Over 100 Countries Pledge to Adopt Policies to Address Violence Against Children 11/11/2024 Sophia Samantaroy A children’s choir at the Bogota conference drew attention to how pervasive violence against children is. The voices of the children’s choir echoed in the conference hall as a reminder that more than one billion children who experience some form of violence each year. Their performance was part of the historic first high-level ministerial conference to end violence against children in Bogota late last week, which brought together government delegations, children, survivors, and other key stakeholders. “We need a pledge for a future of opportunities for each child, so this is a moment to join our voices and resources to protect our children and ensure a peaceful and just future,” urged Luis Gilberto Murillo Urrutia, Colombian Minister of Foreign Affairs in a welcome address to delegates to the largest governmental gathering to address the issue. Governments representing more than 100 nations agreed to a new global declaration to protect children from all kinds of violence, exploitation, and abuse. Nine countries pledged to ban corporal punishment in schools: Burundi, Czechia, Gambia, Kyrgyzstan, Panama, Sri Lanka, Uganda, Tajikistan, and Nigeria. Dozens more pledged to investment in parenting support and national policies. Over half of all children globally experience some form of violence including corporal punishment in schools and at home, bullying, physical abuse, and sexual violence. These numbers, which include the one in eight girls and women who have experienced rape or sexual assault before the age of 18, according to new United Nations Agency for Children (UNICEF) estimates released last month. “Violence does more than harm individual children; it undermines the fabric of our society. It makes it harder for children to build happy, healthy lives and costs the global economy billions of dollars each year,” the WHO said in a statement. Despite this, the Conference represented the first global meeting to address the issue. The scale of children subjected to violence, and its lifelong implications created a sense of urgency at the conference, hosted by the Colombian and Swedish governments, in partnership with WHO, UNICEF and the UN Special Representative of the Secretary-General on ending violence against children.. “The results are serious harm to their physical and mental health and well-being setbacks to their education and future employment, unhealthy behaviors and perpetuating a cycle of violence from generation to generation, addressing this horrific reality requires concerted action from all of our removals at heavy level capitalist, schools, communities, and homes,” remarked Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in a video address at the conference opening. The WHO notes that this violence is often “hidden” and under-reported, with less than 10% of children receiving help. Yet this violence is preventable, as multiple speakers affirmed. The WHO’s INSPIRE package, a seven-point strategy to address violence against children, provides member states with “evidence-based strategies to stop the cycle of violence in a wide range of settings, in homes, through parenting interventions, in schools, through life skill training in social protection skills and through cash transfers in communities,” highlighted Tedros. The WHO notes that when countries implement such strategies, they can reduce violence against children by as much as 20-50%. Evidence-based solutions ‘need to be scaled up’ Solutions include parenting support to help avoid violent discipline, school-based anti-bullying interventions and enabling safe school environments, and laws that reduce underlying risk factors like access to firearms and alcohol. These have the potential to dramatically reduce the number of children who experience violence, said Alex Butchart, WHO unit head for Violence Prevention. “There should be the implementation and enforcement of laws, for instance, that ban corporal punishment by parents in the home or by teachers in the schools,” Butchart told a media briefing. “There should be efforts to denormalize the use of violence. It’s not okay to hit a child any more than it’s okay to hit an adult. There should be efforts to support families that are in danger of slipping under the economic safety level through cash transfers and home income strengthening, and there can be more work on ensuring that within school settings, education and life skills training for younger children and adolescents to help them negotiate tricky areas in life without resorting to aggression,” Butchart argued. Country-level implementation will be a challenge, and advocates in the space hope the record attendance of government participants will spur meaningful change. The conference featured a “Break the Record” campaign to call attention to the “inaction in tackling violence against children,” said Together for Girls, a global partnership founded by sexual abuse survivors working to end violence against children. Pledges to adopt child-friendly policies All countries attending pledged to implement at least one of the 12 key policy areas proposed by conference organisers, ranging from parent and caregiver support to human, financial and infrastructure resources. Many also committed to legislation that would create healthier environments for children. Tanzania committed to investing nearly $70,000 in “Child Protection Desks” in all primary and secondary schools, to investigate cases of violence against children in schools, for example. The Solomon Islands pledged to raise the minimum age of marriage from 15 to 18 years by December 2025. Jordan will provide rehabilitation programs for “perpetrators of domestic violence against women and children as part of national response and preventive services.” And Brazilian government’s pledges included an acknowledgement that those living in peripheral territories have a greater burden of homicides and drug-related violence. Burundi, Czechia, Kyrgyzstan, Panama, Sri Lanka, Uganda, and Tajikistan have pledged to prohibit corporal punishment; while the Gambia and Nigeria have promised to end it in schools. Several countries, including Saudi Arabia and Malaysia, have no prohibitions against corporal punishment, and many more have only partial prohibitions, like the US. “The ban against corporal punishment in 1979 was one of the most significant measures in Sweden for combating violence against children,” remarked Swedish Minister for Social Services, Camilla Waltersson Grönvall. Addressing online harassment Experts at UNICEF and WHO also pointed to the threat of online bullying and sexual exploitation. WHO estimates 15% of children have been bullied online. “Online violence is real. It is, however, often not occurring in an online vacuum, but it is part of a continuum of violence between the interpersonal and the online world, and probably most often, the people that are perpetrating online violence are peers, friends, acquaintances known to the victim,” said Butchart. Nineteen countries made pledges to address online harms. South Africa’s national commitment states its pledge to “build the capacity of different stakeholders on online safety including parents, caregivers, children, frontline workers and strengthen the curriculum in schools promoting the online safety of children by 2027.” Image Credits: WHO. UNICEF: 1 in 7 Young People Live with a Mental Disorder. How Will We Address this Growing Crisis? 10/11/2024 Maayan Hoffman Zeinab Hijazi (left) and Jaime Young One in seven young people aged 10 to 19 live with a diagnosable mental disorder, according to the United Nations Children’s Fund (UNICEF). One in four children lives with a parent with a mental health condition. Suicide is the fourth most significant cause of death for adolescents globally. The economic cost of neglecting youth mental health is estimated at around $387.2 billion annually for children ages 0 to 19, also according to UNICEF. “Adolescents are really struggling globally,” Zeinab Hijazi, a clinical psychologist and global mental health lead at UNICEF, told Garry Aslanyan on a recent episode of his Global Health Matters podcast. “It is really unfathomable that we know this, and we know that all of these conditions, most of them are treatable, but they go undetected, and they go untreated.” Mental health infographic The state of mental health challenges amongst youth was the focus of the latest podcast in honour of World Mental Health Day on October 10 and in light of the growing causes behind these disorders. Hijazi noted that many young people are contending with the devastating impacts of wars and conflicts in places like Gaza, the Congo, and Sudan, while others face the immediate threats of climate crises or unemployment. Jaime Young, a passionate youth leader, mental health advocate, and family caseworker at the Saint Lucia Social Development Fund in the Caribbean, joined the discussion. In her region, a staggering 24% of youth experience mental health disorders, with anxiety and depression accounting for nearly 50% of mental health issues amongst those aged 10 to 19, Young explained. Young identified one of the reasons as heightened stressors. “We have a lot more stresses, and then depression can be something that, if you are not sure how to cope with or if you do not have that support, whether it is with your family or friends, you feel like your back is against the wall. You feel anxious, you have anxiety, you are depressed, and you cannot talk to anybody about it because access to actual resources, a counsellor or a therapist, is extremely expensive where available—and where they are not, they are just not.” She pointed out that mental health disorders remain a “taboo subject” with a persistent “stigma” around seeking help. Additionally, the region often lacks affordable resources for youth mental health support. Nevertheless, Young emphasised the need to raise awareness and take action. She urged those struggling with mental health issues to seek help. “I would say prioritise your mental health,” Young said. “I know you might hear it everywhere or see it everywhere, but it is one thing when we are sick or have a broken bone; we make it our duty to go to the doctor. And it always baffles me that when we know or suspect we have a mental health issue, we do not look for the resources. We ignore it.” She continued, “Do not ignore your mental health because you need your mind; you need to be healthy.” Listen to the episode on Buzzsprout >> Listen on YouTube >> View more Global Health Matters podcast articles on Health Policy Watch >> Image Credits: Global Health Matters | TDR. Four Key Areas Where ‘Anti-Globalist’ Trump Threatens Global Health 08/11/2024 Kerry Cullinan US President-elect Donald Trump railed against “globalists” during his election campaign, and his victory will have serious ramifications for global health – particularly for action against climate change, scientific institutions and regulatory bodies, United Nations agencies and sexual and reproductive health. 1. Climate denial “We will drill, baby, drill,” Trump told the Republican National Convention in July, describing the Biden administration’s “Green New Deal” aimed at reducing greenhouse gases as a “scam”. During his presidency, he persistently favoured industry over the environment, removing around 100 regulations relating to air pollution, water, vehicle emissions, toxic chemicals and wildlife protection, according to the New York Times. For example, within weeks of assuming office in January 2017, Trump expedited the controversial Dakota Access Pipeline to transport crude oil through farms and pristine indigenous land. Oil and gas billionaire Kelcy Warren, whose company, Energy Transfer, was responsible for the pipeline, was the fifth-largest individual contributor to Trump’s latest election campaign with a $5.8 million donation, according to Forbes. He also allowed oil and gas development in the Arctic National Wildlife Refuge in Alaska, one of the last remaining wilderness areas in the US, reauthorised use of an agricultural pesticide, sulfoxaflor, known to kill bees and lifted protections for endangered species. He appointed industry-friendly people to run the Environmental Protection Agency (EPA) and reduced its budget, which drove these measures. However, this time, he might dismantle the agency almost entirely, giving states latitude to decide on environmental issues, according to threats made on the campaign trail. In 2017, Trump announced his intention to pull the US out of the Paris Agreement – the commitment to confine global warming to 1.5°C – saying that it undermined the US economy, hamstrung its ability to open new oil and coal fields, and put the US “at a permanent disadvantage to the other countries of the world”. Trump campaign national press secretary Karoline Leavitt told Politico that he will do the same thing in his second presidency. Why it matters 🌡️The year 2024 is on track to be the warmest year on record, with the global average near surface temperature even higher than in 2023, according to the World Meteorological Organization (@WMOFull). 🔗Full story: https://t.co/94geuImb4e pic.twitter.com/9zhZP0fItU — World Meteorological Organization (@WMO) November 7, 2024 This year is “virtually certain” to be the warmest year on record, with the average global temperature rise being 1.55°C above the pre-industrial era, according to a report from the European Union’s Earth observation programme, Copernicus. Record-breaking heat is driving global extreme weather from hurricanes and floods to drought and fires, threatening the lives and livelihoods of virtually everyone. Trump’s win could lead to an additional four billion tonnes of US emissions by 2030 in comparison with current president Joe Biden’s plans, according to Carbon Brief , based on an aggregation of modelling by various US research groups. This is equal to the total emissions form the European Union and Japan combined, and would cause global climate damages worth more than $900bn, based on the latest US government valuations. Reaction “The nation and world can expect the incoming Trump administration to take a wrecking ball to global climate diplomacy,” said Rachel Cleetus, policy director at the Union of Concerned Scientists, told The Guardian. Environmental justice organisation Greenpeace called on supporters to “resist attempts to roll back environmental and climate protections” and “lean into the intersections between climate justice and democracy protection, given the increasing attacks on freedoms of speech, assembly, and association.” 2. Undermining scientific and regulatory institutions The US Centers for Disease Control and Prevention Trump promoted several quack cures during the COVID-19 pandemic and has apparently promised the world’s leading vaccine skeptic, Robert F Kennedy Jnr, a position at the White House. Kennedy, who has no health qualifications, abandoned his presidential bid in favour of Trump. Trump has said he wants Kennedy to “go wild on health”. That is easy for Kennedy, whose wild ideas including the rejection of most childhood vaccinations and that water fluoridation causes brain disease. It is unclear what position Kennedy will get, but Trump is almost certain to reform and reduce the power of the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The CDC leads disease outbreak investigations, publishing public health recommendations and supporting the work of state and local health departments, which is where around two-thirds of its budget goes. The FDA sets regulatory policy, and decides on the authorisation of new medicines and medical devices. The NIH funds medical research. Kennedy has described public health agencies as “sock puppets for the industries they are supposed to regulate.” He wants to rein in Big Pharma, including by banning TV advertisements for drugs – tricky for Republicans who received significantly more pharma election donations than Democrats. Kennedy has also proposed that half the NIH’s budget should be for “preventive, alternative and holistic approaches to health.” FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything… — Robert F. Kennedy Jr (@RobertKennedyJr) October 25, 2024 He also mused on X that “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.” Why it matters If citizens don’t believe in science or public health institutions, they are unlikely to follow their advice, which could slow recovery form disease and turn outbreaks into epidemics. A Pew Research Center poll in late 2023 found that there has been a 16% drop in Americans’ view that science has a mostly positive effect on society, with only 57% supporting this view. Decisions taken by the CDC and FDA are considered as the global “gold standard”, and are particularly important for countries that lack the resources to map disease responses and authorise medical products for themselves. Reaction “Among the most destructive impacts of a second Trump administration would be to foment distrust in health, medicine and science, ranging from vaccines to water fluoridation,” Professor Lawrence Gostin, the O’Neill Chair in Global Health Law at Georgetown University, warned on X. “Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives.” Among the most destructive impacts of a 2nd Trump administration would be to foment distrust in health, medicine & science, ranging from vaccines to water fluoridation Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives — Lawrence Gostin (@LawrenceGostin) November 7, 2024 However, Gostin also noted that “Trump has no power to ban vaccines or water fluoridation. The states have public health power, not the president. And we have robust institutions that will hold.” Meanwhile, former CDC head Dr Tom Frieden described the body as “the cornerstone of public health in the United States and a global resource—weakening CDC would endanger American lives.” 3. Defunding UN agencies The WHO plays an essential role in assisting poor countries – in this case, assisting Zimbabwe to respond to a cholera outbreak. Trump’s first administration froze the US contributions to the World Health Organization (WHO) in the middle of the COVID-19 pandemic, accusing it of being controlled by China. BREAKING: Trump announced the U.S. is officially leaving the World Health Organization in the middle of a pandemic. WHO is currently coordinating international vaccine and drug trials to fight #Covid19 pic.twitter.com/ZWiXlXbcNs — POLITICO (@politico) May 29, 2020 Trump also cut US funding to the United Nations Population Fund (UNFPA), effectively shrinking the budget of the global sexual and reproductive health agency by around 7% – erroneously accusing the agency of supporting population control programs in China that include coercive abortion. Trump also withdrew the US from the UN Human Rights Council, and UNESCO, the UN’s cultural agency. This is likely to be repeated in Trump 2, Why it matters The WHO leads global health efforts, coordinating and guiding its 194 member states on how best to respond to all health challenges – from infectious diseases such as COVID-19 to non-communicable diseases. It is particularly important in supporting low-income countries. UNFPA provides maternal and reproductive health services throughout the world – excluding abortions. Its role is particularly in humanitarian settings where governments are unable to provide these services. The loss of the US contribution to the WHO will weaken the global body’s ability to assist countries to react to health challenges. Likewise, the UNFPA will have to scale back its operations, which will impact on women in the poorest, conflict-ridden nations. The US also contributes 22% to the UN’s core budget and 27% of the peacekeeping budget. Reaction After Trump withdrew the US in April 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus accused Trump of “playing with fire” by politicising COVID-19, which would result in “many more body bags”. However, a circumspect Tedros reacted to Trump’s re-election this week by saying: “The partnership between WHO and America is vital, and has significantly improved the health of both Americans and people across the globe. We look forward to working with your administration for global health security.” Meanwhile, UNFPA has warned that women will “lose lifesaving services in some of the world’s most devastating crises” in places like Afghanistan, Sudan and Ukraine,” according to Reuters. 4. Sexual and reproductive health A US protest against abortion restrictions. Sexual and reproductive health (SRH) services are in the firing line, with Trump likely to support the expansion of domestic abortion bans, while entrenching opposition to abortion as a key pillar of US foreign aid. Despite the Trump victory, millions of people in seven US states voted to enshrine the right to abortion in their state constitutions, approving amendments in seven of 10 states where measures were on the ballot. However, the Trump administration is expected to try to end access to medication abortion,used in 63% of US abortions, including by prosecuting people who ship and transport abortion pills and supplies. Trump appointed anti-abortion judges to the Supreme Court who overturned the right to abortion, known as Roe v Wade. Seventeen US states have banned abortion since Roe v Wade was overturned, and many doctors are unsure of when it is legal to assist women to terminate pregnancies – even when they are obviously in distress. “In vast swaths of the US South and Midwest, patients are forced to cross multiple state lines to get [abortion] care, but many lack the means to do so,” according to the Center for Reproductive Rights (CRR). “Obstetricians are fleeing states where abortion is banned because they cannot properly care for their patients, including those experiencing severe pregnancy complications. Obstetricians and medical school residents don’t want to work in these states, creating maternal health deserts.” As we continue to process the results of the U.S. election, one thing is clear: on the domestic and international fronts, the anti-rights agenda poses a SERIOUS threat to the progress made on gender equality, reproductive rights, and health care access.https://t.co/Dm0uiaQXZT — Center for Reproductive Rights (@ReproRights) November 7, 2024 One of Trump’s first presidential actions in 2017 was to prohibit foreign NGOs from receiving US government funding for health if they “provided, promoted, or discussed” abortion – known as the Expanded Global Gag Rule (GGR). Many family planning organisations lost their funding and women lost access to contraception in some of the continent’s poorest countries such as Madagascar and Ethiopia – ironically contributing to more unplanned pregnancies. While legal abortion is out of the reach of most African women and girls, 19 African countries have eased access since 1994 – mostly in an attempt to reduce the maternal deaths caused by unsafe abortions. But US groups have campaigned against this easing in Africa, led most recently by former Trump administration officials Valerie Huber, and Alma Golden. Huber was the architect of an anti-abortion pact, the Geneva Consensus Declaration (GCD), adopted in the dying weeks of Trump’s rule in October 2020 with the support of an array of global human-rights polecats such as Iraq, Uganda, Belarus and Sudan. The GCD also promotes “the natural family” – primarly aimed at removing any recognition of the existence of LGBTQ people. While Biden withdrew the US from the GCD, Trump has promised to rejoin it “to reject the globalist claim of an international right to abortion.” “Under my leadership, the United States will also rejoin the Geneva Consensus Declaration, created by my administration and signed by 36 nations, to reject the globalist claim of an international right to abortion.” pic.twitter.com/1r4R4l23Pg — Team Trump (Text TRUMP to 88022) (@TeamTrump) September 20, 2023 Project 2025, the controversial conservative blueprint for a Trump victory written primarily by his former officials, proposes that all US aid including humanitarian assistance, should be conditional on the rejection of abortion. “Proposed measures for USAID [US Agency for International Development] include a significant restructuring, and reduction of budget, the removal of diversity, equity, and inclusion programs, and dismantling of the apparatus that supports gender equality and LGBTQ+ rights,” notes researcher Malayah Harper in an analysis of Project 2025. In 2023, Republican congressional lobbying even put the brakes on the US President’s Emergency Plan for AIDS Relief (PEPFAR), claiming – incorrectly – that some grant recipients were promoting abortion. As a result of the right-wing lobby, PEPFAR projects now receive yearly budgets instead of five-year funding Why it matters Abortion bans have never stopped women and girls from trying to end unwanted pregnancies. It has simply driven them to unsafe providers whose methods often maim and even kill them. Approximately 6.2 million women and girls had abortions in Sub-Saharan Africa in 2019, and the region has the highest rate of unplanned pregnancies and abortion-related deaths in the world – 185 maternal deaths per 100,000 abortions, according to Guttmacher. Reaction Nancy Northup, CEO of the Center for Reproductive Rights (CRR), said that Trump’s re-election means “anti-rights extremists will soon be back in charge of the White House and the US Senate, wielding power to the detriment of vulnerable populations and seeking to undermine decades of progress on gender equality, a lynchpin of which is the ability of individuals to make decisions about their reproductive lives and have access to reproductive health care.” Northup, whose organisation uses the law to advance reproductive rights, said the CRR “will scrutinize every action of the White House and federal agencies, amass the factual and legal record to counter agency actions, and work to stop harmful policies from going into effect. “If they do, we will take them to court. We will vehemently fight any effort to pass a national abortion ban, to stop the provision of medication abortion by mail, to block women from crossing state lines to get care, to dismantle UN protections for reproductive rights and progress made at the national level in countries around the world, and more.” Saoyo Tabitha Griffith, a Kenyan high court lawyer and women’s rights activist, warned that “African women and LGBTQ people must anticipate that Trump’s return will re-ignite an ideological war with real and physical consequences on their bodies”. “Issues such as contraceptives, surrogacy, single parenting, safe abortion, HPV vaccines and sexual orientation are all going to be contested, not through science and data but by conspiracies and misinformation,” she added. Image Credits: Mika Baumeister/ Unsplash, Clay Kaufmann/ Unsplash, Center for Reproductive Rights. WHO: Climate Action Would Save Two Million Lives A Year 07/11/2024 Stefan Anderson Extreme weather, infectious diseases and air pollution are driving at least two million climate-related deaths annually, WHO reports. Two million lives could be saved annually through urgent climate action, the World Health Organization (WHO) declared on Thursday in a stark message to negotiators ahead of next week’s climate summit in Baku, warning that rising temperatures are wreaking havoc on global health, disrupting healthcare systems and fueling disease outbreaks worldwide. The new WHO report, compiled by over 100 organizations and 300 experts, sets out a blueprint of five key climate interventions: implementing heat-health warning systems, electrifying primary healthcare facilities with solar power, improving water and sanitation infrastructure, transitioning to clean household energy, and reforming fossil fuel pricing. The analysis shows that implementing heat-health warning systems in 57 countries could save 98,500 lives each year, while electrifying primary healthcare facilities with solar power across 63 nations could prevent 290,500 deaths annually by 2024. Improving water and sanitation infrastructure could save 173,000 lives, transitioning to clean household energy could prevent 133,000 deaths, and reforming fossil fuel pricing policies could avert over 1.2 million deaths annually by 2034. “That’s comparable to anything else we can do [globally] in public health through a limited number of climate actions,” Dr Diarmid Campbell-Lendrum, WHO’s climate and health lead, said at the launch press conference. “This is something we have to do to protect people’s lives and their future – it brings very large health gains, we know it saves us money, and we know it’s a really good investment.” Blueprint for action WHO identifies ending fossil fuel subsidies as the most effective global public health interventions, potentially saving 1.2 million lives annually from reduced air pollution The findings come at a crucial moment as nations prepare the third generation of climate pledges under the Paris Agreement, known as nationally determined contributions (NDCs), due before next year’s COP30 in Brazil. WHO is pressing governments to include detailed health planning and financing in these national commitments, urging negotiators to abandon their “siloed approach” to climate change and health, which WHO Director-General Dr Tedros Adhanom Ghebreyesus called “a moral and legal imperative.” While health is identified as a priority in 91% of national climate plans, few outline specific actions or financing mechanisms to protect health from climate risks. The stakes are high: climate change is expected to cause 250,000 additional annual deaths between 2030 and 2050, while air pollution already costs $ 8.1 trillion annually (6.1% of global GDP). Despite these massive costs, health remains critically underfunded in climate action, with only 6% of climate adaptation funding and a mere 0.5% of multilateral climate funding going to health projects. Evidence suggests every $1 invested in climate adaptation can return up to $15 in benefits, while WHO estimates the return on its five key policies to prevent deaths from climate change would see a return of four to one. Yet securing funding remains a critical challenge. In the European Union, a leaked blueprint suggests its dedicated health budget may soon be merged with other funds or eliminated entirely, reflecting intense competition for resources amid inflation, wars, and wider climate impacts in even the world’s wealthiest nations. One possible source of funding is fossil fuel subsidies, which WHO describes as “incoherent” with health goals, echoing last week’s Lancet report warning governments to stop “fuelling” the fire caused by oil, gas and coal by subsidising their use. According to the IMF, total subsidies amount to around $7 trillion annually – much of it reflected in health costs. “The largest single component of [subsidies] is effectively health damages,” Campbell-Lendrum explained. “The costs are felt not in the atmosphere but in people’s lungs, triggering heart attacks, impairing children’s development, and giving them asthma.” “If we were to invest those resources more wisely, then we would have both a healthier planet and much healthier local populations,” Campbell-Lendrum added. “We would also save those resources, and save all that money.” Can’t claim they didn’t know The WHO report comes as new data confirms 2024 will be the first year global temperatures breach the 1.5C threshold above pre-industrial levels – a critical target of the Paris Agreement. UN agencies estimate the world is on track for “catastrophic” warming of 3.1C by the end of the century. The crisis deepened further with Donald Trump’s White House victory on Tuesday, as his promised expansion of record-high US fossil fuel production could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target. Reminder: Victory for Trump is likely to all but end global hopes of staying below 1.5C, our analysis found in March https://t.co/D8YonQ4w65 pic.twitter.com/T2Rbkl0T2m — Simon Evans (@DrSimEvans) November 6, 2024 Despite these setbacks and the recent breakdown of the COP16 biodiversity summit casting a shadow over expectations in Baku, WHO remains optimistic that health impacts could drive meaningful progress at COP29. “Health is the argument we need to catalyze urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.” Climate health crisis A young girl reads under a malaria bednet. Photo: UNDP The health impacts of the climate crisis are far-reaching and already being felt. The report documents how rising temperatures are increasing the spread of infectious diseases, worsening air pollution, threatening food security, and creating unprecedented challenges for healthcare systems worldwide. In 2023 alone, people faced an average of 50 more days of health-threatening heat compared to previous years. Disease outbreaks are also intensifying, with dengue cases reaching record highs of over five million cases across 80 countries due to extreme rainfall and heat creating ideal conditions for mosquito-borne diseases. Over half of all pathogens worldwide are aggravated by climate change. Meanwhile, extreme drought affected almost half the world’s land mass, pushing 151 million more people into food insecurity across 124 countries. The WHO’s findings build on data on the escalating climate-driven health crisis published by the Lancet last week. It found heat-related deaths among people over 65 have surged 167% compared to the 1990s, while people worldwide faced an unprecedented 50 more days of health-threatening temperatures last year and extreme heat made even light outdoor exercise dangerous for billions of people. The burden falls disproportionately on those least responsible for emissions. The WHO notes that by 2050, climate change may push up to 16 million more women and girls into poverty than men and boys, while 920 million children are currently highly exposed to water scarcity. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones. “Whether it is the drought in southern Africa leading to malnutrition, the extreme heat which has become the norm each summer, or the recent flooding in Valencia … health is the lived experience of climate change,” said Dr Vanessa Kerry, WHO’s Special Envoy for Climate Change and Health. “We can no longer afford to ignore that fact.” A duty to safeguard health Nearly one-eighth of the global population does not have access to health facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people around the world. The healthcare sector itself faces a double challenge: responding to increasing climate-related health emergencies while also addressing its own significant carbon footprint. The report reveals that the global healthcare sector accounts for approximately 5% of greenhouse gas emissions – equivalent to the emissions of the fifth-largest country in the world. “For the health community, this is incoherent and directly at odds with our duty to safeguard health,” the report states, calling for an urgent transformation of healthcare systems to become both climate-resilient and low-carbon. On Thursday, the UAE – hosts of last year’s COP28 summit in Dubai – became the first country to submit its third-generation climate plan under the Paris Agreement, including commitments to achieve a net-zero healthcare system by 2050. However, critics note the plan fails to address the UAE’s planned 34% fossil fuel expansion by 2035, highlighting the tensions between climate action and economic interests. Cities & shortage Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions. Other areas highlighted by the report include cities, which are identified as crucial battlegrounds for addressing the crisis, being responsible for over 70% of global emissions while also hosting more than half the world’s population. The report calls for urgent action to transform urban areas through clean energy adoption, sustainable transport systems, and improved infrastructure. “We must reshape our cities to prioritise public transportation and human-powered vehicles, not just to reduce emissions but for the health benefits of daily exercise,” Dr Tedros said. “Green spaces can improve air quality, provide space for physical activity, enhance mental health, and help to cool urban areas.” The WHO also highlights a critical shortage in the health workforce, projecting a shortfall of 10 million workers by 2030, with six million of these in sub-Saharan Africa – one of the regions most vulnerable to climate impacts. With COP29 just days away, WHO officials closed with a call to action. “The stark reality is that climate change is magnifying existing global health challenges that we’ve yet to fix,” Kerry said. “Poor health doesn’t just affect our well-being, but epidemics, chronic diseases, maternal deaths, air pollution, and fuels insecurity across communities and countries, destabilises economies, widens inequities and drives political unrest.” “We must address health as a fundamental part of our climate response to prevent these cascading effects,” she added. “Success cannot be measured only in degrees degrees Celsius averted, but in the human cost of this crisis in lives saved.” Image Credits: UN-Water/Twitter , Galen Crout , UNDP. US Should Lift Marburg Travel Restrictions, Urges Africa CDC 07/11/2024 Kerry Cullinan Dr Jean Kaseya The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya. The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening. “Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC). Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him. Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent. Mpox outbreak continues Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad. While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted. However, despite a high case load, Burundi had not yet reported a single death. Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support. While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children. “The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo. “The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.” Kaseya added that children’s co-infection with measles was also contributing to the higher deaths. However, he added that, as Burundi had not recorded any deaths despite high malnutrition, “there are many things we don’t yet understand”. The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available. The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks. So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted. As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. Image Credits: Kobi Gideon / GPO/Wikipedia, Chuttersnap/ Unsplash, Wikimedia. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
UNICEF: 1 in 7 Young People Live with a Mental Disorder. How Will We Address this Growing Crisis? 10/11/2024 Maayan Hoffman Zeinab Hijazi (left) and Jaime Young One in seven young people aged 10 to 19 live with a diagnosable mental disorder, according to the United Nations Children’s Fund (UNICEF). One in four children lives with a parent with a mental health condition. Suicide is the fourth most significant cause of death for adolescents globally. The economic cost of neglecting youth mental health is estimated at around $387.2 billion annually for children ages 0 to 19, also according to UNICEF. “Adolescents are really struggling globally,” Zeinab Hijazi, a clinical psychologist and global mental health lead at UNICEF, told Garry Aslanyan on a recent episode of his Global Health Matters podcast. “It is really unfathomable that we know this, and we know that all of these conditions, most of them are treatable, but they go undetected, and they go untreated.” Mental health infographic The state of mental health challenges amongst youth was the focus of the latest podcast in honour of World Mental Health Day on October 10 and in light of the growing causes behind these disorders. Hijazi noted that many young people are contending with the devastating impacts of wars and conflicts in places like Gaza, the Congo, and Sudan, while others face the immediate threats of climate crises or unemployment. Jaime Young, a passionate youth leader, mental health advocate, and family caseworker at the Saint Lucia Social Development Fund in the Caribbean, joined the discussion. In her region, a staggering 24% of youth experience mental health disorders, with anxiety and depression accounting for nearly 50% of mental health issues amongst those aged 10 to 19, Young explained. Young identified one of the reasons as heightened stressors. “We have a lot more stresses, and then depression can be something that, if you are not sure how to cope with or if you do not have that support, whether it is with your family or friends, you feel like your back is against the wall. You feel anxious, you have anxiety, you are depressed, and you cannot talk to anybody about it because access to actual resources, a counsellor or a therapist, is extremely expensive where available—and where they are not, they are just not.” She pointed out that mental health disorders remain a “taboo subject” with a persistent “stigma” around seeking help. Additionally, the region often lacks affordable resources for youth mental health support. Nevertheless, Young emphasised the need to raise awareness and take action. She urged those struggling with mental health issues to seek help. “I would say prioritise your mental health,” Young said. “I know you might hear it everywhere or see it everywhere, but it is one thing when we are sick or have a broken bone; we make it our duty to go to the doctor. And it always baffles me that when we know or suspect we have a mental health issue, we do not look for the resources. We ignore it.” She continued, “Do not ignore your mental health because you need your mind; you need to be healthy.” Listen to the episode on Buzzsprout >> Listen on YouTube >> View more Global Health Matters podcast articles on Health Policy Watch >> Image Credits: Global Health Matters | TDR. Four Key Areas Where ‘Anti-Globalist’ Trump Threatens Global Health 08/11/2024 Kerry Cullinan US President-elect Donald Trump railed against “globalists” during his election campaign, and his victory will have serious ramifications for global health – particularly for action against climate change, scientific institutions and regulatory bodies, United Nations agencies and sexual and reproductive health. 1. Climate denial “We will drill, baby, drill,” Trump told the Republican National Convention in July, describing the Biden administration’s “Green New Deal” aimed at reducing greenhouse gases as a “scam”. During his presidency, he persistently favoured industry over the environment, removing around 100 regulations relating to air pollution, water, vehicle emissions, toxic chemicals and wildlife protection, according to the New York Times. For example, within weeks of assuming office in January 2017, Trump expedited the controversial Dakota Access Pipeline to transport crude oil through farms and pristine indigenous land. Oil and gas billionaire Kelcy Warren, whose company, Energy Transfer, was responsible for the pipeline, was the fifth-largest individual contributor to Trump’s latest election campaign with a $5.8 million donation, according to Forbes. He also allowed oil and gas development in the Arctic National Wildlife Refuge in Alaska, one of the last remaining wilderness areas in the US, reauthorised use of an agricultural pesticide, sulfoxaflor, known to kill bees and lifted protections for endangered species. He appointed industry-friendly people to run the Environmental Protection Agency (EPA) and reduced its budget, which drove these measures. However, this time, he might dismantle the agency almost entirely, giving states latitude to decide on environmental issues, according to threats made on the campaign trail. In 2017, Trump announced his intention to pull the US out of the Paris Agreement – the commitment to confine global warming to 1.5°C – saying that it undermined the US economy, hamstrung its ability to open new oil and coal fields, and put the US “at a permanent disadvantage to the other countries of the world”. Trump campaign national press secretary Karoline Leavitt told Politico that he will do the same thing in his second presidency. Why it matters 🌡️The year 2024 is on track to be the warmest year on record, with the global average near surface temperature even higher than in 2023, according to the World Meteorological Organization (@WMOFull). 🔗Full story: https://t.co/94geuImb4e pic.twitter.com/9zhZP0fItU — World Meteorological Organization (@WMO) November 7, 2024 This year is “virtually certain” to be the warmest year on record, with the average global temperature rise being 1.55°C above the pre-industrial era, according to a report from the European Union’s Earth observation programme, Copernicus. Record-breaking heat is driving global extreme weather from hurricanes and floods to drought and fires, threatening the lives and livelihoods of virtually everyone. Trump’s win could lead to an additional four billion tonnes of US emissions by 2030 in comparison with current president Joe Biden’s plans, according to Carbon Brief , based on an aggregation of modelling by various US research groups. This is equal to the total emissions form the European Union and Japan combined, and would cause global climate damages worth more than $900bn, based on the latest US government valuations. Reaction “The nation and world can expect the incoming Trump administration to take a wrecking ball to global climate diplomacy,” said Rachel Cleetus, policy director at the Union of Concerned Scientists, told The Guardian. Environmental justice organisation Greenpeace called on supporters to “resist attempts to roll back environmental and climate protections” and “lean into the intersections between climate justice and democracy protection, given the increasing attacks on freedoms of speech, assembly, and association.” 2. Undermining scientific and regulatory institutions The US Centers for Disease Control and Prevention Trump promoted several quack cures during the COVID-19 pandemic and has apparently promised the world’s leading vaccine skeptic, Robert F Kennedy Jnr, a position at the White House. Kennedy, who has no health qualifications, abandoned his presidential bid in favour of Trump. Trump has said he wants Kennedy to “go wild on health”. That is easy for Kennedy, whose wild ideas including the rejection of most childhood vaccinations and that water fluoridation causes brain disease. It is unclear what position Kennedy will get, but Trump is almost certain to reform and reduce the power of the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The CDC leads disease outbreak investigations, publishing public health recommendations and supporting the work of state and local health departments, which is where around two-thirds of its budget goes. The FDA sets regulatory policy, and decides on the authorisation of new medicines and medical devices. The NIH funds medical research. Kennedy has described public health agencies as “sock puppets for the industries they are supposed to regulate.” He wants to rein in Big Pharma, including by banning TV advertisements for drugs – tricky for Republicans who received significantly more pharma election donations than Democrats. Kennedy has also proposed that half the NIH’s budget should be for “preventive, alternative and holistic approaches to health.” FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything… — Robert F. Kennedy Jr (@RobertKennedyJr) October 25, 2024 He also mused on X that “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.” Why it matters If citizens don’t believe in science or public health institutions, they are unlikely to follow their advice, which could slow recovery form disease and turn outbreaks into epidemics. A Pew Research Center poll in late 2023 found that there has been a 16% drop in Americans’ view that science has a mostly positive effect on society, with only 57% supporting this view. Decisions taken by the CDC and FDA are considered as the global “gold standard”, and are particularly important for countries that lack the resources to map disease responses and authorise medical products for themselves. Reaction “Among the most destructive impacts of a second Trump administration would be to foment distrust in health, medicine and science, ranging from vaccines to water fluoridation,” Professor Lawrence Gostin, the O’Neill Chair in Global Health Law at Georgetown University, warned on X. “Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives.” Among the most destructive impacts of a 2nd Trump administration would be to foment distrust in health, medicine & science, ranging from vaccines to water fluoridation Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives — Lawrence Gostin (@LawrenceGostin) November 7, 2024 However, Gostin also noted that “Trump has no power to ban vaccines or water fluoridation. The states have public health power, not the president. And we have robust institutions that will hold.” Meanwhile, former CDC head Dr Tom Frieden described the body as “the cornerstone of public health in the United States and a global resource—weakening CDC would endanger American lives.” 3. Defunding UN agencies The WHO plays an essential role in assisting poor countries – in this case, assisting Zimbabwe to respond to a cholera outbreak. Trump’s first administration froze the US contributions to the World Health Organization (WHO) in the middle of the COVID-19 pandemic, accusing it of being controlled by China. BREAKING: Trump announced the U.S. is officially leaving the World Health Organization in the middle of a pandemic. WHO is currently coordinating international vaccine and drug trials to fight #Covid19 pic.twitter.com/ZWiXlXbcNs — POLITICO (@politico) May 29, 2020 Trump also cut US funding to the United Nations Population Fund (UNFPA), effectively shrinking the budget of the global sexual and reproductive health agency by around 7% – erroneously accusing the agency of supporting population control programs in China that include coercive abortion. Trump also withdrew the US from the UN Human Rights Council, and UNESCO, the UN’s cultural agency. This is likely to be repeated in Trump 2, Why it matters The WHO leads global health efforts, coordinating and guiding its 194 member states on how best to respond to all health challenges – from infectious diseases such as COVID-19 to non-communicable diseases. It is particularly important in supporting low-income countries. UNFPA provides maternal and reproductive health services throughout the world – excluding abortions. Its role is particularly in humanitarian settings where governments are unable to provide these services. The loss of the US contribution to the WHO will weaken the global body’s ability to assist countries to react to health challenges. Likewise, the UNFPA will have to scale back its operations, which will impact on women in the poorest, conflict-ridden nations. The US also contributes 22% to the UN’s core budget and 27% of the peacekeeping budget. Reaction After Trump withdrew the US in April 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus accused Trump of “playing with fire” by politicising COVID-19, which would result in “many more body bags”. However, a circumspect Tedros reacted to Trump’s re-election this week by saying: “The partnership between WHO and America is vital, and has significantly improved the health of both Americans and people across the globe. We look forward to working with your administration for global health security.” Meanwhile, UNFPA has warned that women will “lose lifesaving services in some of the world’s most devastating crises” in places like Afghanistan, Sudan and Ukraine,” according to Reuters. 4. Sexual and reproductive health A US protest against abortion restrictions. Sexual and reproductive health (SRH) services are in the firing line, with Trump likely to support the expansion of domestic abortion bans, while entrenching opposition to abortion as a key pillar of US foreign aid. Despite the Trump victory, millions of people in seven US states voted to enshrine the right to abortion in their state constitutions, approving amendments in seven of 10 states where measures were on the ballot. However, the Trump administration is expected to try to end access to medication abortion,used in 63% of US abortions, including by prosecuting people who ship and transport abortion pills and supplies. Trump appointed anti-abortion judges to the Supreme Court who overturned the right to abortion, known as Roe v Wade. Seventeen US states have banned abortion since Roe v Wade was overturned, and many doctors are unsure of when it is legal to assist women to terminate pregnancies – even when they are obviously in distress. “In vast swaths of the US South and Midwest, patients are forced to cross multiple state lines to get [abortion] care, but many lack the means to do so,” according to the Center for Reproductive Rights (CRR). “Obstetricians are fleeing states where abortion is banned because they cannot properly care for their patients, including those experiencing severe pregnancy complications. Obstetricians and medical school residents don’t want to work in these states, creating maternal health deserts.” As we continue to process the results of the U.S. election, one thing is clear: on the domestic and international fronts, the anti-rights agenda poses a SERIOUS threat to the progress made on gender equality, reproductive rights, and health care access.https://t.co/Dm0uiaQXZT — Center for Reproductive Rights (@ReproRights) November 7, 2024 One of Trump’s first presidential actions in 2017 was to prohibit foreign NGOs from receiving US government funding for health if they “provided, promoted, or discussed” abortion – known as the Expanded Global Gag Rule (GGR). Many family planning organisations lost their funding and women lost access to contraception in some of the continent’s poorest countries such as Madagascar and Ethiopia – ironically contributing to more unplanned pregnancies. While legal abortion is out of the reach of most African women and girls, 19 African countries have eased access since 1994 – mostly in an attempt to reduce the maternal deaths caused by unsafe abortions. But US groups have campaigned against this easing in Africa, led most recently by former Trump administration officials Valerie Huber, and Alma Golden. Huber was the architect of an anti-abortion pact, the Geneva Consensus Declaration (GCD), adopted in the dying weeks of Trump’s rule in October 2020 with the support of an array of global human-rights polecats such as Iraq, Uganda, Belarus and Sudan. The GCD also promotes “the natural family” – primarly aimed at removing any recognition of the existence of LGBTQ people. While Biden withdrew the US from the GCD, Trump has promised to rejoin it “to reject the globalist claim of an international right to abortion.” “Under my leadership, the United States will also rejoin the Geneva Consensus Declaration, created by my administration and signed by 36 nations, to reject the globalist claim of an international right to abortion.” pic.twitter.com/1r4R4l23Pg — Team Trump (Text TRUMP to 88022) (@TeamTrump) September 20, 2023 Project 2025, the controversial conservative blueprint for a Trump victory written primarily by his former officials, proposes that all US aid including humanitarian assistance, should be conditional on the rejection of abortion. “Proposed measures for USAID [US Agency for International Development] include a significant restructuring, and reduction of budget, the removal of diversity, equity, and inclusion programs, and dismantling of the apparatus that supports gender equality and LGBTQ+ rights,” notes researcher Malayah Harper in an analysis of Project 2025. In 2023, Republican congressional lobbying even put the brakes on the US President’s Emergency Plan for AIDS Relief (PEPFAR), claiming – incorrectly – that some grant recipients were promoting abortion. As a result of the right-wing lobby, PEPFAR projects now receive yearly budgets instead of five-year funding Why it matters Abortion bans have never stopped women and girls from trying to end unwanted pregnancies. It has simply driven them to unsafe providers whose methods often maim and even kill them. Approximately 6.2 million women and girls had abortions in Sub-Saharan Africa in 2019, and the region has the highest rate of unplanned pregnancies and abortion-related deaths in the world – 185 maternal deaths per 100,000 abortions, according to Guttmacher. Reaction Nancy Northup, CEO of the Center for Reproductive Rights (CRR), said that Trump’s re-election means “anti-rights extremists will soon be back in charge of the White House and the US Senate, wielding power to the detriment of vulnerable populations and seeking to undermine decades of progress on gender equality, a lynchpin of which is the ability of individuals to make decisions about their reproductive lives and have access to reproductive health care.” Northup, whose organisation uses the law to advance reproductive rights, said the CRR “will scrutinize every action of the White House and federal agencies, amass the factual and legal record to counter agency actions, and work to stop harmful policies from going into effect. “If they do, we will take them to court. We will vehemently fight any effort to pass a national abortion ban, to stop the provision of medication abortion by mail, to block women from crossing state lines to get care, to dismantle UN protections for reproductive rights and progress made at the national level in countries around the world, and more.” Saoyo Tabitha Griffith, a Kenyan high court lawyer and women’s rights activist, warned that “African women and LGBTQ people must anticipate that Trump’s return will re-ignite an ideological war with real and physical consequences on their bodies”. “Issues such as contraceptives, surrogacy, single parenting, safe abortion, HPV vaccines and sexual orientation are all going to be contested, not through science and data but by conspiracies and misinformation,” she added. Image Credits: Mika Baumeister/ Unsplash, Clay Kaufmann/ Unsplash, Center for Reproductive Rights. WHO: Climate Action Would Save Two Million Lives A Year 07/11/2024 Stefan Anderson Extreme weather, infectious diseases and air pollution are driving at least two million climate-related deaths annually, WHO reports. Two million lives could be saved annually through urgent climate action, the World Health Organization (WHO) declared on Thursday in a stark message to negotiators ahead of next week’s climate summit in Baku, warning that rising temperatures are wreaking havoc on global health, disrupting healthcare systems and fueling disease outbreaks worldwide. The new WHO report, compiled by over 100 organizations and 300 experts, sets out a blueprint of five key climate interventions: implementing heat-health warning systems, electrifying primary healthcare facilities with solar power, improving water and sanitation infrastructure, transitioning to clean household energy, and reforming fossil fuel pricing. The analysis shows that implementing heat-health warning systems in 57 countries could save 98,500 lives each year, while electrifying primary healthcare facilities with solar power across 63 nations could prevent 290,500 deaths annually by 2024. Improving water and sanitation infrastructure could save 173,000 lives, transitioning to clean household energy could prevent 133,000 deaths, and reforming fossil fuel pricing policies could avert over 1.2 million deaths annually by 2034. “That’s comparable to anything else we can do [globally] in public health through a limited number of climate actions,” Dr Diarmid Campbell-Lendrum, WHO’s climate and health lead, said at the launch press conference. “This is something we have to do to protect people’s lives and their future – it brings very large health gains, we know it saves us money, and we know it’s a really good investment.” Blueprint for action WHO identifies ending fossil fuel subsidies as the most effective global public health interventions, potentially saving 1.2 million lives annually from reduced air pollution The findings come at a crucial moment as nations prepare the third generation of climate pledges under the Paris Agreement, known as nationally determined contributions (NDCs), due before next year’s COP30 in Brazil. WHO is pressing governments to include detailed health planning and financing in these national commitments, urging negotiators to abandon their “siloed approach” to climate change and health, which WHO Director-General Dr Tedros Adhanom Ghebreyesus called “a moral and legal imperative.” While health is identified as a priority in 91% of national climate plans, few outline specific actions or financing mechanisms to protect health from climate risks. The stakes are high: climate change is expected to cause 250,000 additional annual deaths between 2030 and 2050, while air pollution already costs $ 8.1 trillion annually (6.1% of global GDP). Despite these massive costs, health remains critically underfunded in climate action, with only 6% of climate adaptation funding and a mere 0.5% of multilateral climate funding going to health projects. Evidence suggests every $1 invested in climate adaptation can return up to $15 in benefits, while WHO estimates the return on its five key policies to prevent deaths from climate change would see a return of four to one. Yet securing funding remains a critical challenge. In the European Union, a leaked blueprint suggests its dedicated health budget may soon be merged with other funds or eliminated entirely, reflecting intense competition for resources amid inflation, wars, and wider climate impacts in even the world’s wealthiest nations. One possible source of funding is fossil fuel subsidies, which WHO describes as “incoherent” with health goals, echoing last week’s Lancet report warning governments to stop “fuelling” the fire caused by oil, gas and coal by subsidising their use. According to the IMF, total subsidies amount to around $7 trillion annually – much of it reflected in health costs. “The largest single component of [subsidies] is effectively health damages,” Campbell-Lendrum explained. “The costs are felt not in the atmosphere but in people’s lungs, triggering heart attacks, impairing children’s development, and giving them asthma.” “If we were to invest those resources more wisely, then we would have both a healthier planet and much healthier local populations,” Campbell-Lendrum added. “We would also save those resources, and save all that money.” Can’t claim they didn’t know The WHO report comes as new data confirms 2024 will be the first year global temperatures breach the 1.5C threshold above pre-industrial levels – a critical target of the Paris Agreement. UN agencies estimate the world is on track for “catastrophic” warming of 3.1C by the end of the century. The crisis deepened further with Donald Trump’s White House victory on Tuesday, as his promised expansion of record-high US fossil fuel production could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target. Reminder: Victory for Trump is likely to all but end global hopes of staying below 1.5C, our analysis found in March https://t.co/D8YonQ4w65 pic.twitter.com/T2Rbkl0T2m — Simon Evans (@DrSimEvans) November 6, 2024 Despite these setbacks and the recent breakdown of the COP16 biodiversity summit casting a shadow over expectations in Baku, WHO remains optimistic that health impacts could drive meaningful progress at COP29. “Health is the argument we need to catalyze urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.” Climate health crisis A young girl reads under a malaria bednet. Photo: UNDP The health impacts of the climate crisis are far-reaching and already being felt. The report documents how rising temperatures are increasing the spread of infectious diseases, worsening air pollution, threatening food security, and creating unprecedented challenges for healthcare systems worldwide. In 2023 alone, people faced an average of 50 more days of health-threatening heat compared to previous years. Disease outbreaks are also intensifying, with dengue cases reaching record highs of over five million cases across 80 countries due to extreme rainfall and heat creating ideal conditions for mosquito-borne diseases. Over half of all pathogens worldwide are aggravated by climate change. Meanwhile, extreme drought affected almost half the world’s land mass, pushing 151 million more people into food insecurity across 124 countries. The WHO’s findings build on data on the escalating climate-driven health crisis published by the Lancet last week. It found heat-related deaths among people over 65 have surged 167% compared to the 1990s, while people worldwide faced an unprecedented 50 more days of health-threatening temperatures last year and extreme heat made even light outdoor exercise dangerous for billions of people. The burden falls disproportionately on those least responsible for emissions. The WHO notes that by 2050, climate change may push up to 16 million more women and girls into poverty than men and boys, while 920 million children are currently highly exposed to water scarcity. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones. “Whether it is the drought in southern Africa leading to malnutrition, the extreme heat which has become the norm each summer, or the recent flooding in Valencia … health is the lived experience of climate change,” said Dr Vanessa Kerry, WHO’s Special Envoy for Climate Change and Health. “We can no longer afford to ignore that fact.” A duty to safeguard health Nearly one-eighth of the global population does not have access to health facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people around the world. The healthcare sector itself faces a double challenge: responding to increasing climate-related health emergencies while also addressing its own significant carbon footprint. The report reveals that the global healthcare sector accounts for approximately 5% of greenhouse gas emissions – equivalent to the emissions of the fifth-largest country in the world. “For the health community, this is incoherent and directly at odds with our duty to safeguard health,” the report states, calling for an urgent transformation of healthcare systems to become both climate-resilient and low-carbon. On Thursday, the UAE – hosts of last year’s COP28 summit in Dubai – became the first country to submit its third-generation climate plan under the Paris Agreement, including commitments to achieve a net-zero healthcare system by 2050. However, critics note the plan fails to address the UAE’s planned 34% fossil fuel expansion by 2035, highlighting the tensions between climate action and economic interests. Cities & shortage Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions. Other areas highlighted by the report include cities, which are identified as crucial battlegrounds for addressing the crisis, being responsible for over 70% of global emissions while also hosting more than half the world’s population. The report calls for urgent action to transform urban areas through clean energy adoption, sustainable transport systems, and improved infrastructure. “We must reshape our cities to prioritise public transportation and human-powered vehicles, not just to reduce emissions but for the health benefits of daily exercise,” Dr Tedros said. “Green spaces can improve air quality, provide space for physical activity, enhance mental health, and help to cool urban areas.” The WHO also highlights a critical shortage in the health workforce, projecting a shortfall of 10 million workers by 2030, with six million of these in sub-Saharan Africa – one of the regions most vulnerable to climate impacts. With COP29 just days away, WHO officials closed with a call to action. “The stark reality is that climate change is magnifying existing global health challenges that we’ve yet to fix,” Kerry said. “Poor health doesn’t just affect our well-being, but epidemics, chronic diseases, maternal deaths, air pollution, and fuels insecurity across communities and countries, destabilises economies, widens inequities and drives political unrest.” “We must address health as a fundamental part of our climate response to prevent these cascading effects,” she added. “Success cannot be measured only in degrees degrees Celsius averted, but in the human cost of this crisis in lives saved.” Image Credits: UN-Water/Twitter , Galen Crout , UNDP. US Should Lift Marburg Travel Restrictions, Urges Africa CDC 07/11/2024 Kerry Cullinan Dr Jean Kaseya The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya. The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening. “Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC). Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him. Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent. Mpox outbreak continues Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad. While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted. However, despite a high case load, Burundi had not yet reported a single death. Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support. While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children. “The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo. “The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.” Kaseya added that children’s co-infection with measles was also contributing to the higher deaths. However, he added that, as Burundi had not recorded any deaths despite high malnutrition, “there are many things we don’t yet understand”. The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available. The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks. So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted. As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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Four Key Areas Where ‘Anti-Globalist’ Trump Threatens Global Health 08/11/2024 Kerry Cullinan US President-elect Donald Trump railed against “globalists” during his election campaign, and his victory will have serious ramifications for global health – particularly for action against climate change, scientific institutions and regulatory bodies, United Nations agencies and sexual and reproductive health. 1. Climate denial “We will drill, baby, drill,” Trump told the Republican National Convention in July, describing the Biden administration’s “Green New Deal” aimed at reducing greenhouse gases as a “scam”. During his presidency, he persistently favoured industry over the environment, removing around 100 regulations relating to air pollution, water, vehicle emissions, toxic chemicals and wildlife protection, according to the New York Times. For example, within weeks of assuming office in January 2017, Trump expedited the controversial Dakota Access Pipeline to transport crude oil through farms and pristine indigenous land. Oil and gas billionaire Kelcy Warren, whose company, Energy Transfer, was responsible for the pipeline, was the fifth-largest individual contributor to Trump’s latest election campaign with a $5.8 million donation, according to Forbes. He also allowed oil and gas development in the Arctic National Wildlife Refuge in Alaska, one of the last remaining wilderness areas in the US, reauthorised use of an agricultural pesticide, sulfoxaflor, known to kill bees and lifted protections for endangered species. He appointed industry-friendly people to run the Environmental Protection Agency (EPA) and reduced its budget, which drove these measures. However, this time, he might dismantle the agency almost entirely, giving states latitude to decide on environmental issues, according to threats made on the campaign trail. In 2017, Trump announced his intention to pull the US out of the Paris Agreement – the commitment to confine global warming to 1.5°C – saying that it undermined the US economy, hamstrung its ability to open new oil and coal fields, and put the US “at a permanent disadvantage to the other countries of the world”. Trump campaign national press secretary Karoline Leavitt told Politico that he will do the same thing in his second presidency. Why it matters 🌡️The year 2024 is on track to be the warmest year on record, with the global average near surface temperature even higher than in 2023, according to the World Meteorological Organization (@WMOFull). 🔗Full story: https://t.co/94geuImb4e pic.twitter.com/9zhZP0fItU — World Meteorological Organization (@WMO) November 7, 2024 This year is “virtually certain” to be the warmest year on record, with the average global temperature rise being 1.55°C above the pre-industrial era, according to a report from the European Union’s Earth observation programme, Copernicus. Record-breaking heat is driving global extreme weather from hurricanes and floods to drought and fires, threatening the lives and livelihoods of virtually everyone. Trump’s win could lead to an additional four billion tonnes of US emissions by 2030 in comparison with current president Joe Biden’s plans, according to Carbon Brief , based on an aggregation of modelling by various US research groups. This is equal to the total emissions form the European Union and Japan combined, and would cause global climate damages worth more than $900bn, based on the latest US government valuations. Reaction “The nation and world can expect the incoming Trump administration to take a wrecking ball to global climate diplomacy,” said Rachel Cleetus, policy director at the Union of Concerned Scientists, told The Guardian. Environmental justice organisation Greenpeace called on supporters to “resist attempts to roll back environmental and climate protections” and “lean into the intersections between climate justice and democracy protection, given the increasing attacks on freedoms of speech, assembly, and association.” 2. Undermining scientific and regulatory institutions The US Centers for Disease Control and Prevention Trump promoted several quack cures during the COVID-19 pandemic and has apparently promised the world’s leading vaccine skeptic, Robert F Kennedy Jnr, a position at the White House. Kennedy, who has no health qualifications, abandoned his presidential bid in favour of Trump. Trump has said he wants Kennedy to “go wild on health”. That is easy for Kennedy, whose wild ideas including the rejection of most childhood vaccinations and that water fluoridation causes brain disease. It is unclear what position Kennedy will get, but Trump is almost certain to reform and reduce the power of the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The CDC leads disease outbreak investigations, publishing public health recommendations and supporting the work of state and local health departments, which is where around two-thirds of its budget goes. The FDA sets regulatory policy, and decides on the authorisation of new medicines and medical devices. The NIH funds medical research. Kennedy has described public health agencies as “sock puppets for the industries they are supposed to regulate.” He wants to rein in Big Pharma, including by banning TV advertisements for drugs – tricky for Republicans who received significantly more pharma election donations than Democrats. Kennedy has also proposed that half the NIH’s budget should be for “preventive, alternative and holistic approaches to health.” FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything… — Robert F. Kennedy Jr (@RobertKennedyJr) October 25, 2024 He also mused on X that “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma.” Why it matters If citizens don’t believe in science or public health institutions, they are unlikely to follow their advice, which could slow recovery form disease and turn outbreaks into epidemics. A Pew Research Center poll in late 2023 found that there has been a 16% drop in Americans’ view that science has a mostly positive effect on society, with only 57% supporting this view. Decisions taken by the CDC and FDA are considered as the global “gold standard”, and are particularly important for countries that lack the resources to map disease responses and authorise medical products for themselves. Reaction “Among the most destructive impacts of a second Trump administration would be to foment distrust in health, medicine and science, ranging from vaccines to water fluoridation,” Professor Lawrence Gostin, the O’Neill Chair in Global Health Law at Georgetown University, warned on X. “Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives.” Among the most destructive impacts of a 2nd Trump administration would be to foment distrust in health, medicine & science, ranging from vaccines to water fluoridation Censoring public health agencies, cherry picking the data, and pumping out false information would cost lives — Lawrence Gostin (@LawrenceGostin) November 7, 2024 However, Gostin also noted that “Trump has no power to ban vaccines or water fluoridation. The states have public health power, not the president. And we have robust institutions that will hold.” Meanwhile, former CDC head Dr Tom Frieden described the body as “the cornerstone of public health in the United States and a global resource—weakening CDC would endanger American lives.” 3. Defunding UN agencies The WHO plays an essential role in assisting poor countries – in this case, assisting Zimbabwe to respond to a cholera outbreak. Trump’s first administration froze the US contributions to the World Health Organization (WHO) in the middle of the COVID-19 pandemic, accusing it of being controlled by China. BREAKING: Trump announced the U.S. is officially leaving the World Health Organization in the middle of a pandemic. WHO is currently coordinating international vaccine and drug trials to fight #Covid19 pic.twitter.com/ZWiXlXbcNs — POLITICO (@politico) May 29, 2020 Trump also cut US funding to the United Nations Population Fund (UNFPA), effectively shrinking the budget of the global sexual and reproductive health agency by around 7% – erroneously accusing the agency of supporting population control programs in China that include coercive abortion. Trump also withdrew the US from the UN Human Rights Council, and UNESCO, the UN’s cultural agency. This is likely to be repeated in Trump 2, Why it matters The WHO leads global health efforts, coordinating and guiding its 194 member states on how best to respond to all health challenges – from infectious diseases such as COVID-19 to non-communicable diseases. It is particularly important in supporting low-income countries. UNFPA provides maternal and reproductive health services throughout the world – excluding abortions. Its role is particularly in humanitarian settings where governments are unable to provide these services. The loss of the US contribution to the WHO will weaken the global body’s ability to assist countries to react to health challenges. Likewise, the UNFPA will have to scale back its operations, which will impact on women in the poorest, conflict-ridden nations. The US also contributes 22% to the UN’s core budget and 27% of the peacekeeping budget. Reaction After Trump withdrew the US in April 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus accused Trump of “playing with fire” by politicising COVID-19, which would result in “many more body bags”. However, a circumspect Tedros reacted to Trump’s re-election this week by saying: “The partnership between WHO and America is vital, and has significantly improved the health of both Americans and people across the globe. We look forward to working with your administration for global health security.” Meanwhile, UNFPA has warned that women will “lose lifesaving services in some of the world’s most devastating crises” in places like Afghanistan, Sudan and Ukraine,” according to Reuters. 4. Sexual and reproductive health A US protest against abortion restrictions. Sexual and reproductive health (SRH) services are in the firing line, with Trump likely to support the expansion of domestic abortion bans, while entrenching opposition to abortion as a key pillar of US foreign aid. Despite the Trump victory, millions of people in seven US states voted to enshrine the right to abortion in their state constitutions, approving amendments in seven of 10 states where measures were on the ballot. However, the Trump administration is expected to try to end access to medication abortion,used in 63% of US abortions, including by prosecuting people who ship and transport abortion pills and supplies. Trump appointed anti-abortion judges to the Supreme Court who overturned the right to abortion, known as Roe v Wade. Seventeen US states have banned abortion since Roe v Wade was overturned, and many doctors are unsure of when it is legal to assist women to terminate pregnancies – even when they are obviously in distress. “In vast swaths of the US South and Midwest, patients are forced to cross multiple state lines to get [abortion] care, but many lack the means to do so,” according to the Center for Reproductive Rights (CRR). “Obstetricians are fleeing states where abortion is banned because they cannot properly care for their patients, including those experiencing severe pregnancy complications. Obstetricians and medical school residents don’t want to work in these states, creating maternal health deserts.” As we continue to process the results of the U.S. election, one thing is clear: on the domestic and international fronts, the anti-rights agenda poses a SERIOUS threat to the progress made on gender equality, reproductive rights, and health care access.https://t.co/Dm0uiaQXZT — Center for Reproductive Rights (@ReproRights) November 7, 2024 One of Trump’s first presidential actions in 2017 was to prohibit foreign NGOs from receiving US government funding for health if they “provided, promoted, or discussed” abortion – known as the Expanded Global Gag Rule (GGR). Many family planning organisations lost their funding and women lost access to contraception in some of the continent’s poorest countries such as Madagascar and Ethiopia – ironically contributing to more unplanned pregnancies. While legal abortion is out of the reach of most African women and girls, 19 African countries have eased access since 1994 – mostly in an attempt to reduce the maternal deaths caused by unsafe abortions. But US groups have campaigned against this easing in Africa, led most recently by former Trump administration officials Valerie Huber, and Alma Golden. Huber was the architect of an anti-abortion pact, the Geneva Consensus Declaration (GCD), adopted in the dying weeks of Trump’s rule in October 2020 with the support of an array of global human-rights polecats such as Iraq, Uganda, Belarus and Sudan. The GCD also promotes “the natural family” – primarly aimed at removing any recognition of the existence of LGBTQ people. While Biden withdrew the US from the GCD, Trump has promised to rejoin it “to reject the globalist claim of an international right to abortion.” “Under my leadership, the United States will also rejoin the Geneva Consensus Declaration, created by my administration and signed by 36 nations, to reject the globalist claim of an international right to abortion.” pic.twitter.com/1r4R4l23Pg — Team Trump (Text TRUMP to 88022) (@TeamTrump) September 20, 2023 Project 2025, the controversial conservative blueprint for a Trump victory written primarily by his former officials, proposes that all US aid including humanitarian assistance, should be conditional on the rejection of abortion. “Proposed measures for USAID [US Agency for International Development] include a significant restructuring, and reduction of budget, the removal of diversity, equity, and inclusion programs, and dismantling of the apparatus that supports gender equality and LGBTQ+ rights,” notes researcher Malayah Harper in an analysis of Project 2025. In 2023, Republican congressional lobbying even put the brakes on the US President’s Emergency Plan for AIDS Relief (PEPFAR), claiming – incorrectly – that some grant recipients were promoting abortion. As a result of the right-wing lobby, PEPFAR projects now receive yearly budgets instead of five-year funding Why it matters Abortion bans have never stopped women and girls from trying to end unwanted pregnancies. It has simply driven them to unsafe providers whose methods often maim and even kill them. Approximately 6.2 million women and girls had abortions in Sub-Saharan Africa in 2019, and the region has the highest rate of unplanned pregnancies and abortion-related deaths in the world – 185 maternal deaths per 100,000 abortions, according to Guttmacher. Reaction Nancy Northup, CEO of the Center for Reproductive Rights (CRR), said that Trump’s re-election means “anti-rights extremists will soon be back in charge of the White House and the US Senate, wielding power to the detriment of vulnerable populations and seeking to undermine decades of progress on gender equality, a lynchpin of which is the ability of individuals to make decisions about their reproductive lives and have access to reproductive health care.” Northup, whose organisation uses the law to advance reproductive rights, said the CRR “will scrutinize every action of the White House and federal agencies, amass the factual and legal record to counter agency actions, and work to stop harmful policies from going into effect. “If they do, we will take them to court. We will vehemently fight any effort to pass a national abortion ban, to stop the provision of medication abortion by mail, to block women from crossing state lines to get care, to dismantle UN protections for reproductive rights and progress made at the national level in countries around the world, and more.” Saoyo Tabitha Griffith, a Kenyan high court lawyer and women’s rights activist, warned that “African women and LGBTQ people must anticipate that Trump’s return will re-ignite an ideological war with real and physical consequences on their bodies”. “Issues such as contraceptives, surrogacy, single parenting, safe abortion, HPV vaccines and sexual orientation are all going to be contested, not through science and data but by conspiracies and misinformation,” she added. Image Credits: Mika Baumeister/ Unsplash, Clay Kaufmann/ Unsplash, Center for Reproductive Rights. WHO: Climate Action Would Save Two Million Lives A Year 07/11/2024 Stefan Anderson Extreme weather, infectious diseases and air pollution are driving at least two million climate-related deaths annually, WHO reports. Two million lives could be saved annually through urgent climate action, the World Health Organization (WHO) declared on Thursday in a stark message to negotiators ahead of next week’s climate summit in Baku, warning that rising temperatures are wreaking havoc on global health, disrupting healthcare systems and fueling disease outbreaks worldwide. The new WHO report, compiled by over 100 organizations and 300 experts, sets out a blueprint of five key climate interventions: implementing heat-health warning systems, electrifying primary healthcare facilities with solar power, improving water and sanitation infrastructure, transitioning to clean household energy, and reforming fossil fuel pricing. The analysis shows that implementing heat-health warning systems in 57 countries could save 98,500 lives each year, while electrifying primary healthcare facilities with solar power across 63 nations could prevent 290,500 deaths annually by 2024. Improving water and sanitation infrastructure could save 173,000 lives, transitioning to clean household energy could prevent 133,000 deaths, and reforming fossil fuel pricing policies could avert over 1.2 million deaths annually by 2034. “That’s comparable to anything else we can do [globally] in public health through a limited number of climate actions,” Dr Diarmid Campbell-Lendrum, WHO’s climate and health lead, said at the launch press conference. “This is something we have to do to protect people’s lives and their future – it brings very large health gains, we know it saves us money, and we know it’s a really good investment.” Blueprint for action WHO identifies ending fossil fuel subsidies as the most effective global public health interventions, potentially saving 1.2 million lives annually from reduced air pollution The findings come at a crucial moment as nations prepare the third generation of climate pledges under the Paris Agreement, known as nationally determined contributions (NDCs), due before next year’s COP30 in Brazil. WHO is pressing governments to include detailed health planning and financing in these national commitments, urging negotiators to abandon their “siloed approach” to climate change and health, which WHO Director-General Dr Tedros Adhanom Ghebreyesus called “a moral and legal imperative.” While health is identified as a priority in 91% of national climate plans, few outline specific actions or financing mechanisms to protect health from climate risks. The stakes are high: climate change is expected to cause 250,000 additional annual deaths between 2030 and 2050, while air pollution already costs $ 8.1 trillion annually (6.1% of global GDP). Despite these massive costs, health remains critically underfunded in climate action, with only 6% of climate adaptation funding and a mere 0.5% of multilateral climate funding going to health projects. Evidence suggests every $1 invested in climate adaptation can return up to $15 in benefits, while WHO estimates the return on its five key policies to prevent deaths from climate change would see a return of four to one. Yet securing funding remains a critical challenge. In the European Union, a leaked blueprint suggests its dedicated health budget may soon be merged with other funds or eliminated entirely, reflecting intense competition for resources amid inflation, wars, and wider climate impacts in even the world’s wealthiest nations. One possible source of funding is fossil fuel subsidies, which WHO describes as “incoherent” with health goals, echoing last week’s Lancet report warning governments to stop “fuelling” the fire caused by oil, gas and coal by subsidising their use. According to the IMF, total subsidies amount to around $7 trillion annually – much of it reflected in health costs. “The largest single component of [subsidies] is effectively health damages,” Campbell-Lendrum explained. “The costs are felt not in the atmosphere but in people’s lungs, triggering heart attacks, impairing children’s development, and giving them asthma.” “If we were to invest those resources more wisely, then we would have both a healthier planet and much healthier local populations,” Campbell-Lendrum added. “We would also save those resources, and save all that money.” Can’t claim they didn’t know The WHO report comes as new data confirms 2024 will be the first year global temperatures breach the 1.5C threshold above pre-industrial levels – a critical target of the Paris Agreement. UN agencies estimate the world is on track for “catastrophic” warming of 3.1C by the end of the century. The crisis deepened further with Donald Trump’s White House victory on Tuesday, as his promised expansion of record-high US fossil fuel production could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target. Reminder: Victory for Trump is likely to all but end global hopes of staying below 1.5C, our analysis found in March https://t.co/D8YonQ4w65 pic.twitter.com/T2Rbkl0T2m — Simon Evans (@DrSimEvans) November 6, 2024 Despite these setbacks and the recent breakdown of the COP16 biodiversity summit casting a shadow over expectations in Baku, WHO remains optimistic that health impacts could drive meaningful progress at COP29. “Health is the argument we need to catalyze urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.” Climate health crisis A young girl reads under a malaria bednet. Photo: UNDP The health impacts of the climate crisis are far-reaching and already being felt. The report documents how rising temperatures are increasing the spread of infectious diseases, worsening air pollution, threatening food security, and creating unprecedented challenges for healthcare systems worldwide. In 2023 alone, people faced an average of 50 more days of health-threatening heat compared to previous years. Disease outbreaks are also intensifying, with dengue cases reaching record highs of over five million cases across 80 countries due to extreme rainfall and heat creating ideal conditions for mosquito-borne diseases. Over half of all pathogens worldwide are aggravated by climate change. Meanwhile, extreme drought affected almost half the world’s land mass, pushing 151 million more people into food insecurity across 124 countries. The WHO’s findings build on data on the escalating climate-driven health crisis published by the Lancet last week. It found heat-related deaths among people over 65 have surged 167% compared to the 1990s, while people worldwide faced an unprecedented 50 more days of health-threatening temperatures last year and extreme heat made even light outdoor exercise dangerous for billions of people. The burden falls disproportionately on those least responsible for emissions. The WHO notes that by 2050, climate change may push up to 16 million more women and girls into poverty than men and boys, while 920 million children are currently highly exposed to water scarcity. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones. “Whether it is the drought in southern Africa leading to malnutrition, the extreme heat which has become the norm each summer, or the recent flooding in Valencia … health is the lived experience of climate change,” said Dr Vanessa Kerry, WHO’s Special Envoy for Climate Change and Health. “We can no longer afford to ignore that fact.” A duty to safeguard health Nearly one-eighth of the global population does not have access to health facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people around the world. The healthcare sector itself faces a double challenge: responding to increasing climate-related health emergencies while also addressing its own significant carbon footprint. The report reveals that the global healthcare sector accounts for approximately 5% of greenhouse gas emissions – equivalent to the emissions of the fifth-largest country in the world. “For the health community, this is incoherent and directly at odds with our duty to safeguard health,” the report states, calling for an urgent transformation of healthcare systems to become both climate-resilient and low-carbon. On Thursday, the UAE – hosts of last year’s COP28 summit in Dubai – became the first country to submit its third-generation climate plan under the Paris Agreement, including commitments to achieve a net-zero healthcare system by 2050. However, critics note the plan fails to address the UAE’s planned 34% fossil fuel expansion by 2035, highlighting the tensions between climate action and economic interests. Cities & shortage Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions. Other areas highlighted by the report include cities, which are identified as crucial battlegrounds for addressing the crisis, being responsible for over 70% of global emissions while also hosting more than half the world’s population. The report calls for urgent action to transform urban areas through clean energy adoption, sustainable transport systems, and improved infrastructure. “We must reshape our cities to prioritise public transportation and human-powered vehicles, not just to reduce emissions but for the health benefits of daily exercise,” Dr Tedros said. “Green spaces can improve air quality, provide space for physical activity, enhance mental health, and help to cool urban areas.” The WHO also highlights a critical shortage in the health workforce, projecting a shortfall of 10 million workers by 2030, with six million of these in sub-Saharan Africa – one of the regions most vulnerable to climate impacts. With COP29 just days away, WHO officials closed with a call to action. “The stark reality is that climate change is magnifying existing global health challenges that we’ve yet to fix,” Kerry said. “Poor health doesn’t just affect our well-being, but epidemics, chronic diseases, maternal deaths, air pollution, and fuels insecurity across communities and countries, destabilises economies, widens inequities and drives political unrest.” “We must address health as a fundamental part of our climate response to prevent these cascading effects,” she added. “Success cannot be measured only in degrees degrees Celsius averted, but in the human cost of this crisis in lives saved.” Image Credits: UN-Water/Twitter , Galen Crout , UNDP. US Should Lift Marburg Travel Restrictions, Urges Africa CDC 07/11/2024 Kerry Cullinan Dr Jean Kaseya The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya. The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening. “Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC). Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him. Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent. Mpox outbreak continues Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad. While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted. However, despite a high case load, Burundi had not yet reported a single death. Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support. While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children. “The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo. “The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.” Kaseya added that children’s co-infection with measles was also contributing to the higher deaths. However, he added that, as Burundi had not recorded any deaths despite high malnutrition, “there are many things we don’t yet understand”. The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available. The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks. So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted. As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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WHO: Climate Action Would Save Two Million Lives A Year 07/11/2024 Stefan Anderson Extreme weather, infectious diseases and air pollution are driving at least two million climate-related deaths annually, WHO reports. Two million lives could be saved annually through urgent climate action, the World Health Organization (WHO) declared on Thursday in a stark message to negotiators ahead of next week’s climate summit in Baku, warning that rising temperatures are wreaking havoc on global health, disrupting healthcare systems and fueling disease outbreaks worldwide. The new WHO report, compiled by over 100 organizations and 300 experts, sets out a blueprint of five key climate interventions: implementing heat-health warning systems, electrifying primary healthcare facilities with solar power, improving water and sanitation infrastructure, transitioning to clean household energy, and reforming fossil fuel pricing. The analysis shows that implementing heat-health warning systems in 57 countries could save 98,500 lives each year, while electrifying primary healthcare facilities with solar power across 63 nations could prevent 290,500 deaths annually by 2024. Improving water and sanitation infrastructure could save 173,000 lives, transitioning to clean household energy could prevent 133,000 deaths, and reforming fossil fuel pricing policies could avert over 1.2 million deaths annually by 2034. “That’s comparable to anything else we can do [globally] in public health through a limited number of climate actions,” Dr Diarmid Campbell-Lendrum, WHO’s climate and health lead, said at the launch press conference. “This is something we have to do to protect people’s lives and their future – it brings very large health gains, we know it saves us money, and we know it’s a really good investment.” Blueprint for action WHO identifies ending fossil fuel subsidies as the most effective global public health interventions, potentially saving 1.2 million lives annually from reduced air pollution The findings come at a crucial moment as nations prepare the third generation of climate pledges under the Paris Agreement, known as nationally determined contributions (NDCs), due before next year’s COP30 in Brazil. WHO is pressing governments to include detailed health planning and financing in these national commitments, urging negotiators to abandon their “siloed approach” to climate change and health, which WHO Director-General Dr Tedros Adhanom Ghebreyesus called “a moral and legal imperative.” While health is identified as a priority in 91% of national climate plans, few outline specific actions or financing mechanisms to protect health from climate risks. The stakes are high: climate change is expected to cause 250,000 additional annual deaths between 2030 and 2050, while air pollution already costs $ 8.1 trillion annually (6.1% of global GDP). Despite these massive costs, health remains critically underfunded in climate action, with only 6% of climate adaptation funding and a mere 0.5% of multilateral climate funding going to health projects. Evidence suggests every $1 invested in climate adaptation can return up to $15 in benefits, while WHO estimates the return on its five key policies to prevent deaths from climate change would see a return of four to one. Yet securing funding remains a critical challenge. In the European Union, a leaked blueprint suggests its dedicated health budget may soon be merged with other funds or eliminated entirely, reflecting intense competition for resources amid inflation, wars, and wider climate impacts in even the world’s wealthiest nations. One possible source of funding is fossil fuel subsidies, which WHO describes as “incoherent” with health goals, echoing last week’s Lancet report warning governments to stop “fuelling” the fire caused by oil, gas and coal by subsidising their use. According to the IMF, total subsidies amount to around $7 trillion annually – much of it reflected in health costs. “The largest single component of [subsidies] is effectively health damages,” Campbell-Lendrum explained. “The costs are felt not in the atmosphere but in people’s lungs, triggering heart attacks, impairing children’s development, and giving them asthma.” “If we were to invest those resources more wisely, then we would have both a healthier planet and much healthier local populations,” Campbell-Lendrum added. “We would also save those resources, and save all that money.” Can’t claim they didn’t know The WHO report comes as new data confirms 2024 will be the first year global temperatures breach the 1.5C threshold above pre-industrial levels – a critical target of the Paris Agreement. UN agencies estimate the world is on track for “catastrophic” warming of 3.1C by the end of the century. The crisis deepened further with Donald Trump’s White House victory on Tuesday, as his promised expansion of record-high US fossil fuel production could add more than 4 billion tonnes to US emissions by 2030, effectively ending hopes of meeting the 1.5C target. Reminder: Victory for Trump is likely to all but end global hopes of staying below 1.5C, our analysis found in March https://t.co/D8YonQ4w65 pic.twitter.com/T2Rbkl0T2m — Simon Evans (@DrSimEvans) November 6, 2024 Despite these setbacks and the recent breakdown of the COP16 biodiversity summit casting a shadow over expectations in Baku, WHO remains optimistic that health impacts could drive meaningful progress at COP29. “Health is the argument we need to catalyze urgent and large-scale action in this critical moment,” said Dr Maria Neira, WHO’s health and climate lead. “We’re putting forward this very strong health argument to ensure no one can leave COP29 claiming they didn’t know climate change is affecting health.” Climate health crisis A young girl reads under a malaria bednet. Photo: UNDP The health impacts of the climate crisis are far-reaching and already being felt. The report documents how rising temperatures are increasing the spread of infectious diseases, worsening air pollution, threatening food security, and creating unprecedented challenges for healthcare systems worldwide. In 2023 alone, people faced an average of 50 more days of health-threatening heat compared to previous years. Disease outbreaks are also intensifying, with dengue cases reaching record highs of over five million cases across 80 countries due to extreme rainfall and heat creating ideal conditions for mosquito-borne diseases. Over half of all pathogens worldwide are aggravated by climate change. Meanwhile, extreme drought affected almost half the world’s land mass, pushing 151 million more people into food insecurity across 124 countries. The WHO’s findings build on data on the escalating climate-driven health crisis published by the Lancet last week. It found heat-related deaths among people over 65 have surged 167% compared to the 1990s, while people worldwide faced an unprecedented 50 more days of health-threatening temperatures last year and extreme heat made even light outdoor exercise dangerous for billions of people. The burden falls disproportionately on those least responsible for emissions. The WHO notes that by 2050, climate change may push up to 16 million more women and girls into poverty than men and boys, while 920 million children are currently highly exposed to water scarcity. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones. “Whether it is the drought in southern Africa leading to malnutrition, the extreme heat which has become the norm each summer, or the recent flooding in Valencia … health is the lived experience of climate change,” said Dr Vanessa Kerry, WHO’s Special Envoy for Climate Change and Health. “We can no longer afford to ignore that fact.” A duty to safeguard health Nearly one-eighth of the global population does not have access to health facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people around the world. The healthcare sector itself faces a double challenge: responding to increasing climate-related health emergencies while also addressing its own significant carbon footprint. The report reveals that the global healthcare sector accounts for approximately 5% of greenhouse gas emissions – equivalent to the emissions of the fifth-largest country in the world. “For the health community, this is incoherent and directly at odds with our duty to safeguard health,” the report states, calling for an urgent transformation of healthcare systems to become both climate-resilient and low-carbon. On Thursday, the UAE – hosts of last year’s COP28 summit in Dubai – became the first country to submit its third-generation climate plan under the Paris Agreement, including commitments to achieve a net-zero healthcare system by 2050. However, critics note the plan fails to address the UAE’s planned 34% fossil fuel expansion by 2035, highlighting the tensions between climate action and economic interests. Cities & shortage Long-term exposure to air pollution and lack of green spaces significantly increases the risk of hospitalization for respiratory conditions. Other areas highlighted by the report include cities, which are identified as crucial battlegrounds for addressing the crisis, being responsible for over 70% of global emissions while also hosting more than half the world’s population. The report calls for urgent action to transform urban areas through clean energy adoption, sustainable transport systems, and improved infrastructure. “We must reshape our cities to prioritise public transportation and human-powered vehicles, not just to reduce emissions but for the health benefits of daily exercise,” Dr Tedros said. “Green spaces can improve air quality, provide space for physical activity, enhance mental health, and help to cool urban areas.” The WHO also highlights a critical shortage in the health workforce, projecting a shortfall of 10 million workers by 2030, with six million of these in sub-Saharan Africa – one of the regions most vulnerable to climate impacts. With COP29 just days away, WHO officials closed with a call to action. “The stark reality is that climate change is magnifying existing global health challenges that we’ve yet to fix,” Kerry said. “Poor health doesn’t just affect our well-being, but epidemics, chronic diseases, maternal deaths, air pollution, and fuels insecurity across communities and countries, destabilises economies, widens inequities and drives political unrest.” “We must address health as a fundamental part of our climate response to prevent these cascading effects,” she added. “Success cannot be measured only in degrees degrees Celsius averted, but in the human cost of this crisis in lives saved.” Image Credits: UN-Water/Twitter , Galen Crout , UNDP. US Should Lift Marburg Travel Restrictions, Urges Africa CDC 07/11/2024 Kerry Cullinan Dr Jean Kaseya The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya. The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening. “Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC). Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him. Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent. Mpox outbreak continues Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad. While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted. However, despite a high case load, Burundi had not yet reported a single death. Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support. While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children. “The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo. “The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.” Kaseya added that children’s co-infection with measles was also contributing to the higher deaths. However, he added that, as Burundi had not recorded any deaths despite high malnutrition, “there are many things we don’t yet understand”. The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available. The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks. So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted. As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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US Should Lift Marburg Travel Restrictions, Urges Africa CDC 07/11/2024 Kerry Cullinan Dr Jean Kaseya The US should lift its Marburg-related entry restrictions on people travelling from Rwanda as they are “killing” that country’s economy, according to Dr Jean Kaseya. The US requires people who have visited Rwanda in the past 21 days to fly to one of only three airports for health screening. “Now that we are out of the [US] election, let us start to talk science and let us lift this entry status,” said Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC). Kaseya added that not a single Marburg case had been transmitted out of Rwanda. Rwanda has had no new Marburg cases in the past week, and its 66 cases are all linked to the index case and health workers who treated him. Kaseya also called on the US to deliver on the pledge made by President Joe Biden to contribute $500 million to assist Africa with the current mpox outbreak. He added that less than 20% of partners’ mpox pledges had been delivered to the continent. Mpox outbreak continues Meanwhile, Mpox cases continue to rise, particularly in Central Africa, with 2,532 new cases in the past week – including 20 in Rwanda, which hadn’t recorded any cases in the past few weeks, and a new district of the Central Africa Republic bordering Chad. While vaccinations were generally progressing well in the DRC and Rwanda, Burundi has not yet received any doses as the Africa CDC was still discussing some issues with the country, Kaseya noted. However, despite a high case load, Burundi had not yet reported a single death. Africa CDC’s mpox lead, Dr Ngashi Ngongo, attributed this to dedicated inpatient treatment centres for mpox patients that offered treatment as well as nutritional and psycho-social support. While the overall case fatality rate is 9,3%, the death rate for younger children is four or five times that of adults, said Ngongo, adding that a forthcoming paper would offer more analysis about the contributing factors to the high mortality in children. “The context is important. In some of these countries, especially in Central Africa, there’s a high malnutrition rate in those children. In Burundi, about 53% of children below five are chronically malnourished. In DRC, it’s about 42%,” said Ngongo. “The second element that might be contributing to the DRC figure is that in the case of malnourished children who are so fragile, the more time you take to seek care, I think the more advanced the disease and the poorer the outcome.” Kaseya added that children’s co-infection with measles was also contributing to the higher deaths. However, he added that, as Burundi had not recorded any deaths despite high malnutrition, “there are many things we don’t yet understand”. The continent is still struggling to protect young children from mpox, as the MVA-BN vaccines at hand can only be used on children from 12 years of age. The Japanese LC16 vaccines that can be used on children are not yet available. The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization has advised that, although MVA-BN is currently not licensed for persons under 18 years of age, it may be used “off-label” in infants, children and adolescents, and in pregnant and immunocompromised people in outbreak settings where the benefits of vaccination outweigh the potential risks. So far, the mpox cases in Africa this year are 545% higher than in 2023 and cases are increasing at a steady pace of between 2000 and 3000 cases every week, Kaseya noted. As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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As Global Temperatures Surge, Countries Lack Data to Address Climate Change 07/11/2024 Disha Shetty Climate data could help countries respond to extreme weather events better but many countries lack data, according to WMO’s latest report. There are big gaps in the data that governments rely on to make decisions to mitigate the effects of climate change, according to the latest report by the UN body World Meteorological Organization (WMO), released on Thursday. Climate data includes information about rainfall, drought, sea level rise, storm surges, and cyclones, as well as the impacts of these on vulnerable communities. This data can help policymakers issue advance warnings to limit deaths and economic damage, as well as effectively distribute their resources to those most in need. Around a third of countries’ National Meteorological and Hydrological Services (NMHSs) provide climate services at an ‘essential’ level, and nearly one-third at an ‘advanced’ or ‘full’ level, according to the report. But there are still many countries that only provide basic level of climate services or none. This is a long way off from the UN’s target of all countries to have access to a full range of climate services by 2027. The report added that while countries in Asia and Africa in particular have made strides in boosting their capacity, gaps persist. Big gaps in Asia, Africa The WMO reports say there have been improvements in capacity in regions like Asia and Africa but more needs to be done. Latin America and the Caribbean, for instance, face a growing need for early warning services to deal with hazards such as forest fires and droughts. “We need to make the necessary investments for a sustainable future. The cost of no action is several times higher than the cost of action,” said WMO Secretary-General Celeste Saulo. Too few nations are creating tailored climate services for their citizens, and there are still significant gaps, especially in Least Developed Countries (LDCs) and Small Island Developing States (SIDS), the report found. The availability of climate services has improved in Asia and Africa at the back of increased investments. Deaths from extreme weather events like storms and floods have also surged, as have the economic losses. Some deaths are not even recorded due to low levels of death registrations, especially in low- and middle-income countries making the toll a likely underestimate. And so the UN has reiterated that a portion of this impact can be mitigated with timely warnings well in time. Rising need for climate services There is a growing awareness of the importance of climate services from countries as well as the funding these services. Over 80% of the 58 countries that have submitted national adaptation plans to UNFCCC, the UN process for negotiating an agreement to limit dangerous climate change, recognized the importance of climate services as part of their national adaptation strategies. The WMO analysis shows that the services being provided to national governments, agriculture and emergency planning and response are in highest demand. The European Union’s Earth observation programme, Copernicus, released a report on Wednesday noting that 2024 is “virtually certain” to be the warmest year on record – with the average global temperature rise being 1.55°C above the pre-industrial era. The 2015 Paris Agreement commits global leaders to contain the increase in the global average temperature to 1.5°C above pre-industrial levels. A warmer world means more frequent and more intense extreme weather events as well as their intensity. Investments in climate services Of the $63 billion being spent on climate adaptation, nearly a third goes towards climate-informed investments. Of this, only about $4 to $5 billion goes to explicitly supporting climate services and early warning activities, according to the report. UN Secretary-General António Guterres has been pushing countries to invest in early warning systems to respond better to extreme weather events. The UN has also launched an initiative called ‘Early Warning Systems for All’ that has set a target to provide the full range of life-saving early warning systems by the end of 2027 for everyone. Other stakeholders have already begun taking a lead from the UN. The Asian Development Bank (ADB) released its report in August this year that looked at the state of climate data in Asia. Of the 29 countries in the Asia and the Pacific region that were assessed, only 17 covered climate data in some form. Experts from the ADB reiterated the need to go a step further and combine climate data with other socio-economic parameters like poverty and unemployment levels to identify the most vulnerable populations so they can be helped in the aftermath of the extreme weather events. WMO has flagged regional cooperation as a key enabler for the successful development and delivery of climate services “In the face of unprecedented environmental challenges, the development, delivery, and use of climate information to enable climate action has never been more crucial,” Saulo of WMO said. “On our journey towards sustainable development, we need to do more to turn climate science and climate information into actionable services, to make climate services more accessible and to use them more effectively,” she added. Image Credits: WMO 2024 Calendar Competition – Winner – Muhammad Amdad Hossain, WMO. Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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Nations Back Landmark Health Deal at Troubled UN Biodiversity Summit 04/11/2024 Stefan Anderson The UN biodiversity summit in Cali yielded welcome decisions on health, Indigenous representation and benefit sharing from genetic sequences but fell short of major questions of finance and implementation. Nearly 200 nations have backed a groundbreaking global action plan linking health and the natural world at the close of UN biodiversity negotiations in Cali, Colombia, marking a rare victory in a summit otherwise characterised by disappointment. The final agreement on a “health and biodiversity action plan” was approved as a voluntary rather than mandatory measure, serving as a best-practice guide for nations to integrate health considerations into their nature protection plans. But it still stands as an achievement, capping four years of negotiations and reflecting health’s growing prominence in environmental diplomacy. “Parties approved a global action plan on biodiversity and health designed to help curb the emergence of zoonotic diseases, prevent non-communicable diseases, and promote sustainable ecosystems,” the COP16 secretariat announced as the Cali meeting closed early on Saturday morning after a frantic overnight session. “The strategy embraces a holistic ‘one health’ approach that recognises the health of ecosystems, animals and humans as interconnected,” the secreteriat added. Other key developments from the 16th conference of parties to the Convention on Biodiversity (COP16) included a new voluntary framework whereby a small percentage of corporate profits derived from genetic resources harvested in countries should be allocated to a new global fund for biodiversity protection – dubbed the Cali fund. Nations also agreed to establish a permanent body for Indigenous peoples within the UN treaty framework following three decades of advocacy on the issue. Yet the likely legacy of COP16 came in its complete failure to mobilise funds anywhere near the $200bn annual target for nature protection by 2030 set out in the landmark Convention on Biodiversity (CBD) agreement reached in Montreal in 2022. It raised just $163 million in new funds to combat the biodiversity crisis – 500 times short of the 2030 goal. In a final blow to the summit’s ambitions, nations failed to agree on mechanisms to monitor compliance with the treaty and its targets – this after the world has missed every single UN biodiversity goal since the CBD framework’s establishment in 1992. Global action plan links health and nature protection In the panel “Prioritizing Actions in Biodiversity and Health” at #COP16, Colombia @MinSaludCol and Nigeria @SalakoIziaq led the dialogue on the Global Action Plan on Biodiversity and Health, discussing key measures to prevent pathogen transmission. 🌎👨⚕️ pic.twitter.com/kslZWqYxHa — COP16 COLOMBIA 🇨🇴 (@COP16Oficial) November 1, 2024 The new UN biodiversity and health action plan urges governments to put health at the heart of their nature protection strategies. While voluntary, the agreement marks a turning point in environmental policy by formally recognising for the first time that “biodiversity loss and its direct drivers are a threat to animal, human and plant health”. The decision comes as scientists increasingly warn that the destruction of natural habitats is driving disease outbreaks and raising pandemic risks. The loss of biodiversity also undermines Earth’s basic life support systems – from food security and clean water to medicinal plants and vital ecosystem services. These impacts are amplified by the climate crisis, creating a feedback loop that further threatens public health. Drawing on “lessons” from Covid-19, the plan emphasises the “urgent need to conserve, restore and sustainably use biodiversity” to prevent future zoonotic diseases – those that jump from animals to humans. ‘Embracing the interconnectedness of biodiversity and health’ The decision document places particular emphasis on how vulnerable groups, including women, children, the elderly and people with disabilities face outsized health impacts, while Indigenous communities are especially hard hit, given their “unique interdependent relationship” with local ecosystems. Key rehabilitation strategies outlined in the 21-page health and biodiversity blueprint call on countries to set health-relevant targets that would also help reach the overall targets of the Convention on Biodiversity. These include, for example, the promotion of more healthier and sustainable agriculture, fisheries and forestry; addressing wildlife fragmentation and species management; land and sea use; and reducing pollution in multiple forms, from air pollutants to microplastics. The text also calls for countries to address the unsafe disposal of antimicrobials and pharmaceuticals – which fuel drug resistance already claiming 1.27 million lives every year and threatening the efficacy of medicines used by billions globally. “This is a breakthrough moment affecting humans, wildlife and other animals, and ecosystems,” the Wildlife Conservation Society, which provided technical input to the negotiations said in a statement. “Millions died and suffered due to the COVID-19 pandemic, and this Convention is charting an excellent path to fully embrace the integration and interconnectedness of biodiversity and health,” WCS vice-president Susan Lieberman added. “There can be no prevention of future pandemics of zoonotic origin without the protection and ecological integrity of nature,” Lieberman said. “We have no future without nature.” No binding measures adopted However, as one of few documents achieving consensus in Cali, the final text emerged somewhat diluted. The plan repeatedly emphasizes its voluntary nature, stating that “nothing” in the document “should be interpreted as modifying the rights and obligations” of any nation that is party to the legally binding CBD agreement reached in Montreal in 2022. Specific references to industry’s impacts on biodiversity and health were softened. For instance, explicit mention of “unsustainable agricultural intensification” was removed from the final text. Ditto for a blunt reference to the “increasing human demand for animal protein” as a factor driving zoonotic diseases. Instead, the final text notes that infectious diseases “can be exacerbated by human activities, such as unsustainable land-use change practices and habitat fragmentation.” Even so, advocates of a stronger linkage between health and biodiversity said the decision was a step in the right direction. “At the end of the day, this plan is only going to be voluntary, but it’s still good guidance,” Dr Colman O’Criodain, head of biodiversity policy at WWF, told Carbon Brief. “Even if countries that don’t commit formally to implement it use the guidance and take the parts of it that are relevant to them, that’s still a good thing.” Landmark ‘Cali Fund’ created for companies to share profits from the use of genetic resources Another key agreement came in the early hours of Saturday morning, when nations agreed to create a new global biodiversity fund, financed by corporate profits derived from the creation of new products using genetic resources. The agreement, which first appeared uncertain amid hundreds of early textual disputes, stood out as a rare note of final consensus in an otherwise divided summit. At the heart of the new arrangement is the sharing of Digital Sequence Information (DSI) – which can map the unique genetic blueprint of virtually any plant species or micro-organism, including pathogens, at the digital level, making sharing faster and more efficient than through biological tissue samples. Big food, cosmetics and pharmaceutical companies worldwide now harness and use genetic resources, captured as DSI, across far-flung borders, to create new products worth billions of dollars annually. But developing countries have long maintained that they are left out of the loop of benefits that come from the harvesting of new genetic resources in their regions. The new plan marks the first global attempt to address the imbalance. The agreement targets companies meeting two of three thresholds: annual sales exceeding $50 million, profits over $5 million, or assets above $20 million. These firms “should” contribute either 1% of revenue or 0.1% of profits to the new “Cali Fund” to support developing country biodiversity preservation and restoration. Although the rates remain “indicative”. Further underlying that voluntary nature, a last-minute revision stripped out a requirement for companies to “demonstrate” they hadn’t used DSI in their products. “The deal reached means businesses have the option of voluntarily contributing to a new fund – known as the Cali Fund – if they use this genetic information from nature, said the UK Government’s Department for Environment, Food and Rural Affairs, calling it a “new deal for biodiversity from using nature’s genetic information”. Global patterns of gene sequence data sharing, June-November 2022. The bigger the dot/higher the number, the more DSI data generated by the country was used by researchers elsewhere. The CBD will manage the funds collected for nature conservation, with at least half flowing to indigenous communities. In that way, the new Cali Fund also aims to avoid the pitfalls of closely attributing the profits from genetic resources culled by industry to one particular country or community. “Parties and non-Parties are invited to take administrative, policy or legislative measures, consistent with national legislation, to incentivise contributions from users in their jurisdiction to the global fund in line with the modalities of the multilateral mechanism,” the text urges. UN Environment chief Inger Andersen also hailed the mechanism as a “big win” – even if further refinements to the profit-sharing mechanism will have to rely on national interpretation – or next year’s next COP 17. “The new ‘Cali Fund,’ although imperfect and with many details still to be ironed out, is an important step forward,” said Kirsten Schuijt, Director General of WWF International. “It ensures that companies profiting from nature contribute fairly to biodiversity conservation and directs critical funding to the people and places that need it most.” Notably, the United States, home to many leading agro, pharma and cosmetics giants is not a signatory to the CBD – leaving Washington outside the scope of compliance altogether. Pharma voices concerns over impacts on medicines and vaccines R&D Inudstry groups from all sectors showed up in full force to the Cali negotiations. / Graph by DeSmog. Despite its voluntary nature, the new arrangement quickly came under fire from pharma industry voices who expressed fears that the arrangement could hinder the rapid sharing of genetic data on pathogens, critical for new medicines development during health emergencies. Pharma has argued that pathogens, unlike genetic resources used to develop new plant products or cosmetics, need to be shared with researchers with no strings attached so as to expedite the development of new vaccines and medicines. Pathogens also mutate, rapidly crossing borders and making their genetic origins all the more difficult to trace. During COVID-19, for instance, mRNA vaccines by Moderna, Pfizer and BioNTech relied on hundreds of digital genetic sequences to roll out vaccines in record time – generating billions in profits but also saving millions of lives. “The decision adopted today does not get the balance right between the intended benefits and potential costs to society and science,” warned David Reddy, Director General of IFPMA in a press statement. “The pharmaceutical industry has long supported the Convention on Biological Diversity’s objective to protect our natural world,” Reddy said. Even so, “The ability to rapidly use scientific data known as “digital sequence information” (DSI) is essential for developing new medicines and vaccines,” he added. “Any new system should not introduce further conditions on how scientists access such data and add to a complex web of regulation, taxation and other obligations for the whole R&D ecosystem – including on academia and biotech companies. “Ahead of COP17, it is critical that governments work to ensure the implementation of any new mechanism on digital sequence information does not stifle medical research and innovation that can bring the next wave of medical progress to people around the world.” Issue is also being debate in WHO-led negotiations on a Pandemic accord WHO member states discuss new pandemic convention or treaty, 18 July 2022. Another complication lies in the fact that a mechanism for linking pharma pathogen access and benefit sharing (PABS) is also being debated in WHO-led member state negotiations over a Pandemic Accord, which resumed on Monday in Geneva. Any decision ultimately reached in a Pandemic Accord could potentially supersede the arrangements in the CBD, particularly since the Accord is supposed to be a legally binding agreement. Meanwhile, independent experts are still divided over if and how a profit-sharing mechanism could be designed that did not also hamper rapid vaccine development and outbreak monitoring and reporting by countries. The DSI Scientific Network, a global alliance of experts from over 20 countries, has, on the one hand, suggested sales-tax like levies on end products– could balance seamless genetic sequence access for research with profit-sharing. It has also proposed “in-kind” contributions like vaccine doses to ensure equitable access. Yet charging companies for using particular genetic sequences in their end products – may in fact be much harder than it sounds, the same expert network observes. “Research that uses DSI routinely compares and selects among millions of sequences, often merging or editing them, making it impossible to attribute products to any single sequence,” DSI Network researchers explained in one brief, which explored Moderna’s COVID-19 vaccine patent application as an example. “With many nearly identical sequences from different countries, proving which ones were used to develop commercial products becomes unfeasible,” the researchers said. Funding shortfalls for biodiversity preservation The majority of nations have yet to submit their national biodiversity protection required by the Montreal-Kunming Agreement, but officials say the less than two year deadline – and the incredible complexity of ecosystems like the Amazon, means these plans take time to develop. While observers say that the new ‘Cali Fund’ for DSI profit sharing could eventually generate up to $1 billion annually for biodiversity protection, reaping those funds is years away. And that still falls far short of the target in the legally binding UN biodiversity of 2022. That treaty called for $200 billion annually for nature protection by 2030, including $20 billion from rich countries on a voluntary basis. The needs, meanwhile, rise as high as $700 billion annually required to sustainably protect and restore global ecosystems, independent experts have maintained. Over the two-week run of COP 16, just $163 million from eight countries – including Germany, Austria, France, Norway and the UK – was pledged to the CBD’s ‘Global Biodiversity Framework Fund’ (GBFF), hosted by the World Bank. That brings currently available funding to $400 million – 500 times short of the 2030 target. After COP 16 stretched into overtime, lasting all night Friday until 9am Saturday morning, the summit was abruptly suspended when too few countries remained in the room for decisions to be made. Many smaller delegations, unable to afford costs to rebook flights, had to leave – an unceremonious end that encapsulates the core frustration expressed by developing nations, scientists and civil society observers alike: where is the money? Where is the money? Originally, funds were expected to come from slashing $500 billion in environmentally harmful subsidies, which the 2022 Montreal CBD agreement had pledged to eliminate. Governments, however, allocated a record-breaking $1.4 trillion to fossil fuel subsidies in 2023. And the World Bank estimates countries spent $1.25 trillion subsidizing agriculture, fossil fuels, chemical production and other industries that destroy biodiversity. While the EU announced it will double its biodiversity funding to $7 billion for 2021-2027 and committed hundreds of millions to other projects to deliver –”on global financing commitments to protect nature” – a strong push led by the African Group and Brazil to establish a new biodiversity fund was rejected. Developing nations had argued that the World Bank-hosted GBFF is too complicated to access and controlled by wealthy countries – an argument rejected by the European Union and other major donors. Ultimately, the meeting even failed to agree on a budget for the Convention on Biological Diversity itself, the instrument under which the biodiversity COPs are organized. Debt crisis sidelined As developing countries face unprecedented debt burdens, nations argue finance in the issued in the form of debt should not be counted towards nature spending targets. Host nation Colombia’s also pushed to have the burgeoning debt crisis recognized in financing arrangements – but that too failed to receive support. Donor nations in Europe and elsewhere provide the majority of their biodiversity funding as loans – and that trend is accelerating, with about 80% or more of new funding in 2021-2022 coming as loans rather than grants. China – which holds trillions in developing country loans – also opposed recognizing debt as part of the biodiversity crisis. Last month, the World Bank revealed the world’s 26 poorest countries are in their worst financial shape since 2006, as natural disasters and COVID-19’s reverberating shocks continue to hit their economies. Over 3 billion people now live in nations spending more on debt financing than education and health budgets, according to UN figures. Developing countries trapped under major debt burdens argue loans should not count as finance. An expert report on debt, nature and climate released just ahead of COP16 meanwhile found that countries most exposed to biodiversity loss and climate-driven extreme weather now rely increasingly on expensive loans to rebuild and cope with changes. “Emerging markets and developing economies have seen both the levels and cost of debt soar,” the Independent Expert Group reported. “This means that EMDCs can borrow less, at greater cost, at a moment when they need more and cheaper finance to limit the extent of future shocks.” “It is essential today to change debt for climate action,” Colombia’s President Gustavo Petro said at the opening of COP16. “Those who emit the most CO2 into the atmosphere are the fossil, oil and coal economies, they are the powerful economies of the United States, China and Europe,” and they are the ones who “charge interest rate surcharges to countries that can still absorb CO2.” “That is a true moral and deadly contradiction,” he said. “It is the richest, predatory countries that must be taxed to eliminate carbon from production and consumption,” he added. Historic victory for indigenous peoples Yet amid the summit’s setbacks, one significant victory emerged: the agreement by nations to establish a permanent body for Indigenous Peoples within the CBD framework. The new subsidiary body recognizes “Indigenous Peoples and people of African descent as key protagonists in biodiversity conservation,” providing them with a seat at the table to protect traditional knowledge systems, strengthen representation in decision-making, and promote Indigenous territorial biodiversity management. It is the first formal mechanism for indigenous communities’ representation within UN environmental negotiating frameworks. “This is an unprecedented occasion in the history of multilateral environmental agreements,” said Camila Paz Romero, Indigenous Peoples’ spokesperson at the summit. “Indigenous peoples and local communities of the world – connected from our knowledge systems in the care of life and biodiversity – remember the long road we have travelled towards this agreement.” Image Credits: COP16, CIFOR-ICRAF, UNCTAD. Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. 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Negotiators Have a Week to Decide if Pandemic Agreement Possible by December 04/11/2024 Kerry Cullinan INB co-chairs Anne-Claire Amprou and Precious Matsoso, alongside WHO Director-General Dr Tedros Adhanom Ghebreyusus. The pandemic agreement talks resumed on Monday for two weeks, but parties only have a week to decide whether they have sufficient common ground to call a special World Health Assembly (WHA) in December to adopt the document. Procedurally, 12 November is the last day by which a December WHA can be called. Negotiators will “stocktake” progress on Friday and decide by next Monday whether to call a December WHA or wait until next year’s regular assembly in May. Several countries are pushing for a December agreement amid growing geopolitical uncertainties including the imminent US election, and outbreaks of mpox, H5N1 and Marburg. A Donald Trump victory could mean the US withdrawal from the negotiations and withholding their dues from the World Health Organization (WHO), which Trump did during the COVID-19 pandemic. US and African negotiators pushed for the December WHA during the opening of the 12th meeting of the intergovernmental negotiating body (INB), while others including stakeholders, cautioned against sacrificing content for speed. But WHO Director-General Dr Tedros Adhanom Ghebreyesus warned negotiators not to make “the perfect the enemy of the good”, stressing that no party will get all their demands. “With the proposals on the table, I believe you have the ingredients in place to meet your objective,” Tedros told the INB, which has been negotiating for almost three years. He also said that reaching agreement would provide hope that, “despite political and ideological differences between countries, we can still come together to find common solutions to common problems”. Africa, US push for December adoption Tanzania, speaking for the Africa Group, wants the agreement adopted in December. “The Africa group is resolute in its ambition to finalise the agreement process by December 2024. This timeline is not arbitrary, but a moral imperative,” said Tanzania, speaking on behalf of the Africa Group of 48 countries. For Ethiopia’s Ambassador Tsegab Kebebew Daka, “the outstanding issues are not that many, but are those that require political decisions to ensure whether the language in the current text addresses the shared threat of the next pandemic and the challenges that our countries are facing on the ground”. US Ambassador Pamela Hamamoto told the INB: “There’s no question that this pandemic agreement will have real-world consequences. The recent declaration of mpox as a public health emergency of international concern (PHEIC) demonstrates just how relevant our work remains. “Concluding these negotiations is a priority for the United States, and we seek to facilitate an effective agreement by year-end, if at all possible.” Hamamoto said that the Friday stock-take was crucial to “carefully assess progress made and accurately identify areas of convergence, as well as issues that will require further discussion before consensus can be reached”. To assist, she appealed to the INB bureau to develop a framework of clear criteria for member states to consider to make the December call. US Amabassador Pamela Hamamoto. At a stakeholder briefing last week, the INB Bureau stressed that they are aiming for a document that can grow in the future – in other words, what commentators have described as a pandemic agreement “lite” that can provide the framework for more detailed plans about contentious issues such as the proposed pathogen access and benefit-sharing (PABS) system. ‘Consensus is the silver bullet’ But many countries advocated caution, including the European Union (EU). EU Ambassador Lotte Knudsen called for “pragmatic solutions that work for all of us” given that “a number of key issues are still outstanding” “To proceed with calling a special session, we all need to be fully convinced that the agreement will be ready for adoption. This is too important an objective to make any leap of faith that is not properly grounded in tangible progress in the negotiations,” Lotte stressed. The agreement’s test is whether it will make a substantial difference to improving prevention, preparedness and response on the ground, she added. “The content will be far more important than the timing of its adoption. Consequently, our top priority remains to achieve a meaningful and impactful agreement that can command large, ideally universal, participation.” Comparing the agreement to food, Germany’s Bjorn Kummel stressed that negotiators had to ensure that the “dish needs to be tasteful to all of us” for it to be adopted by all 194 member states. “Consensus is the magic bullet here,” Kummel stressed. Germany’s Bjorn Kummel. Equity challenges Malaysia, on behalf of the 35 countries making up the Equity Group, spelt out the mountain that still needs to be climbed to change the status quo in favour of low and middle-income countries. The Equity Group’s key concern is how the proposed PABS system ensures that countries sharing information about pathogens with pandemic potential can benefit from vaccines, therapeutics and diagnostics (VTDs) developed as a result. “We cannot leave all the critical details for the PABS system for the future,” Malaysia noted. Malaysia, speaking for the Equity Group, outlined some of the shortcomings of the current draft. The Equity Group’s demands to ensure fair and equitable benefit sharing include a clear link between access and benefit sharing, making 20% of real-time production of VTDs available to LMICs during a pandemic and annual payments for access to PABS by entities that may profit, such as pharmaceutical companies. Appeal from the coalface Meanwhile, Rwanda’s Minister of State for Health Dr Yvan Butera said that his country’s outbreak of the deadly Marburg virus shows that the world is “prone to shocks at any time and anywhere”. When asked by Health Policy Watch whether he had a message for INB negotiators, Butera said “being able to work together collaboratively to handle these situations efficiently” is essential. “The capacity to be able to prevent, rapidly detect, respond, and deploy innovative tools in terms of prevention, therapeutics and diagnostics, is extremely important,” said Butera. “And then sharing the knowledge so that it can shape better policies or better tools to contain and control future diseases that have potential to become outbreaks, epidemics or pandemics.” Meanwhile, Africa CDC’s lead on mpox, Dr Ngashi Ngongo, stressed that “benefit-sharing really resonates”. “If you have used the viruses and pathogens from an African country to develop vaccines, it is really common sense that, in the distribution of the medical countermeasures, those that also contributed with the pathogens also get a share,” said Ngongo. “Perhaps the lines were a bit hard at the first time, but we are hoping, with everything that has gone behind the scenes, that both sides will be able to come to to a compromise.” Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. Image Credits: Kobi Gideon / GPO/Wikipedia, Chuttersnap/ Unsplash, Wikimedia. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Hans Kluge Re-Elected Regional Director of WHO’s European Region, and other Regional Committee Take-Aways 03/11/2024 Sophia Samantaroy WHO European Region leaders and member states met to discuss policies and priorities for the coming years, including a focus on health security and health systems strengthening. WHO Member States gathered in Doha, Washington, D.C, Copenhagen, Manila, and Brazzaville for their respective World Health Organization (WHO) Regional Committee sessions in the past months to set policies, strategies, and frameworks for the coming years. The WHO Regional Committees – the WHO’s governing bodies in each of six regions – meet yearly to formulate regional policies, supervise WHO activities, comment on the regional components of WHO’s budget, and every five years, nominate a regional director. On Wednesday, in the final edition of the regional series, the WHO European Regional Committee nominated Dr Hans Henri Kluge as WHO Regional Director for Europe for a second 5-year term, which will begin in February 2025 after his formal re-election by the WHO Executive Board at their January 2025 meeting. That followed the nomination of a new Regional Director for WHO’s African Region in late August, where Dr Faustine Engelbert Ndugulile of Tanzania was nominated to take over the helm from Matshidiso Moeti, Africa’s first female RD, who served ten years in the position. The AFRO Regional Committee featured WHO director general Dr Tedros Adhanom Ghebreyesus pledging support for Africa CDC and the African Medicines Agency, in an attempt to sooth purpoted tensions between the two agencies. The Pan American Health Organization Directing Council, which met in early October, unveiled a roadmap for a new strategic plan, after member states adopted policies ranging from health system strengthening to climate and health adaptation and mitigation. Kluge’s tenure began at the beginning of the COVID-19 pandemic, and along with the pandemic response, he has made a name for himself leading the Region through a broad range of other health emergencies. Those range from extreme weather events, to Europe’s mpox outbreak, the war in Ukraine and the Region’s response to crises in Africa and the Eastern Mediterranean regions. “By identifying and acting on priorities of importance to the almost one billion people across Europe and Central Asia, our Member States display welcome solidarity and multilateralism at a time of deepening distrust and division,” said Dr Kluge at the close of the Regional Committee session, where he was nominated for a second term. “Health can and does bring countries and communities together. We at WHO/Europe are grateful for the opportunity to work with our Member States and partners to help shape the future of health for the benefit of all.” At the European Regional meeting, member states also discussed plans and strategies for: healthcare system resiliency and primary healthcare investment, health emergency preparedness – known as “Preparedness 2.0”, emergency medical teams capacity, and health innovations and emerging technologies. Member states also discussed five year plans and strategies around national health security, mental health, the climate crisis, and gender-based violence. Western Pacific focuses on improving health financing, digital health The Western Pacific Region (WPRO) member states, home to more than 1.9 billion people across 37 countries and areas, including the Philippines, Malaysia, Australia, Korea, China, and Japan, met 21 to 25 October, adopting strategies that aim to increase national public health funding, and implement digital health solutions. Despite recent reforms in health financing, public health spending in the Western Pacific Region remains “inadequate” to meet growing needs, the WRPO said in a press release. The lack of healthcare service access and the financial burden of care costs presents a growing burden in the Region, where in 2019 more than 300 million people faced “catastrophic” health costs. To curb costs, the Regional Committee endorsed a regional action framework for health financing. The Framework aims to improve health financing through five action domains: 1) greater reliance on public funding for health; 2) more equitable and efficient health spending; 3) financing primary health care (PHC) now and into the future; 4) strengthening governance for health financing; and 5) promoting health for all in economic and social policy, according to a statement. The Committee also endorsed measures to accelerate digital healthcare technologies, which calls on countries to prioritize “governance, socio-technical infrastructure, financing and economics, digital health solutions, and data in strengthening health systems in the era of digital transformation.” Regional conflicts take center stage at Eastern Mediterranean regional committee Dr Hanan Balkhy, EMRO director, at the Regional Committee meeting in Doha. On 14 October, meanwhile, Eastern Mediterranean Region member states met in Doha, Qatar, for its 71st regional committee. The conflicts in Gaza, Sudan, Yemen, and Lebanon occupied much of the discussion. The devastation of health infrastructure and the outbreaks of vaccine-preventable diseases – “an unprecedented series of emergencies” – were the backdrop to the Committee’s “Health Beyond Borders” theme. “In several countries in the Eastern Mediterranean Region, conflicts, epidemics and political unrest have weakened health services, requiring responsibility, solidarity and equity to improve the lives of all people. We have learned from pandemics and epidemics the importance of solidarity, and that protecting health requires global efforts that transcend national borders,” observed Dr Hanan Al-Kuwari, Qatar Minister of Health in her opening remarks. WHO director general Dr Tedros Adhanom Ghebreyesus echoed the intensity of threats facing the region in his opening address, noting : “The eruption of conflict in Lebanon has put the health of millions more people at risk. The number of internally displaced people is growing rapidly, and so is the threat of disease outbreaks, compounded by overcrowding in shelters and the closure of hospitals.” The Director General urged EMRO Member States to engage in Pandemic Agreement negotiations, “and if possible, to complete it by the end of this year” as well as to participate in the ‘WHO Investment Round’ that aims to raise some $7 billion in supplementary funds to fill a gaping hole in WHO’s $11 billion budget for the next four years. The EMRO four-year strategic plan focuses on three flagship initiatives: expanding equitable access to essential medicines, vaccines and medical products, investing in a more resilient health workforce and scaling up public health action on substance abuse. Member states formally adopted the plan at the end of the four day conference; approved a strategic frameworks for implementation of Immunization Agenda 2030, strengthening health laboratory services in the Region 2024–2029. The Committee also endorsed a new regional strategy to strengthen local vaccine production. South Asia regional meeting under cloud of Regional Director’s controversy Saima Wazed (in black), along with her mother Bangladesh Prime Minister Sheikh Hasina, during an official visit to the United States to meet US President Joe Biden and First Lady Jill Biden in 2023. A few months later, Wazed’s nomination as the next SEARO Regional Director was confirmed by the WHO Executive Board. In New Delhi, meanwhile, South-East Asian (SEARO) Member States converged in the first week of October to adopt resolutions on adolescent health and set measles and rubella elimination targets. The meeting took place despite late summer unrest in neighbouring Bangladesh that saw Prime Minister Sheikh Hasina resign and flee the country. That followed the controversial election in February 2024 of Sheikh Hasina’s daughter, Dr Saima Wazed, as the new SEARO regional director – in a vote that critics said was laced with politics. There were fears that the subsequent resignation of Sheikh Hasina could further complicate Wazed’s job as the new SEARO RD. However, despite the political upheaval, the Regional Committee session took place on schedule. The SEARO event also featured a number of regional health achievements by member states. Those included six countries’ attainment of SDG targets for reducing under five mortality and still birth rates; India’s elimination of trachoma; Timor-Leste’s elimination of lymphatic filariasis; Bhutan’s achievement of interim WHO targets for cervical cancer elimination; and Maldives and Sri Lanka’s progress on Hepatitis B control in children. “The progress being made is the Region is heartening. I congratulate countries for their achievements which demonstrates their commitment to health and wellbeing of people. I look forward to together building on this momentum to further accelerate efforts for equitable access to health services for all in our Region in the coming years,” said Dr Wazed in a press release at the close of the meeting. WHO ‘investment rounds’ now a feature of Regional Committee meetings In a new twist on the decades’ old formula, WHO has also now been making use of the Regional Committee events to stage awareness-raising events about the agency’s new ‘Investment Round’ strategy – which aims to streamline and amplify member states’ voluntary contributions so as to raise roughly $7.4 million more to fund WHO’s 2025-28 budget of $11.1 billion. In the case of the African, WPRO and SEARO regions, fund raising events even took place directly at the regional meetings. In the first-ever SEARO WHO Investment Round,countries pledged some $345 million, beyond their assessed annual contributions. That followed pledges from the African region for $45 million at their annual meeting in August. At the Western Pacific Regional meeting, in late October, meanwhile, countries pledged a total of $20 million. As for other (richer) regions, such as the European Region, the Americas and the Eastern Mediterranean, those all-important pledges are being recruited and announced separately. A gala European Region event was featured at the mid-October World Health Summit in Berlin, which garnered nearly a$1 billion for the organization – although major donors such as France, Spain and the United Kingdom did not announce commitments there. As for the conflict-wracked EMRO region, which also includes wealthy Gulf countries, and the Americas, where a US election win by former President Donald Trump could lead to another US disengagement from WHO, as per the moves made during his last term, the Regional Committee meetings were used for briefings and awareness-raising. But it remains to be seen when and how concrete pledges will actually be finalized and announced. WHO Secures $1 Billion at First European Investment Round See the following links for Health Policy Watch coverage of outcomes from two other WHO regional committees – the Pan American Health Organization (PAHO) and the African Region (AFRO). Image Credits: WHO/EURO, WHO/EMRO, X. Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. Image Credits: Kobi Gideon / GPO/Wikipedia, Chuttersnap/ Unsplash, Wikimedia. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
Study: Alcohol, Not Psychedelics, Linked to Heightened Trauma in Survivors of Attack on Israeli Festival Goers 01/11/2024 Maayan Hoffman Abandoned cars and campers debris litter the entrance to theNova Music Festival in Israel, following the surprise attack by Hamas on festival goers in the early morning hours of 7 October 2023. Israeli researchers were surprised to find that alcohol use, as compared to psychedelics, contributed more significantly to psychological challenges amongst survivors of the October 7, 2023, Nova music festival attack, following a study, conducted by researchers from Sheba Medical Centre and Ben-Gurion University of the Negev. The study was published in October in World Psychiatry. On October 7, about 4,000 people were attending the Nova music festival in southern Israel when Hamas militants entered early in the morning and began attacking their encampment. The massacre claimed the lives of nearly 400 people at the festival, as well as another 800 people living in surrounding rural communities and military outposts. Some 250 people, including about 40 festival goers, were also abducted by Hamas and taken to Gaza. Many attendees had consumed various recreational drugs and alcohol, including LSD, MDMA, MMC, cannabis, and combinations of these. They had to react quickly, fleeing and hiding to save their lives. The research team wanted to examine how the use of these drugs and alcohol impacted the way attendees responded to the attack, explained Prof Mark Weiser, chairperson of the Division of Psychiatry at Sheba and a professor at Tel Aviv University. The team hypothesised that survivors who were on drugs at the time would have been more hyper-aware of the event and their surroundings, thereby experiencing more post/trauma from the attack overall. However, they were wrong. ‘It was the alcohol’ “It was the alcohol,” he told Health Policy Watch. “These people were the ones who had more severe post-traumatic symptoms.” After the attack, a total of 232 people sought treatment at Sheba Medical Center, located near Tel Aviv, which was treating post-trauma victims. Of these, 123 survivors qualified for the study, after excluding those with severe physical injuries or histories of mental disorders, including prior PTSD, as well as two participants who had used hallucinogenic mushrooms and ketamine before the event. The latter two were excluded due to the small sample size for these substances. The average age of participants was 28. Most (61%) were male, 69% were single, and 68% had at least a high school diploma or equivalent. Amongst participants, 71 reported using psychoactive drugs, 12 only alcohol, nine only LSD, seven only MDMA, six only cannabis, three only MMC, 15 a combination including alcohol, and 19 a combination excluding alcohol. The researchers administered a series of questionnaires to assess how these substances impacted participants’ cognitive and stress responses during the attack. They found that all participants experienced high levels of anxiety and hyperarousal-related symptoms, regardless of drug use. Amongst those who had taken drugs, such responses were significantly elevated during the crisis, which lasted for hours. Alcohol consumption and brain function A installation in Tel Aviv’s Hostage Square to the victims of the Nova Music Festival attack; some 400 people died and 40 were taken hostage by Hamas on 7 October 2023. Even so, those who consumed alcohol—either alone or with drugs—had a much greater likelihood of experiencing post-traumatic symptoms such as depression, anxiety, arousal and hyperactivity, as well as emotional numbness. “Alcohol consumption exerts various effects on brain function and behaviour, ranging from anxiolytic and mild disinhibitory effects to sedation, motor incoordination, altered memory, and emotional processing,” the researchers wrote. “Therefore, pre-trauma alcohol consumption may have interfered with the cognitive, emotional, and psychological processes necessary to cope with the traumatic event.” They researchers did not differentiate between the different types of drugs used as there was not a large enough sample size. Weiser noted that this study only looked at participants up to two months after the event. To determine any potential long-term effects, or whether drugs and alcohol might impact cognitive responses differently over time, further research would be needed. Weiser said he hoped that he and his research team might follow up with these 123 participants to assess their status over a year after the attack. He also emphasised the small sample size, which primarily includes “people who were treatment seekers,” meaning those who recognised their need for help. “There were a lot of people at Nova who were frightened, saw horrible things, but they went home, and life went on,” Weiser said. “It is important to realise we are talking about treatment seekers and not a random sampling from the party.” Weiser added that, statistically, 15% to 20% of people who experience trauma will develop longer-term post traumatic stress disorder (PTSD). He noted that PTSD has a very broad diagnostic range, including those who have recurring bad dreams or troubling memories as well as those whose trauma disrupts their daily lives and ability to function. Suicide after trauma Beyond this study, however, a comprehensive tracking of the health and mental health outcomes of the festival goers, has not been undertaken. Just last week, one Nova festival survivor, 22-year-old Shirel Golan, took her own life after a year-long struggle with PTSD, according to her parents. Her death has sparked concerns about whether the country is providing enough support for survivors of the October 7 events. Hundreds of survivors continue to face serious mental health challenges, including PTSD, survivor’s guilt, depression, and anxiety. In April, festival survivor Guy Ben Shimon told a State Audit Commission that “there have been almost 50 suicides amongst the Nova survivors.” However, the Health Ministry quickly countered, stating it has no data confirming this claim, and Weiser agrees. In response to October 7, the Israeli government established a public mental health support program offering free therapy. Survivors with PTSD qualify for up to 36 sessions, while others can receive up to 12. As of July, nearly 1,900 survivors had been referred for treatment. The government has committed about $5 million to this and related programs. “Every suicide is a tragedy, but it is very premature and inappropriate to say [Golan] suicided because of her experience at Nova,” Weiser said. “This does not mean it is not true, but suicide is a multifactorial event, and we don’t fully understand why one person may end their life while another does not.” Both in Israel and the United States, studies have shown elevated suicide rates amongst those with PTSD, and especially those who served in the military. As of 2021, 30,177 US active-duty soldiers and veterans who had served in Afghanistan, Iraq and other conflict zones over the past two decades, had died by suicide, as compared to 7,057 combat-related deaths over the same period, according to the United Service Organisations. In Israel, suicide also was the leading cause of death amongst soldiers in 2021, two years before the Gaza war broke out, with 11 soldiers taking their lives that year. Image Credits: Kobi Gideon / GPO/Wikipedia, Chuttersnap/ Unsplash, Wikimedia. Posts navigation Older postsNewer posts