominated the purchasing and processing of its minerals. In the past two months, the DRC has opened its rare minerals supply to the US.

In late January, the DRC sent the US a shortlist of state-owned assets involving manganese, copper, cobalt, gold and lithium, for US investors to consider as part of a minerals partnership, Reuters reports.

Meanwhile, the US MOU with Guinea, signed on 27 February, was also preceded by a minerals MOU, signed with the US on 5 February, giving the US access to “critical minerals”.

The health MOU prioritises strengthening the country’s “laboratory networks with biosafety and biosecurity management aligned with international standards by 2027”.

Legal backlash in DRC

But not all countries want to exchange their minerals and other assets for aid.

A group of lawyers in the DRC are challenging the minerals MOU in their Constitutional Court, arguing that it violates the country’s Constitution in various ways, including undermining national sovereignty over natural resources.

“By filing this case with the Constitutional Court, we are assuming our responsibility as Congolese citizens to protect the sovereignty of our country and safeguard our patrimony for future generations,” said attorney Jean-Marie Kalonji, one of the plaintiffs. The case has yet to be heard.

Meanwhile, Zimbabwe recently backed out of talks with the US as it was unhappy with what the US required from it in terms of outbreaks.

“Zimbabwe was being asked to share its biological resources and data over an extended period, with no corresponding guarantee of access to any medical innovations—such as vaccines, diagnostics, or treatments—that might result from that shared data,” explained Nick Mangwana, Secretary for Information, Publicity and Broadcasting Services.

“In essence, our nation would provide the raw materials for scientific discovery without any assurance that the end products would be accessible to our people should a future health crisis emerge. The United States, meanwhile, was not offering reciprocal sharing of its own epidemiological data with our health authorities.”

Kenya’s MOU with the US, the first of the series, has been halted by the country’s High Court as it faces two separate court challenges for giving the US access to patient data and pathogen information.

The government of Zambia acknowledged last week that it is unhappy with part of a proposed health aid deal with the United States that “does not align with the country’s interests” and has requested “revisions” to the MOU.

The Zambia-US bilateral health deal was due to be signed last December, but it faltered after the US linked the billion-dollar deal to access to Zambian minerals, particularly copper and cobalt.

Just four days before the MOU was due to be signed, the US announced that the two countries had committed to a plan to unlock “a substantial grant package of US support in exchange for collaboration in the mining sector and clear business sector reforms that will drive economic growth and commercial investment that benefit both the United States and Zambia”.

‘Extractive’ policy

Sophie Harman, professor of international politics at Queen Mary University of London, argues in last week’s BMJ that “extraction is the core principle of US President Donald Trump’s America First global health policy”.

“The current US administration does not aim to improve health worldwide, instead it intends to make US companies richer and facilitate ‘leveraging US global health leadership to compete with China’,” writes Harman.

“Entering a deal with the US government is a potential lose-lose for states. These countries risk losing resources and opportunities for wealth creation in their own countries, threatening alliances with China for relatively small advances in health, and creating political turmoil in domestic courts.”