WHA Advances Global Health Architecture Reform Amidst Questions About Where Process Will Really Lead

23/05/2026 Felix Sassmannshausen

World Health Assembly delegates debate the newly adopted Global Health Architecture Reform in Committee B.

The 79th World Health Assembly adopted a widely anticipated Global Health Architecture Reform initiative. While WHO and many member states lauded it as a landmark move, the actual mandate is, in fact, highly restrictive. The process will not yield recommendations on “revisions to organizational mandates nor specific mergers or consolidations” in the often overlapping functions of multiple UN global health agencies. The process also must navigate sharp developed and developing world priorities, regarding equity. And the framework faces fierce backlash from civil society groups over their exclusion from the joint task force steering the initiative.

The World Health Assembly on Friday endorsed a joint process for Global Health Architecture (GHA) Reform with the United Nations and other major, multilateral health agencies.

Dr Tedros promises bottom-up reform.

The process complementing the broader UN80 reform initiative, aims to yield recommendations that: a) enhance “alignment of the mandates and capacities” of global health actors with essential functions across global, regional and national levels; b) enhance “coordination and collaboration” and c) align financing, especially to “advance national self-reliance and ensure sustainable and predictable support”. But the carefully curated mandate also precludes concrete recommendations for agency mergers or revisions to their mandates, leaving big questions about where the process will really lead.

Proponents have promoted the reform as a means of shifting power dynamics toward national authorities, aligning multilateral financing with sovereign priorities.

WHO Director-General Dr Tedros Adhanom Ghebreyesus emphasised that the overhaul must remain intrinsically bottom-up and mirror the agency’s own recent 16-month internal restructuring efforts. He explained that the Secretariat is identifying its absolute core mandates and will explicitly delegate non-core responsibilities to other global health partners based on their comparative advantages, thereby eliminating systemic duplication.

“All we do in the GHA should actually be bottom up, and we need to understand the needs of the countries we support,” said Dr Tedros.

Consolidating governance and the Lusaka agenda

Chef de Cabinet Razia Pendse reassures the Assembly that robust safeguards protect WHO’s constitutional mandate.

Leading the process is a 25-member task force, including 14 WHO member state representatives, including developed and developing nation co-chairs. The task force will also include up to four representatives of other UN health-related entities, as well as the World Bank and “a regional health organization.”

And the task force will include five representatives of the largest, non-UN global health organizations, including Gavi, the Vaccine Alliance; Global Fund to Fight AIDS, Tuberculosis and Malaria; the Coalition for Epidemic Preparedness Innovations; Unitaid; and the World Bank-hosted Pandemic Fund.

Governed by consensus, the body must hold regular Geneva-based consultations to ensure member states retain ultimate decision-making authority over international health policies. To synthesise its recommendations, the task force will engage with parallel reform efforts like the UN80 Initiative and the Lusaka agenda, a non-binding agreement launched in 2023 that aligns external financing with domestic health priorities.

Reassuring the Assembly, Chef de Cabinet Razia Pendse confirmed that the reform includes robust safeguards to protect the WHO’s constitutional mandate, noting that member states will ultimately review all proposed reform recommendations.

“WHO will approach this mandate with humility and with an inclusive spirit,” said Pendse.

Core mandate lacks ambition

Some member states, as well as a leading philanthropy, Wellcome Trust, criticised the lack of a real mandate to enact substantive structural changes in the way the UN agencies and its partners do business. These restrictive boundaries are explicitly defined in the proposal, stating:

“The process will propose neither revisions to organizational mandates nor specific mergers or consolidations, which fall within the authority of the relevant governing bodies, and will not address disease- or intervention-specific approaches.”

Currently, multiple United Nations entities – including UNICEF, UNFPA, UNAIDS, UN Women, and Unitaid, as well the UN Environment Programme and a range of UN humanitarian agencies, all engage in global health activities to some extent, with oft-overlapping activities as well as sometimes fierce competition for donor funds.

As for major non-UN agencies like Gavi, and the Global Fund, critics have suggested that the vertical, disease-focused nature of those programmes also reinforces that tendency at national level and thus countervenes the needed drive towards integration of health system services. For instance, The Global Fund manages a huge, and efficient mechanism for procurement supporting diagnostics and medicines access across dozens of low and middle income countries. But that mandate covers only the three major diseases. That leaves national governments scrambling to procure health products to address the soaring burden of noncommunicable diseases through other channels.

In light of all of that, a meaningful process must consider opportunities to streamline institutions through concrete recommendations regarding the merger and consolidation of global health organizations, argued Wellcome’s representative during the WHA debate.

This lack of practical objectives or outcomes to the reform process was also challenged by some member states. The delegate from Colombia expressed concern that the WHO Secretariat’s proposal focused heavily on methodology without clearly addressing the central, substantive issues of the reform. The Belgian delegate echoed the demand for a robust approach.

“We expect this reform to be ambitious and not just cosmetic,” he emphasised.

Civil society condemns exclusion

The Women Deliver representative demands civil society from the Global South be meaningful reform co-designers.

Meanwhile, non-state actors, led by the NCD Alliance, condemned their structural exclusion from the core, joint task force, noting that sidelining affected communities undermines meaningful governance and removes a critical force for accountability. To preserve the primarily intergovernmental nature of the reform, civil society groups other than the five named to the task force, would be relegated to peripheral consultations in “stakeholder constituency groups.”

“By excluding civil society and people living with NCDs from the joint task force set up to oversee this process, Member States are sidelining the voices of those most affected,” said NCD Alliance Policy and Advocacy Director Alison Cox in a statement to Health Policy Watch.

Pivoting to demands for direct representation, a coalition including the NCD Alliance, Save the Children and Wellcome argued, to no avail, for a modification of the process so that more civil society and frontline humanitarian expertise are embedded directly into the core task force body. They warned that ignoring these voices contradicts existing commitments to social participation and leaves the new architecture vulnerable to health-harming commercial interference.

“We urge member states to ensure that civil society, especially from the global south, are meaningful co-designers throughout all phases of this reform to truly leave no one behind,” said the Women Deliver representative during a continuation of the debate on Friday.

Complicating this push for inclusion, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) argued that the joint task force must also include private sector representation. The industry group further cautioned that the reform process should avoid encroaching upon intellectual property, licensing, and pricing decisions.

North-South frictions: demanding equity and sovereign control

The Cypriot delegate, representing nearly 50 nations, calls for urgent multilateral reform to stabilise the strained global system.

Despite civil society concerns, a broad coalition of member states unanimously supported the draft WHA decision on GHA Reform – describing it as a crucial response to declining official development assistance and escalating health emergencies.

Speaking on behalf of the European Union and nearly 50 aligned nations, Cyprus praised the resolution as a timely intervention for a highly strained multilateral system. The delegation noted that existing structures have reached their operational limits amid severe funding cuts, economic instability, and complex geopolitical conflicts.

“The time to act is now, and we should seize this opportunity,” said the Cypriot delegate during the debate.

Underlying frictions that emerged during the debate also revealed a divide between high-income countries focused on streamlining and stabilising the strained multilateral system and the Global South’s demands for more equity in health financing and to shift more control to countries.

Representing the 47 member states of the WHO African Region, Zimbabwe underscored that while they support the process, the reform must actively reflect regional political priorities rather than merely streamlining at headquarters. The delegation demanded that the new design secure sustainable financing while protecting essential health functions and regional coordination capacities worldwide.

“The region calls for the provision of focused support to countries most affected by financial shocks, including WHO Africa member states, with a view to rationalising international health financing and strengthening regional coordination capacities,” said the Zimbabwean delegate.

Echoing these Global South concerns, Thailand, representing the South-East Asia Region, requested that the Secretariat translate multilateral decisions into practical country-level support. And Indonesia demanded robust equity safeguards to protect developing nations.

Pakistan demands ‘lean must not mean less’

The Pakistani delegate warns against organizational streamlining, insisting that a “lean” WHO must not mean less.

Pakistan also warned against the unintended consequences of organizational streamlining.

“Lean must not become synonymous with less,” said the Pakistani delegate, who expressed worries that agency consolidation seen as more efficient by donor nations also could weaken WHO’s country-level footprint. Taking issue with language in the document, he stressed that the task force should organize regular “consultations” rather than “information sessions” with other WHO member states to ensure their ongoing involvement in the process.

Addressing specific regional vulnerabilities, South Africa also stressed that sexual and reproductive health rights needs to be embedded within the new frameworks to prevent unintentionally reversing hard-won development gains in crisis contexts. Voicing the distinct concerns of Pacific Island states, Tonga demanded that the redesign preserve equitable pooled procurement mechanisms to reduce high transaction costs across their vast ocean distances.

“We want to be part of this conversation so that we can share our skills and explain our needs,” said the Tongan delegate.

Although the fine print of the text was not modified at the meeting, Chef de Cabinet Pendse and Director General Tedros reassured member states that their calls for equity and inclusion had been heard and would be “acted upon as we move the process forward.”

Reform must address economic weaponisation and power

KEI warns the health architecture reform remains incomplete without addressing economic sanctions.

While the Secretariat emphasised inclusive decision-making and internal institutional safeguards, experts warn that real change requires moving beyond procedural vocabulary to address the external structural dependencies that produce global inequity.

Highlighting the profound humanitarian consequences of geopolitical trade restrictions, Knowledge Ecology International (KEI) insisted that the GHA Reform would remain fundamentally incomplete without addressing trade sanctions and economic barriers that fragile states and marginalised populations face amidst increased geopolitical tensions.

“Medicine, medical equipment, and humanitarian goods should not be used as weapons of economic warfare,” said KEI representative Thirukumaran Balasubramaniam on Friday.

Ilona Kickbusch points out that global health reform is fundamentally a struggle over power.

Similar to this demand to tackle systemic barriers, Ilona Kickbusch, Co-Chair of the World Health Summit Council, cautioned that true institutional change requires confronting the political and financial interests of the states that dominate global governance.

“The current debate about reforming the global health architecture is, at its core, a debate about power – who holds it, who is losing it, and who intends to use this moment of rupture to consolidate it on new terms,” said Kickbusch ahead of this year’s World Health Assembly.

WHA reform success hinges on building consensus

While experts debate these broader power dynamics, the joint task force must focus on its operational mandate along a tight timeline. It will need to convene and begin synthesising evidence and proposals immediately, with the aim of submitting an interim report by late 2026 for review by the WHO Executive Board.

The ambition is high. For instance, member states also expect the joint task force to work to help align international funding with sovereign health strategies, ensuring greater readiness for emerging threats like the ongoing Ebola outbreak in the Democratic Republic of the Congo.

Ultimately, the success of the Global Health Architecture Reform will depend on whether the global community can navigate these competing priorities and translate them into a Geneva-based consensus for final approval at the Eightieth World Health Assembly.

Cuts cause operational risks

Delegates participate in a Committee B meeting to debate WHO administrative, financial, and governance matters.

Independent oversight bodies had issued stark reminders about the deadly consequences of the sharp financial reductions. A Global Preparedness Monitoring Board report, released earlier this week, warned that while investments in pandemic preparedness strengthened post COVID-19 pandemic, “shifting geopolitical priorities threaten to undermine this progress.”

As warned in the Report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme, current cost-saving measures and workforce reductions risk repeating the fatal mistakes made after the 2008 global economic recession, when health emergency-related functions and teams were similarly deprioritized.

To weather the WHO’s fiscal shortfall, the global health body had managed 2,507 staff separations worldwide, of which 1,232 were direct post abolitions, as of 13 March 2026, according to the WHA report presented to member states.

“This trend reflects structural pressure which could compromise the operational capacity of the organisation, particularly at country level,” warned Panama’s delegate during the human resources debate on Thursday.

Speaking on behalf of 47 African member states, Botswana’s delegate reminded the Assembly that WHO’s workforce remains the organisation’s greatest asset.

“It is … critical that ongoing reforms and workforce adjustment preserve technical expertise, institutional memory, and adequate support to regional and country offices,” added Botswana’s delegate.

Secretariat warns against staff burnout

Assistant Director-General Raul Thomas urges member states to align expectations with the WHO Secretariat’s new fiscal realities.

Beyond the loss of technical expertise, member states also expressed deep concerns over the mental health status of WHO staff who have weathered the current restructuring. Along with witnessing the job loss and departures of friends and peers, those who survived had to undergo months of internal departmental wrangling, fierce competition over a reduced number of organisational placements, and finally team, departmental or even geographic relocations. Panama highlighted a troubling spike in psychosocial support requests, while Poland emphasised that staff cannot sustain global health outputs without a supportive working environment.

Acknowledging the immense pressure on the remaining personnel, Assistant Director-General Raul Thomas noted that staff are also now struggling with unrealistic expectations.

“People are under the understanding that they will have to deliver the same results with a reduced workforce,” said Thomas on Thursday.

To protect the workforce from burnout, he urged that member states recalibrate their expectations to align with the stark new fiscal realities. The Secretariat emphasised that countries must focus purely on essential mandates, rather than pulling the organisation in other directions through earmarked funding.

No immediate funding solutions in sight

The Cyprus delegate addresses the World Health Assembly on Wednesday during tense institutional budget debates.

Addressing the persistent financial vulnerability, Bhutan, speaking for the South-East Asia Region, underscored the urgent need to broaden the WHO’s heavily concentrated base of “voluntary” donors who give far more than the required assessed contributions. These have generally included only the highest income economies but fewer of emerging upper-middle and middle-income countries that could well afford to contribute, as well, as they become more developed. Cyprus, speaking for the European Union, reaffirmed the absolute necessity of sustainable, flexible financing, and a clear way forward to address the remaining 15 percent programme budget funding gap.

Emphasising that a strong WHO is vital for responding to disease outbreaks and recurrent health emergencies, Zambia appealed to donors for “increased sustained, predictable and flexible financing.” Speaking on behalf of the African Region during Wednesday’s budget debate, the delegate argued that this flexibility is required to enable the organisation to efficiently allocate resources to core mandates like health system strengthening, primary healthcare, and universal health coverage.

To stabilise the organisation, delegates emphasised the critical role of mandatory assessed contributions, which in accordance with a milestone agreement in 2022, are being increased on a step-wise basis so that fixed contributions will comprise 50% of the overall base budget by the 2030-2031 cycle. However, collection rates remain stagnant at 70%, leaving over $184 million unpaid for 2025 alone. Member states that do not pay face suspension of WHA voting privileges – a sanction that nine member states currently remain under, while ten additional nations face the same penalty at next year’s Assembly if they fail to pay.

Looking ahead to long-term sustainability, the Secretariat confirmed that the next planned stage of increase in assessed contributions for the 2028-2029 biennium will be placed on the agenda of the WHO’s Regional Committees this autumn, ahead of a formal WHA decision in May 2027. However, timely solutions are of the essence; if member states fail to also inject flexible, voluntary funding in the interim, officials warn that frontline responses to concurrent humanitarian and viral crises would face immediate and fatal disruption.

See related story.

https://healthpolicy-watch.news/who-iran-voting-rights-us-faces-suspension/

Image Credits: Felix Sassmannshausen/HPW.

Attack on Ebola Hospital in Eastern Congo Echoes Past Violence Against Health Workers

23/05/2026 Stefan Anderson

Ebola

An angry crowd set fire to Ebola isolation tents outside a hospital in the Democratic Republic of Congo’s (DRC) Ituri province on Thursday after the family of a young man who died of the virus was refused permission to take his body to be buried.

The attack on Rwampara General Hospital, near the city of Bunia, came as the World Health Organization (WHO) raised its risk assessment of the DRC outbreak from “high” to “very high” for the country, citing the rapid spread of cases and growing insecurity.

The risk remains “high” regionally and “low” globally, WHO Director-General Dr Tedros Adhanom Ghebreyesus told a Geneva media briefing on Friday.

Six patients were being treated in the two tents set alight, according to ALIMA, the medical charity that ran the isolation unit. Police fired warning shots and teargas to disperse the crowd, and local authorities placed health workers at the hospital under military protection.

Protesters set a hospital on fire in DR Congo amid an Ebola outbreak, after a family disputed the virus caused their relative’s death and demanded custody of the body.

Health authorities warn the latest outbreak of Ebola ‘is not small’ and requires ‘all hands on deck’. pic.twitter.com/3qll33ZBJn

— Al Jazeera English (@AJEnglish) May 21, 2026

Dr Anne Ancia, WHO’s representative in DRC, told reporters that the incident would “significantly jeopardize” containment efforts in Bunia, one of three hotspots in the outbreak.

The tents had been set up to separate suspected Ebola patients from those receiving routine care in the main hospital building, said Ancia, addressing the media briefing via phone from the DRC.

She said that WHO security teams were meeting with the provincial governor and health authorities, and hoped that operations at the hospital “will be able to start again tomorrow”.

Contact tracing is uneven across the affected provinces. Ancia said tracing in South Kivu was “sufficient” at around 80%, with 89 contacts already identified for a single new case confirmed in Riho.

But in violence-affected Bunia, the figure stood at just 11% as of Wednesday evening.

Dr Anne Ancia, WHO’s lead in the DRC.

“This outbreak can still be contained, but the window for action is narrow,” said Gabriela Arenas, the International Federation of the Red Cross’ region lead. “What happens in the coming days – in homes, in communities, and across borders – will matter enormously.”

While some media reports suggested that the infected patients had fled into the community during the chaos, all six patients from the isolation tents “are currently being cared for at the hospital,” ALIMA said in a statement.

ALIMA CEO Dr Moumouni Kinda told Health Policy Watch the response was being held back by a combination of conflict, weak local administration, and community members’ lack of knowledge about the disease in a region that had not previously faced Ebola.

“The war, the disorganization of local public authorities, and the lack of resources mean that, of course, the Ebola outbreak will continue to worsen,” Kinda said.

“This is a region that has not known Ebola. It is new, and the people do not necessarily have the reflexes as in zones like Goma or others which have seen Ebola in the past.”

A rare strain, with no vaccine or treatment

Health workers in the DRC put together protective gear during an Ebola outbreak in 2019.

The outbreak is caused by the Bundibugyo strain of Ebola, a rare and deadly variant with no licensed vaccine or therapeutic that kills up to half of those it infects. WHO officials said this week that candidate vaccines in the pipeline could take up to nine months to reach patients.

The outbreak is “spreading rapidly”, with 82 cases and seven deaths confirmed in DRC, Tedros told reporters on Thursday.

“We know the epidemic in DRC is much larger,” Tedros said.

The outbreak is centred in Ituri province, with cases also confirmed roughly 350 miles southwest in Goma, in North Kivu. Across the two provinces, around four million people need urgent humanitarian assistance, two million are displaced, and 10 million face acute hunger, according to UN figures.

In neighbouring Uganda, two cases have been confirmed in people who travelled separately from DRC, including one death. Yet the situation in Uganda remains “stable”, Tedros said.

Ugandan authorities have suspended flights, boats, buses and all other public transport across the border for at least four weeks, a significant decision in a region where cross-border movement is fundamental to livelihoods.

More than 186,000 people per month moved across eight border points during the previous Ebola outbreak that killed 2,299 people over nearly two years, according to the International Organization of Migration (IOM).

Local beliefs, deep distrust

Ebola response workers in the DRC.

“There is significant distrust of outside authorities among the local population,” Tedros said. “Building trust in the affected communities is critical to a successful response, and is one of our highest priorities.”

The man whose death triggered Thursday’s violence was a well-known local footballer. His mother told Reuters she believed her son had died of typhoid fever, not Ebola.

Meanwhile, a local politician who witnessed the attack told the BBC that residents did not believe that the virus existed.

The bodies of Ebola victims remain highly infectious after death. Traditional funeral rites in the region, during which mourners touch and wash the deceased, have been a persistent driver of transmission in past outbreaks.

While WHO guidelines mandate “safe and dignified” burials handled by trained teams, convincing the local population to set aside their rituals can be a difficult task.

“We have learned from the past that epidemics are not contained by medical response alone,” Arenas said. “They are contained when communities trust the response, when people have reliable information, and when local action is supported quickly and consistently.”

He described community reactions as mixed: “For some people, the outbreak is very real, and they are seeking information on how to protect themselves and their families. For others, there is still suspicion and misinformation with claims that Ebola is fabricated.”

Valet Chebujongo, a community mobiliser in Bunia, told CNN that fear in the affected communities was being fuelled by superstition, and people were turning to prayer and traditional remedies.

ALIMA, the charity operating the tents, also warned against social media rumours that could “fuel fear, misinformation and mistrust towards health facilities and the teams involved in the Ebola response.”

A region with a history of attacks on health workers

WHO Scales Back Ebola Response Following Deadliest Attacks Ever On DRC Health Workers

The fire raised dark memories for veterans of DRC Ebola outbreak response in North Kivu and Ituri a few years ago, the second-largest on record.

At least 25 health workers were killed in violent attacks between 2018 and 2020, 13 of them working for international agencies, while 27 were abducted by armed groups, according to an analysis by Insecurity Insight.

In total, more than 450 acts of violence or threats against health workers were recorded, the analysis found.

Some attacks were targeted assassinations. Dr Richard Mouzoko, a Cameroonian WHO epidemiologist, was shot dead during a raid on a hospital in Butembo in April 2019.

In Lwemba, civilians associated with a Mai-Mai militia set fire to four health facilities and 18 houses belonging to Ebola responders following the death of a local Red Cross worker.

Others were driven by community mistrust. A Lancet Infectious Diseases study conducted in Beni and Butembo found that one in four respondents believed the Ebola outbreak was not real, and that such beliefs were strongly associated with a “decreased likelihood of adopting preventive behaviours, including acceptance of Ebola vaccines.”

The violence in late November 2019 forced WHO to evacuate non-essential staff from the Biakato Mines area, the first time it had pulled personnel at that scale during an outbreak.

Cases surged in the weeks that followed.

Health workers also paid a direct toll from the virus itself. By the end of the outbreak, 171 health workers had contracted Ebola, accounting for roughly 5% of all cases.

Logistical challenges in the current outbreak compound the risks. Goma’s airport, the nearest major hub to Bunia, is under the control of the M23 rebel group and is no longer functioning.

In a statement this week, M23 – which has never handled a public health crisis as a governing authority – said it had identified and isolated all contacts of the confirmed Goma case and urged residents of “the liberated areas to remain vigilant, avoid panic, and strictly adhere to the preventive measures recommended by health services.”

“Surveillance and emergency response teams remain fully mobilised to monitor the situation and protect communities,” a spokesperson for the group said.

Image Credits: WHO, John Wessels/ MSF, WHO AFRO.

WHO to Convene Donor Conference on Gaza Rehabilitation

23/05/2026 Elaine Ruth Fletcher

Gaza tent camp amidst rain and rubble in January 2026. Flooding has now given way to heat waves and swarms of rats.

A stiffly-worded resolution approved this week by World Health Organization member states condemned the “wanton” destruction of Gaza’s health facilities and “extreme violence of the illegal Israeli settlers.” The decision called on Israel to ensure humanitarian access to Gaza of medicines, fuel, and other essentials, refrain from further destruction of food production and water supplies, and release Palestinian civilians arbitrarily detained.

After hours of debate straddling Tuesday and Wednesday, World Health Organization member states approved two overlapping reports and resolutions on the situation in Israeli-occupied territories, calling on WHO to convene a donor conference on the rehabilitation of Gaza’s health infrastructure before the next World Health Assembly.

The WHO report cites in painstaking detail the degree of destruction seen in Gaza during the two-year Israeli-Hamas war, along with desperate realities facing Palestinians today in the limbo of an uneasy ceasefire and with little progress so far in the reconstruction plans, hyped by the United States-sponsored Board of Peace. As of end 2025, some 75,000 lives had been lost since 7 October 2023, 72,373 of them Palestinian, while Gaza’s housing, health, water and sanitation and food production infrastructure all remain at their knees. The report and companion resolution also points to the increasingly precarious situation of West Bank Palestinians in accessing health care in the face of tough new military clampdowns, Israeli settlement expansion and mounting settler violence.

Heated debate over diverging narratives

Children at a community kitchen in Khan Yunis, Gaza in August 2025, in months of hunger that preceeded the October cease-fire.

Hours of heated debate also reflected the often sharply diverging narratives held by member states around the root problems and solutions.

On the one hand, there were multiple references to the genocide that had taken place in Gaza, led by regional actors as well as Brazil and South Africa, and a reference by Pakistan to Israel as a “genocidal state.”

Pakistan, speaking on behalf of the Organisation of Islamic States (OIC), objected to a references in one WHO report to the war’s beginnings on 7 October 2023 when Hamas invaded about a dozen Israeli community, took over 200 Israeli hostages and killed some 1,200 people, mostly civilians. (A second report cites only Palestinian data for 2025).

“Israel has reduced Gaza to ruins, strewn with the blood of the innocent, where those who have managed to survive cling to a life of starvation, deprivation and disease. Its catalogue of horrors continues, notwithstanding the purported ceasefire. The victims are the intentional targets of a concerted campaign, a crime against humanity, aimed at erasing the Palestinian people as a group,” declared South Africa.

Ryad Awaja, Palestine delegate to the WHA.

Palestine’s WHA delegate, Ryad Awaja accused “the occupying power” of describing an “alternate reality … that hides the crimes that are taking place in Gaza today and the occupied Palestine territories, crimes of which the victims are women, the elderly, and children” in remarks that refrained from calling Israel by name.

Claiming that the real number of deaths from the two-year war in Gaza exceeds 200,000, Awaja described it as “the result of an occupation that has lasted more than 70 years.”

The 1948 Arab-Israeli war that followed the UN’s resolution on the partition of Palestine into separate, independent Jewish and Arab states ended with Gaza under Egyptian rule and the West Bank under Jordanian control.

Debate over October 7 references to Hamas attacks on Israeli communities

Israeli Nova festival goers flee Hamas gunmen who broached Gaza’s fences and entered Israel on 7 October, 2023, killing some 1200 people.

Conversely, other member states expressed concerns that Hamas “terrorism” in the initial 7 October incursion, the holding of Israeli hostages and militarisation of health facilities still needs more scrutiny.

That was reflected in the vote on the main resolution, approved 89-5, but with nearly 70 countries absent and another 31 countries abstaining, including the United Kingdom.

The United Kingdom’s abstention reflects “our continued concern about this country-specific agenda item that uniquely singles out the state of Israel.” At the same time the UK remains “firmly committed to Palestinian self-determination and a Palestinian state,” said the UK delegate.

Canada, in its remarks, condemned the “October 7, 2023 terrorist attacks” on Israeli communities and called for Hamas’ disarmament to clear the way for new governance arrangements post ceasefire. But it also decried the “catastrophic humanitarian situation that remains in Gaza, despite the ceasefire, and “escalating needs in the West Bank caused by the expansion of Israel settlements and increasing extremist settler violence.”

The Netherlands, similarly, denounced the “weaponising” of humanitarian aid, a veiled allusion to Israel. But it also expressed reservations about the resolution’s references to “wanton” attacks on health facilities.

“We condemn indiscriminate attacks. We believe, however, an independent investigation is needed to determine whether all instances of destruction of health facilities can be categorically qualified as ‘wanton’, or that all medical and military facilities, including medical personnel, were, without exception, indiscriminately attacked,” said The Netherlands’ delegate.

Gaza’s Nasser Hospital in the aftermath of Israeli operations in 2025. Former Israeli hostages have described being held there in the initial months of the war.

Growing risks of rodents and sanitary degradation

Beneath the polemics, lurk the very real problems of Gaza’s stagnating, unresolved political and humanitarian situation and a festering West Bank status quo, plagued by a tightening vise of Israeli economic and military restrictions.

In Gaza, Israeli limits on the import of “dual use” items essential for health care, water and sanitation, as well as for demolition clearance and reconstruction is slowing down progress and adding to health risks, member states and civil society groups pointed out at the debate.

“We call on Israel to facilitate…the delivery of sufficient humanitarian aid, including goods that classifies as dual use,” said the Netherlands.

One growing time bomb noted repeatedly is the proliferation of rodents due to rotting waste and sewage alongside cramped, improvised shelters. Even short-term fixes like imports of extermination products are often not allowed due to their dual use features.

“The spread of rodents and insects in emergency shelters and tents is driving a worsening health crisis. We have children living in overcrowded and sewage contaminated conditions who are paying the price,” said Malaysia.

For many months, Gaza’s population has been dealing with the worst infestation of rodents, parasites, and skin diseases that are spreading like wildfire throughout displacement camps, markets, and communities in the coastal enclave. The spread of uncollected trash, raw sewage,… pic.twitter.com/agdKTQhsub

— Ahmed Fouad Alkhatib (@afalkhatib) May 5, 2026

The 365 square kilometre enclave also faces severe challenges in responding to people with ongoing needs from burns and trauma, in a place that is home to the largest number of child amputees per capita, in the world. WHO’s frequent appeals to Israel to resume referral of sick Gaza citizens to hospitals in East Jerusalem and the West Bank have so far gone unanswered. Referrals were halted at the outset of the 2023 war.

Conundrum of the occupied Syrian Golan

Waleed Gadban, counselor in Israel’s Geneva’s UN Mission; Druze members of his extended family in the Golan enjoy good access to health services.

Alongside the Palestinian debate, some member states also pressed WHO to redouble its efforts to report on the “health conditions in the occupied Syrian Golan,” a mountainous region that Israel seized from Syria during the 1967 Six-Day War, and unilaterally annexed in 1981 with its international political status remains unresolved.

According to the WHO report: “Comprehensive disaggregated health data on the Syrian populations in the occupied Syrian Golan remain limited, hindering a full assessment of the availability and coverage of health services. WHO continues to coordinate with relevant authorities and explore possibilities for a field mission by a multidisciplinary team of experts.”

The Golan’s population has been “rendered invisible by Israel’s continued unlawful and illegal occupation,” charged Pakistan.

But the WHO had never requested such a mission, Israel retorted, protesting that health conditions in the Golan Heights are “better than most places represented in these halls.”

The Golan’s 30,000-strong Druze minority community has lived under Israeli civil law since 1981 with access to Israeli health funds, social security and citizenship, and the realities of Druze communities are either poorly understood or misused, said Israel’s Waleed Gadban, political counsellor at the Geneva UN Mission.

“Some of my family are Druze in the Golan and I am now hearing that they are being deprived of their fundamental right to health care and that is simply not the case. No one in the Golan is being deprived of their fundamental right to health – quite the contrary,” said Gadban, addressing the assembly in Arabic.

“And if the idea here is to ensure that the Druze be protected, then why isn’t there more concern about the protection of the Druze in Sweida, Syria, where they were massacred only last year in July?” he asked, referring to the attacks of Druze communities by Syrian government-aligned forces that devastated tens of thousands of Druze homes, businesses and places of worship, and led to some 1,700 deaths.

Two-track reporting on OPT to continue for another year

Ever since 1967, WHO has issued an annual report on conditions in the occupied Palestinian territory, including East Jerusalem and the occupied Syrian Golan.

Map delineates the 2025 cease fire “Yellow Line”, with red dots showing positions of Israeli military outposts.

In the aftermath of the war in Gaza and consequent humanitarian emergency, a second WHO report specifically focused on Gaza, the West Bank and East Jerusalem was commissioned and approved by WHA member states in 2024, and has since become a standing item on the annual agenda.

Member states agreed to continue the two-track reporting system for another year in a companion resolution, heeding calls by Palestine and its allies regarding the “essential” nature of the two reports, and rejecting Israel’s appeals to consolidate the work.

“Israel does not claim that it is above scrutiny,” said Israel’s representative ahead of the vote, adding “In a time when efficiency should be prioritised, these agenda items drain precious resources while doing nothing for the improvement of health.”

Image Credits: m.saed.gaza/Haaretz, Palestinian Water Authority , X/UNHCR, X/via Israel Ha Yom, WHO, cc/Al Jazeera .

EXCLUSIVE: World Health Assembly Declines to Recognize Argentina’s Withdrawal From WHO

22/05/2026 Felix Sassmannshausen

Delegates and the secretariat huddle to negotiate the complex legal text of resolutions on Argentina’s withdrawal notification.

After a full day of intense diplomatic debate, the World Health Assembly adopted a last-minute compromise text on Friday declining formal recognition of Argentina’s withdrawal notification, and leaving the nation’s legal status unresolved.

Final amendments to the draft resolution on Argentina’s WHO withdrawal notification.

GENEVA – Delegates at the Seventy-Ninth World Health Assembly in Geneva reached a compromise regarding Argentina’s withdrawal from the global health body. The finalised text, seen by Health Policy Watch, takes note of Argentina’s departure notification but officially resolves that “it is not considered that any further action at this stage is desirable”.

This passive manoeuvre effectively ignores the exit declaration, preventing a historic legal precedent for the international organisation. Had the assembly formally accepted the departure, it would have been the first time the organisation officially recognised a member state as leaving – despite the absence of a pre-existing constitutional caveat.

Diplomatic horse-trading behind the scenes

The Paraguayan delegation details their initial proposal regarding Argentina’s withdrawal at the World Health Assembly.

Ahead of the compromise vote, Norway and Paraguay agreed to a compromise amendment to endorse a unified resolution. Paraguay had initially proposed that the assembly formally recognise the exit, while an opposing bloc insisted that the body remain ambiguous.

The Norwegian delegation leads intense, last-minute negotiations on the assembly floor.

The final compromise now contains both a direct reference to Argentina’s withdrawal notification – a reference that the Norwegian-led bloc had originally deleted in its draft – but it also states firmly the WHA decision to refrain from formally recognising the member state’s departure.

While the final resolution passed by consensus and was accompanied by applause in the UN Assembly Hall, a diplomat involved in the negotiations expressed deep frustration at the process. Speaking to Health Policy Watch, the diplomat criticised the introduction of last-minute amendments that caught negotiating delegations by surprise, eventually delaying the process by hours.

Navigating Argentina’s withdrawal legality

In contrast to the situation with Buenos Aires, the United States explicitly reserved the right to exit WHO when it joined the organisation in 1948. However, this week, the Assembly moved to suspend American voting rights by 2027 due to unpaid contributions, enforcing the strict financial conditions attached to that original American accession.

The American withdrawal required a one-year notice alongside the full payment of outstanding financial obligations. Because Washington failed to settle outstanding fees for 2024 and 2025, the WHO refused to recognise the US departure as legally binding.

Stars and Stripes No Longer Flying at WHO – But US Can’t Really Leave Until Dues are Paid, Agency Says

The WHO constitution lacks a formal mechanism for member states to withdraw, leaving diplomats without a clear protocol. Consequently, the organisation treats attempted departures with intentional ambiguity, classifying quitting states as inactive members who can return seamlessly.

WHA leaves backdoor open for Argentina

The secretariat presides, as experts note the UN will likely continue listing Argentina and the US as members.

This non-decision leaves Argentina’s obligations and privileges suspended in a bureaucratic grey area. The member states were clear to state in the final text that the organisation will always welcome the South American nation’s full cooperation, leaving a backdoor for future administrations to rejoin the organisation.

“The UN, in the absence of an express decision by the WHA to recognise Argentina’s withdrawal, will probably continue to list both Argentina and the US as members,” explained Former WHO Legal Counsel, Gian Luca Burci, in a statement to Health Policy Watch.

The current decision on Argentina mirrors how the organisation handled seven Soviet-bloc nations that attempted to leave in 1949 and 1950. Those nations eventually resumed active participation years later, without navigating a formal re-accession process.

Image Credits: Thiru Balasubramaniam, Felix Sassmannshausen/HPW.

Liver Disease, Social Media Harms and ‘Health Taxes’ Dominate Non-Communicable Disease Debate

22/05/2026 Kerry Cullinan

The Netherlands, speaking for Belgium and Luxembourg, requested WHO guidance on how to address the negative impact of social media on mental health.

Liver disease, social media harms and health taxes dominated the World Health Assembly’s (WHA) discussion on non-communicable diseases (NCDs) on Thursday.

For the first time, countries resolved to include steatotic liver disease (SLD), which is closely linked to obesity and diabetes, into NCD plans.

Formerly known as fatty liver disease, SLD affects an estimated 1.7 billion people and is one of the fastest-growing causes of chronic liver disease globally. Without effective prevention and care, SLD can progress to liver fibrosis, cirrhosis, and liver cancer.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said that the resolution “highlights the growing recognition of the need to address metabolic conditions in a more integrated way.”

“Metabolic conditions are becoming an increasingly important challenge globally. The rising prevalence of obesity, diabetes, cardiovascular and steatotic liver diseases, are driven by shared risk factors and determinants,” Tedros told an event convened by the European Association for the Study of the Liver (EASL) in Geneva this week.

The resolution was sponsored by Egypt, and its Health Minister Khaled Abdel Ghaffar described it as “a missing piece in the global NCD response” at the EASL event.

Meanwhile, EASL said: “For the first time in history, WHO Member States have an explicit, formal international mandate to include liver disease in their national NCD strategies and health system planning – placing it alongside long-established priorities such as cardiovascular disease, cancer, and diabetes.”

An estimated 780 Europeans die each day of liver disease, costing the region €55 billion a year.

During the same session, member states also endorsed a resolution committing to action on haemophilia, von Willebrand Disease, and other rare clotting factor deficiencies.

Mental health and social media

Dr Dévora Kestel, WHO head of NCDs and mental health.

Netherlands, speaking for Belgium and Luxembourg, highlighted the impact of “digital technologies, including social media” on mental health.

“They can severely affect mental health by encouraging cyberbullying, unhealthy lifestyles, gambling, and screen addiction,” said the Netherlands, and called on the WHO to “advance research and provide effective guidance that can help countries to ensure that digital environments support rather than undermine health and well-being”.

“We would welcome clear recommendations on minimum age rules, robust age assurance, and age-appropriate design for social media use.”

Estonia, for the Nordic countries and Lithuania, also cited “harmful use of social media” as one of the driving factors of “the growing trend of mental health problems among youth and older people”.

Noting member states’ appeal for guidance, WHO head of NCDs and mental mealth, Dr Dévora Kestel, responded that the global body “is closely monitoring the evolving evidence on [social media] bans and promoting online safety through technology design, digital health literacy and strengthened oversight of digital platforms”.

The WHA was discussing the implementation of the political declaration of the United Nations High-Level Meeting on NCDs and mental health, adopted last year by all WHO member states (only the United States and Argentina opposed it).

Suicide prevention

Maldives, speaks on behalf of the WHO South East Asia region, said that the region “continues to confront the escalating mental health burden driven by social, economic, and environmental and humanitarian determinants, including the long-term impacts of the COVID-19 pandemic, climate-related emergencies, inequalities, economic insecurities, and rising psychosocial distress among young and vulnerable populations”.

It also “recognises suicide prevention as an urgent public health priority and encourages strengthened multi-sectorial strategies, responsible media reporting, and expanded access to timely mental health and psychosocial support services, particularly for children, adolescents, and vulnerable populations.

South East Asia accounts for nearly 40% of global suicides with an estimated suicide incidence rate of 17.7 per 100,000 people – roughly 60% higher than the global average.

Health taxes

Estonia, for the Nordic countries and Lithuania, called for stronger action to address the “environmental and commercial drivers” of NCDs.

“Effective measures include health taxes and limiting the marketing of harmful products and vulnerable groups,” noted Estonia.

It also called for “promoting healthier diets and physical activity, and reducing harm caused by tobacco, nicotine products, and alcohol”.

Ethiopia, speaking for the African region, also proposed sustainable financing for NCD prevention “through health taxes” and domestic budget allocation.

Indoor Air Pollution: The Invisible Health Risk to Children, Older People and Vulnerable Groups

22/05/2026 Sophia Samantaroy

Children are especially vulnerable to poor indoor air quality, leading advocates to push for legislation to protect air quality in schools.

While the health harms of biomass cookstoves, and the smoke they produce inside the homes of developing countries has received significant attention in the past two decades, a wide range of chemical and pathogenic air pollutants create hazards in modern homes and buildings – also threatening health. Investments in ventilation, air filtration, monitoring, and clean indoor air policies could deliver a rare triple benefit — protecting children’s health, strengthening outbreak preparedness, and creating healthier indoor environments. In a high-level dialogue on the margins of the WHA convened by the Geneva Health Forum and the French Ministry of Health, public health advocates etched a pathway to bigger changes.

When Dr Georgia Lagoudas testified in front of the Rhode Island State legislature, lawmakers in the packed, poorly ventilated room were restless and unfocused.

The room had already exceeded carbon dioxide levels deemed safe by the US federal occupational health agency. At 6,000 CO2 parts per million, breathing air can lead to fatigue, headaches, reduced cognitive function, and nausea.

For Lagoudas, the argument made her push for a bill on indoor air quality in schools “easy.”

“All I shared was this number: 6,000,” the Brown University Pandemic Center senior fellow said. “The air quality in the room not only exceeded the health-based standard of 800 parts per million, but also the US workplace safety limits of 5,000 parts per million.”

“This was a wake-up call to turn the invisible visible,” she concluded, speaking at the GHF Forum on the margins of the WHA.

Calibrated to odor and comfort not health-based metrics

In modern office buildings, schools and homes, indoor air quality is typically calibrated to odor and comfort rather than health-based metrics.

The result: “When we measure indoor air quality, it’s typically poor,” said Dr Bronwyn King, a co-founder of a coalition of indoor air advocates, Air Club, and an Australian physician and entrepreneur, also speaking at the event.

“It’s often filled with pathogens, pollutants like wildfire smoke, vehicle emissions, particulate matter, or toxic substances like forever chemicals, or even microplastics. All of those airborne hazards are detrimental to health.”

The group’s logo, a canary, is symbolic of the “first” air pollution monitor–the canaries used in coal mines.

Panelists from left: French Assembly member Emmanuel Mandon, youth advocate Katja Čič, RANI CEO Eloise Todd, Brown University senior fellow Georgia Lagoudas, CERN researcher Andre Henriques, and Air Club co-founder Dr Bronwyn King.

Lagoudas, a biosecurity expert and co-founder of Air Club, spoke at a G7 event on the sidelines of the 79th World Health Assembly (WHA). It marked the culmination of a year of growing global awareness on indoor air quality sparked by a UN General Assembly meeting in New York City in September 2025, which drew over 300 high-level attendees. It was there that Air Club, a global coalition for indoor air quality, launched a high-level pledge to galvanise action.

France and Montenegro were the first Member States to sign. Capitalizing on the momentum, the Geneva Health Forum and the French Ministry of Health convened a high-level dialogue on healthy indoor air on 19 May. The WHA side-event is to be followed by other high-level meetings this year. Next Tuesday (9 June), an EU-funded summit on indoor air pollution The Air We Share, takes place in Brussels. This will be followed by the Third European Conference on Indoor Air Quality, in Rome on 30 October. The ultimate aim is to build political will for action by WHO member states at a future WHA, as well as in European governments and other regional fora.

With the windows open to the Swiss mountains, the air at the indoor air quality meeting – fittingly – was crisp. Yet the reality for most buildings across the globe, far from the shores of Lake Geneva, is one of poor ventilation, air flow and contamination.

A ‘paradox’: 90% of time spent indoors, with little protection

Low cost air quality sensors provide crucial data to people indoors, especially in schools.

People in Europe, North America, and some parts of the Middle East and East Asia spend on average 90% of their time indoors.

For the past several decades, modern buildings have become increasingly energy efficient and air tight. This prolonged time spent in poorly ventilated spaces can expose people to a host of pathogens, gases like radon and carbon dioxide, and other pollutants from mold to volatile organic compounds.

The consequences of breathing poor quality air, King pointed out, are numerous: lung diseases from asthma, to bronchitis and pneumonia, cancer, heart attacks, brain health and cognitive declines.

“Think about how much of your everyday life is spent indoors,” said Katja Čič, a youth activist from Slovenia and International Youth Health Organization leader. “At home, school, university, or work. At the library, for groceries, cinema, shopping–all of that is indoors, and then you go back home.”

“Yet sometimes the most dangerous risk is actually trapped inside with you. Fresh air literally stops at the front door,” she said.

Despite the risks, indoor air quality remains largely “underestimated, insufficiently regulated, and too often absent from public debate,” said Antoine Saint-Denis, director for European and International Affairs with the French Ministry of Health.

The many sources of contamination of indoor air, as listed by the US EPA.

Most countries lack any form of health-based indoor air quality standards. Air Club points to five countries as leading examples with policy actions for healthy indoor air: Belgium, South Korea, Taiwan, the UAE, and the US. About 10 other countries have some regulation or at least action plans in progress, including the UK, Germany, France, Finland, Japan, and Singapore.

The paradox, Saint-Denis said, is the very luxury of living in more modern buildings with sealed windows, or driving cars sealed to the outside air, threatens the wellbeing of the millions lucky enough to afford them.

“Buildings should protect us, not expose us,” Čič said.

Indoor air pollution ranks third in the list of leading killers associated with poor air, behind ambient outdoor air pollution and cooking-related air pollution, which kills an estimated 2.9 million people each year.

A burden on school children, other vulnerable groups

Rosamund Kissi-Debrah holds a sign at a London demonstration with her daughter’s picture, Ella Roberta, who succumbed to air pollution-triggered asthma. Kissi-Debrah founded an advocacy group that fights for clean air, especially for children.

Rosamund Kissi-Debrah’s daughter, Ella Roberta, was nine years old when she died from an asthma attack. Ella’s death – the first in the world to have air pollution listed as a cause – was a wake-up call to her family and her community.

“Children continue to die,” said Kissi-Debrah, whose family lived in one of the most air polluted neighborhoods of South London.

A city that was historically smothered with industrial smog, London became ground-zero for the advocacy work of the Ella Roberta Foundation, the organisation Kissi-Debrah launched, dedicated to cleaner air for all children. Already, London has pioneered ultra-low emission zones and electric buses across the city.

She urged policymakers in the room to read her daughter’s coroner’s report outlining steps to prevent future deaths from air pollution–and offered a searing indictment of government inaction across the world.

“There are solutions,” Kissi-Debrah argued. “But governments are reluctant. I’m not going to stand here and say it is easy. It is not, but we can do something about it.”

Dr Bronwyn King (right) co-founded a global coalition to address indoor air quality. Her colleague Dr Andre Henriques described the live indoor air quality at the Geneva-based event.

Children are especially vulnerable to the effects of air pollution – not only because their lungs are still developing, but also because of prolonged exposure, up to eight hours in poorly ventilated schools.

Several policymakers pledged to raise awareness and work with their governments on indoor air quality policies following Kissi-Debrah’s intervention. But even these advocates, like French national assembly member Emmanuel Mandon, acknowledged the steep barriers to translating the scientific reality into government action.

“Fragmentation is a real challenge,” Mandon said. France, which was one of the first signatories of the indoor air quality pledge, has a complex administrative system “not ideal” to take swift action, like upgrading ventilation in public transportation or providing monitoring in schools.

Yet Mandon and other French delegates remained optimistic about the issue, especially as awareness grows at the highest levels of the government.

“This is fundamentally a question of human dignity and equity,” said Saint-Denis, pointing to the groups subjected to the worst indoor air quality and the most vulnerable to its health effects: children in poorly ventilated schools, patients in overcrowded medical facilities, workers in toxic indoor environments, prisoners, and the socioeconomically vulnerable in poor housing.

“They are also frequently the least protected and the least able to take control of the environment that they are in,” said Jane Hulton, CEO of Coalition for Epidemic Preparedness Innovations (CEPI).

Indoor air, biosecurity and pandemic preparedness

Airborne infectious disease outbreaks, like that of hantavirus on the cruise ship Hondius, rapidly spread unchecked in poorly ventilated indoor spaces.

An underappreciated aspect in the fight for clean indoor air is its potential to mitigate the spread of airborne pathogens.

In close confines, the percentage of breath that is the exhalation of someone else is much higher than outdoors. So with highly infectious airborne diseases such as coronaviruses, measles, or influenza, the risk of becoming sick is much higher indoors.

The COVID-19 pandemic accelerated calls for better ventilation and monitoring, especially as buildings like schools, churches, and hospitals became hotspots for transmission. Halton called awareness of the dangers of indoor air contamination a lesson “learned too late”, recalling that transmission was “especially efficient indoors in poorly ventilated spaces”.

Her organization, launched in the wake of the deadly 2014-16 Ebola outbreaks, aims to rapidly produce vaccines against pandemic threats. She sees improving indoor air quality as a crucial step in buying time to deploy vaccines and other medical countermeasures.

CEPI’s 100-day mission, which would deliver a vaccine ready for manufacturing at scale within 100 days of identifying a new pandemic threat, is contingent upon preventing widespread transmission in the first 10 days, Halton said.

“If we can’t prevent transmission in those first 10 days, we’ve exacerbated the problem.”

Biosecurity experts often draw parallels as to how the fight to eliminate water-borne pathogens came not through vaccines, but through infrastructure–water filtration and sanitation.

“The lesson is broader than any one disease,” Halton said. “How we manage indoor air matters for preparedness, resilience, and health security across all manner of threats and risks. Taking a breath in a poorly managed indoor environment actually can amplify a biological risk.”

Progess in Montenegro, France, and a patchwork of US states

The experts, advocates, and policymakers gathered at the Geneva Health Forum to discuss solutions to improve indoor air quality.

Lagoudas’s work led her to champion indoor air policies across the US and to collaborate with an unlikely ally – the government of Montenegro.

The Adriatic coastal nation has been receptive to evidence-based solutions such as installing air purifiers, windows that open and close, and energy efficient ventilators–machines that bring in outdoor air, filter it, and then either heat or cool it.

Its government has also launched efforts to monitor air quality in school buildings. While it is fairly common now to be able to check the levels of outdoor air, information of indoor air is much harder to come by.

In the past decade, advancements in small, affordable air monitors have empowered everyday citizens to track their indoor air, providing crucial real-time monitoring for health awareness.

France, meanwhile, is at the forefront of global indoor air quality advocacy, outlining actions through their IAQ observatory and their requirements for schools and elder care facilities.

Lagoudas and the Air Club have also worked with Montenegro to advance what they term “durable policy solutions”– measures that would outlast political changes or sentiments.

Closer to home, at least a dozen US states have passed laws to advance indoor air quality, “which is actually quite remarkable,” Lagoudas said.

Children are among the most vulnerable to indoor air pollutants in poorly ventilated classrooms.

These state-level actions have typically taken the form of one of four solutions: classroom air quality monitoring, building ventilation assessment, program funding and public data sharing, and the designation of “who’s in charge” in the form of a task force or council to take action.

This “decentralized”, patchwork approach means that very few states have implemented all four of the measures, but it nevertheless provides “it provides a great foundation” for future action, Lagoudas said.

California requires indoor CO2 monitoring and assessments in schools receiving grants for infrastructure improvement. Connecticut also has stringent indoor air quality legislation. Other states, like Arizona, Illinois, and Massachusetts, have legislation in the books, though most states, at a bare minimum, address radon testing and carbon monoxide alarms.

The North Star, she hopes, is federal legislation to keep school children safe across the United States – which can build upon existing programs from the EPA. A bipartisan bill has been introduced to Congress, though it has yet to progress in the legislative progress.

The benefits to children in schools, in particular, spur indoor air quality advocates forward.

“Healthy indoor air is actually not a niche issue,” Halton said. “It’s a core public health infrastructure issue.”

This story was updated 5 June.

Image Credits: Kelly Sikkema, S. Samantaroy/HPW, Tim Witzdam , US EPA, Ella Roberta Foundation, Franklin Braeckman/Oceanwide Expeditions , GHF, Unsplash.

UN Backs Landmark ICJ Climate Crisis Ruling, Defying US and Petrostates

22/05/2026 Stefan Anderson

Water

The UN General Assembly voted 141-8 to endorse a landmark International Court of Justice opinion finding that states are bound under international law to curb greenhouse gas emissions driving the climate crisis and protect states most affected by its fallout.

“Climate change is an unprecedented challenge of civilisational proportions,” the resolution states. “The well-being of present and future generations of humankind depends on our immediate and urgent response to it.”

Thursday’s historic vote was opposed by many of the world’s largest fossil fuel producers, reflecting the growing distance between nations fuelling the climate crisis and the vulnerable countries and people facing the brunt of its floods, droughts and extreme weather.

Voting against were Belarus, Iran, Israel, Liberia, Russia, Saudi Arabia, the United States and Yemen — a coalition of major oil and gas producers, sanctioned states, and close US allies.

“The world’s highest court has spoken. Today, the General Assembly has answered,” UN Secretary-General Antonio Guterres said, calling the vote “a powerful affirmation of international law, climate justice, science and the responsibility of states to protect people from the escalating climate crisis.”

Abstaining were a bloc of 28 countries spanning emerging emitters and traditional petrostates, including India, Iraq, Kuwait, Qatar, Nigeria, the Czech Republic and Turkey, which will host COP31 in November.

The 141 in favour included Australia, Canada, China, France, Germany, Japan, the United Arab Emirates and the United Kingdom — wealthy historic emitters and current fossil fuel exporters now formally on record backing the court’s findings.

“Those least responsible for climate change are paying the highest price,” Guterres added. “That injustice must end.”

Youth wins

🇻🇺 @VanuatuUN Ambassador, @odo_tevi, is opening the session with a powerful statement: "The credibility of this institution is at stake today […] This day will be remembered. It will be remembered as the moment the UN decided what to do with the @CIJ_ICJ climate ruling." pic.twitter.com/jgMcY0jmkw

— Center for International Environmental Law (@ciel_tweets) May 20, 2026

For Vanuatu, the low-lying Pacific island nation that filed the original case at the ICJ and championed Thursday’s resolution, the vote was the culmination of a seven-year diplomatic campaign aimed at putting climate change inside the framework of binding international law.

The path from the ICJ to the General Assembly traces back to a 2019 campaign by 27 law students at the University of the South Pacific in Vanuatu’s capital, Port Vila, who lobbied Pacific governments to take the climate crisis to the world’s top international court.

Vanuatu took up the cause in 2021 and led an 18-month diplomatic push that resulted in the General Assembly’s unanimous request for an advisory opinion in March 2023. The UN court’s unanimous ruling, issued in July last year, capped the most participated advisory case in the ICJ’s history, with 96 states and 11 international organisations taking part in oral hearings, alongside a record 91 written submissions.

Leaders of the student campaign celebrated Thursday’s General Assembly victory, with Vishal Prasad, director of the Pacific Islands Students Fighting Climate Change, calling it “a turning point in accountability for damaging the climate.”

“The journey of this idea from classrooms in the Pacific to The Hague and the United Nations gives us continued hope that when people organise, the world can be moved to act,” Prasad said. “Communities on the frontlines, like in the Pacific, have been waiting far too long and continue to pay too high a price for the actions of others.”

Paris, renewables, and responsibility

Thursday’s resolution proposes a series of measures to meet the ICJ’s legal obligations, drawing on mainstays of UN climate negotiations.

It calls on all states to comply with the ICJ opinion by “preventing significant harm to the environment by acting with due diligence” and “using all means at their disposal to prevent activities carried out within their jurisdiction or control from causing significant harm to the climate system.”

The resolution recalls the court’s finding that a breach of those obligations is “an internationally wrongful act” that can require the responsible state to provide “full reparation to injured States in the form of restitution, compensation and satisfaction.”

It urges states to implement the Paris Agreement’s 1.5 degrees Celsius temperature goal, including by “tripling renewable energy capacity and doubling the global average annual rate of energy efficiency improvements by 2030, transitioning away from fossil fuels in energy systems in a just, orderly and equitable manner and so as to reach net zero by 2050.”

The resolution further calls for the phase-out of “inefficient fossil fuel subsidies that do not address energy poverty or just transitions as soon as possible.”

“At a time when fragmentation between nations feels more visible than ever, the UN resolution endorsing the ICJ climate ruling offers a renewed path for international cooperation,” said Camille Cortez, senior campaigner on climate justice at Amnesty International.

“Fossil fuel infrastructure alone poses risks for the health and livelihoods of at least 2 billion people globally, roughly a quarter of the world’s population,” she added. “This new UN resolution paves the way for governments to show they stand for climate justice and has the potential to shape global climate accountability for years to come.”

‘So-called’ obligations

US ambassador to the United Nations, Tammy Bruce, dismissed the legitimacy of the UN court ruling.

The resolution drew sharp opposition from Washington, which led the small bloc voting against the text and used its floor time to challenge the legal foundations of the court’s ruling. US Ambassador to the UN Tammy Bruce, a former Fox News host, called the resolution “highly problematic,” dismissing the “so-called ‘obligations'” contained in the ICJ’s advisory ruling.

The United States, Bruce said, had opposed seeking an opinion from the UN court in the first place.

“Throughout the negotiation of this resolution, the United States has been consistent in conveying our opposition to this initiative,” Bruce told the assembly. “This resolution is highly problematic in calling on States to comply with so-called ‘obligations’ that are based on non-binding conclusions of the Court on which UN Member States’ views diverge.”

While the Hague-based ICJ’s rulings are not legally binding, they carry significant symbolic weight and are frequently used to substantiate legal arguments in national courts. The July 2025 opinion is already being woven into climate litigation around the world, with judges starting to cite it in their rulings.

While Washington “understands the concerns that Vanuatu and other countries have about specific environmental threats and the importance they attach to the Court’s opinion,” Bruce said, the resolution “improperly treats the Court’s opinion as irrefutably authoritative and as setting out binding obligations on States.”

The resolution also “amplifies legal errors from the Court’s opinion,” Bruce added, arguing the duty to prevent transboundary climate harm “would impermissibly interfere with each State’s sovereign rights to regulate and manage its own energy policy.”

“The opinion does not invent new law; it clarifies the law that already binds us,” said Odo Tevi, Vanuatu’s UN ambassador. “The ruling matters because the harm is real, and it is already here — for low-lying islands and coastlines, for communities facing drought and failed harvests, for people whose homes, livelihoods and cultures are being reshaped by forces they did nothing to set in motion.”

Saudi Arabia, which sided with the US against the resolution, called the inclusion of any reference to the ICJ’s opinion in negotiating texts at the last UN climate summit, COP30 in Belem, a “deep, deep, deep red line.”

That dynamic now sets the stage for COP31 in Antalya in November, where Turkey — among Thursday’s abstainers — will preside over talks already shadowed by the collapse of fossil fuel language at the previous summit.

With the Arab Group, Russia and the United States lined up against the court’s findings, and key emerging emitters refusing to back them, the path to translating Thursday’s legal victory into meaningful diplomatic outcomes looks steep.

“Climate change is an existential problem of planetary proportions that imperils all forms of life and the very health of our planet,” Guyana’s representative said, speaking on behalf of the Caribbean region. “It is crucial that we not only welcome the opinion in this moment but also ensure meaningful follow-up.”

Image Credits: UN, Gage Skidmore.

Polio Eradication Needs Political Commitment as Conflict Makes Vaccination ‘Impossible’ in Areas Like North Yemen

21/05/2026 Disha Shetty

Polio remains endemic in the WHO’s Eastern Mediterranean Region (EMRO) region.

The world is in the last stretch of polio eradication, but closing this gap will require political commitment, the World Health Organization (WHO) told member states at the ongoing 79^th session of the World Health Assembly (WHA).

Polio virus has shown resurgence in conflict-hit or hard-to-reach areas like northern Yemen, Gaza, Afghanistan, and Pakistan. Conflict has limited access in some of these areas and made vaccination campaigns near impossible in others.

“We are closer to polio eradication than ever, but the final stretch demands exceptional operational discipline and sustained political commitment. The remaining reservoirs are the hardest to access, the most politically complex, and the most unforgiving of operational gaps,” said Dr Hanan Balkhy, WHO regional director for the Eastern Mediterranean Regional Office (EMRO).

WHO said that the support of every member country and the collective political will have brought the world to the brink of success.

“The gaps mostly are in the political web, gaps in vaccination coverage, where children are still being missed, gaps in access, where insecurity and instability limit our reach, and gaps in financing, where resources must match the urgency of the final push,” said Dr Razia Pendse, WHO Chef de Cabinet.

Wild polio transmission is declining

Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean Regional Office (EMRO).

Even in areas where the polio cases are endemic, there are showing positive signs of decline. Afghanistan and Pakistan reported 99 wild polio cases in 2024, 52 in 2025 and just six as of May 2026.

“Transmission is now limited to a small number of high-risk areas, particularly along cross border corridors between the two countries,” Balkhy said.

While the two countries are coordinating for vaccination campaigns, there are still children going without vaccinations in the southern Khyber Pakhtunkhwa region of Pakistan.

WHO said it has managed to vaccinate nearly 600,000 children in Gaza, averting a larger polio outbreak. Egypt too managed to successfully interrupt the transmission of the virus with vaccination campaigns which WHO highlighted as an example of a successful result when the political will exists.

Northern Yemen is completely out of reach

WHO has been unable to conduct vaccination campaigns in conflict-hit northern Yemen.

In northern Yemen, an outbreak has paralysed 450 children. “Most of them in the northern governance, where no mass vaccination campaign has been possible since 2022, and we continue to try. I urge member states to continue raising the need for access as a priority in northern Yemen,” Balkhy said.

Yemen had been polio-free since the year 2006. Balkhy assured that the WHO is pushing for improved access for polio eradication campaigns, and asked others to do so as well.

Canada highlighted the important role of the health workers against such a harsh backdrop.

“The tireless efforts of frontline health workers, the majority of whom were women, made this achievement possible. We want to highlight the challenging context in which these health workers perform their duty every day, in some cases at risk to their personal safety,” Canada’s representative told WHA.

Also read: Polio Eradication Imperiled by $2.3 Billion Funding Gap

Access and funding challenges

The 79th World Health Assembly in session.

Unpredictable funding is getting in the way of the polio eradication campaign. The campaigns have been plagued by funding challenges, and the gap is a whopping $2.3 billion.

“Several countries, including Iraq, Libya, and Syria have already transitioned polio functions to domestic financing, demonstrating that polio infrastructure, when embedded in health systems, delivers lasting returns,” Balkhy said, citing examples of countries that have become self-reliant.

The global vaccine alliance, Gavi, has urged countries to use an integrated approach to reach zero-dose children with vaccination and primary health care, especially in humanitarian settings and emergencies. It assured countries of its continued support.

It is an approach that Japan too supported, adding that the country, “will continue to work in collaboration with WHO and other relevant organizations to contribute to polio eradication and to sustaining a polio-free world beyond eradication.”

“To finally end polio, we must sustain access, close funding gaps, maintain operational discipline, and reach every last child. If we do that, and I’m pretty sure we will finish this job,” Balkhy said.

Image Credits: WHO, WHO Yemen, X/WHO.

Restore Funds for Malaria, Africa Urges

21/05/2026 Kerry Cullinan

Nigeria, on behalf of African states, called for more investment in malaria.

The African region made an impassioned appeal for global funding to be restored for malaria elimination at the World Health Assembly on Wednesday.

Drastic aid cuts in the past 18 months, particularly by the United States, have had a dramatic effect on malaria efforts – particularly as they coincide with growing drug resistance.

Nigeria, speaking for African member states, noted that the World Health Organization’s (WHO) malaria elimination effort known as E-2025 has not been funded since 2024. The initiative had focused on supporting 25 countries with the potential to eliminate malaria by 2025 with Global Fund money.

Around 95% of global malaria cases are in Africa, and Nigeria is the worst-affected country in the world, accounting for almost a quarter of the world’s malaria cases and a third of all deaths.

It requested the assembly to “restore financing for malaria elimination, including the E 2025 initiative, and accelerate roll out of the RTS,S (Mosquirix) and R21 (Matrix-M) vaccines”.

Instead of being on track to meet the Sustainable Development Goal target of reducing malaria cases by 90% by 2030, global incidence has risen by 8.5%, according to the WHO’s World Health Statistics 2026.

Millions of lives at risk

In mid-2025, the WHO warned that funding cuts to malaria programmes put “millions of additional lives at risk and could reverse decades of progress”.

Between 2010 and 2023, the US contributed around 37% of global malaria financing.

By early April 2025, more than 40% of planned distribution of insecticide-treated nets (ITNs) – the cornerstone of malaria prevention – were delayed, according to data provided by national malaria programmes.

“Nearly 30% of seasonal malaria chemoprevention (SMC) campaigns to protect 58 million children were also off track,” the WHO reported.

Angola told the WHA that malaria is one of its leading causes of morbidity and mortality, yet its efforts to address the disease were being hampered by “climate-related vulnerabilities and declining external financing”.

Several other countries mentioned changing climate was increasing their vulnerability to malaria.

On a positive note, Cabo Verde became the first sub-Saharan country in 50 years to be certified malaria-free.

Suriname, which used to have the highest annual malaria incidence in the Amazon region, has also received the WHO malaria elimination certification.

Suriname said its success relied on two critical pillars: decentralised primary health care and the rollout of rapid diagnostic tests and artemisinin-based combination therapy.

Malaysia, which aims to be malaria-free by 2030, asked for more WHO support.

New plan for tuberculosis

The assembly endorsed a decision requesting the Director-General to develop a post-2030 tuberculosis (TB) strategy for the 2028 WHA.

Poland reminded the assembly that tuberculosis remains “one of the world’s deadliest infectious diseases, despite being preventable and curable”.

Its own TB response had been challenged by “the influx of refugees from Ukraine after 2022”, which it addressed by “flexible, patient-centred, and community-based care”.

Poland’s contribution to the post 2030 TB strategy has been focused on drug-resistant TB, migration-sensitive approaches, patient-centred care, and health system resilience.

“On tuberculosis, our region is outpacing the world. Incidence is down 28% and mortality down 46% since 2015, and we lead globally on TB-HIV integration,” said Nigeria.

Nigeria also noted that 23 African countries have eliminated at least one neglected tropical disease, while vaccination had averted 1.9 million deaths in 2024.

“These gains share the same ingredients: political leadership, integrated systems, mobilised communities, and partners align behind one national plan, but they are fragile.

“Our region still carries 95% of the global malaria burden. Ten countries account for 80% of zero-dose children. We hold 17% of the world’s 30 high-burden TB countries.

“Our frameworks are sound. What is missing is the financing, the integration and the accountability to match them.”