Jubilant and exhausted members of the Intergovernmental Negotiating Body (INB) pose after marathon pandemic agreement talks finally resulted in agreement in the early hours of 16 April.

The final draft of the pandemic agreement for the World Health Assembly (WHA) next week was published by the World Health Organization (WHO) on Wednesday – along with a document outlining the long road member states still have to travel before it is enforced.

This follows the historic agreement reached on the text in the early hours of 16 April after three years of talks on how to prevent, prepare for, and deal with, future pandemics in an equitable manner – unlike what happened during COVID when wealthy nations hoarded vaccines at the expense of low- and middle-income countries.

The procedural document outlining the steps to adoption, which will be done in terms of Article 19 of the WHO Constitution, makes sobering reading.

While the agreement needs a two-thirds vote to pass, “adoption of the text by consensus automatically fulfils this requirement”, it notes.

Once the WHA has adopted the agreement via a resolution, it will be deposited with the Secretary-General of the United Nations, who will ensure it is prepared in various languages for signature.

Member states are expected to notify the WHO Director General on whether they intend to accept the agreement within 18 months of its adoption by the WHA.

Still more PABS negotiations

But member states’ signature of the pandemic agreement will only happen after the adoption of an annex on the much-contested Pathogen Access and Benefit-Sharing (PABS) System – a mechanism on how to share information about pathogens with pandemic potential and any possible benefits (such as vaccines and therapeutics) that might arise from sharing this information.

This annex – called the PABS instrument – still has to be negotiated, and it deals with a range of issues including “the provisions governing the PABS System, definitions of pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions”.

This means the PABS can of worms will be reopened in the coming months and member states will once again have to find agreement on this highly contested subject.

Only once the annex has been agreed, will the WHO Pandemic Agreement be open for signature by heads of state.

But even once the heads of state have signed the agreement, countries are not bound by its provisions. 

Instead, by signing, a head of state would be “expressing political approval of the treaty concerned, and raises an expectation that the signatory will in due course take the appropriate domestic actions to become a contracting party”. 

However, before domestic ratification, member states that have signed the treaty will be expected not to undermine the agreement.

Countries that have ratified the pandemic agreement will then be expected to deposit instruments of ratification with the UN Secretary-General and once 60 countries have done so, it will come into force and the first Conference of Parties will be held.

The entire process is likely to take several years, during which time another pandemic can engulf the world.

The Pandemic Agreement still has to pass through several hoops, including more negotiations on a PABS System, before it comes into force.

 

Image Credits: Thiru Balasubramaniam.

In the shakeup, only four members of WHO’s existing senior leadership team remain: Farrar, Ihekweazu, Nakatani and Pendse.

A brand-new World Health Organization (WHO) leadership team has been announced, including a dramatically reduced number of leaders and a major shake-out of longstanding faces including Dr Mike Ryan, the Deputy Director General and emergencies director, and Dr Bruce Aylward, who helped the Director-General steer the organization through the COVID-19 crisis but also got the heat for some of the mistakes made by the organization in the process.

In Ryan’s place, Dr Chikwe Ihekweazu, a Nigerian-German who is currently head of Health Emergency Intellience and Surveillance at a WHO pandemic hub in Berlin, will take over as head of the entire health emergencies operation at headquarters, the largest department in the organization, Health Policy Watch learned from an internal email sent by DG Dr Tedros Adhanom Ghebreyesus to staff Wednesday morning.

A formal WHO announcement followed shortly afterwards during remarks by Tedros at the opening meeting of the Programme Budget and Adminstration Committee (PBAC), a member state group convening ahead of next week’s World Health Assembly.

Dr Jeremy Farrar, a well-respected British scientist and former head of Wellcome Trust, will take on the second biggest appointment as Assistant Director-General (ADG) of Health Promotion, Disease Prevention and Control – one of the major pillars of the new organization – which will consolidate the 10 existing divisions into four.

New WHO organizational plan, announced 22 April, reduces 10 divisions at headquarters to just four.

Farrar will be replaced as Chief Scientist by Dr Sylvie Briand, former director of WHO’s Epidemic and Pandemic Preparedness and Prevention Department and current director of the Global Pandemic Preparedness and Monitoring Board, an independent body co-convened by the WHO and the World Bank to ensure preparedness for global health crises.

Sylvie Briand, far right, to become WHO Chief Scientist.

Japanese national Dr Yukiko Nakatani will remain on the team as head of the third new programme division, ADG of,Health Systems.

Raul Thomas, of Trinidad and Tobago, will remain as WHO’s ADG of Business operations along with Razia Pendse, an Indian national, as the ‘Chef du Cabinet.’

In his announcement to staff, Tedros said that the appointments would take effect on 16 June. Speaking shortly afterwards to the PBAC, he added, “The new team has been chosen after very careful consideration, and to ensure gender balance and geographical representation.

“I am confident that this new team, under the restructured organization, is best positioned to now guide WHO as we face the challenges of the coming years.”

Early reactions to new team

Dr Tedros Adhanom Ghebreyesus on 10 April – facing tough budget cuts.

Very initial reactions from staff inside the organization and outsiders seemed to be positive.

“It was a difficult decision for the DG, because he had to ensure, gender, geographical equity, and that donors priorities were also met,” said one long-time WHO insider, “but overall it seems like a good balance,” noting that most of the new appointees have solid professional reputations.

The sweep out of old leadership long associated with Tedros’ tenure may help improve the organization’s image and help press “reset” for further changes, the source added.

Notably, there is neither a Chinese nor an American in the new leadership team – reflecting perhaps an attempt to sidestep the fraught geopolitical tensions that have plagued the organization since COVID.

Along with Ryan, Aylward, ADG for Universal Health Coverage, who served WHO for 30 years, including leadership of its Global Polio Eradication initiative and the WHO Emergencies Programme, is also gone. Aylward, a Canadian physician, also led some of the Organization’s early response to the COVID pandemic. Although rightly or wrongly, Aylward, like Tedros and other senior WHO leadership, also later came under fire for being too deferential to China, or even praising China’s handling of the outbeak in its early days – as the crisis swept across the world, paralyzing travel and shutting down economies.

Farrar, meanwhile, has emerged as an even more senior figure in the agency shake-up and someone to watch for the future.

Briand, a French national, as head of research offers the WHO the opportunity to strengthen its organizational links to European research institutions at a time when the United States is cutting funding for science research and innovation both at home and abroad.

“In that context, it’s historic to see a French national become head of research,” said one WHO scientist.

WHO Organization as of January 2025 boasted 10 divisions and 76 department directors.

The new team now faces the big challenge of reducing the number of WHO directors at headquarters by more than half, in line with a plan to dramatically cut WHO’s budget in the face of the loss of funds due to the US withdrawal, WHO’s largest donor, from the agency, announced by new US President Donald Trump in January.

Facing a $600 million shortfall in 2025 and a $1.7 billion funding gap for the 2026-27 biennium, according to the latest estimates, the WHO reorganisation would cut the number of departments at headquarters by nearly half – from 76 department directors as of January 2025 to around 34 departments and directors, according to the new organogram.

The number of directors at headquarters would be slashed by more than half, from 76  to 34, according to Tedros, speaking to PBAC.

“Decisions about which directors will lead which departments will be made following the World Health Assembly. That, I know, will also be tough, given the downsizing from 76 to 34 departments,” Tedros said in his message to PBAC members.

“I emphasize that our focus on strengthening our country offices is unchanged, although we do plan to close some offices in high-income countries that no longer need in-country support.”

Options for programme relocation outside of Geneva HQ

Illustrative options for WHO programme relocation to less-expensive settings in Europe and Africa, presented to the member state Planning, Budget and Administration (PBAC) meeting today.

At the closed-door PBAC meeting, Tedros also provided member states with an initial review of possibilites for relocating certain WHO departments and teams now based in Geneva to other existing WHO or UN hubs in more affordable locations – in Europe as well as Africa, Health Policy Watch learned.

Such “illustrative” options include: the relocation of certain health workforce teams to Lyon, two hours from Geneva in nearby France; moving more health emergency functions to Berlin, where WHO already has a pandemic surveillance office co-supported by the German government; relocation of IT support to an existing UN hub in Valencia; and finally, relocation of critical WHO infectious disease programmes to South Africa, Nairobi or Addis Ababa. This could bring those programmes “closer to the world regions with heaviest disease burden” alongside other major UN and African policy and research hubs.

Such relocations could help mitigate some of the fallout at headquarters, were as many as 30-40% of WHO’s 2600 rank-and-file staff could reportedly be facing layoffs, based on WHO’s existing budget shortfall there, the biggest  in the organization.

“We anticipate that the most significant staff reductions will be at headquarters, while regional offices will also be affected to varying degrees,” Tedros told PBAC, although he has so far provided no exact projections as to how many would be laid off, saying that will only become clear once a more detailed organizational “prioritization” exercise is completed. Tedros added, however, that WHO already has introduced “a range of support mechanisms, and we are committed to supporting the mental health and well-being of all our colleagues.”

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

“Now they have to cut down 50% of the directors, so the work is only begun,” one observer said. “”In any case this is a transitional team because the Director-General will complete his term in two years time.”

The retrenchment follows years of expansion during the COVID pandemic, and post-COVID outbreaks and humanitarian crises, when the number of WHO’s most senior directors nearly doubled, along with the ranks of consultants. See related story:

https://healthpolicy-watch.news/exclusive-number-of-who-senior-directors-nearly-doubled-since-2017-costs-approach-100-million/

Image Credits: WHO , WHO, Fletcher/HPW , WHO, 2025, WHO .

Scarcity of food in Gaza is increasingly causing malnutrition and severe hunger as the war continues.

All 2.1 million people in Gaza face hunger and diseases while life-saving supplies sit just beyond the borders, denied entry after nine weeks of a total blockade, Dr Hanan Balkhy, World Health Organization (WHO) regional director for the Eastern Mediterranean, told a media briefing on Tuesday.

“The Israeli authorities propose to shut down the UN-led aid distribution system and deliver aid under conditions set by the military, but WHO and the United Nations will not participate in any initiative that violates humanitarian principles. Aid must reach those in need, wherever they are, and the blockade must end,” she added.

Dr Hanan Balkhy, World Health Organization (WHO) regional director for the Eastern Mediterranean.

The entire population is facing high levels of acute food insecurity, while half a million people (one in five) are facing starvation, according to the Integrated Food Security Phase Classification (IPC) report released on Monday.

Three quarters of Gaza’s population are at “emergency” or “catastrophic” food deprivation, the worst two levels of IPC’s five level scale of food insecurity and nutritional deprivation.

Since the blockade began on 2 March, 57 children have reportedly died from the effects of malnutrition. 

If the situation persists, nearly 71 000 children under the age of five are expected to be acutely malnourished over the next 11 months, according to the IPC report.

Dr Richard Peeperkorn, WHO Representative in the occupied Palestinian territory.

Dr Richard Peeperkorn, WHO Representative in the occupied Palestinian territory, told the media briefing that 70,000 pregnant and lactating women “are expected to require treatment for acute malnutrition”, with their children facing long-term effects including stunted growth and impaired cognitive development.

The United States announced last week that it supported food aid being channelled to Gaza via a private company un by US contractors, the Gaza Humanitarian Foundation. 

The Israeli government has said that it supports the plan, but the UN has described it as “weaponizing aid”.

Peeperkorn said that there needed to be an immediate lifting of the blockade but that aid needs to be delivered via “One UN action” in terms of the “global humanitarian principles of humanity, impartiality, independence and neutrality”.

“There is a well established and proven humanitarian coordination system led by the UN and its partners that is already in place and must be allowed to function fully to ensure that aid is delivered in a timely and equiptable manner,” said Peeperkorn.

He added that discussions are ongoing between the UN, Israel and the US and he hoped this would result in the resumption of aid as the WHO, World Food Programme and UNICEF were all ready with “massive amounts of food, medicine and water and hygiene supplies”.

US President Donald Trump addresses the US-Saudi investment conference

US President Donald Trump arrived in Saudi Arabia on Monday night for a three-day visit to the Middle East focused on economic partnerships.

Addressing a US-Saudi investment forum on Tuesday evening, Trump said that he hoped Saudi Arabia will rejoin the “Abraham Accords”, agreements the US negotiated between Israel and some Arab countries during his first term. However, Saudi Arabia has ruled out normalising relations with Israel while it is at war with Gaza.

On the eve of Trump’s visit, The Guardian reports that his Middle East envoy Steve Witkoff said that the US “want to bring the hostages home, but Israel is not willing to end the war. Israel is prolonging it”.

‘Forgotten crises’

Yemen is also facing one of the world’s largest cholera outbreaks with over 270,000 suspected cases and 900 deaths in the past year, said Dr Ahmed Zouiten, acting regional emergency director for WHO EMRO.

Some 19.6 million people in Yemen are in need of humanitarian aid after 10 years of war.

Recent escalation in violence has threatened the country’s main port and airport, key gateways for humanitarian aid.

WHO only received 8% of $56 million funding it needs to address the crisis in Yemen.

“We need to secure further funding as soon as possible otherwise one mother and six newborns will continue to die every two hours already,” said Zouiten.

Meanwhile, Sudan is facing the world’s worst hunger crisis in terms of scale,with  an estimated 24.6 million people facing food insecurity this month, including 770,000 children suffering from severe acute malnutrition, said Balkhy.

“Some 8.2 million people are losing or at risk of losing access to health because of the shrinking funding for WHO and the health cluster partners. So we need support in Yemen. We need support in other forgotten crisis – Afghanistan and Pakistan, Syria and Somalia.”

Image Credits: WHO.

Fatmata Bamorie Turay (left) and Elizabeth Tumoe, registered nurses look after newborns at the Princess Christian Maternity Hospital in Freetown Sierra Leone

Although the international nurse workforce has increased by about two million between 2018 and 2023, there is still a huge global shortage concentrated in poorer nations, according to the State of the World’s Nursing 2025 report published on Monday.

There was a global shortage of around 5.8 million nurses in 2023, an improvement on 2018 when there was a 6.2 million shortage, but the shortage is felt most acutely in low-and middle-income countries (LMICs).

Close to half (46%) of all 29.8 million nurses globally are concentrated in high-income countries (HICs), which represent only 17% of the population, according to the report.

The shortage of nurses is felt most acutely in poor countries, particularly in Africa and South East Asia.

LMICs face “challenges in graduating, employing and retaining nurses in the health system” and need to raise domestic investments to create and sustain nursing jobs, according to the report, which was compiled by the World Health Organization (WHO) and the International Council of Nurses (ICN).

Meanwhile, HICs need to “manage high levels of retiring nurses and review their reliance on foreign-trained nurses, strengthening bilateral agreements with the countries they recruit from”, it adds.

In 20 mostly high-income countries, retirements are expected to outpace new entrants, which raises “concerns about nurse shortfalls, and having fewer experienced nurses to mentor early career nurses”.

Migration is depleting fragile workforces

Almost a quarter (23%) of nurses in high-income countries are foreign-born, in contrast to upper-middle-income countries (8%), lower-middle-income countries (1%), and low-income countries (3%).

“When wealthy countries recruit from low-income nations, they risk depleting already-fragile nursing workforces,” warns the ICN, noting that migration is also driven by the under-employment of nurses in low-income countries. 

“The combination of workforce shortages, poor working conditions and compensation, and imbalanced distribution all fuel the vicious cycle of inequitable migration patterns,” notes the ICN.

The report stresses that all countries need to adhere to the WHO Global Code of Practice on the International Recruitment of Health Personnel, and where recruitment from one country to another occurs, there should be “bilateral agreements that translate into mutual and proportional benefits for source countries”.

Although low-income countries are increasing nurse graduate numbers at a faster pace than high-income countries, in many countries, this is “not resulting in improved densities due to the faster pace of population growth and lower employment opportunities”.  

To address this, countries should create jobs to ensure graduates are hired and integrated into the health system and improve working conditions.

“The report clearly exposes the inequalities that are holding back the nursing profession and acting as a barrier to achieving universal health coverage (UHC),” said ICN president Pam Cipriano. 

“Delivering on UHC is dependent on truly recognising the value of nurses and on harnessing the power and influence of nurses to act as catalysts of positive change in our health systems.”

“We cannot ignore the inequalities that mark the global nursing landscape. On International Nurses Day, I urge countries and partners to use this report as a signpost, showing us where we’ve come from, where we are now, and where we need to go – as rapidly as possible,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

At a media briefing on Monday, Howard Catton, ICN CEO, said real progress has been made in areas such as “advanced practice nursing, increased Chief Nursing Officer roles, increased graduate preparation of nurses, and reducing outdated gendered associations and attracting more men to the profession”. 

But little progress has been made on “the global health emergency of nursing shortages, hugely worrying indicators of inadequate working conditions and pay, troubling patterns of inequalities and nurse migration, and continued failures to fully enable nurses as leaders working to their full scope of practice and influence”, he added.

Pay and working conditions

Countries that regulate working conditions

The global median entry-level wage of nurses in 2023 was $774 per month in 82 countries, with significant differences by WHO region and by income group. 

Median wages in HICs were twice as high those of upper-middle-income countries, and three times as high LICs. 

Wages adjusted for purchasing power parity indicated that the European and Eastern Mediterranean regions have the highest median entry wages, and the WHO African and South-East Asia regions have the lowest. 

Most countries reported laws on minimum wages (94%), social protection measures (92%) and health worker safety (78%).  But only 55% had regulations on working hours and conditions, and even fewer had provisions for mental well-being.

“Mental health and workforce well-being remain areas of concern. Only 42% of responding countries have provisions for nurses’ mental health support, despite increased workloads and trauma experienced during and since the COVID-19 pandemic,” according to the report.

Policy proposals include empowering nurses to contribute to the climate agenda through education, advocacy, climate-conscious practice in health settings and leadership. 

South East Asian countries had the highest percentage of protections in place (70%) while Western Pacific countries had the lowest (21%). 

By income group, HICs had the most countries (63%) reporting provisions regarding working conditions and hours, while LICs had the fewest (48%). Other sources have described a related pattern in that excessive working hours, defined as working over 48 hours per week, were more frequently reported by nurses and midwives in low- and lower middle-income countries, many in Africa.

Attacks on healthcare workers

An attack on ambulance outside Al-Shifa hospital in Gaza in November 2023.

Measures to prevent attacks on health workers were reported in 59% of the responding countries, representing an increase from the 37% of countries reported on this in 2020. 

This was found to be highest amongst the responding countries in South-East Asia (90%) and lowest in the Americas (36%)

“Data from WHO’s Surveillance System for Attacks on Health Care indicate that between 1 January 2018 and 31 March 2025, there were more than 8,300 incidents of attacks reported from 22 countries/territories with over 3,000 deaths and over 6,000 injuries of health workers and patients,” according to the report.

The report recommends measures to support nurses and other health workers in post-conflict settings and reduce attrition including providing opportunities for professional development, incorporating financial incentives and allowing flexibility.

Image Credits: World Bank/Flickr, WHO, MSF/ Dr Obaid.

Nurses preparing rapid COVID-19 diagnostics in 2020. Post-pandemic, new and more affordable rapid tests for HIV and other infections remain a major R&D priority.

A Nigerian Health Tech firm, Codix Bio, has been awarded a license to develop and manufacture a new generation of rapid diagnostic tests (RDTs) royalty-free for African consumers, using technology transferred from a South Korean firm. The deal is a breakthrough for WHO’s new Health Technology Access Programme (HTAP) and the non-profit Medicines Patent Pool – which aim to facilitate tech transfer to the Global South post-COVID pandemic, when the dearth of local manufacturing left many countries short on medicines and diagnostics as well as vaccines.

Using innovative new technology supplied by South Korea’s SD Biosensor, Codix Bio will first develop and produce a new line of highly-sensitive rapid tests for HIV/AIDS, which can generate results within 20 minutes, WHO said in an announcement of the deal on Friday. But the technology can also be adapted to develop and manufacture tests for malaria and syphilis, among other diseases.

In December 2023, SDB signed a non-exclusive license with MPP to enable development and manufacture of new diagnostic tools using its cutting edge technology in low- and middle-income countries, in sharing arrangements brokered under the auspices of the WHO COVID-19 Technology Access Pool (C-TAP).

In January 2024, CTAP morphed into HTAP – with a mandate to stimulate innovation and facilitate access to new health technologies beyond COVID tools in underserved regions, by expanding local manufacturing capacity. Through HTAP, WHO and MPP issued an open call for applications by LMIC-based manufacturers to produce diagnostics using the SDB innovations, with Codix Bio selected as the first sublicensee.  According to the original SDB license with MPP, the tech transfer is royalty free for product sales in low- and middle-income countries.

The WHO announcement coincided with a gala launch of the partnership at the Codix Bio campus in Ogun State, near Lagos, with the participation of the Korean firm alongside their Nigerian counterparts.

“This landmark agreement is a defining moment in our journey of health-tech innovation and a breakthrough for local healthcare manufacturing in Africa. Being selected as the first sublicensee under this global initiative underscores our commitment to contribute meaningfully to pandemic preparedness and regional health security,” said Sammy Ogunjimi, CEO, Codix Group.

“With support from WHO and MPP, we are committed to producing high-quality, rapid diagnostic tests that can transform access to timely diagnosis, not just in Nigeria, but across the continent,” he said.

“The announcement of this sublicensing agreement with Codix Bio marks an important milestone in our partnership with WHO and MPP,” said Hyo-Keun Lee, Vice Chairman of SD Biosensor, Inc. “By coupling the technology transfer with coordinated support, this initiative not only helps Codix Bio respond to health priorities in Nigeria and the region – it also demonstrates a collaborative model for building sustainable and self-reliant local manufacturing capacity.”

Speaking from Geneva, Yukiko Nakatani, WHO Assistant Director-General, Access to Medicines and Health Products called the agreement “a major milestone in strengthening manufacturing capabilities in regions where they are needed most.

“It can help advance global commitments made at the 2023 World Health Assembly to promote equitable access to diagnostics as a cornerstone of universal health coverage and pandemic preparedness.”

Image Credits: University of Washington Northwest Hospital & Medical Center.

US conservative Christian group Family Watch International president Sharon Slater (centre) meets with Uganda’s first lady, Janet Museveni, and other government officials in April 2023 to encourage passage of a new anti-homosexuality law.

Women’s groups and human rights organisations have raised the alarm about an African anti-rights conference taking place this weekend in Uganda, followed by another next week in Nairobi, featuring prominent US conservatives, aimed at developing “an African charter on family sovereignty and values”. 

Previous conferences have been used to mobilise for anti-LGBTQ laws and promote restrictions on sexual and reproductive rights on the continent, critics say.

Similar “African family” conferences have tried to “strip women of their basic human rights and dignity and reinforce the dominance of men within our society using ‘family values’ as a vehicle”, notes Women’s ProBono Initiative (WPI), a Ugandan women’s rights group.

The Entebbe Inter-Parliamentary Forum opened on Friday (9 May). Since its inception three years ago, it has served as a conservative platform for ultra-conservative African Members of Parliament.

Hosted by Uganda’s president and parliament, the forum has mobilised for copycat anti-LGBTQ laws in Uganda and Ghana with prison terms for those who identify as lesbian, gay, transgender, and bisexual. Conservative Kenyan MPs are working on a similar law.

Other concerning examples of shared policies are the Kenyan government’s 2023 “family protection policy” which undermined no-fault divorce, instead forcing parties into mediation even in cases of domestic abuse, says WPI. This has since been replicated by Uganda.

The Entebbe conference aims to adopt a conservative African ‘Charter’.

Notorious ‘hate groups’

The Entebbe forum taking place over the weekend is co-sponsored by Family Watch Africa, the continental branch of the Arizona-based Family Watch International (FWI), an anti-choice, abstinence-only organisation, also designated as a ‘hate group’ by the Southern Poverty Law Center in the US for its anti-LGBTQ agenda. 

Family Watch International’s Sharon Slater is due to speak at both anti-rights conferences.

FWI president Sharon Slater, who is presenting the opening session, is notorious for championing anti-LGBTQ laws in Africa and organises annual “training sessions” for African politicians in Arizona on how to lobby for conservative causes at the United Nations and other multilateral forums.

“Whenever an anti-LGBTQ law is passed in Africa, you are assured Sharon Slater had a hand in it!” says Tabitha Saoyo Griffith, a human rights lawyer and Amnesty International Kenya board member.

Last year’s forum featured addresses by two of the continent’s most vociferous anti-vaxxers, Shabnam Mohamed and Wahome Ngare, who delivered blistering attacks on several life-saving vaccines, as reported by Health Policy Watch.

Mohamed heads the Africa chapter of Children’s Health Defense, the anti-vaccine group founded by Robert F Kennedy Jr, currently the US Secretary of Health and Human Services.  

Ngare is a director of the conservative lobby group, the Kenyan Christians’ Professionals Forum (KCPF). Nine Ugandan medical professional bodies issued a statement disavowing Wahome’s misinformation after his address. 

This year’s forum will not be public, and attendees have to agree to abide by “Chatham House rules” (no disclosure or attribution of information) when registering. 

“This is worrying because these elected representatives, discussing African family values, are accountable to the people who elected them. The secretive nature of these discussions points to a sinister plan that will result in harmful decisions with life-and-death consequences,” says Joy Asasira, a sexual and reproductive health rights advocate from Uganda.

From Entebbe to Nairobi

On Monday, May 12, a day after the Entebbe forum ends, the Pan-African Conference on Family Values convenes in Nairobi, Kenya. 

Co-hosted by anti-vaxx Ngare’s KCPF, this is an even bigger gathering than Entebbe. It aims at “promoting and protecting the sanctity of life, family values and religious freedom”, as well as equipping delegates “with tools to strengthen advocacy efforts at national, regional, and global levels,” according to pre-conference publicity. 

Ironically, its keynote speakers are predominantly white conservative men from the United States and Europe. US Secretary of State Marco Rubio had even been invited to speak, but cancelled his planned visit to Kenya – reportedly in protest against Kenyan President William Ruto’s recent visit to China.

There is a proliferation of white Western men as  keynote speakers for the Pan-African Conference on Family Values in Nairobi that starts on 12 March.

The cast of speakers includes Austin Ruse, the president of the ultra-conservative Center for the Family and Human Rights (C-Fam), who describes himself as “descended of colonists” and a “Knight of Malta”, a Catholic order.

Also due to speak are Family Watch International’s Slater; Dutch conservative lobbyist Henk Jan van Schothorst; and US anti-LGBTQ politicians Robert Destro, a deputy secretary of state under the first Trump administration, and former senator John Crane; as well as leaders of the ultra-conservative Polish group, Ordos Iuris. Kenya’s Labour Ministry is also supporting the conference.

Advisors to Trump’s ‘Project 2025’ co-sponsoring events

Two of the Nairobi conference co-sponsors – C-Fam and the Alliance Defending Freedom – were on the advisory committee of Project 2025, the conservative blueprint being followed by the US Trump administration which has led to life-threatening cuts to development aid in Africa. Meanwhile, another sponsor, FWI, has worked with the Heritage Foundation, which authored Project 2025.

Project 2025’s proposals to slash US Agency of International Development (USAID) grants, prioritise funding for faith-based organisations and prohibit funding for “sexual reproductive health and reproductive rights” and “gender equality” programmes have all been implemented.

“It is outrageous that these organisations have been given a platform, when they are part of an initiative that pushed for slashing aid that is harming Africa families, and undermining the health of children, women and men and vulnerable communities,” said Dr Haley McEwan, a research associate at the University of Witwatersrand’s Centre for Diversity Studies in South Africa.

“This conference is part of decades-long activities of US Christian right organisations in the region. The fact that it features high-profile government speakers shows that they are gaining influence and power and this is even more concerning, particularly in light of the damaging funding cuts.”

Three of the sponsors of the Pan-African Conference on Family Values in Nairobi served on the Project 2025 advisory committee that proposed the Trump administration slashes development aid.

“Why are these white American men so concerned about African families? Is this not another form of colonialism? ” asks Kemi Akinfaderin, chief global advocacy officer for Fòs Feminista, a global network of over 150 organisations working for sexual and reproductive rights.

“They are trying to instil fear by claiming that there is an agenda to reduce Africa’s fertility and population rates, but this is an imposition of Western problems, such as declining fertility rates, on Africa.” 

Human rights organizations petition against use of Red Cross-owned hotel 

Over 20 Kenyan human rights organisations, backed by more than 12,000 signatories, petitioned the Red Cross, the main shareholder of Nairobi’s Boma Hotel where next week’s conference is being held, to try to persuade them to refuse to host the gathering.

In their letter, the human rights organisations point to the KCPF’s opposition to laws aimed at curbing maternal mortality in Kenya and its involvement in promoting Uganda’s Anti-Homosexuality Act. The KCPF is also opposing access to contraception for people under the age of 18.

“By giving the conference a platform, Red Cross Kenya is endorsing discriminatory ideologies that contradict the Red Cross’s commitment to alleviating human suffering and prioritising the lives of the most vulnerable,” they wrote.

However, the Red Cross, a principal recipient of the Global Fund grants in Kenya, responded that it was not involved in the day-to-day running of the hotel.

Human rights organisations have also sponsored billboards on the road from Nairobi’s airport to the hotel, stating: “True family values bring everyone together – not tear us apart.”

Billboards on the road from Nairobi’s airport protest anti-rights conferences with messages calling for an inclusive definition of families.

Narrow Western definition of ‘family’

Akinfaderin notes that the anti-rights groups have a “Western-centric, Eurocentric definition” of the family centred on a man as the head of the family, which is “not aligned with the more expansive realities of African families”.

“According to these groups, women’s rights, LGBTQI rights, access to safe abortion and comprehensive sexuality education, are anti-family initiatives,” says Akinfaderin.

“Their justification is that, if more women and girls know their rights and having a sense of value and empowerment, it means that they’re less likely to want to stay home and bear children. But women’s and girls’ aspirations are greater than their reproductive capacities. They want to go to school, work, and earn their income. They want the right to decide for themselves: physical, economic, social, and bodily autonomy,” she adds.

Anti-LGBTQ legislation was introduced in Uganda and Ghana shortly after previous year’s conferences. Ghana’s former president did not sign his country’s bill into law but conservative MPs are planning to reintroduce it under the new government. 

There are fears that this month’s events will galvanise Kenyan MPs to do the same, particularly as the conference is supported by Kenya’s Department of Labour and President Ruto is an evangelical Christian with close ties to US conservatives.

Sierra Leone is debating a Safe Motherhood Bill that will allow access to abortion to reduce its high maternal mortality rate.

Meanwhile, Akinfaderin points to several other ‘family values’ conferences in the offing in Africa in the coming months, including the Strengthening Families Conference organised by the Church of Latterday Saints (Mormons) in June in Sierra Leone. FWI’s Slater is a Mormon.

Sierra Leone’s lawmakers are currently considering the Safe Motherhood Bill, which would allow abortion up to 12 weeks (24 weeks in cases of rape, incest or danger to the mother’s health) as a measure addressing the country’s currently high maternal mortality rate. An estimated 10% of maternal deaths are due to now illegal, unsafe abortions. Lobbying by religious anti-abortion groups has thwarted a 2016 initiative to decriminalise abortion in Sierra Leone.

“It’s no mistake that they’re targeting Sierra Leone,” says Akinfaderin.

Where are the pro-family initiatives?

If these organisations and conferences are really pro-family, why are they not promoting policies that support families to thrive, ask the women’s groups and activists?

“Families need food, water, housing, access to healthcare, and protection,” says Saoyo Griffith.

“They should be talking about policies that help individuals to be able to make informed decisions about having children,” says Akinfaderin. “Pro-family policies should be about expanding access to contraception and family planning, assisted reproductive techologies like in vitro fertilisation (IVF), child care services, parental leave, social protection, and ending sexual violence in the home.” 

Women are at the core of families and if MPs want to support families, they should fast-track laws that protect women, such as the East African Community Sexual and Reproductive Health Bill, and laws on sexual offences and policies to extend social protection to single parents, says WBI.

“Families should never be a place where women’s rights are stripped away or where women live as second-class citizens who only exist to serve men. Instead, families should be a place of liberation where women can thrive and live life to the fullest on their own terms,” adds WBI.

Image Credits: Africa News.

Vadym, a Ukranian living with HIV, with a box of ARV medication. Ukraine’s HIV response has been severely affected by the US government’s withdrawal of funds.

As countries dependent on United States aid for their HIV response report looming shortages of antiretroviral medicine, the Joint UN Programme on HIV/AIDS (UNAIDS) is also fighting for survival.

Meanwhile, more shocks may be ahead for the HIV sector as the US Health and Human Services plans to curtail research collaboration between US scientists and foreign researchers, a common occurrence in the HIV sector.

UNAIDS is cutting full-time staff by more than half – from 608 to 280 – and almost halving country offices, from 75 to 36, according to a communique sent to staff, as reported by Devex.

This follows the Trump administration’s decision to end US Agency for International Development (USAID) funds to UNAIDS, which affects around 40% of its budget.

Further cuts may be necessary if a proposal from an internal UN task force is heeded, which would see UNAIDS merging with the World Health Organization, as previously reported by Health Policy Watch.

But Farhan Aziz Haq, deputy spokesperson for the UN Secretary General’s Office, said that the UN restructuring proposals are “the preliminary result of an exercise to generate ideas and thoughts from senior officials”. The UN80 task force will report its final recommendations to the UN General Assembly in 2026.

UNAIDS executive director Winnie Byanyima and International AIDS Society chair Sharon Lewin at the launch of the UNAIDS report in Munich

Medicines, supply chains disrupted

While UNAIDS faces an internal crisis, so too do the countries and communities worst affected by HIV that it serves.

By the end of 2023, 30.7 million people were accessing antiretroviral (ARV) treatment and 61% lived in just 10 countries – South Africa, Mozambique, India, Nigeria, Tanzania, Kenya, Zambia, Uganda, Zimbabwe and Malawi.

The US President’s Emergency Plan for AIDS Relief (PEPFAR) was one of the biggest purchasers of ARVs and the breakthrough injectable ARV, cabotegravir, that prevents HIV infection that was being rolled out as pre-exposure prophylaxis (PrEP).

PEPFAR spent almost $500 million a year on ARVs and PrEP, and any reduction in its orders is likely to push global prices up, yet another obstacle in the fight against HIV.

“Sustained predictability in HIV commodity demand forecasts is essential to guarantee a stable supply, maintain prices, and ensure the availability of affordable generic medicines for national HIV responses,” according to a UNAIDS report issued on 30 April.

PEPFAR also funded ARV supply chains and logistics in many countries, and almost half (46%) of the 56 countries most affected by HIV have reported supply chain disruptions in the past month or so, according to UNAIDS.

By the end of April, seven countries out of the 56 most HIV-affected reported that they had six or less months of stock in at least one antiretroviral line. These are Burundi, Côte d’Ivoire, Ghana, Haiti, Uganda, Ukraine and Zimbabwe.

The Democratic Republic of Congo (DRC), one of the biggest PEPFAR beneficiaries, expects both ARV and condom stockouts in the next three to six months.

It’s antenatal testing of pregnant women, delivery care for women living with HIV, early infant diagnosis and paediatric treatment services are all affected, UNAIDS reported last week.

However, 22 countries said that they were not reliant on PEPFAR funding for ARV procurements but that the loss of funds had disrupted their medicine supply chains.

Focus on ‘key populations’ is lost

The HIV sector’s focus on the “key populations” most vulnerable to HIV is likely to be lost – possibly forever – due to a lack of funds. 

Key populations comprise groups that face heavy stigma – sex workers, gay men and other men who have sex with men, transgender people, people who inject drugs and prisoners. 

HIV is stubbornly high in these groups, who are generally difficult to reach and often face legal barriers to access treatment. 

However, the scientific consensus in the sector is that HIV can only be stopped if it is addressed in these groups – and until Donald Trump became US president, PEPFAR was prepared to fund this approach.

In South Africa, for example, only 17% of the country’s HIV response was covered by PEPFAR, but the vast majority of those funds went to providing services for key populations.

But all PEPFAR-supported services for key populations have been stopped, as these groups are pariahs for Trump Republicans.

So too has a plan to integrate mental health and HIV services, according to Dr Gloria Maimela from the Foundation for Professional Research.

However, South Africa also prioritises young women who are amongst the most vulnerable to HIV, and outreach to them has also been curtailed.

The HIV treatment centre in Bahir Dar in Ethiopia geared to helping young people and key populations has closed.

The situation is similar in Ethiopia, where centres for key populations and young people have closed as staff have not been paid.

Centres offering services to key populations and young people in Bahir Dar to Mikadra, Humera, and Dansha have stopped.

“For two months, no new clients have been enrolled in PrEP, the prevention prophylaxis taken orally that protects from HIV infection. HIV testing has dropped by 43%. More than 800 people have faced treatment interruption. And 215 survivors of gender-based violence have lost access to the support services they once relied on,” according to a UNAIDS report issued last week.

Numerous countries report longer-term closures of certain ARV dispensing points, particularly at community level and those serving key populations, according to UNAIDS

Global PrEP rollout affected

PEPFAR funding covered more than 90% of PrEP initiations globally in 2024, and numerous countries report that they have been unable to sustain high-risk patients on PrEP, including in Guatemala, El Salvador, Haiti, Ukraine, Viet Nam and Zambia.

Last year, PEPFAR purchased 95% of ViiV’s cabotegravir stock for PrEP, but it has not delivered much of this to low and middle-income countries as promised, including to South Africa which was promised 230,000 doses.

“Restrictions in eligibility to access US government-funded HIV prevention commodities effectively leaves out numerous populations at high risk of acquisition,” UNAIDS notes.

HIV-linked commodities such as condoms and opiod replacement medication have also been disrupted thanks to the dominant role of PEPFAR in their  procurement, distribution and delivery.

Close to a quarter (23%) of countries reported six or less months of condom or PrEP stocks.

A recent survey by International Network of People who Use Drugs (INPUD) reports a large-scale suspension of outreach and harm reduction programmes, including needle and syringe distribution, HIV and hepatitis C testing, overdose prevention and legal support services.

Centres distributing opioid agonist maintenance therapy (OAMT) closed for a month in Uganda and Tanzania, for example.

OAMT is often prescribed as oral medication to alleviate the symptoms of withdrawal and reduce injecting drug use. In 2022, the risk of acquiring HIV was 14 times higher for people who inject drugs than the overall adult population.

“Fearing a stock out of methadone–the OAMT medicine–we have witnessed people returning to heroin use and hitting the black market,” Banza Omary Banza, director of Community Peers for Health and Environment Organisation in Tanzania, told UNAIDS.

Millions of lives at risk

While the Global Fund is helping to address some gaps, it is unable to fill the gap left by PEPFAR. 

UNAIDS modelling predicts that the permanent discontinuation of PEPFAR-supported HIV programmes would lead to an additional 6.6 million new HIV Infections (about 2300 per day) and an additional 4.2 million AIDS-related deaths (over 600 per day) by 2029.

Image Credits: The Global Fund/ Saiba Sehmi, Global Fund, UNAIDS.

Afghan families navigate daily life under challenging conditions, with the WHO warning that 80% of the health facilities it supports may close by June due to aid cuts.

Bibi Sharifa’s grandmother died of tuberculosis when there was no medicine available in her village in central Afghanistan and visiting shrines of the dead holy men was the only healing they could get.

That was two decades ago when the country’s entire healthcare system was in shambles under the first term of a brutal Taliban regime in the late 1990s. Then, when the west-backed democracy was set up following the US invasion in 2001, Afghanistan saw the establishment of clinics and community healthcare centers in villages and towns that revived the miserable population’s hopes and trust in modern medicine to some extent.

Now, Sharifa herself is infected by that consuming disease which killed her grandmother. With the drastic cuts by the Trump administration to the healthcare system worldwide, she told Health Policy Watch she has no hope of healing except by visiting the dead holy men’s graves.

“I cough all night and head to the Mazar (shrine) of Hakeem Senai in Ghazni in the day. Whenever I visit and ask for help, the preachers there advise me to either just touch and kiss the shrine, or they give me a paper with something written on it to put in a leather cover and wear it. I don’t even know what is written on it and it hasn’t helped me stop coughing,” Sharifa explained.

She was referring to a ‘taweez’, or amulet worn on the body in some beliefs to give the wearer protection. 

Dr Siraj Uddin, a physician in Ghazni province, Bibi’s home town, told the Health Policy Watch that many deadly diseases, such as TB  are prevalent. Until the latest aid cut, medicines and treatments were available to keep them under control.

“These days, all the government hospitals and the few charity-run clinics throughout Afghanistan are running out of medicine and other resources and with the cut in aid announced by (President Donald) Trump, it is going to get worse”, he said.   

Patients like Sharifa are facing the effects of this aid cut already. 

“There is no healthcare or medicine available even when we go to the hospitals,” she lamented, her voice heavy with despair. “And if it is in the private pharmacies, it’s too expensive. We pay for both healthcare and visiting the Mazar. If I could, I would rather pay the money for medicine to get some relief because the Mazar could not heal my grandmother,” she said.

The situation is similarly bleak in the capital, Kabul.

“First, we lost access to female doctors due to the Taliban’s policies, and now the lack of access to medicines via aid agencies is only making our difficulties worse,” said Sumaya Ahmadi, speaking on the telephone from  western Kabul while visiting a shrine in Karte Sakhi to seek help for her daughter’s chronic kidney condition.

“My husband and I brought our daughter to Mazar. We also visited a holy man in our area who wrote something on a piece of paper and performed a blessing over our daughter. If she drinks the water with that paper in it, hoping it will help. We try to manage, but it’s never enough.”

Vicious cycle of poverty and suffering

Afghan children are particularly vulnerable as immunization rates are critically low and food insecurity is widespread.

The United Nations (UN) has urged the global donor community to continue critical support to Afghanistan, where almost 23 million people will need humanitarian assistance this year.

“If we want to help the Afghan people escape the vicious cycle of poverty and suffering, we must maintain support to meet urgent needs while laying the foundation for long-term stability,” said Indrika Ratwatte, UN Resident and Humanitarian Coordinator in Afghanistan.

The UN has warned that the global funding crisis “could jeopardize the fragile improvements achieved in stabilizing Afghanistan over the last four years, such as improved food security levels and moderate economic growth”.

The World Health Organization (WHO) has also sounded the alarm, warning that 80% of the health services it supports could cease by June due to funding shortages.

By early March, 167 healthcare facilities had closed, depriving 1.6 million Afghans of access to healthcare. Another 220 are at risk of closing, affecting 1.8 million people.

“Afghanistan is already battling multiple health emergencies, including outbreaks of measles, malaria, dengue, polio and Crimean-Congo haemorrhagic fever,” according to the WHO.

“Without functioning health facilities, efforts to control these diseases are severely hindered. Over 16 000 suspected measles cases, including 111 deaths, were reported in the first 2 months of 2025. With immunization rates at critically low levels (only 51% for the first dose of the measles vaccine and 37% for the second), children are at heightened risk of preventable illness and death.”

The Trump administration’s decision to slash United States aid to Afghanistan is particularly devastating given that the US is the country’s largest donor, contributing over 43% of the $1.72 billion in aid raised last year. While the US has pledged waivers for life-saving aid, the scope and reliability of these waivers remain unclear.

The UN-coordinated $2.4 billion Afghanistan Humanitarian Needs and Response Plan for 2025 is only about 13% funded.

Meanwhile, a woman dies every two hours from preventable complications in Afghanistan and 3.5 million children and 1.2 million pregnant or breastfeeding women are acutely malnourished or at risk of becoming so.

Women like Sharifa and Ahmadi know little about the geopolitical decisions that are stripping away their access to healthcare. 

In desperation, they turn to shrines and holy men, seeking the only kind of healing still available to them. But their stories raise a critical question for the international community: where does the moral responsibility of the global healthcare system begin – and end?

Image Credits: WHO EMRO.

In the first episode of “Trailblazers with Gary,” Global Health Matters podcast host Dr Garry Aslanyan sat down in South Africa with Professor Tulio de Oliveira — one of TIME Magazine’s 100 most influential people in global health.

Oliveira leads the Centre for Epidemic Response and Innovation at Stellenbosch University and was part of the team that first identified the Beta and Omicron variants of COVID-19.

Aslanyan and Oliveira met in Oliveira’s lab to talk about the real story behind the Omicron discovery, how Africa came together to fight the pandemic, and why pandemic preparedness must remain a top priority, even as the world moves on.

Oliveira opened up about his roots in Brazil, his family’s move to Africa during the post-apartheid years, and how those early experiences shaped his life’s mission. Oliveira said he sees global health not as a job, but as a moral responsibility — one that requires constant vigilance, collaboration, and investment.

Aslanyan and Oliveira also discussed how climate change is already fueling new health crises across the globe. From dengue outbreaks in Ethiopia to cholera in Malawi, Oliveira explained how extreme weather, flooding, and increased mobility are making epidemics more likely — and more dangerous.

His message was clear: global health funding cuts are not just short-sighted — they’re dangerous. Pathogens don’t respect borders. Without strong, coordinated systems in place, we’re setting ourselves up for the next pandemic to hit even harder.

His advice to the global health community? Stay focused. Deliver results. And never underestimate the power of preparation.

Watch the full episode:

 

Image Credits: TDR – Global Health Matters.

Heated tobacco products (left and middle) are electronic devices that heat tobacco inserts. (The device on the right is an e-cigarette.)

Big tobacco companies are marketing heated tobacco products (HTP) as a less harmful alternative to cigarettes, but researchers warned this week that there is no evidence to support this or the industry claim that they can help smokers to quit.

HTPs are electronic devices that heat an insert of processed tobacco, often in a stick or pod, to produce an aerosol containing nicotine and other chemicals. The tobacco insert is often flavoured, including with flavours such as bubble gum and lime that appeal to young people.

“There are three key things policymakers and consumers need to know,” said Dr Sophie Braznell, a researcher from the University of Bath who co-authored a brief on HTPs released on Wednesday by STOP, a tobacco industry watchdog.

“First, heated tobacco products cause harmful effects. Second, there is no clear evidence that they are safer or less safe than other tobacco and nicotine products, even cigarettes. Third, available research lacks the independence and quality that might help us draw any conclusions about the impacts of real-world use,” Braznell told a media briefing on Wednesday.

Billion-dollar market

The main players in the HTP market.

The HTP market is estimated to be worth $36.7 billion and is projected to grow by over 52% between now and 2032, according to market research company Stellar.

“HTPs are available in at least 57 countries across Europe, North and South America, Eurasia, and East Asia. The market for HTPs in Africa and the Middle East is small but growing,” according to Stellar, with Asia Pacific being the fastest-growing region in the market.

HTPs have become more popular than cigarettes in Japan, while sales are surging internationally with promotions at events aimed at youth.

The HTP market leader is Philip Morris International’s (PMI) IQOS, an abbreviation of “I Quit Ordinary Smoking”, while British American Tobacco (which makes Glo) and Japan Tobacco International (Ploom) are the other key players.

HTPs are available in a limited number of African countries, including South Africa, Kenya, Nigeria, Botswana, Zambia, Zimbabwe and Ghana. 

However, the cost of the device is a barrier, acknowledged Frederic de Wilde, PMI’s president for South and Southeast Asia, the Commonwealth of Independent States, the Middle East, and Africa region.

“Africa definitely has a role to play and we are committed to coming up with smoke-free products to offer alternatives to African smokers,” de Wilde told African Business in an interview in late December 2024.

But he said that the current HTPs were “premium devices”, and PMI is “piloting a new simple device that is less expensive and targeted for medium and low price segments”.

How PMI’s Heated Tobacco Products are being consumed across the world.

Biased clinical trials

Braznell has spent the past five years reviewing clinical trials involving HTPs. She and colleagues found 49 clinical trials on humans, but 34 were linked to the tobacco industry, with one-third linked to Philip Morris International. 

In addition, they were usually run over a very short time – five days or less – and in controlled settings like laboratories, rather than real-world settings.

“Overall, 39 of the trials were judged to have a high risk of bias,” said Braznell, including selective reporting of results. She and colleagues also published their findings on the trials in the BMJ this week.

Aggressive marketing

Sophia San Luis, executive director of Imagine Law, a Philippines-based public interest law group

Sophia San Luis, executive director of Imagine Law, a Philippines-based public interest law group, told the media briefing that big tobacco companies were aggressively marketing their HTPs to young people.

President Ferdinand Marcos has hosted PMI since he assumed office in 2022, and the company has promoted its smoke-free products at events organised by First Lady Liza Araneta Marcos.

Renowned DJ Steve Aoki promotes IQOS products, and there is a ‘limited edition” HTP bearing his name. However, a range of NGOs and community organisations stopped an IQOS-sponsored concert featuring Aoki on the grounds that it violated advertising bans on tobacco products.

Marketing of PMI’s IQOS in Philippines was boosted by support from DJ Steve Aoki, with limite edition devices branded in his name.

Dmytro Kupyra, executive director of “Life,” a Ukrainian NGO working to reduce mortality and morbidity from non-communicable diseases, said his country had increased taxes on HTP six-fold in 2021, which had contained sales. 

However, in 2024, the Ministry of Finance reduced HTP taxes by 25%, after the tobacco companies conducted an intense campaign for taxes to be reduced. This means that Ukraine is no longer aligned with the European Union on taxation.

“For next four year, between 2025 to 2028, Ukraine will lose around $500 million in tobacco excise taxes, and Ukraine will have around 24,000 additional deaths from hamful tobacco use,” said Kupyra, who said that about 15% of young Ukrainians aged 18 to 28 use HTPs thanks to aggressive marketing.

Ukraine backtracked on HTP taxation in 2024.

Hazel Cheeseman, CEO of the UK’s Action on Smoking and Health (ASH), said that PMI had a three-pronged strategy to promote HTPs.

“First of all, they want to aggressively secure a share of the nicotine market for their heated tobacco product, and are aggressively marketing them in ways that the UK Government does not believe is in line with the law,” said Cheeseman, whose public health charity set up by the Royal College of Physicians to end the harm caused by tobacco in the UK.

Hazel Cheeseman, CEO of the UK’s Action on Smoking and Health (ASH)

“They’re also seeking to secure a beneficial regulatory environment for their products through their lobbying efforts. But also, they want to be seen as a credible partner by the UK government on the basis that they have this apparently less harmful product,” said Cheeseman.

The UK’s comprehensive advertising restrictions on tobacco products were passed before HTPs existed, so PMI had marketed HTPs more aggressively and openly than they could for cigarettes, said Cheeseman.

When the UK government challenged PMI, they undertook to suspend marketing – but there are  numerous pop-up promotions of IQOS.

Questionable industry claims

“We are often told by the industry that heated tobacco products are a scientifically backed better alternative for adult smokers. But our own research shows us that we should be questioning whether, in fact, they are better for health,” said Braznell.

We’ve brought up questions and concerns about the quality of the available evidence, as well as other research that we’ve done over the last few years, which has shown that the tobacco industry continues to manipulate and misuse science for profit. 

“Work of our colleagues around the world has shown that many heated tobacco product users are not successfully quitting smoking using these products, and in fact, are perpetually continuing to use both heated tobacco products and cigarettes. 

“And lastly, we know that again and again, the tobacco industry is not just marketing heated tobacco products at smokers, but also to non-smokers and children.”

Image Credits: Filter, PMI.