NIH staff are protesting against the politicisation of the body.

Over 300 employees of the US National Institutes of Health (NIH) have urged NIH director Dr Jay Bhattacharya to “restore grants delayed or terminated for political reasons so that life-saving science can continue”.

They have also appealed to him to reinstate staff, enable global collaboration, and research to be published in peer-reviewed journals.

“We dissent to [Trump] Administration policies that undermine the NIH mission, waste public resources, and harm the health of Americans and people across the globe,” the staff declared in a letter sent to Bhattacharya and Health Secretary Robert F Kennedy Jr on Monday morning.

In the letter, which they name the “Bethesda Declaration” after the location of the NIH headquarters, the staff say they are “compelled to speak up when our leadership prioritizes political momentum over human safety and faithful stewardship of public resources.”

They describe themselves as “workers from every Institute and Center at NIH”, including some who have signed anonymously “due to a culture of fear and suppression”.

“Standing up in this way is a risk, but I am much more worried about the risks of not speaking up,” said Dr Jenna Norton, one of the declaration organisers, in a media release circulated by a group called Stand Up for Science.

“If we don’t speak up, we allow continued harm to research participants and public health in America and across the globe,” added Norton, who is a programme director at the National Institute of Diabetes and Digestive and Kidney Diseases.

The letter is timed to coincide with Bhattacharya’s appearance at the Senate’s Appropriations Committee for the NIH’s budget request on Tuesday.

‘Multiple universities’ targeted for ‘political aims’

The staff decry the Trump administration’s “politicisation of research by halting high-quality, peer-reviewed grants and contracts” based on “political ideology”. 

Since Trump took office on 20 January, NIH has terminated 2,100 research grants totaling around $9.5 billion and $2.6 billion in contracts. 

Targets include “multiple universities” who have been hit “with indiscriminate grant terminations, payment freezes for ongoing research, and blanket holds on awards regardless of the quality, progress, or impact of the science’ for political aims, according to the letter.

“Many [research] terminations contradict federal regulations that mandate protections for research participants and require grant awards to specify potential termination reasons.”

Some terminations eliminate years of hard work and millions of dollars. 

“Ending a $5 million research study when it is 80% complete does not save $1 million, it wastes $4 million,” the letter notes.

In addition, “NIH trials are being halted without regard to participant safety, abruptly stopping medications or leaving participants with unmonitored device implants.”

“The partnership between NIH and the academic community has made huge contributions to almost every aspect of the health of people across the US,” said Jeremy Berg, former director of the National Institute of General Medical Sciences.

Reinstate staff, restore global partnerships

The NIH Clinical Center, formed in 1953, is a hospital devoted entirely to finding cures for a range of diseases.

They urge Bhattacharya to “reinstate the people who make NHI work”, noting that firing “talented, hard-working professionals and critical departments without thought to their purpose or need has slowed the pace of science, held up extramural grant and contract funding, made NIH less transparent and efficient, and put Clinical Center patients at risk.”

The NIH Clinical Center is the largest US hospital devoted entirely to clinical research, including of cancer, dementia and rare diseases.

They also urge him to “allow rigorously peer-reviewed research with vetted foreign collaborators to continue without disruption”, as American scientists are being “cut off from the global scientific community”.

South Africa may lose 70% of its medical research capacity following the cancellation of NIH funds, crippling 16 universities and setting back two decades of HIV and tuberculosis research.

This follows the NIH decision to prohibit US scientists from working with foreign researchers via “sub-awards”, leading to the immediate and mass cancellation of such grants with South African institutions.

At least 39 TB and HIV clinical research sites in South Africa are under threat due to NIH funding cuts, jeopardising at least 27 HIV trials and 20 TB trials, according to an analysis by the Treatment Action Group (TAG) and Médecins Sans Frontières (MSF) mostly of grants from the NIH’s Division of AIDS (DAIDS).The “unprecedented reduction in NIH spending does not reflect efficiency but rather a dramatic reduction in life-saving research,” they conclude.

Stand up for Science, a Washington-based non-profit formed to defend science and democracy, has also mobilised high-profile scientists, including 19 Nobel laureates, to support the NIH staff.

Echoing Great Barrington Declaration 

The Bethesda Declaration is deliberately styled after the Great Barrington Declaration, published by Bhattacharya and others during COVID-19, which argues against any measures to prevent COVID-19 other than “focused protection” for those most vulnerable, while allowing widespread SARS-CoV-2 infection to enable “herd immunity”.

The Great Barrington Declaration, sponsored by the American Institute for Economic Research (AIER), a libertarian free-market think tank associated with climate change denial, was widely condemned as being unscientific.

Last month, NIH staff staged a walkout during a Town Hall addressed by Bhattacharya in which he said he supported the idea that the COVID-19 pandemic was “caused by research conducted by human beings,” possibly partly sponsored by the NIH.

“If it’s true that we sponsored research that caused a pandemic – and if you look at polls of the American people, that’s what most people believe, and I looked at the scientific evidence; I believe it – what we have to do is make sure that we do not engage in research that’s any risk of posing any risk to human populations,” Bhattacharya said in a recording obtained by CNN.

Image Credits: Stand up for Science, NIH.

People collect water from a pump in Kinshasa in the Democratic Republic of Congo. Cholera is an acute enteric infection, primarily linked to insufficient access to safe water and proper sanitation.

Cholera in Africa is being driven by years of under-investment in water and sanitation, according to the Africa Centres of Disease Control and Prevention (Africa CDC).

Four countries – Angola, Democratic Republic of Congo (DRC), Sudan and South Sudan  – account for over 85% of the continent’s cholera cases and all have above-average death rates, according to Dr Ngashi Ngongo, Africa CDC incident lead on mpox.

Access to clean water, sanitation and hygiene (WASH) is poor in all four countries. Only 35% of Sudanese have access to safe water, and although the DRC leads the group, only around two-thirds of its citizens have clean water, according to the Africa CDC.

Only 16% of those living in South Sudan have access to basic sanitation and almost three-quarters of the rural population practises open defecation.Only 10% of schools in South Sudan have handwashing facilities for children.

Half the Angolan population has basic sanitation, the best of the group.

South Sudan has the biggest cholera outbreak with 48,828 cases and 908 deaths. It is followed by DRC with 25,520 cases and 557 deaths, then Angola with 21,000 cases and 630 deaths and Sudan with 13,743 cases and 296 deaths, Ngongo told the Africa CDC media briefing on Thursday.

Ngongo said that the expected case fatality rate should be around 1% but this was far higher in all four countries. South Sudan’s rate is 1.9%, DRC is 2.1%, Sudan is 2.5%, and Angola is 3%.

Multi-sectoral, continental commitment

Earlier in the week, African Heads of State from the 20 countries worst affected by cholera convened and resolved to create a continental Incident Management Support Team (IMST) similar to that coordinating the mpox response, to reinforce cross-border surveillance. 

The countries also pledged to establish national presidential task torces on cholera to “strengthen multisectoral coordination, mobilise domestic resources, and enforce accountability frameworks”, according a media release from Africa CDC. 

Angolan President and African Union chairperson João Manuel Gonçalves Lourenço urged countries to “invest robustly in water, sanitation, and health systems”. 

Meanwhile, Africa CDC Director General Dr Jean Kaseya told the leaders that the systemic drivers of the crisis were “limited WASH infrastructure, insecurity, weak coordination, and vaccine shortages”.

“Africa needs 54 million doses of oral cholera vaccine annually but receives barely half. This gap is unacceptable. Urgent action is needed to scale up local production and secure supply,” said Kaseya.

Only one manufacturer is currently making the vaccine globally, producing around half the vaccines that are needed. 

“Africa needed 80 million doses but only received 26 million doses [in 2024] because doses had to be distributed also to other regions,” said Ngongo.

“This is the reason why there’s a greater push from Africa CDC, and now also from the Head of State for local manufacturing,” he said, adding that $150 million was needed to finance this.

In closing, Zambian President and meeting host Hakainde Hichilema said: “We have issued a clear Call to Action. Now we must deliver—through scaled-up domestic investments, strengthened cross-border coordination, and community-driven responses. Africa needs one continental IMST, one community-centred plan, and one accountability framework.”

Mpox ‘most concerning’ in Sierra Leone

The mpox outbreak in Sierra Leone, which accounts for over half of the new mpox cases in the past week, is the “most concerning”, said Ngongo.

The country has 4,032 suspected cases reported so far (3140 confirmed) and 15 deaths. Cases seem to be falling, with 531 cases in the past week in comparison to 684 the previous week, but the country’s surveillance is inadequate, he noted.

“What is of really great concern is the test positivity rate, which is at 93% overall for the entire country, with seven districts reporting 100% positivity rate,” said Ngingo.

“This means that people come themselves to health facilities, and those that come are already at advanced stage. It’s a reflection that the surveillance is primarily passive.” 

However, Ngongo acknowledged that Sierra Leone’s surveillance programme involving community health workers “has stopped because of difficulties in funding”.

While mpox appears to be stabilising in the DRC, which is where the majority of cases are, the country’s low testing rate “makes it very difficult to interpret the stabilisation that we are seeing”, said Ngongo.

However, he confirmed that conflict in North and South Kivu provinces was settling, enabling vaccination.

The DRC is the only country that is now vaccinating children below 18 years using the Japanese vaccine LC16. Japan has donated 4.5 million LC16 doses to the DRC, while France has donated 100,000 Bavarian Nordic doses and the United Arab Emirates has donated 20,000 doses.

Image Credits: Eduardo Soteras Jalil/ WHO.

Protestors gathered outside USAID headquarters in Washington DC.

Governments have been advised to impose ‘sin taxes’ on tobacco, alcohol and other unhealthy products to offset the severity of cuts to official development assistance (ODA), World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus told a tuberculosis meeting on Thursday.

His statements came two days after the administration of US President Donald Trump formally requested his country’s Congress to cancel previously approved budget allocations for global health programmes and projects amounting to $9.4 billion. Tuesday’s request was made by Russ Vought, head of the Office of Management and Budget in Trump’s office, and co-author of Project 2025, the conservative blueprint for the Trump presidency based on expanded presidential power and an ultra-conservative social vision.

Should Congress agree, this would officially endorse the cuts already made in grants to the US Agency for International Development (USAID) and US President’s Emergency Plan for AIDS Relief (PEPFAR) by the Department of Government Efficiency (DOGE) under the leadership of Elon Musk, who resigned from his DOGE role this week as well. Congressional action would also cement cuts to UN agencies including the WHO, UN Children’s Fund (UNICEF), UN Development Program (UNDP), and the UN Population Fund (UNFPA).

“In the past few months, I have spoken to many ministers, and the impact on their  programmes of the sudden cuts in official development assistance is severe,” Tedros told a WHO Town Hall meeting on tuberculosis.

“We are seeing treatment interruptions, clinics closed, health workers losing their jobs, disruptions and more – not just for TB, but for malaria, HIV, neglected tropical diseases, vaccinations, maternal and child health, sexually transmitted infections, family planning and so on.”

The WHO’s advice to countries trying to raise domestic resources to offset the cuts is to start immediately with the “sin taxes” while, in the longer-term, implementing social health insurance and community-based health insurance, Tedros added.

‘Reject rescission package’

Meanwhile, the Global Health Council urged US Congress to reject the rescission package, describing it as “a systematic effort to diminish the longstanding role of the United States as a global health leader” that puts lives at risk.

The One Campaign also called on Congress “to reject rushed attempts to override their previous decisions and to continue supporting smart, effective international assistance programs.”

One Campaign added that the rescissions package “gives scant detail about the nature and impact of the proposed cuts. When lifesaving assistance is at stake, Congress needs real details. For example, the package cuts nearly a billion dollars from health and infectious disease funding which deserves more explanation than 11 vague sentences.”

Trump claims the cuts are aimed at “wasteful foreign assistance spending” to “eliminate programs that are antithetical to American interests”.

Speaking in the US Senate on Thursday, Democratic Senator Dick Durbin asked “why in the world would we cut such low cost but impactful programmes?”

“If there were international programmes that were ineffective, and I admit such work can be difficult and with mistakes, the place to fix them is through the regular appropriations process, not the wholesale gutting of a complete programme like USAID.”

The US Congress has 45 days to consider the proposal.

Gutting of USAID

USAID staff offload emergency supplies.

The Trump administration wants to rescind $500 million of the USAID’s global health programs for “activities related to child and maternal health, HIV/AIDS, and infectious diseases”, claiming that this would not reduce treatment but “eliminate programs that are antithetical to American interests and worsen the lives of women and children, like ‘family planning’ and ‘reproductive health,’ LGBTQI+ activities, and ‘equity’ programs.”

Projections from March indicated that up to 29,000 health workers had lost or were at risk of losing their jobs in Uganda alone due to cuts in foreign assistance. Other African countries severely affected by the US cuts include Ethiopia, Nigeria, and the Democratic Republic of Congo.

“As Uganda’s health workers and Ministry of Health were mounting an effective, coordinated response to contain the Ebola outbreak, the sudden freeze of US foreign assistance created serious challenges,” said Irene Atuhairwe, Seed Global Health’s Country Director in Uganda.

“Health workers lost their jobs, and contact tracing and surveillance efforts had to be scaled back. With limited resources and reduced staffing, health officials were forced to narrow their efforts, potentially increasing the risk of further spread,” added Atuhairwe.

“Diseases like Ebola don’t stay within borders. It takes just one infected traveller boarding a plane or crossing borders for a local outbreak to go global. The very abrupt cuts to foreign assistance have made all of us less safe.”

There were more than 50 USAID-funded staff dedicated to outbreak response in Uganda, but that number has been reduced to just six, who are now responsible for preparedness and response efforts for Ebola, Marburg virus, mpox, and bird flu.

The Trump administration also wants to rescind $400 million of the $6 billion appropriated for HIV programmes, namely the PEPFAR grants administered via USAID.

Numerous African HIV treatment programmes receiving PEPFAR grants through USAID have had to scale down or close because their grants have been terminated, potentially affecting 20 million people.

Also on the rescinding chopping block is $2.5 billion in USAID development assistance to “end extreme poverty and promote resilient, democratic societies”, and $496 million for international disaster assistance in response to natural disasters, conflicts, and other emergencies.

Trump wants to rescind  $1.7 billion from the Economic Support Fund for “countries of strategic importance to the US”, claiming this has been used “to fund radical gender and climate projects.” However, it has largely assisted countries transitioning to democracy and for Middle East peace talks.

Trump also wants to jettison the entire $125 million allocated to the Clean Technology Fund, as it invests in “climate-friendly projects in developing countries that do not reflect America’s values or put the American people first”. 

The fund provides low-cost finance for “promising low-carbon technologies in developing countries”, including “renewable energy, energy efficiency, sustainable transport, and green industry projects.”

International organisations and programmes

The entire $437 million allocated to international organisations and programmes is up for rescission, which would eliminate funding for the UNICEF, UNDP, UNFPA and the Montreal Protocol, which regulates ozone-depleting substances. 

“Eliminating these programs will do real harm,” said Global Health Council President and CEO, Elisha Dunn-Georgiou. 

“These are not fringe initiatives. They make the world safer, healthier, and more just. When the US invests in equitable, inclusive, and evidence-based global health programs, we don’t just improve lives abroad – we strengthen public health security, global cooperation, and America’s reputation as a principled and effective leader.”

The council urged people to “push back against efforts to politicise public health”, noting that “these proposed cuts are about ideology, not money. And they put lives at risk.”

Image Credits: Reuters Youtube, USAID Press Office.

Ambassador Amma Twum-Amoah (left) and Dr Delese Mimi Darko.

CEO of Ghana’s Food and Drugs Authority (FDA) Dr Delese Mimi Darko has been appointed the inaugural Director-General of the African Medicines Agency (AMA) by the agency’s Conference of State Parties (CoSP) at a meeting in Rwanda this week.

Darko has a “wealth of experience and a distinguished track record in regulatory excellence”, according to a media release from the African Union.

Darko has been CEO of Ghana’s FDA since 2017, currently chairs the WHO African Vaccines Regulatory Forum and serves on several international and local committees related to medicines and regulation.

“The appointment of the Director General is an important step toward the operationalisation of AMA,” said Ambassador Amma Twum-Amoah, the AU’s Commissioner for Health, Humanitarian Affairs and Social Development. 

“The AMA has been established to harmonise and strengthen regulatory systems for medical products across Africa. We are confident that under Dr Darko’s leadership, the agency is poised to accelerate its efforts in coordinating and standardising regulatory practices, facilitating joint assessments and inspections, and fostering a harmonised approach to medicines regulation that will ultimately benefit all African citizens,” added Twum-Amoah.

Dr Francine Dekandji, Chad’s Minister of State of Health and chairperson of the CoSP, said that AMA “is crucial for ensuring that medical products on our continent meet international standards of quality, safety, and efficacy”. 

The CoSP also elected a new Bureau to guide its future work and endorsed an additional member to the AMA Governing Board. 

Establishing the agency has been a slow process in the evolution of the harmonisation of the regulation of medicines on the continent.

“The appointment of Dr Darko as the Director General of the AMA represents an important milestone for the organization. The depth of her scientific and regulatory experience will be invaluable in shaping the future of medicine regulation in Africa,” said David Reddy, Director General of the International Federation of Pharmaceutical Producers and Manufacturers Associations (IFPMA).

“By supporting national regulatory authorities across the continent, the AMA has real potential to help facilitate faster access to quality medicines, contribute to tackling substandard and falsified medicines, and support medical innovation.”

Bunmi Femi-Oyekan and Zainab Aziz, co-chairs of the Africa Regulatory Network at IFPMA, both offered their congratulations.

“Under her leadership, the AMA can make important progress in its mission to strengthen initiatives to harmonise medicines regulation and promote cooperation and reliance of regulatory decisions,” said Femi-Oyekan.

Aziz described her appointment as “a crucial step toward a fully functional agency that has the potential to transform access to quality-assured medicines across Africa and foster a more predictable, efficient regulatory environment for innovation”. 

Image Credits: African Union.

An oil rig operates off the coast of Denmark.

Over 30 health organizations representing 12 million doctors, nurses, and public health professionals globally have pledged to no longer work with advertising agencies that partner with the fossil fuel industry, citing conflicts of interest and the resulting health effects from industry disinformation campaigns.

The organizations span five continents and include prominent groups such as Médecins Sans Frontières, The Lancet, the World Organisation of Family Doctors, and the Yale Centre on Climate Change and Health.

For decades, oil and gas companies have employed PR and lobbying tactics strikingly similar to those of the tobacco industry: seeding doubt about established science, creating front groups, and pushing misleading narratives to stall regulation despite overwhelming evidence that fossil fuel pollution harms human and planetary health.

Yet many of the same PR and advertising agencies employed by health groups to promote healthy habits, vaccinations, and cancer prevention have continued partnering with fossil fuel companies, spreading misleading messages that downplay or deny these health harms and delay action needed to curb emissions.

“The same PR firms spreading fossil fuel disinformation are also working with health organizations—a clear conflict of interest for health,” said Shweta Narayan, Campaign Lead at the Global Climate and Health Alliance (GCHA). “Fossil fuels are making us sick, and the companies behind them are spending millions on advertising and PR to cover it up.”

Air pollution from fossil fuel combustion causes more than five million premature deaths annually. Burning oil and gas has been linked to increases in respiratory illnesses, cardiovascular diseases, cancers, and adverse pregnancy outcomes.

“As health professionals guided by humanitarian values, we have a responsibility to speak out when public health is under threat,” said Dr Maria Guevara, international medical secretary for Médecins Sans Frontières. “Fossil fuels are at the heart of a growing global health crisis, and the PR and advertising firms that help obscure this reality undermine efforts to protect lives.”

Cutting ties 

Royal Dutch Shell headquarters in The Hague, Netherlands.

The health sector often relies on professional advertising and PR services for public health messaging, including cancer awareness, infectious disease prevention, and vaccine uptake.

In 2020, the World Health Organization hired Hill+Knowlton to fight COVID-19-related disinformation. Scientists and environmental groups have widely criticised the company for its oil and gas portfolio, including clients ExxonMobil, Shell, Chevron and Saudi Aramco.

Edelman, the world’s largest PR company with over $1 billion in revenue, exemplifies this contradiction and the scale of the challenge.

The company assembled a task force of global health and pharmaceutical companies, including Novo Nordisk, GSK, and Roche to “accelerate the transition to net zero health systems” in India and China—a campaign hailed as groundbreaking public-private collaboration.

Yet Edelman won the bidding war for Shell’s worldwide public relations account in 2024, extending their decades-long relationship in a deal worth tens of millions—one of the agency’s most lucrative contracts. In March, Shell abandoned a key climate target for 2035 and weakened another goal for 2030.

While Edelman publicly states it “believes climate change is the biggest crisis we face as a society,” the firm creates “innovative promotional campaigns” for Shell, including a video game where users imagine themselves as engineers “keeping the lights on.”

The Climate Investigations Center describes Edelman as “the dominant PR firm for trade associations that promote an anti-environmental agenda.”

“Just like health leaders once stood up to Big Tobacco and its advertising, it’s time to stand up to Big Oil,” said Jeni Miller, GCHA executive director. “Organisations are demonstrating that they won’t help spread fossil fuel disinformation, and will use every tool they have, including their ad and PR dollars, to protect people’s health and the planet.”

Building on healthcare’s trusted voice

Ipsos Global Trustworthiness Index 2024.

With doctors and nurses consistently ranked among the world’s most trusted professions, advocacy groups believe their voices are essential to reframing fossil fuels as a health crisis rather than just a climate issue.

“We are trusted voices in the community,” said Dr Viviana Martinez Bianchi, president-elect of the World Organization of Family Doctors. “We are uniquely positioned to inform, explain, and speak about the equity implications. We can counteract this disinformation and mobilize public understanding and action.”

The decision to cut ties with these PR firms aligns with a broader movement to place health at the heart of climate policy and counteract the “commercial determinants of health,” where corporate practices from sectors like tobacco, ultra-processed food, and fossil fuels shape conditions for disease.

“We see the effects first-hand in vulnerable populations,” Bianchy explained, citing patients with asthma exacerbations, cardiovascular conditions, and poor respiratory health, all linked to pollution exposure.

Decades of scientific studies have linked fossil fuel activities to rising rates of asthma, heart disease, heat-related illness, infectious disease spread, and mental health stress during climate-related disasters—evidence that health professionals say has forced them to act.

“We, the health community, have a duty to warn humanity about the profound health harms from burning fossil fuels and to act on that knowledge,” said Edward Maibach, Director of the George Mason University Center for Climate Change Communication. “We must refuse to work with any marketing agency that works with fossil fuel companies.”

Industry disinformation campaigns

Plastic waste sorting
Over 30 metric tonnes of plastic are burned each year, mostly in lower and middle income countries, leaving millions exposed to toxic air pollutants.

For over fifty years, fossil fuel companies have run multi-billion-dollar campaigns to misinform, lobby, and confuse the public about the climate crisis, varying their messaging strategy by region and audience.

In the global North, these tactics focus on “greening” the gas industry by positioning fossil fuels as climate solutions.

The playbook includes shifting blame to individuals through concepts like the personal carbon footprint, which British Petroleum popularised in 2004 with a calculator that encouraged people to tally up how their morning commute, grocery runs, and vacation flights were heating the planet.

The industry also championed plastic recycling, rolling out blue bins across American driveways while chemical giants like Chevron, DuPont, and Exxon knew the technology to recycle at scale did not exist.

Plastics are now a key justification used by nations and companies to pursue higher fossil fuel production, even though only 9% of plastic ever produced has been recycled. The technology to recycle complex polymer plastics at scale still does not exist decades later.

In the global South, fossil fuel-producing nations and companies promote oil as essential for economic and sustainable development, according to Vivek Parekh, an analyst with London-based climate risk think tank Influence Map.

Saudi Arabia made this argument while trying to block the climate resolution at last week’s World Health Assembly, saying: “As an oil producing sector, we are aware of our role in [energy] transformation, but can’t ask developing countries to pay the price for transformation when they are not responsible for the problems.”

Saudi delegate explains their take on the WHO Climate Change and Health action plan in WHA debate.

“The fossil fuel industry dominates the lobbying landscape,” Parekh said. “What we see is the industry’s attempt to weaken and obstruct climate policy, despite clear economic, health and climate benefits.”

At major UN climate conferences, fossil fuel lobbying groups have dramatically outnumbered health organizations. Nearly 2,500 fossil fuel lobbyists attended COP28 in Dubai—more than delegates from the ten most climate-vulnerable nations combined.

At November’s plastic treaty negotiations, 220 fossil fuel and chemical industry lobbyists descended on Busan, forming the largest single delegation and outnumbering host South Korea’s 140 representatives as well as the European Union and its 27 member states.

The oil giants got what they came for, successfully derailing what was meant to be the final treaty adoption session by opposing any caps on plastic production.

This strategy has led UN Secretary-General António Guterres to call fossil fuel companies the “godfathers of climate chaos.”

“It’s an almost comical conflict of interest that Big Oil’s spin doctors are also in charge of communications for the UN climate talks,” Dr. Geoffrey Supran, a Harvard researcher who studies fossil fuel disinformation tactics, told environmental news website DeSmog.

Despite some victories, including a Dutch court upholding The Hague’s ban on fossil fuel advertising and Energy Australia apologizing for greenwashing, greater transparency is needed as the industry’s activities continue undermining climate action.

“We can’t be neutral,” added Dr. Jemilah Mahmood, executive director of Malaysia-based Sunway Centre for Planetary Health. “Our Hippocratic Oath goes beyond just treating disease to preventing it.” Like the tobacco industry, she argued, fossil fuel companies “manipulate the truth,” leaving marginalized communities polluted and vulnerable to health risks.

Image Credits: CC, IPSOS, SweepSmart.

Mahmoud Ali Youssouf, chairperson of the African Union Commission, and Bill Gates, chair of the Gates Foundation.

Philanthropist Bill Gates announced on Monday that the majority of the $200 billion he plans to donate over the next 20 years will be spent in Africa.

The focus will be “on partnering with governments that prioritise the health and wellbeing of their people”, Gates told government leaders, diplomats and partners during an address at the African Union headquarters in Addis Ababa, Ethiopia.

“By unleashing human potential through health and education, every country in Africa should be on a path to prosperity – and that path is an exciting thing to be part of,” Gates said.

He called on  primary healthcare (PHC) to be prioritised, emphasizing that this “has the greatest impact on health and wellbeing.”

 “With primary healthcare, what we’ve learned is that helping the mother be healthy and have great nutrition before she gets pregnant, while she is pregnant, delivers the strongest results. Ensuring the child receives good nutrition in their first four years as well makes all the difference.”

Gates singled out Ethiopia, Rwanda, Zimbabwe, Mozambique, Nigeria, and Zambia for showing bold leadership that harnesses innovation, from expanding frontline health services to deploying advanced tools against malaria and HIV, and safeguarding PHC.

 “I’ve always been inspired by the hard work of Africans even in places with very limited resources.” He added, “The kind of field work to get solutions out, even in the most rural areas, has been incredible,” said Gates

Gates also spoke about the transformative potential of artificial intelligence, noting its relevance for the continent’s future. 

Drawing a parallel to the continent’s mobile banking revolution, he said that “Africa largely skipped traditional banking and now you have a chance, as you build your next generation healthcare systems, to think about how AI is built into that.”  

He pointed out that Rwanda is using “AI-enabled ultrasound to identify high-risk pregnancies earlier, helping women receive timely, potentially life-saving care.”

 “In Ethiopia and Nigeria this week, Gates will see first-hand the state of health and development priorities in the wake of foreign aid cuts, and he will affirm his and the foundation’s commitment to supporting Africa’s progress in health and development over the next 20 years,” according to a media release from the Gates Foundation.

Image Credits: African Union.

Africa needs 6.4 million mpox vaccines in the next few months to address the outbreak, which is now concentrated in Sierra Leone, according to the Africa Centres for Disease Control and Prevention (Africa CDC).

Three-quarters of Africa’s confirmed new mpox cases are in Sierra Leone, all concentrated in high-density areas in all districts, with 648 confirmed cases in the past week. Yet the country only has around 10,000 vaccine doses.

Meanwhile, Ethiopia reported its first three cases this week: parents and their baby who were diagnosed in Moyale, a town in the Oromia district near the border with Kenya.

“Given also the proximity of Somalia, and knowing all the challenges that are there, we need to be really very bold and aggressive to control this outbreak at the source so that it doesn’t expand further,” according to Dr Ngashi Ngongo, Africa CDC’s mpox incident manager.

The 16,915 confirmed cases for the first five months of this year are almost as many as the total for the entire 2024.

Mpox vaccinations are being carried out in seven countries, and while the Africa CDC has appealed for more vaccine donations, the 1.5 million LC16 vaccines from Japan are estimated to finally arrive over the weekend.

Nineteen African countries have active mpox cases, and 2,836 new suspected cases were reported in the past week. 

Meanwhile, 20 countries have cholera outbreaks affecting some 127,409 people, and addressing this is on the agenda of the African Heads of State meeting on 2 June, according to Ngongo

Seventeen member states have measles outbreaks, seven have dengue in seven member and four have Lassa fever.

WHO says there is an 80% chance that at least one of the next five years will exceed 2024 as the warmest on record.

Global temperatures are expected to remain near record levels over the next five years, and there is an 80% chance that at least one of the next five years will exceed 2024 as the warmest on record.

This is the key takeaway from a new report from the World Meteorological Organization (WMO). The temperature rise is expected to worsen the climate impacts on countries, their economies, and sustainable development.

“We have just experienced the 10 warmest years on record. Unfortunately, this WMO report provides no sign of respite over the coming years, and this means that there will be a growing negative impact on our economies, our daily lives, our ecosystems and our planet,” WMO’s Deputy Secretary-General Ko Barrett said.

There is an 86% chance that at least one of the next five years will be more than 1.5°C above the 1850-1900 average, which is commonly known as the pre-industrial era, after which the use of fossil fuels began on a large scale.

The Arctic region continues to warm at a higher rate than the global average, and that risks pushing up the rate of sea level rise.

This report comes a few months after WMO’s State of the Global Climate 2024 report, which confirmed that 2024 was likely the first calendar year to be more than 1.5°C above the pre-industrial era. It was also the warmest year in the 175-year observational record of the world.

In 2015, following the Paris agreement, world leaders agreed to limit global warming to 1.5°C. But this report of the WMO now projects that there is a 70% chance that the five-year average warming for 2025-2029 will be more than 1.5 °C.

For now, though the long-term warming that is an average of temperature over decades, typically over 20 years, remains below 1.5°C.

Rising global temperatures

The average global mean near-surface temperature that combines temperatures for both air and the sea surface is predicted to be between 1.2°C and 1.9°C higher for each year between 2025 and 2029, when compared to pre-industrial era.

The report forecasts that there is a 70% chance that the five-year average warming for 2025-2029 will be more than 1.5°C shows that the warming is intensifying.

This forecast is up from 47% in last year’s report (for the 2024-2028 period) and up from 32% in the 2023 report for the 2023-2027 period.

The WMO reiterated that every additional fraction of a degree of warming matters. It drives more harmful heatwaves, extreme rainfall events, intense droughts, melting of ice sheets, sea ice, and glaciers. It also worsens heating of the ocean and rising sea levels.

Fast warming Arctic region, wetter Sahel

The warming in the Arctic region is predicted to be more than three-and-a-half times the global average over the next five extended winters (November to March). This risks melting its large reserves of ice and pushing up the rates of sea level rise.

On the whole, the warming in the Arctic is projected to be at 2.4°C above the average temperature during the most recent 30-year baseline period (1991-2020).

This is likely to result in reductions in sea-ice concentration in the Barents Sea, Bering Sea, and Sea of Okhotsk, which are in the Arctic region.

Precipitation patterns are also projected to change, with wetter-than-average conditions projected for the semi-arid Sahel region in Northern Africa for the May-September period between 2025 and 2029, according to the report.

Similar conditions are predicted for northern Europe, Alaska, and northern Siberia.

The South Asian region has also been wetter in recent years, and the report forecasts similarly wet periods for the 2025-2029 period.

However, drier-than-average conditions over the Amazon are predicted.

Continued monitoring is essential, but is under threat

The scientific community has repeatedly warned that warming of more than 1.5°C risks unleashing more severe climate change and extreme weather, and every fraction of a degree of warming matters.

“Continued climate monitoring and prediction is essential to provide decision-makers with science-based tools and information to help us adapt,” Barrett said.

However, with funding cuts to US federal agency National Oceanic and Atmospheric Administration (NOAA), weather and climate observations available for climate reports has begun to fall.

Reports like this one from the WMO rely on multiple data sources from a range of organizations to validate their findings, which the defunding of NOAA has affected in recent months.

These reports are meant to provide policymakers with the updates they need ahead of the UN climate change conference, COP30, that will take place later this year.

This is an important COP as it will consider updated climate action plans from countries known as Nationally Determined Contributions, in which countries list the actions that they commit to taking to cut down their carbon emissions.

This report is produced by the UK’s Met Office, which is acting as the WMO Lead Centre for Annual to Decadal Climate Prediction. It provides a synthesis of the predictions from WMO-designated Global Producing Centres and other contributing centres around the world.

Image Credits: WMO/João Murteira.

Nigeria’s AMR plan was recognised as a best practice by the WHO.

From hospitals facing up to 80% antibiotic resistance to gonorrhoea that is resistant to almost all treatment, antimicrobial resistance (AMR) is a serious and growing problem, countries told the World Health Assembly (WHA) on Tuesday.

But it has been 10 years since the global action plan on antimicrobial resistance was adopted, and the WHA endorsed the World Health Organization’s (WHO) proposal to present an updated plan to next year’s assembly.

This also follows a request from the United Nations High-Level Meeting on AMR last year for an updated global action plan by 2026.

By 2024, over 170 countries reported that they had national AMR action plans, but only 29% of countries had costing, budgeting and monitoring implementation. Member states also reported that a lack of financing and technical capacity are key constraints.

Slovenia outlined the damage already caused by AMR: “In 2021, AMR was linked to nearly five million deaths, over one million directly. This is not a future threat, it’s a present crisis. ”

“A particularly alarming example is drug-resistant gonorrhoea, once easily treatable, it is now resistant to nearly all antibiotics, raising the risk of untreatable infections, infertility and increasing HIV transmission,” said Slovenia.

“Preventing infections is our first line of defence,” added Slovenia, urging countries to focus on “improving infection control, hygiene, waste management and vaccine access” to reduce both infections and antibiotic demand.

‘Critical blindspots’

Bangladesh described AMR “misuse in animal health, pharmaceutical runoff in the environment, and weak regulatory oversight beyond the human health sector” as “critical blind spots that must receive the same priority as the human health interventions”. 

Nigeria’s second national action plan on AMR launched in 2024, focuses on “domestic resource mobilisation and multi-sectoral engagements.”

“With surveillance systems operational in multiple human, animal and environmental health laboratories and a dedicated national budget line now in place, Nigeria has met the who 2025 minimum standards for infection prevention and control (IPC) and is proud to have been recognised in the WHO 2024 global IPC report as a global best practice,” said the country representative.

But Nigeria acknowledged “lingering challenges”, and to address these, it is “prioritising sustainable, innovative financing, decentralised governance and sub-national capacity-building, expansion of surveillance into primary and community health sectors and integrating stewardship efforts across the health system”.

Indonesia told the WHA that it needs support in “strengthening surveillance efforts, laboratory infrastructure and R & D”. It supports an updated plan that will guide AMR “governance, financing, workforce development and concrete strategies to address socioeconomic determinants of AMR”.

Barbados, whose Prime Minister Mia Mottley chairs the Global Leaders Group on AMR, called for accelerated action on AMR and “sustained technical and financial support, especially for small island developing states”. 

Spain, which confessed to being one of the biggest consumers of antibiotics in primary healthcare, said it had implemented controls in 2014 that had slowed this trend. 

“We’ve launched a new plan for 2025-2027 focused on strengthening surveillance, professional training and research and development for new antibiotics and therapeutic alternatives,” Spain told the WHA.

Numerous countries reported financial challenges in addressing AMR, including countries such as Micronesia, whose AMR efforts were supported by the US Centers for Disease Control (CDC)  However, several countries reported getting support from the UK-based Fleming Fund.

The WHO will submit a draft of the updated report to next year’s executive committee.

WHO is urging countries to work to create a framework to regulate and standardize traditional medicine products.

The World Health Assembly delivered a landmark victory for traditional medicine and indigenous cultures Monday evening, approving a strategy that calls for increased investment in research and integrating ancient healing practices into modern healthcare systems worldwide.

The approval marks a breakthrough moment for advocates of traditional medicine, with nations across Asia, Africa, the Middle East and Latin America celebrating the decision. Iran called it “a visionary yet realistic roadmap” to integrate thousands of years of medical like its own.

But the strategy text shows WHO walking a careful tightrope, embracing practices that represent “accumulated wisdom and healing practices passed down through generations” while demanding they meet modern scientific evidence standards that could take decades to satisfy.

The strategy that will be in place between 2025-2034 was passed after an intense discussion that saw the European Union voice concerns about quality and safety, embodying the tension between empirical science and millennia-old traditions at the heart of the UN health body’s move.

“We urge the organization to be firm and vocal against harmful and or inefficient practices that may be disguised as alternative medicines,” said the delegate from Poland who made a statement on behalf of the EU and its 27 member states.

The strategy does not imply a preference for TCIM practice over biomedical practice, WHO said. While acknowledging traditional medicine’s “immense value” as a “vast repository of knowledge,” the strategy consistently emphasises that integration must be “scientifically valid” and “evidence-based.”

“It seeks to harness the potential contribution of TCIM to health and well-being based on evidence,” the strategy reads. “It is also designed to prevent misinformation, disinformation and malinformation.”

More than 80% of the world’s population in over 170 of the 194 WHO member states use traditional medicine of some form. In some industrialized countries like France and Canada, usage reaches nearly half the population. 

The WHO’s move reflects recognition of a field that serves billions of people worldwide and acknowledges the significant contributions of indigenous cultures to medicine. Around 40% of pharmaceutical products have their origins in traditional medicine, according to the WHO.

“The history, the cultural heritage, the ancestral knowledge…all anchor our traditional medicine work,” said Dr Bruce Aylward, Assistant Director-General for Universal Health Coverage at WHO, while assuring countries of WHO’s support as they find the best ways to integrate their traditional practices in their national systems.

Between Tradition and Evidence

78th Session of the World Health Assembly

This strategy begins what will be a long and expensive process to standardize and regulate care with traditional methods. Hurdles lie ahead, from financing and research capacity to government wrangling over how to establish global standards.

The scale of the task is enormous: systematically studying thousands of years of accumulated knowledge to meet regulatory standards for integration into national health systems. Yet no countries nor WHO made any pledges for further investment in traditional medicine research, and the strategy contains no funding figures either.

“I think that what’s new in this [final] version that wasn’t there before is also looking at the cross-sector value of traditional approaches and learning. There is this big section on protection of indigenous practice and knowledge, and how we can learn from them,” said Tido von Schoen-Angerer, a Geneva-based physician and President of the Traditional, Complementary and Integrative Healthcare Coalition (TCIH).

The central challenge remains evidence. WHO is encouraging countries to integrate traditional medicine into their national health systems, but only when supported by rigorous scientific research that much of traditional medicine currently lacks.

“I don’t think anybody expects WHO to recommend something that is not fully evidence-based,” Schoen-Angerer said. But at this point, while there is strong evidence for some traditional medicine, there is next to nothing for others.

Schoen-Angerer told Health Policy Watch that there was opposition to this draft from Europe, though Asian, African, Middle-Eastern and Latin American countries were largely onboard.

“You have very good evidence for some methods like acupuncture, mindfulness, et cetera, for certain herbs, and you have less evidence for other practices,” Schoen-Angerer said, adding that the WHO’s push for more investment will help create more evidence in the coming years.

This view received pushback from Switzerland-based civil society group Medicus Mundi International Network—a reaction that puts the tension of applying modern science to ancient tradition on full display, raising the question of whether tradition can ever be truly “scientifically valid” by Western paradigms.

“The WHO’s draft Traditional Medicine Strategy (2025–2034) recognizes the value of traditional and Indigenous healing but falls short by privileging Western scientific paradigms over Indigenous epistemologies,” said the delegate from the organization.

“Centering ‘evidence-based’ validation risks displacing practices rooted in land, culture, and spirituality,” she added.

The Funding Challenge: Big Ambitions, Modest Resources

WHO wants countries to spend on research, but the strategy lacks concrete funding commitments—a familiar challenge in the current global health arena. No countries, groups or WHO itself made new funding announcements in Geneva during the passing of the strategy.

The expectation is that WHO’s new strategy will encourage countries to allocate more funding for research, but the strategy places far more burden on member states than on WHO itself.

While directing countries to “establish a national research agenda” and “allocate dedicated resources,” WHO’s own commitments are limited to developing guidelines and technical documents.

The lack of WHO investment likely stems from its own financial crisis. The organization is currently facing a $1.5 billion budget deficit after already slashing its budget by nearly a quarter.

In 2022, India gave WHO $85 million over ten years to build evidence and towards the setting up of WHO Global Centre of Traditional Medicine in Jamnagar. 

Historically, such specialised areas struggle for funding. Women’s health, for example, receives only about 10% of U.S. National Institutes of Health funding.

Conversation on Standardizing Care

WHO’s latest strategy on traditional medicine asks countries to invest in research and create evidence

Traditional medicine spans both oral and codified forms of medicine, and this draft seeks to get countries to work towards creating unified standards—a complex task given the vast diversity of practices across cultures and continents.

“We urge WHO to support countries in developing context-sensitive methodologies, including those that encompass non-codified and oral traditions, to ensure scientific rigour,” a delegate from Thailand said.

The EU, which had already pushed back against the strategy prior to this week’s vote, urged WHO to be guarded as it engages with the industry to prepare standards.

“We strongly recommend preventing conflicts of interest in line with FENSA (Framework of Engagement with Non-State Actors), when engaging with industry and practitioners to devise regulations, and standards for TCIM products and activities,” the delegate from Poland said.

Balancing Rights of Indigenous People with the Challenge of Spurious Products

The WHO’s endorsement has created new opportunities for countries to address a persistent challenge: how to protect legitimate traditional medicine practices while cracking down on fake cures and fraud operations under the cover of spirituality.

Such problems are already widespread globally. For instance, the Indian company Patanjali, which claims to sell products rooted in India’s traditional medicine system of Ayurveda but is embroiled in several lawsuits for “false and misleading” claims. The company in its early years saw fast growth due to its branding and benefited from a relatively lax regulation system for traditional medicine products. 

African nations like Comoros and Togo acknowledged that while TCIM is widely used in their countries, the sector remains unregulated and training the providers remains a challenge.

“It has a great deal of potential, and it has been practised for a very long time by our ancestors. However, it is not within a framework or well-regulated,” the delegate from Comoros said.

In many small island nations, indigenous people are the custodians of TCIM. In others, TCIM is often the only available healthcare for large parts of the population.

“Our traditional medicine, while not fully aligned with the formal, traditional, complementary and interpretive medicine definition, is rooted in local customs, indigenous knowledge and natural resources,” said the delegate from Micronesia, a group of islands in the Pacific Ocean. “We see these practices as important to supporting our health systems and advancing universal health coverage.”

Thailand, too, said it was important to uphold the rights of indigenous people and ensure that any profit made from using local biodiversity and indigenous knowledge ought to be shared with them—a contentious issue that will get pushback from pharmaceutical companies, who argue that paying for access to resources would hinder innovation. 

Image Credits: WHO, WHO, WHO.