CDC officials accuse US Health Secretary Robert F Kennedy Jr of politicising science.

Details from the resignation letters of top officials from the United States’ Centers for Disease Control and Prevention (CDC) show that the government’s top health experts have been ignored and sidelined by Health and Human Services (HHS) Secretary Robert F Kennedy Jr.

Kennedy has never been briefed by any experts from the CDC’s National Center for Immunization and Respiratory Diseases (NCIRP), which deals with immunisation, viral and bacterial diseases, influenza and coronaviruses, according to Dr Demetre Daskalakis, NCIRP director until his resignation on Wednesday.

“We are seven months into the new administration, and no CDC subject matter expert from my Center has ever briefed the Secretary. I am not sure who the Secretary is listening to, but it is quite certainly not to us,” said Daskalakis in his letter, which he published on X.

“Unvetted and conflicted outside organisations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources,” he added.

The resignations came during a day of chaos at the CDC as Kennedy sought to remove director Dr Susan Monarez, the Republican pick for the post confirmed by the US Senate a month ago. 

Reports indicate that Kennedy attempted to pressure Monarez into supporting new restrictions on COVID-19 vaccines and instructed her to dismiss senior staff. Late Wednesday, Monarez’s legal counsel said that she refused to resign, but her appointment was later “terminated” by the White House.

During the COVID-19 pandemic, Kennedy was one of the foremost spreaders of anti-vaccine misinformation and conspiracies, while the organisation he founded, Children’s Health Defense, has campaigned against several vaccines for years.

Surging measles cases

Former CDC Chief Medical Officer Dr Debra Houry

Chief Medical Officer Dr Debra Houry, the institution’s most senior career leader, resigned on Wednesday after 10 years at the CDC, serving under both Republican and Democratic administrations.

“The science at CDC should never be censored or subject to political pauses or interpretations,” Houry wrote in her letter, published by Inside Medicine.

Asserting that vaccines save lives, Houry said that, while it is important to question research, this should be done “by experts with the right skills and experience, without bias, and considering the full weight of scientific evidence”. 

“Recently, the overstating of risks and the rise of misinformation have cost lives, as demonstrated by the highest number of US measles cases in 30 years and the violent attack on our agency,” she added.

Dr Daniel Jernigan, director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, has worked at the CDC since 1994.

“I believe strongly in the mission of public health and the leadership that CDC has given for almost 80 years; however, given the current context in the department, I feel it is best for me to offer my resignation,” said Jerigan.

CDC data manipulation?

Dr Jennifer Layden, director of the CDC’s Office of Public Health Data, Surveillance, and Technology, has also resigned, although her reasons have not been made public. 

There have been indications for months that the CDC’s database is under political pressure.

The CDC has removed 146 datasets since March, according to Stat. Meanwhile, on numerous datasets, the word “gender” was replaced by “sex”, according to a study published in The Lancet in July.

Axios reported on 8 August that the CDC had changed the wastewater viral activity for COVID-19 from “low” to “moderate”. However, when Health Policy Watch checked the CDC site, it indicated that wastewater data for COVID-19 has not been updated since 9 August due to a “technical issue”, but the COVID risk was now classified as “low”. This suggests it had been downgraded since the Axios report – despite no new data being available.

CDC database on wastewater and COVID-19, accessed on 27 August 2025.

The CDC apparently also took down its public database showing that Republican-governed states have higher homicide rates than Democratic states.

‘Eugenics’ at play?

Daskalakis makes several damaging allegations in his letter, one being that “eugenics plays prominently in the rhetoric being generated” about vaccines.

“The intentional eroding of trust in low-risk vaccines, favoring natural infection and unproven remedies, will bring us to a pre-vaccine era where only the strong will survive and many, if not all, will suffer,” he argues.

“The nation’s health security is at risk and is in the hands of people focusing on ideological self-interest,” he says, adding that he has “never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people”.

Daskalakis also says that recent restrictions on access to COVID-19 vaccines threaten the lives of young children and pregnant women, and criticises Kennedy’s preference for communicating via social media rather than office channels.

“I must also cite the recklessness of the administration in their efforts to erase transgender populations, cease critical domestic and international HIV programming, and terminate key research to support equity as part of my decision. Public health is not merely about the health of the individual, but it is about the health of the community, the nation, the world,” he concludes.

Kennedy’s response

Kennedy was dismissive of the resignations during an interview on Fox News, suggesting the institution is “in trouble” and that “some people should not be working there anymore”.

Republican Senator Bill Cassidy, chair of the Senate health committee, simply said on X that the CDC’s “high-profile departures will require oversight” by his committee.

However, Senator Patty Murray (D-Wash.), the top Democrat on the Senate health committee, called for Kennedy to be fired: “We cannot let RFK Jr. burn what’s left of the CDC and our other critical health agencies to the ground – he must be fired. I hope my Republican colleagues who have come to regret their vote to confirm RFK Jr. will join me in calling for his immediate termination from office.”

Image Credits: HHS.

Wildfires in Canada and the US have substantially worsened their air pollution levels.

The eighth AQLI report released on Thursday, establishes a global warming link to air pollution – surprisingly in the United States and Canada. However, the global air pollution hotspot remains in South Asia. 

NEW DELHI – The latest data is out on how much air pollution is estimated to shorten lives, and New Delhi tops the global list for the eighth year running. 

The Indian megacity’s pollution level in 2023 was high enough to shave off 8.2 years of a person breathing its polluted air over the long term.

South Asia remains the most polluted region in the world. In countries here, the impact of particulate pollution on life expectancy is nearly twice that of childhood and maternal malnutrition and more than five times that of unsafe water, sanitation and handwashing. The report has been produced by the Energy Policy Institute at the University of Chicago (EPIC).

The 2025 Air Quality Life Index report shows South Asia to have the highest air pollution.

Within South Asia, Bangladesh is more polluted than India, averaging 60.8 micrograms/cubic metre (µg/m³) of the fine pollutant, PM 2.5, compared to 41 µg/m³ of it’s larger neighbour. But its capital Dhaka (76.4 µg/m³) is less polluted than Delhi, which – with 88.4 micrograms – is the highest of the global cities analysed. 

Air pollution poses the greatest threat to life expectancy in South Asian countries, in comparison to other major risks.

While India’s capital has topped the AQLI list for each of the eight reports so far, the data shared with Health Policy Watch shows a declining trend. It’s down from almost 10 years of life expectancy potentially lost in the 2018 report to 8.2 years in the latest report. 

Explaining what the declining numbers mean for a Delhi resident’s life span, Tanushree Ganguly, AQLI’s Director, told HPW, that, “our annual reports do not estimate the number of years of life already lost. Instead, they estimate the number of years that could be lost on average if people were exposed to the pollution levels of a given year over the long term.”

Government action in last eight years

While India and its cities continue to dominate rankings such as AQLI and those by IQAir, the government points to a series of measures it has implemented in the past decade, which it says are paying off.

It informed Parliament last month that the National Clean Air Programme (NCAP)  launched in January 2019, has shown “positive results” with pollution reducing in 103 cities. As many as 22 cities have met the national standards, which aren’t as stringent as WHO’s recommendations.

The government’s Delhi-centred action includes the creation of an empowered agency, CAQM, and an emergency response plan, GRAP, to shut down sources of pollution on days when air pollution spikes. 

Across India, a network of real-time, high-quality monitors has been installed, from a handful in 2014 to almost 600 now. It ‘leap-frogged’ fuel standards, jumping from Bharat Stage 4 to BS 6 (BS being at par with Euro standards). The most significant programme was NCAP which aimed to cut pollution in about a hundred cities. Since then it expanded the cities covered to about 130, and the raised the target to cut pollution levels by 40% by 2026.

Is air quality action reducing pollution?

AQLI’s data, too, shows a decline for both Delhi and India. However, Ganguly says it is “difficult to conclusively determine” with current evidence if these changes are due to meteorological changes or on-ground action. The year-to-year differences in these estimates reflect actual measured changes in pollution levels. To a lesser extent, they may also be influenced by improvements in the underlying satellite-derived models.  

AQLI Report Year AQLI India (years) AQLI Delhi (years)
2018 4.2 9.75
2019 4.07 9.23
2020 4.09 9.24
2021 3.73 7.89
2022 3.87 8.6
2023 3.92 8.61
2024 3.5 7.81
2025 3.5 8.2

Source: AQLI, EPIC, New Delhi. 

Each report is based on data from two years prior; so 2025’s report is based on 2023 data, and 2018’s report on 2016’s data.

Despite the progress in government policy there have been gaps, some literally. Obstacles include a 46% vacancy rate in pollution control agencies, government’s inability to enforce a ban on burning crop residue and fireworks, recent setbacks over targeting sources of high pollution from old vehicles and coal-fired power plants, and the fact that the NCAP prioritises PM 10 pollution (large particles like dust) rather than PM 2.5, which is far deadlier for human health and harder to contain. 

Huge jump in US, Canada air pollution

Globally, the United States and Canada sprang a surprise. Wildfires in Canada significantly worsened air quality in 2023, with PM2.5 levels rising by over 50% in Canada. Air quality in the US, which has recorded huge wildfires in California and is also affected by the Canadian fires, worsened by 20% compared to 2022. Both countries recorded their largest year-on-year increases in PM2.5 concentrations since 1998. 

Canada’s wildfire season was the worst in its history. The AQLI report points to growing evidence of a link between climate change and air pollution. Canada’s most polluted provinces were Northwest Territories, British Columbia, and Alberta. Here, particulate pollution levels in 2023 were comparable to polluted Latin American countries like Bolivia and Honduras, cutting people’s lives short by more than two years. 

The AQLI team wants the ‘life index’ to resonate with people by communicating the health consequences of air pollution shortening their lifespans. They reason that when communities have access to data on the air they breathe – and

understand its impact on their health – they are more likely to take protective action and push governments toward accountability.

Image Credits: Mike Newbry/ Unsplash, AQLI 2025 Report.

The headquarters of the US Centers for Disease Control and Prevention.

The White House “terminated” Dr Susan Monarez as director of the Centers for Disease Control and Prevention (CDC) late Wednesday night after she refused to resign.

On Wednesday evening, Monarez’s legal counsel said that she would not resign as CDC director despite an earlier announcement on X  by the US Department of Health and Human Services (HHS) that she was no longer in her post.

“When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving an agenda,” said her legal counsel, Mark Zaid, in a statement.

Zaid also accused Kennedy and HHS of “[setting] their sites on weaponising public health for political gain”, adding that his client had not been informed of her dismissal, which comes barely a month after she was confirmed in her position by the US Senate.

However, four top CDC officials did resign on Wednesday. They are CDC chief medical officer Dr Debra Houry; Dr Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases; Dr Daniel Jernigan from the National Center for Emerging and Zoonotic Infectious Disease, and Dr Jennifer Layden, head of the office public health data.

Daskalis said in a statement on X that he was resigning because he is “unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health”.

Daskalis added that the recent change in the adult and children’s immunization schedule “threaten the lives of the youngest Americans and pregnant people” and that “the data analyses that supported this decision have never been shared with CDC despite my respectful requests to HHS and other leadership”.

FDA restricts access to vaccines

The CDC turmoil comes a day after the US Food and Drug Administration (FDA) restricted  COVID-19 vaccines to Americans aged over 64. Access to younger people is restricted to those with at least one underlying medical condition that exposes them to severe risk. Children may only receive the vaccine if they consult a medical provider. 

The FDA has also removed the emergency use listing for vaccines for children. This means that the BioNTech-Pfizer COVID-19 vaccine, Comirnaty, is only available for children over the age of five, according to Pfizer. 

The Novavax vaccine has been licensed for those aged 12 and over. Moderna’s COVID-19 vaccine, Spikevax, is now the only vaccine available to children from the age of six months – but only if they have underlying conditions.

Newer COVID-19 formulations from Pfizer, Moderna and Novavax to address the latest variants have only been approved for those over the age of 11 years who have at least one underlying condition.

In reaction, the Infectious Diseases Society of America (IDSA) has urged physicians to continue to recommend COVID-19 vaccines based on “the best available science” after the US Food and Drug Administration (FDA) restricted  COVID-19 vaccines to Americans aged over 64.

“By narrowing its approval, FDA has made a decision that completely contradicts the evidence base, severely undermines trust in science-driven policy and dangerously limits vaccine access, removing millions of Americans’ choice to be protected and increasing the risk of severe outcomes from COVID,” said IDSA president Dr Tina Tan in a statement.

Off-label use

Tan added that “scientific evidence continues to strongly support broad vaccination far beyond the limited populations outlined in the FDA’s new label”.

“Physicians can still provide COVID vaccines off-label, and IDSA strongly urges doctors to continue recommending and administering vaccination to their patients based on the best available science,” said Tan.

She warned that “pharmacists’ ability to provide off-label vaccines may be severely constrained, underscoring the vital role of physicians and other clinicians in maintaining access”. 

IDSA also called on insurers to “continue covering COVID vaccines consistent with multiple medical society recommendations and scientific evidence”, and urged the US Congress to “conduct strong oversight of the administration’s decision to restrict Americans’ freedom to choose vaccination as we approach the upcoming respiratory virus season”. 

Dr Tom Frieden, CEO of Resolve to Save Lives and a former CDC director, said that “the change to the vaccine label, which has been driven by falsehoods, may put vaccines out of reach of many Americans who want to protect themselves and their loved ones from illness”.

Earlier this month, the American Academy of Pediatrics recommended COVID-19 vaccines for children between the ages of six months and two years, who are most vulnerable to severe disease.

Research shows that long COVID may have affected up to six million children in the US. 

Although Axios reported on 8 August that the CDC had changed the wastewater viral activity for COVID-19 from “low” to “moderate”, data from the CDC has not been available since 9 August due to a “technical issue” and the risk is now classified as “low”.

CDC advisory committee still to weigh in

Meanwhile, Health Secretary Robert F Kennedy Jr welcomed the FDA’s decisions on X, saying that he has delivered on his promises to “end covid vaccine mandates; keep vaccines available to people who want them, especially the vulnerable; demand placebo-controlled trials from companies, and end the emergency”.  

The CDC has yet to make its recommendations about this year’s COVID-19 vaccines. However, in June Kennedy Jr fired all 17 members of the CDC’s Advisory Committee for Immunization Practices (ACIP). At least half of the eight people he replaced them with have spoken out against the handling of COVID-19 and vaccines.

The new appointees are Dr Joseph Hibbeln, Martin Kulldorff, Retsef Levi, Dr Robert Malone, Dr Cody Meissner, Dr Michael Ross, Dr James Pagano and Vicky Pebsworth.

Malone has promoted several false and alarmist claims about COVID-19 vaccines, and said they did not work. 

Pebsworth is a director and board member at the National Vaccine Information Center, which has questioned the safety of COVID-19 vaccines and encouraged people to seek alternatives.

Kulldorff was co-author of the Great Barrington Declaration with Dr Jay Battacharya, new director of the National Institutes of Health, which favoured herd immunity to address COVID-19 for all but the most vulnerable.

Meissner, is in favour of children and pregnant children being excluded from the COVID-19 vaccine schedule.

Levi, who has questioned the safety of COVID-19 vaccines, has also been appointed to chair a new review committee to review COVID-19 science.

In his resignation statement, the CDC’s Daskalakis said that the “recent term of reference for the COVID vaccine work group created by this ACIP puts people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader.   Their desire to please a political base will result in death and disability of vulnerable children and adults.  Their base should be the people they serve not a political voting bloc.”

This story was updated with news of the disruptions in the CDC leadership.

Image Credits: Photo by Mat Napo on Unsplash.

Representatives from Gavi and Unicef at the Mwalumina Rural Health Centre in Zambia, the first clinic in the country to receive solar power as part of Gavi’s Health Facility Solar Electrification (HFSE) programme.

Zambia has become the first country to inaugurate a solar clinic as part of Gavi’s $28 million Health Facility Solar Electrification (HFSE) programme, which aims to power 1,277 clinics across four countries by June 2026 – improving services for 25 million people.

The weekend event, at Mwalumina Rural Health Centre in Zambia’s Chongwe District, is the first step towards bringing reliable solar power to 250 Zambian health facilities across the country, improving health services for 1,3 million Zambians.

“By bringing sustainable power to our rural health facilities and ensuring vaccines and essential medicines reach every child, we are investing in healthier communities and a stronger health system,” Zambian Health Minister Dr Elijah Muchima told the inauguration on Sunday.

The initiative prioritises health facilities that provide maternity services and serve remote communities. It aims to ensure the safe storage of vaccines and medicines, enable the use of critical diagnostic and medical equipment, improve working conditions for health professionals and strengthen resilience and equity in primary health care services.

Several vaccines – including some of those to combat COVID-19 – need to be refrigerated, which is a challenge for many rural clinics that don’t have reliable electricity.

“These efforts will light up maternity wards, keep vaccines safe, and deliver care to the hardest-to-reach communities,” said Gavi CEO Dr Sania Nishtar.

“In places where one in four health facilities have no electricity, solarisation is more than a technical fix, it is a lifeline.”

Rollout to Ethiopia, Pakistan and Uganda

The HFSE initiative will deploy solar photovoltaic systems and cold chain equipment to health facilities in Ethiopia, Pakistan and Uganda, as well as Zambia.

The initiative will also improve the climate resilience of health facilities, reducing reliance on coal- and hydro-electric power, and reduce carbon emissions.

By the end of the rollout in June 2026, an estimated 25 million people will benefit from an increased range of services such as expanded access to immunisation services and availability of clean water.

The Ethiopia launch of HFSE took place in October 2024, and aims to reach 300 health facilities, improving services for an estimated 6.7 million Ethiopians.

“Climate change is increasing the burden of diseases in the most vulnerable communities, and access to electricity is a core determinant of a country’s ability and readiness to provide quality health services,” Thabani Maphosa, Gavi’s Chief Country Delivery Officer, told the Ethiopia launch.

“Establishing and scaling health facility solar electrification represents an unprecedented opportunity to strengthen primary health care systems, contribute to a greener planet, and drive improved health outcomes.”

Gavi has also contributed significantly to the roll-out of solar-powered cold chain equipment through its Cold Chain Equipment Optimisation Platform (CCEOP), established in 2016 to assist countries to buy cold storage equipment they need. 

“However, fridges alone aren’t enough,” according to Gavi. “This pilot tests whether that model can be scaled to fully solarize health facilities by powering lights, equipment, and digital tools. If successful, it could unlock co-investment and long-term government support for maintenance, ensuring sustainability.”

New initiative to improve vaccine delivery

Zambia also launched an initiative called DRIVE – the Direct Delivery of Routine Immunisation Vaccines and other Essential health commodities for Equity – alongside the solar project.

DRIVE “works like a social enterprise, involving community volunteers, young people, and others at the local level to help deliver vaccines and health supplies directly to clinics and outreach sites”, according to a media release from the Zambian government. 

“These delivery partners will work up to 10 days a month transporting vaccines, and for the rest of the month, they can use the same transport to earn income through other activities, helping them support themselves and maintain the vehicles.”

DRIVE is being launched in 41 districts and will create 200 jobs as well as improving immunisation.

“The two initiatives we are launching today work hand in hand to strengthen our health system. By bringing vaccines and supplies directly to health centres and providing clean, reliable energy, we are making healthcare more accessible and consistent. These efforts support health workers, create jobs, build community ownership, and help us adapt to climate challenges,” explained Dr. Nejmudin Kedir Bilal, UNICEF’s Zambia Representative.

The HFSE initiative is supported by UNICEF and the World Health Organization.

Image Credits: Gavi.

Construction workers are particularly vulnerable to heat stress.

Hundreds of migrant construction workers are likely to have died of heat stress while building soccer stadiums in the Qatari desert for the recent Fifa World Cup.

But people’s exposure to extreme heat – temperatures of 38°C and higher – is becoming widespread as climate-related temperatures soar.

“Billions of people are already exposed to dangerous heat at work, elevating their risk of heat stroke, dehydration, kidney disease and other serious illnesses,” Dr Rüdiger Krech, World Health Organization (WHO) director of Environment, Climate Change and Health, told a media briefing on Thursday.

“In agriculture, construction and other physically demanding sectors, we’re seeing a clear rise in heat stroke, dehydration and long-term kidney and cardiovascular damage due to dangerous working conditions,” added Krech during the launch of a new report on heat stress, published by the WHO and the World Meteorological Organization (WMO).  

“The workers keeping our societies running are paying the highest price. These impacts are especially severe in vulnerable communities with limited access to cooling health care and protective labour policies.”

WMO director Johan Stander told the media briefing that the past 10 years are the hottest on record and 2024 was the hottest year ever.

Extreme heat has “accelerated” in Europe, Africa, North America and Asia, where new record temperatures were recorded, he added.

“In the Middle East, we’ve seen temperatures in the region of 50°C, and areas in Europe have topped around 40°C.”

The report defines workplace heat stress as “increased heat storage in the body of a worker as a result of excessive heat exposure in the workplace”. This can be due to hot environmental conditions, increased metabolic heat from performing physically demanding tasks; and/ or the requirement to wear heavy protective clothing, which limits the body’s ability to dissipate heat (for example, health workers wearing PPE in hot climates during disease outbreaks).

It describes heat stroke as “a life-threatening condition defined by profound central nervous system dysfunction”, including severe disorientation, seizures, coma.

Outdoor construction and agricultural work during the hot season are considered the highest-risk occupations for experiencing morbidity and mortality associated with workplace heat stress.

The WMO’s Johan Stander, WHO’s Rudiger Krech and Joy Shumake-Guillemot, lead of the WHO/WMO Joint Office for Climate and Health

Safe working environments

The International Labour Organization (ILO)’s Joaquim Pintado Nunes told the briefing that it is mandatory for the 187 countries that are ILO members “to promote safe and healthy working environments”.

“More than 2.4 billion workers are exposed to excessive heat, and this represents 71% of the world’s total working population,” said Nunes, the ILO’s head of Occupational Safety and Health and the Working Environment.

Heat exposure causes more than 22 million occupational injuries and almost 19,000 deaths each year, according to an ILO report published last year. In 2020, there were an estimated 26.2 million persons living with chronic kidney disease attributable to workplace heat stress.

The ILO report found that workers in Africa (92.9%) and the Arab states (83.6%) had the worst heat exposure, but the fastest changing working conditions are in Europe and Central Asia, with the proportion of workers affected rising by 17.3%, almost double the global average increase.

“Heat exhaustion and sometimes fatal heatstroke have been repeatedly reported among coal miners, surface miner workers and gold miners, as well as workers in agriculture and construction workers in the United States of America,” according to the WHO-WMO report.

“Climate change is reshaping the world of work,” said Nunes. “Without bold, coordinated action, heat stress will become one of the most devastating occupational hazards of our time, leading to a significant loss of life, significant loss of productivity and with catastrophic effects in the future of work.”

Joaquim Pintado Nunes, chief of Occupational Safety and Health and the Working Environment, International Labour Organization (ILO)

Data about workers’ conditions is often hard to come by. To establish the cause of death of the migrant workers in Qatar, researchers triangulated the mortality data of Nepalese migrants in Qatar, interviews with returning migrants about their working conditions, and temperatures.

Most of the migrant workers were young men aged 25 to 35. Globally, this group usually only records a 15% death rate from cardiovascular disease (CVD). But 22% of the Nepalese migrants who died while working in Qatar died of CVD in the cool season and 58% died in the hot season – which the researchers concluded to be likely due to “extreme heat stress”.

Clear recommendations

The report, the first on the subject since 1969, offers guidance to governments, workers, employers, local authorities and health experts to mitigate heat stress.

Recommendations include occupational heat-health policies with “tailored plans and advisories that consider local weather patterns, specific jobs, and worker vulnerabilities”.

Those most vulnerable to heat include middle-aged and older workers, people with chronic health conditions and lower physical fitness.

The report also recommends educating all stakeholders on how to recognise and treat the symptoms of heat stress – particularly essential for subsistence farmers, who are not part of organised workplaces and may not understand what is happening to them.

Krech told reporters that the threshold for the human body is 38°C, over which it is dangerous to work.

Professor Andreas Flouris from the University of Thessaly in Greece said that there is “ongoing discussion” in Europe on “moving towards thresholds of environmental limits where workers can safely work”.

Cyprus, Spain, Belgium already have such thresholds defined in legislation, added Flouris, who was the report’s editor.

“The report provides the evidence that policy makers can use to convince both the employers and the workers that it’s in their best interest for both in terms of health but also productivity, to move to such solutions,” said Flouris.

Image Credits: Shraga Kopstein/ Unsplash, WHO-WMO.

The US Centers for Disease Control and Prevention in Atlanta, which a gunman recently attacked.

US Health and Human Services Secretary Robert F Kennedy Jr has been given until 2 September to stop spreading anti-vaccine information by hundreds of current and former staff members from the Center for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the HHS.

In a letter released by “Save HHS” on Wednesday, over 750 staff – about half of whom opted to remain anonymous – say that they are gravely concerned about “America’s health and safety” following an attack on the CDC early this month, when a man opposed to COVID-19 vaccines fired hundreds of bullets at the institution. A police officer was killed in the attack.

“The attack came amid growing mistrust in public institutions, driven by politicised rhetoric that has turned public health professionals from trusted experts into targets of villainization – and now, violence,” according to the letter, which has been sent to Kennedy and Members of the US Congress.

Lukewarm response to CDC gunman

In a media release accompanying the letter, the staff described Kennedy’s response to the shooting as “delayed and cursory”. He also “failed to take accountability for his role in the denigration of HHS employees and his decades of anti-vaccine rhetoric that reportedly contributed to the shooter’s motives”.

In an interview shortly after the attack, Kennedy criticised the CDC’s response to the COVID-19 pandemic.

The staff accuse Kennedy of being “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information”.

They say he has sown public mistrust, including by calling the CDC a “cesspool of corruption”, falsely claiming mRNA vaccines “failed to protect effectively” during the COVID-19 pandemic and subsequently cancelling $500 million in contracts for mRNA vaccine development, “possibly our best line of defence against another respiratory virus pandemic”.

They also cite his disbanding of the US Advisory Committee on Immunization Practices (ACIP) as part of his anti-vaccine activity.

They also accuse the health secretary of falsely claiming the measles vaccine has not been “safety tested” and that protection “wanes very quickly” while “promoting inappropriate prevention measures like vitamin A even as US measles case numbers are at their highest in more than 30 years”.

Finally, they say Kennedy has misused data to “falsely claim childhood vaccines are the cause of autism despite decades of research demonstrating otherwise”.

‘Dangerous and deceitful’

Describing these Kennedy statements as “dangerous and deceitful”, the letter gives the HHS Secretary until 2 September to “cease and publicly disavow the ongoing dissemination of false and misleading claims about vaccines, infectious disease transmission, and America’s public health institutions”.

It also asks him “acknowledge and affirm that CDC’s work is rooted in scientific, non-partisan evidence focused on improving the health of every American” and “guarantee the safety of the HHS workforce”.

Dr Anne Schuchat, former Principal Deputy Director of CDC, said that “an attack on a U.S. government agency should be a moment in time when we come together”. 

“Instead, Secretary Kennedy continues to spread misinformation at the risk of American lives,” she added.

Dr Ian Morgan, an NIH scientist and steward of NIH Fellows United, said that the attack on the CDC  on the death of the police officer should have been a “wake-up call” for Kennedy and NIH Director Jay Bhattacharya.

“Yet, we’ve seen them persist in the same antivaccine and anti-science rhetoric that led to the shooting, endangering the lives of HHS workers and the American public. This dangerous rhetoric from HHS leaders must stop,” said Morgan.

Neither Kennedy nor the HHS had responded to the letter by the time of publication.

An examination of 51 studies has assembled more evidence that exposure to air pollution is linked to a higher risk of dementia.

Air pollution, specifically the tiny particles known as PM2.5, is linked to higher rates of dementia, according to a recently published study in The Lancet.

Nitrogen dioxide (NO2) and black carbon, which is the black soot left behind when combustion is incomplete, have also been linked to higher risk of dementia in the study, which is headed by researchers at UK’s Cambridge University.

“What this means is that cleaner air policies, including those targeting diesel, could help protect brain health, not just lung and heart health. Dementia is a devastating disease, and while we wait for a cure, we need to act on modifiable risk factors. Air pollution is one of the biggest,” Haneen Khreis, one of the authors of the study, told Health Policy Watch.

Researchers reviewed 51 existing studies across several countries up to October 2023 to arrive at this conclusion.

PM2.5 is 1/28 of the width of a human air and much of it is released during the burning of gasoline, oil, diesel or wood. PM10 particles are relatively larger, though still invisible to the naked eye.

“PM2.5, or fine particulate matter, can cross the blood-brain barrier, resulting in inflammation and disruption of brain function. There is also evidence to suggest that fine particles can travel through the olfactory nerve into the brain,” Pallavi Pant, who is the head of global initiatives at Health Effects Institute told HPW.

“Exposure to air pollution may also have impacts on brain development and functioning in children, including an increased risk for neurodevelopmental disorders like autism and psychological disorders like anxiety and depression,” Pant pointed out.

The dangers of PM2.5

A comparison of the sizes of PM2.5, PM10, human hair and fine beach sand.

Air pollutants are categorized by their sizes. There is PM2.5 and there is PM10. Evidence does not yet link PM10 with higher rates of dementia, but the number of studies looking closely at PM10 were small, the researchers concluded.

Gases like NO2, and particles the size of PM2.5 or less, are dangerous because they are small enough to enter the bloodstream from the lungs after being inhaled.

Once inside the body, they can travel from head to toe, according to Palak Balyan, research lead at Climate Trends, headquartered in New Delhi.

There are two ways patients can develop dementia, a broad term describing a decline in mental abilities severe enough to interfere with a person’s everyday life, says Balyan.

One is a natural consequence of ageing, while the other is caused by blockage in the brain – including by air pollution.

“These small particles (PM2.5) block a lot of arteries, veins or small capillaries in our brain. That also leads to dementia,” she said.

Black carbon

While PM2.5 and PM10 do get some attention, black carbon does not.

“Most studies have focused on PM2.5 and NO₂, but we need much more attention on black carbon, given its major role in both health harms and climate change. These pollutants mainly come from car exhaust, power plants, industry, and diesel engines,” said Khreis, who added that black carbon or soot is sometimes smaller than PM2.5 and sticky.

“If that small sized black carbon particle sticks inside your lung or inside any other capillary in your body, that can create more damage than any other bigger sized particle,” Balyan explained.

Limited evidence from Global South

Most of the world’s population breathes in polluted air.

Of the 51 studies that were examined, 20 (39%) were done in Europe and 17 (33%) in North America, representing more than half of the overall evidence.

“Most of the data comes from high-income countries, and often from White, urban populations. That means we’re missing critical evidence from low- and middle-income countries, and from groups that face the highest exposures because of structural inequalities,” Khreis said.

She added that the global burden is probably underestimated and the risk in some groups within urban areas is concealed.

“It is likely that the deleterious impact of PM2.5 on dementia risk is mediated by other factors such as overall health status, specific co-morbidities, exercise and nutrition. Hence it is important to generate data from geographically and socioeconomically diverse populations across the world to develop a more customized and holistic framework for risk reduction interventions,” said Vaibhav A. Narayan, PhD, head of innovation and strategy for the Davos Alzheimer’s Collaborative, which is supporting a “Global Cohorts Programme” with other research partners to generate such data in low-resourced settings.

A majority of the world’s most polluted cities are in the developing countries. In 2024, 49 of the world’s most polluted cities were in Asia and one in Africa, according to data from IQAir, a Swiss air monitoring company.

But only 12 studies (24%) from Asia were included and none from Africa or Latin America. Two (4%) others were from Oceania (both in Australia).

Some of the earliest studies linking air pollution and impacts on the brain were conducted in Mexico City. Dogs living in polluted environments in Mexico City had more neurodegeneration than dogs living in cleaner environments outside Mexico City, according to one study. Similar studies were also done with children going back to 2008.

Evidence from India also suggests that those using polluting sources of cooking fuel were at a higher risk of cognitive impairment, especially rural women, given that they tend to have higher exposure to polluting cooking fuels like firewood.
“A majority of studies are currently from Europe or North America, or China, and we need a broader global evidence base representing other regions,” Pant said.

“Having said that, with the available evidence, the case for addressing air pollution to help reduce the dementia burden at the population level is strong,” she added.

A ‘modifiable risk factor’ for dementia

WHO’s outgoing director of the Department of Environment, Climate Change and Health, Dr Maria Neira, is widely credited with increasing awareness about air pollution.

The Lancet Commission has included air pollution as a modifiable risk factor for dementia in 2024, as it is possible to improve air quality.

Balyan sees some positive trends in addressing air pollution, including more awareness, more funding for research on air pollution and more collaboration.

“Now engineers and doctors are collaborating, they are working together. So that kind of collaboration has also increased which is leading to more number of studies. International collaboration has also increased because of this easy to work online system,” she said.

Dr Maria Neira, the outgoing director of the World Health Organization’s (WHO) Department of Environment, Climate Change and Health since 2005, is widely credited with increasing awareness about the impact of air pollution on health.

Image Credits: WHO, U.S. Environmental Protection Agency (EPA), WHO, US Mission Geneva .

China’s representative at the World Health Assembly in May.

China has suggested that the access pharmaceutical manufacturers get to information about dangerous pathogens should be “contingent” on their home country being a party to the Pandemic Agreement recently adopted by the World Health Assembly (WHA).

This will encourage World Health Organization (WHO) member states to ratify the agreement in their respective countries, but it is also a dig at the United States, which has pulled out of the WHO, under whose auspices the agreement was negotiated.

China’s proposal is part of a list of suggestions by WHO member states ahead of a meeting of the Intergovernmental Working Group (IGWG) on 15 September.

At its first meeting in July, the IGWG appealed to member states for suggestions about what should be included in the major outstanding issue of the agreement – an annex on a pathogen access and benefit sharing (PABS) scheme.

Disagreement about PABS has long been the main obstacle to the pandemic agreement – so much so that it was kicked down the road by the WHA in May. The WHO has entrusted the new body, the IGWG, to thrash out how the scheme will work before the next WHA in 2026. 

Once this has been done, the pandemic agreement will be complete and ready for country ratification.

Essentially, the PABS scheme will regulate how the genetic sequencing and other information about “pathogens with pandemic potential” is shared. Many countries, particularly in the global South, want any sharing that they do to be on condition that they get benefits from products that manufacturers make as a result.

Restricted access

China proposes that the annex defines the scope of eligible participants in PABS and the modalities of their engagement. For manufacturers, the annex should “specify qualification criteria, boundaries of liability, and both financial and technical benchmarks, and make these contingent on whether their home state is a party to the Pandemic Agreement”, says China.

It also proposes that the WHO establish a “tracing and tracking mechanism” for PABS materials based on “transparency and traceability”. 

However, it suggests restricted access to high-risk information with “a mechanism that tracks both the chain of custody of biological samples and the linkage to associated data”, based on the Influenza Virus Traceability Mechanism (IVTM).

Russia also wants restricted access as some pathogens which could become “weapons of mass destruction”. It suggests that “pathogens with pandemic potential” should not be transferred to countries that lack “national biosafety and biosecurity regulations and certified laboratory facilities and personnel”.

Legally binding contracts

The Africa Group’s proposal reiterates its longstanding position that the scheme should be based on both “rapid and timely access” to PABS materials and sequence information and the “rapid, timely, fair and equitable sharing of benefits” arising from this information. 

Africa envisages that the WHO will have individual legally binding contracts with manufacturers that join PABS, the terms of which will be public.

During a “pandemic emergency”, these manufacturers will make available to the WHO “20% of their real-time production of safe, quality and effective vaccines, therapeutics, and diagnostics for the pathogen causing the pandemic emergency”. At least 10% of this will be free, and the remaining 10% at “affordable prices”.

Australia, the United Kingdom, Norway, Canada, and New Zealand also support the 20% allocation to WHO.

Africa also wants the contracts with manufacturers to include annual monetary contributions to the PABS system “to support initiatives for transfer of technology and know-how, research and development, scientific and research collaborations, and laboratory capacity strengthening”.

Pandemic simulation exercise

The European Union’s proposal simply notes five areas that PABS needs to cover, with the “benefit-sharing parameters” based on contracts with participating manufacturers that demarcate issues such as the “set-aside quantities” and donations (to the WHO) of vaccines, therapeutics and diagnostics developed.

Japan submitted a diagram that succinctly presents issues to be covered.

Switzerland, in collaboration with the WHO Collaborating Centre at the Spiez Laboratory, proposes to organise “a simulation exercise to support the negotiations of the annex”. 

The one-day exercise would test the “practical feasibility and operational functionality of a potential PABS Mechanism by simulating a realistic pandemic emergency scenario”. 

An informal IGWG meeting is planned for 12 September, with the next formal meeting from 15-19 September.

The IGWG Bureau, the administrative body overseeing the talks, is also compiling a list of experts to assist with negotiations. These will also be circulated to member states.

Experts are essential for this part of the talks, which are complex given that the annex will need to harmonise with several international agreements covering intellectual property and trade, as well as the Nagoya Protocol, which determines how to share the benefits arising from the utilisation of genetic resources fairly and equitably.

Ahmad, 15, and his younger brother Sahil, 12, at the Torkham border between Pakistan and Afghanistan with their family, after returning from Pakistan.

Afghanistan’s fragile healthcare system is at breaking point under the strain of hundreds of thousands of Afghans deported from Iran and Pakistan over the past few months, many in urgent need of medical care.

This follows the decision by both Pakistan and Iran to repatriate Afghans, even those with refugee status in the case of Pakistan. Earlier this year, the UN High Commission for Refugees estimated that there were over 3,5 million Afghan refugees in Iran and 1,7 million in Pakistan.

Between January and 13 August, some 1.86 million Afghans have been returned from Iran and over 314,000 from Pakistan, bringing the total returns to over two million people over the past eight months alone.

Over eight million Afghans have fled their country over decades of war, but those in Iran and Pakistan are being deported to an uncertain future.

At Afghanistan’s Islam Qala border crossing with Iran, the human cost is stark: toddlers with sunken cheeks and dehydrated skin, elders bent over in coughing fits, heavily pregnant women staggering through the dusty camps, some giving birth amid chaos.

For the past many months, overwhelmed border Afghan health teams have confronted the same cycle of illnesses almost daily. Health workers say the illnesses surging through the camps are a predictable fallout of forced displacement colliding with an already overwhelmed healthcare system.

“Commonly reported health issues among returnees include trauma, malnutrition, infectious diseases such as acute watery diarrhoea and acute respiratory infections, and mental health problems,” according to the World Health Organization (WHO).

The sweltering camp for deportees reeks of over-flowing latrines and antiseptic, a grim reminder that these makeshift checkpoints have become the country’s first, and often only, line of defense against disease outbreaks.

In a torn tarpaulin’s thin shade, Zaher Qayumi, a father of five from Badghis Province, shields his children from the relentless sun. Just 10 days earlier, after five years in Iran, his nine-member family was abruptly expelled from Tehran. His children suffer from diarrhea and dizziness, their faces flushed with heatstroke.

“The situation here is terrible. Medicines, even for simple pain or diarrhea, are almost impossible to find,” Qayumi told Health Policy Watch. 

“Iranian authorities are expelling everyone. The elderly and children suffer the most. People have no means and resources. Everyone is sick.”

It is extremely difficult and complicated to navigate for returnees to access what little public health services there are, and Qayumi’s words reveal the human face of the slow-motion public health emergency playing out across the desert border.

A WHO-supported disease surveillance support team conducts a health education session for returnees at Islam Qala border crossing.

Plea for immediate assistance

Stephanie Loose, UN Habitat head for Afghanistan, told a recent press briefing in Geneva that families are arriving after days of travel in blistering heat, enduring overcrowded tents and nights without enough food, water, or shelter. 

“The real challenge is still ahead of us… people need access to basic services, to water, to sanitation, and overall, they do need livelihood opportunities for having a long term perspective and for also allowing them to, you know, lead their lives in dignity and to support their families,” said Loose.

Afghanistan’s humanitarian system is in free-fall. The country’s 2025 aid plan, valued at around $2.4 billion, is only 12% funded, according to the UN.

Aid agencies warn they are already cutting food, health, and shelter support, leaving millions at risk. UN officials are urging donors to act immediately, stressing that without swift contributions, lifesaving operations could collapse, plunging vulnerable communities into further desperation.

“At [Islam Qala’s] zero-point clinic, returning families arrive dehydrated, malnourished, and sick with respiratory and diarrheal diseases,” said Dr Noor Ahmad Mohammadi, head of the WHO-supported clinic. “We treat hundreds of children daily, most never vaccinated. Immediate action is critical to prevent rapid outbreaks.”

The clinic provides outpatient care and polio vaccinations, seeing roughly 200 patients and vaccinating 100 children under 10 each day. But with thousands crossing daily, their modest resources are overwhelmed.

UNHCR has expressed concern that many Afghans, regardless of status, “face serious protection risks in Afghanistan due to the current human rights situation, especially women and girls”.

Forgotten crisis

Afghanistan’s health system, hollowed out by decades of conflict, chronic underfunding, and the exodus of medical professionals following the Taliban’s rise to power in 2021, was already on the brink of collapse before the deportations began.

“Afghanistan is facing a deepening humanitarian crisis fuelled by a deteriorating human rights situation, prolonged economic hardship, recurring natural disasters and limited access to critical services. The large-scale returns of over 2.1 million Afghans from Iran and Pakistan in 2025 have further exacerbated the situation,” said UNHCR in a statement.

Aid agencies warn that as many as three million Afghans could be pushed back by the year’s end, raising the risk of a preventable public health disaster without urgent scale-up of clean water, vaccinations, and emergency care.

“The crisis is forgotten by much of the world,” said Nicole van Batenburg of the International Federation of Red Cross and Red Crescent Societies in a statement. “Local health systems are simply not equipped to cope.”

Many families were given mere hours to leave homes in Iran or Pakistan, abandoning belongings, medication, and any sense of security. Children arrive with fevers, diarrhea, scabies, and trauma; parents carry the weight of uprooted lives.

By spring 2025, more than 200 health facilities across Afghanistan had closed or suspended services due to lack of funds, the WHO reports. 

Dr Edwin Ceniza Salvador, WHO’s Afghanistan representative, warns that 80% of supported health services could shut down without fresh funding.

“Mothers are unable to give birth safely, children missing lifesaving vaccines, and more preventable deaths every day,” he said.

In a corner of the border camp, Zohra*, a 28‑year‑old pregnant woman, lay on a thin mat, clutching her stomach. She was seven months pregnant when her six-member family was forcibly expelled from Mashhad in Iran.

“We were told to leave within hours. I couldn’t procure the medicines I needed even before this ultimatum as I feared arrest going to the hospitals,” she said in a faint voice. “The journey was long and hot. I thought I would lose my baby on the road.”

By the time she reached the Afghan border, Zohra was severely dehydrated and showing signs of early labour. Border clinic staff managed to stabilise her, but they warned that complications could turn deadly if she cannot access a proper hospital in time.

“I wish my daughter comes to this world alive and healthy, but I worry what kind of place my children would live and grow in Afghanistan”, Zohra said.

An earlier wave of deportations from Pakistan has already strained the Afghan healthcare system. Since late 2023, tens of thousands of Afghans, many of whom had lived in Pakistan for decades, have been forced to cross back to Afghanistan with little more than what they could carry.

The UN estimates that in this year alone, at least 314,000 Afghans had been returned from Pakistan by the end of July, often arriving with untreated chronic conditions, respiratory infections, and severe malnutrition, while vaccination records are frequently missing.

No medicine or food

Halima Bibi, an elderly diabetic woman, had lived as a refugee in Pakistan for years before she was expelled from the outskirts of Islamabad with her son’s 10-member family. Her health situation embodies the health crisis in Afghanistan.

“My feet are swollen, and I can barely stand,” she said. “I haven’t had my medicine or proper food for days. We had to wait anxiously for days to get an extension for our stay in Pakistan, but they forced us to leave without any consideration or time to prepare.” 

Across Afghanistan’s border, in provinces like Nangarhar where Bibi lives, clinics and hospitals are swamped, lacking the resources to meet the urgent needs as well as management of chronic diseases like diabetes. 

Halima is fearful that insulin medicine would not be easily available for her in Afghanistan and this will cause her serious health complications. 

The Taliban’s deputy minister for refugees and repatriation, Abdul Rahman Rashid, has publicly rebuked host countries for the mass expulsions, describing the removal of Afghans as a “serious violation of international norms, humanitarian principles, and Islamic values.”

“The scale and manner in which Afghan refugees have been forced to return to their homeland is something Afghanistan has never before experienced in its history,” Rashid told a press conference in Kabul last month.

Back at Islam Qala border crossing, the transit clinic operates 24/7 where the returnees arrive with health conditions that are manageable in a well-resourced hospital, but often life-threatening here. Women and girls face particular concerns over movement restrictions and access to healthcare.

As summer heat intensifies and thousands continue to arrive daily, aid workers warn the window to prevent a full-blown humanitarian and public health catastrophe is closing fast.

Image Credits: UNHCR/ Oxygen Empire Media Production, UNHCR, WHO Afghanistan.

At 7am Friday morning, the plastics negotiations were called off in Geneva after countries fail to reach agreement on the basics. No advances in the text were made over the 12-day talks.

GENEVA — Negotiations over a United Nations (UN) treaty to combat the plastic pollution crisis ended in failure early Friday morning, as 183 nations were unable to bridge vast divides over production limits, toxic chemicals and financing after three years of diplomacy.

Norway officially announced the failure at 7am Geneva time after a final overtime negotiation session lasting over 24 hours.

Denmark, co-chair of the High Ambition Coalition supported by around 100 countries, said it was “truly sad to see that we will not have a treaty to end plastic pollution here in Geneva”, adding that the coalition has “clearly and repeatedly stated that we need an international, legally binding instrument that effectively protects human health and the environment from plastic pollution.”

A treaty that is able to fulfil this mandate must “at a minimum address the full life cycle of plastics, the “unsustainable consumption and production of plastics” and include “global measures and criteria on plastic products and chemicals in products,” added Denmark, which also raised the possibility of voting.

The talks were themselves an extension following December’s failed summit in Busan, South Korea. Rules requiring unanimous agreement kept the process in stalemate throughout the 12-day session.

Both draft texts presented by negotiation chair Luis Vayas Valdivieso of Ecuador were rejected by all parties. The chair’s approach, predicated on placating the lowest-ambition nations, proved insufficient even for those countries.

The petrochemical producing bloc (which calls itself the “like-minded countries”) led by Saudi Arabia and flanked by the United States (US), Russia, India, Malaysia and others, rejected even hollowed-out texts that had angered high-ambition countries by removing all mentions of chemicals, production limits, health, climate emissions, and mandatory finance. 

Further negotiations will reconvene at an undetermined date and location, based on the draft text from Busan, leaving the agreement no closer to completion than six months ago. 

Many delegates questioned the purpose of the Geneva talks, as the outcome appeared predetermined with no apparent strategy to break the deadlock. If the rules of engagement requiring unanimous agreement remain unchanged, it is uncertain whether high-ambition nations or civil society will attend future talks.

Defeat for multilateralism

UNEP executive director Inger Anders, speaking after the collapse of the talks in Geneva.

Speaking outside the assembly hall after the collapse, Inger Andersen, executive director of United Nations Environment Programme (UNEP) said: “Tell me of a treaty that has been done, in a shorter time, and then we can discuss. Would I have liked this in two years? Absolutely. 
At this point, it is critical that we take some time first to sleep and then to reflect and then to regroup. In the end, this is a member state’s lead process, and we from the United Nations are here to support it.

“I believe that everybody is very disappointed. However, multilateralism is not easy. What I can say about the future, I can’t say, we literally just walked off the floor.”

The breakdown represents a significant defeat for multilateralism at a time when its capital, Geneva, is facing mounting challenges to its value as a global diplomatic capital. 

It is also a blow for UNEP, which spent millions organising the talks but serves only as a mediator without the ability to sway outcomes, which are decided by nation-states.

“We cannot hide that the European Union and its member states had higher expectations,” EU Environment Commissioner Jessika Roswall said in a statement. 

“We came to conclude a global plastics treaty here in Geneva. We have confidence in the science that impels us, confidence in the people that pushed us, confidence in a majority of countries of both developing and developed that are aligned.

“That is what we fought for. We have not managed to get there.” 

The failure exposes a fundamental rift in visions for global plastics governance between more than 130 countries seeking legally binding measures to curb plastic production and the powerful bloc of oil-producing states intent on protecting the financial benefits of the plastics boom.

With plastic production expected to triple by 2060, according to OECD projections, and 99% of plastics made from fossil fuels, the sector represents a crucial revenue stream for petrostates as traditional energy demand shifts toward renewables.

“I am disappointed, and I am angry,” said French Environment Minister Agnès Pannier-Runacher following the collapse. “A handful of countries, guided by short-term financial interests rather than the health of their populations and the sustainability of their economies, blocked the adoption of an ambitious treaty against plastic pollution.”

Plastic
Most plastics that are produced end up in landfills in poorer countries.

“This was never going to be easy – but the outcome we have today falls short of what our people, and the planet, need,” said Surangel Whipps Jr, President of Palau and chair of the Alliance of Small Island States (AOSIS), many of whom are overwhelmed by plastic pollution and stand to lose much of their territories to climate-related rising sea level.

“Still, even after six rounds of negotiations, we will not walk away. The resilience of islanders has carried us through many storms, and we will persevere – because we need real solutions, and we will carve pathways to deliver them for our people and our planet.”

The global petrochemical industry, valued at $638 billion in 2023, is expected to be worth $838 billion by 2030. Saudi Aramco, the state-owned oil company, plans to channel about one-third of its oil production to plastics and petrochemicals by 2030. Petrochemicals make up 82% of Saudi foreign exports critical to its government budget. 

“The scientific and medical evidence is overwhelming: plastic kills. It poisons our oceans, our soils, and ultimately, it contaminates our bodies.”

Production off the table 

The central battle throughout negotiations centered on whether the treaty would address plastic production or focus solely on waste management and recycling, as advocated by the petrochemical bloc and its allies.

These nations insist that the plastics crisis can be solved through better waste management, despite technological limitations that have kept global recycling rates below 10% after decades of research and billions spent to improve recycling technologies. 

The nations pushing recycling as the solution have failed at it themselves. Saudi Arabia recycles just 3-4% of its plastic waste, Russia between 5-12%, and the US only 5-6%, according to OECD data.

The like-minded nations successfully blocked any mention of plastic production limits in the draft texts. They also removed references to climate change, emissions, fossil fuels, and petrochemicals, despite plastic production releasing more than two gigatons of CO2 annually.

If the plastics industry were a country, it would be the world’s fifth-largest greenhouse gas emitter. At projected growth rates, plastics alone could consume a quarter of the remaining carbon budget to meet the Paris Agreement’s 1.5°C target.

Health impacts sidelined, science ignored 

The infiltration of plastics and microplastics into air, rain, oceans, ecosystems and human organs has been linked to cancer, infertility, cardiovascular disease and hundreds of thousands of premature deaths annually.

A Lancet study released during the talks estimated the cost of just three plastic chemicals at $1.5 trillion per year across 38 countries. One chemical of the 16,000 used in plastics, BPA, was associated with 5.4 million cases of heart disease and 346,000 strokes in 2015. 

“Toxics and microplastics are poisoning our bodies, causing cancer, infertility, and death, while corporations keep profiting from unchecked production,” said Giulia Carlini, senior attorney at the Center for International Environmental Law (CIEL). “The science is undeniable. Yet here, it has been denied and downplayed.”

Complete safety information is missing for more than two-thirds of the chemicals used in plastics. Three-quarters have never been properly assessed for human health impacts. Just six per cent of all plastic chemicals are regulated under multilateral environmental agreements.

Yet despite the science, petrochemical states continued to argue that health impacts fall beyond the treaty’s mandate, insisting that regulation should be governed by the WHO.

Many of the same countries arguing health is outside the scope of the plastics treaty, including Russia and Iran, held the opposite position at the latest World Health Assembly, contending chemicals should not be regulated by World Health Organization (WHO) due to UNEP’s mandate. 

“The inability to reach an agreement in Geneva must be a wakeup call for the world: ending plastic pollution means confronting fossil fuel interests head on,” said Graham Forbes, head of the Greenpeace delegation to the treaty negotiations.

“The vast majority of governments want a strong agreement, yet a handful of bad actors were allowed to use process to drive such ambition into the ground,” Forbes added. “The plastics crisis is accelerating, and the petrochemical industry is determined to bury us for short-term profits.”

Petrochemical industry influence

At least 234 fossil fuel and petrochemical lobbyists attended the Geneva talks, exceeding the combined delegations of the EU and its 27 member states. They outnumbered expert scientists by three to one.

The process itself faced criticism for its opacity, with many meetings closed even to national delegations. Chair Valdivieso, Ecuador’s ambassador to the UK, was roundly criticised for his handling of negotiations, the vast majority of which occurred behind closed doors.

Civil society groups, including indigenous peoples, waste pickers and frontline communities who travelled from around the world, found themselves actively sidelined

In the closing plenary, only the Youth Plastic Coalition was allowed to speak before the US and Kuwait cut proceedings short, silencing the rest of civil society.

“This is the real health crisis,” Kuwait’s delegation said, alluding to the long night faced by negotiators as the clock struck 9am. 

Less developed nations stood up to industry and rich country pressure that had cornered them behind the scenes with economic threats, yet even this resistance could not break the deadlock.

The consensus requirement allowed low-ambition countries to “hold the entire process hostage,” as Ethiopia’s delegation put it.

“This INC was doomed from the start,” said Andrés Del Castillo, senior attorney at CIEL. “Poor time management, unrealistic expectations, lack of transparency, and a ministerial segment with no clear purpose.”

Image Credits: Stefan Anderson, Photo by Hermes Rivera on Unsplash, UNEP.