Dr Jean Kaseya, Director General of Africa CDC.

New weekly cases of mpox across Africa have dropped to around 2,000 for the first time this year giving hope that the outbreak may be waning, according to Dr Jean Kaseya, Director-General of Africa Centres for Disease Control and Prevention (Africa CDC).

In the mpox epicentre of the Democratic Republic of Congo (DRC), new cases dropped to 1,453 – the first time this year that this has been below 2,000 – despite an increase in testing. 

Mpox in DRC, 17 April 2025

There has also been a decrease in confirmed cases in the DRC and a significant increase in contact tracing.

Mpox in health workers – a priority in the continental vaccination efforts – has almost halved since November when over 100 health workers were infected.

Seven countries are currently vaccinating against mpox, with over 595,000 people vaccinated so far.

However, mpox cases in Uganda continue to rise, with 271 cases confirmed over 247 the previous week.

China, Switzerland and the UK have all reported mpox cases in the past few weeks.

“I’m calling the emergency consultative group meeting on the 17 May. Our experts will analyse all data and all evidence, and they will tell us if we still need to continue with the public health emergency of continental security (PHECS) for mpox,” said Kaseya.

One human case of anthrax

One person has been identified with anthrax in Uganda. 

Meanwhile, in the eastern DRC – a hotspot for various disease outbreaks – anthrax has only been identified in animals, including hippos in Virunga Park in north Kivu.

Around 50 hippos as well as buffalo have died from the disease in the park, according to earlier reports from the park’s director, Emmanuel De Merode.

However, recent animal deaths in South Sudan and Uganda indicate the disease may have spread across the borders.

“We don’t have any evidence today that humans are affected, but will continue to follow what’s happening,” said Kaseya.

Anthrax is caused by bacteria in soil and animals can become infected when they inhale the spores in soil, plants or water.

Health financing

Over the past two weeks, Kaseya has been traveling internationally to try to drum up more funding for health on the continent to fill the huge hole left by departing aid – particularly from the United States.

The continent has lost 70% of its official development aid since 2023, down from $81 billion to $25 billion this year – and some countries are on the brink of running out of essential medicines including antiretroviral medicine to treat HIV.

“There are reports of people migrating to other countries just to get ARVs,” Kaseya disclosed.

He has met the CEO of Ethiopian Airlines Mesfin Tasew to explore the possibility of a levy on airline tickets that could be used for health programmes.

In addition, a meeting with the government of the United Arab Emirates (UAE) is likely to result in investment in local manufacturing, and the digital agenda, supply chain management and the health work force, Kaseya said.

“Emirates is one of the countries making huge progress in the health system by using AI, and we are moving toward a strong programme with this country for Africa,” he added, saying that details of this collaboration would be announced soon.

Latest report released by the International Council of Nurses highlights the challenges faced by those in the nursing profession.

Nearly half of national nursing associations (48.4%) report a significant increase in nurses’ migration or exodus from the profession altogether since 2021 – against stagnant salaries, poor health system performance, and growing violence directed at nurses along with a continually increasing workload.

These are among the key findings in a new report by the International Council of Nurses (ICN), warning of a deepening crisis in the global nursing workforce.

The report is backed by surveys showing that around 72.1% of National Nursing Associations (NNAs) reported little or no increase in nursing salaries since 2021, including in more affluent OECD countries. When accounting for inflation, over one-third, or 36.4%, of NNAs indicated that nurses have effectively experienced a decrease in salary in real terms.

Increased violence against health care workers, poor pay, and exhaustion are driving many nurses to leave the profession altogether.

“A shocking 86.2% of nurses’ associations reported experiences of violence from patients or the public, yet a third of countries had no policies in place to protect nurses from workplace violence,” said ICN’s President Pamela Cipriano, in launching the new findings.

Compensation has stagnated in OECD countries.

Growing demands on nurses’ time

These findings come against a background of growing demands on nurses in their day-to-day duties since the height of the pandemic in 2021 – as reported by some 61.7% of nursing associations.

The report, Our Nurses. Our Future. Caring for Nurses Strengthens Economies, is complemented by a survey of 68 NNAs between 2021–2024. The ICN is a federation of over 130 national nurses’ associations representing millions of nurses worldwide.

“The publications we are launching today show that many of the world’s nurses are at breaking point, pushed into burnout and facing enormous physical, mental, and emotional pressures. Unacceptable working conditions, inadequate compensation, and a failure to protect nurses from workplace violence and occupational hazards or provide opportunities to advance and practice at full scope are driving this crisis, which affects not only nurses but the health of entire populations,” said Cipriano.

Some 38% of national nursing associations rate their country’s capacity to meet current healthcare needs as “poor” or “very poor”, the survey of NNAs also found – partly as a result of the cumulative pressures on the nursing workforce and their exodus.

Threats to safety and low pay are major threats

Pamela Cipriano, president of the International Council of Nurses (ICN)

Along with low pay, various threats to safety while at work are among the key issues nurses face, she added.

“The survey results also underscore a failure to protect nurses’ safety,” Cipriano said.

“Our report highlights how direct attacks on nurses and healthcare workers in conflict settings have also dramatically increased.”

Outside of conflict settings, however, violence directed against nurses is often a result of the frustration patients and their caregivers have towards the health systems, as many nurses work in resource-poor settings. In India, for instance, violence against healthcare professionals is a huge issue, often linked to the over-extended public healthcare system.

Violence against nurses is a global issue.

Report’s recommendations

The report flags a range of solutions for policymakers and governments. Investment in the right resources and equipment, safe and decent working conditions, and training support are among the top three “asks.”

It also suggests improving work culture so that nurses can thrive in a supportive environment.

Another one is to improve access to healthcare for healthcare professionals themselves.

Poor health among health care workers accounts for approximately 2% of national health care expenditure on average, draining valuable resources, according to the findings.

“Remove barriers to health care access for nurses by streamlining pathways to ensure easy, timely access to preventive care, treatment and support services. Ensure these services are readily available and designed to meet nurses’ unique needs,” it states.

And finally, there is a need to pay nurses fair and competitive compensation.

Investing in nurses’ well-being would boost health sector productivity by 20%

Global shortage of nurses reaching record numbers.

Despite mounting evidence of the nursing workforce crisis, many leaders and decision makers continue to prioritize short-term solutions over the sustainable investments that are needed to address the root causes of the health workforce emergency, ICN’s CEO, Howard Catton noted. Fundamental to that is the growing nurses shortage.

International Council of Nurses CEO Howard Catton
Howard Catton, CEO of the International Council of Nurses

The report makes an economic case for investing in more nurses, as well as increasing their well-being. “For nurses, improving their health and resource allocation could boost health workforce productivity by as much as 20%, which directly translates into cost savings and improved health care delivery,” it states.

“We have clear evidence that supporting and caring for nurses is not a cost: it is a smart and strategic investment in the health and prosperity of all people, with the total potential value of initiatives to improve nurses’ wellbeing is estimated at $100-300 billion based on capturing lost workforce productivity alone,” Catton said. He said the estimates are based on the World Economic Forum & McKinsey’s 2025 Thriving Workplaces report, which estimated that investing in workers’ health, more broadly, could unlock some $11.7 trillion in global economic returns.

“Extrapolating those figures to the proportional size of the nursing workforce, we get a possible opportunity value of $100-$300 billion, in increased economic returns,” Catton said, framing those as reduced sick leave and attrition, absenteeism, etc.

Savings obtained from investments outweigh the costs

Numerous case studies show that investments in nurses’ health can yield clear economic returns.

“There is no concrete number put on the amount of investment required to bring about these benefits, however we do know that there is a strong return on investment on investing in nursing and in health: studies show that every dollar invested in health systems can generate a $2-$4 return (McKinsey Global Health Institute/Remes et al., 2020),” Catton added.

ICN has said that it will continue to push for increased protections for nurses at the upcoming World Health Assembly, 19-27 May, where WHA member states will consider the extension of a global strategy on Nursing and Midwifery, currently scheduled to expire this year.

“ICN is strongly advocating for this to be extended and prioritized, amidst grave risks to global health funding and a historic and chronic lack of investment in the health and care workforce,” said Richard Elliott, ICN spokesperson.

“The WHA has to decide to extend the current global nursing strategy,” Catton added.  “We obviously want a positive decision and are lobbying hard for that. However we are concerned that health workforce budgets at WHO and in countries are at risk and could be seen as a soft target for cuts. WHO in our view, has for a long time not invested proportionately in the health workforce – and given that it is so central to delivering so much, we are therefore very alert to risks of cuts.”

WHA will also include discussions on the Global Strategy on Human Resources for Health: Workforce 2030 and the most recent results of country compliance with the WHO Global Code of Practice on the International Recruitment of Health Personnel, which was released and reviewed at the WHO Executive Board in February.

“A strong, well-supported nursing workforce is more critical than ever to address global health challenges and support healthy, productive populations. It is now time for action to move nurses from being invisible to invaluable across all regions,” Cipriano said.

Image Credits: Unsplash, International Council of Nurses , International Council of Nurses, 2025, Studioregard.ch.

The final green text of the pandemic agreement, alongside INB co-chair Anne-Claire Amprou.

At around 3am Wednesday, after three years of often intense negotiations, World Health Organization (WHO) member states agreed on a draft Pandemic Agreement, which sets out basic terms of engagement to prepare for, prevent and respond to pandemics.

Bleary-eyed negotiators and co-chairs Precious Matsoso and Anne-Claire Amprou welcomed the final greening of the entire text after another tough, long day of talks.

“Now the real work begins to make this agreement a reality,” said Matsoso, with the draft due to be presented to the World Health Assembly (WHA) next month. Once adopted, it will become a legally binding document.

Amprou, admitting that she addressed the Intergovernmental Negotiating Body (INB) with great emotion, said: “Together, we have achieved an impressive work that has led to a massive step forward for global health, health security, equity and international solidarity. The world is watching us, and you can be very proud of what you have just achieved.”

For an hour after the entire agreement was finally “greened” at the WHO headquarters in Geneva, negotiators expressed their support – and often relief.

Tanzania, speaking for 77 African states, described the agreement as a “significant, and challenging step forward in our collective commitment to enhancing global health security. 

“While the process may not have yielded all the outcomes we aspired for, it has opened an important avenue for future collaboration and growth in our efforts to be better prepared to face potential pandemics,” said Tanzania.

Tanzania on behalf of Africa.

“We have not achieved all our objectives in the negotiation, but we believe that the new agreement, if effectively implemented, will make the world more resilient and better equipped to face the global health security challenges of the future,” said the European Union (EU).

“The COVID 19 pandemic was suffering on a worldwide scale and tested public health system to the limit. Our collective achievement today shows that international solidarity, enhanced collaboration and decisive action are the way forward.”

Germany stressed that, “once adopted, the pandemic agreement will serve as a new collective tool to jointly address the risks of future pandemics across the full spectrum of necessary action”.

Germany also warned that countries would need to ensure its practical implementation.

“This why we have also advocated strongly for transfer of technology to be voluntary for technology holders, and this is how we understand the current provisions in the text,” stressed Germany, highlighting one of the most contested aspects of the talks.

Germany addresses the final session of the INB.

At around 4am, WHO Director-General Dt Tedros Adhanom Ghebreyessus got his turn to address the INB, saying that the agreement “reflects your resilience, unity and unwavering commitment to the health and well being of people everywhere.

“In the face of enormous challenges, you have come together, rising above borders and differences, united by a common goal, the protection of humanity,” said Tedros.

“By reaching this milestone together, you have made history and shown how powerful collaboration can be,” added Tedros, who paid special tribute to “my African compatriots who saved the day with your flexibility”.

A WHO statement issued after the close of the meeting stressed that the agreement: “affirms the sovereignty of countries to address public health matters within their borders, and provides that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.”

An extensive and damaging misinformation campaign incorrectly asserted that the agreement is a “power grab” by the WHO aimed at imposing various demands on countries.

A group of protestors against the WHO and the pandemic agreement, representing a wide range of interests, march in the streets of Geneva outside last year’s World Health Assembly in June 2024

Sharing pandemic products

The INB was set up in December 2021 to negotiate an agreement to ensure more equitable access to vaccines, therapeutics and diagnostics (VTDs) in the next pandemic. 

Over time, much of the agreement has been watered down – but it has retained one of the important stipulations: that the WHO will get 20% of the real-time production of vaccines, therapeutics, and diagnostics (VTDs) for the pathogen causing the pandemic, with 10% as a donation.

The WHO will then distribute these vaccines, medicines and tests to low- and middle-income countries according to need – partly righting the inequitable access to vaccines during COVID-19 when wealthy countries hoarded scarce vaccines.

All manufacturers who want to be part of a Pathogen Access and Benefit-Sharing (PABS) system will need to agree to this 20% allocation – although the details of the PABS system still need to be agreed on.

“My initial mandate was for 45% of VTDs to be made available for the WHO because you can be effective with that. But negotiations are negotiations, give and take. You have to be flexible,” Dr Aquina Thulare, who heads the South African negotiations, told Health Policy Watch. 

Further tough negotiations lie ahead to bring this PABS system into existence, something that has been deferred to the Conference of the Parties that will bring the agreement into being.

Dr David Reddy, Director General of  the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), said  that the industry has “made proactive commitments to deliver equitable access, pledging to reserve an allocation of real-time production of vaccines, treatments and diagnostics for priority populations in lower income countries and take measures to make them available and affordable”.

 But Reddy stressed that “intellectual property protection and legal certainty are essential for the innovative-based pharmaceutical industry to invest in high-risk R&D and enable voluntary partnerships that we will need in the next pandemic.

“We hope that in subsequent negotiations Member States maintain the conditions for the private sector to continue innovating against pathogens of pandemic potential.”

Recognition of human-animal connection

The agreement also sets out countries’ obligations to prevent disease outbreaks from becoming pandemics – including a “One Health” approach to prevent zoonotic diseases – those that spread from animals to humans.

“By embedding One Health and prevention at source into the pandemic agreement, member states are finally acknowledging what science has long confirmed: we cannot prevent future pandemics without improving how we treat animals and our environment in the present. This is a paradigm shift in the scope of global health policy and a victory for animals, for people, and for the planet,” says Nina Jamal, from the animal rights group Four Paws.

“For the first time, an international binding agreement has enshrined One Health principles and collaborative surveillance,” noted Wildlife Conservation Society’s Dr Chris Walzer.

Research and development

Medecins sans Frontieres (MSF) and DNDi, which develops new treatments for neglected tropical diseases, expressed support for the “groundbreaking research and development (R&D) access requirements”.

“Countries have recognised that when they finance research and development for new treatments, diagnostics, or vaccines through public funding, they need to attach conditions to that funding that ensure public benefit,” said Michelle Childs, Director of Policy Advocacy at DNDi.

Other positive issues highlighted by MSF include the commitment to ensuring frontline healthcare workers get priority access to medical products during emergencies, building a global supply chain and logistics network, and more transparency in government purchasing agreements.

Impact on young people

Katja Čič, a member of the WHO Youth Council based in Slovenia, said that the COVID-19 pandemic “cancelled the world in a few weeks… Schools were closed. Work happened over Zoom, socialising got uprooted. Stress was through the roof. Lots of people as their loved ones.

“Young people will live with the long-term consequences of today’s decisions the longest and be the most impacted. Everyone deserves to grow up in a world that can handle a health crisis, whether that means we will get a faster warning when something’s wrong, equal access to vaccines and tests and treatments, or our education is not disrupted.”

Success of multilateralism

“The pandemic agreement is a beacon of unified multilateral cooperation at a critical time, and we salute the member states for their tenacity and commitment in getting to this point.” said Helen Clark, Co-Chair of The Independent Panel for Pandemic Preparedness and Response, the Pandemic Action Network, Panel for a Global Public Health Convention and Spark Street Advisors.

Clark, and her co-chair Ellen Johnson Sirleaf, urged leaders to take action today to build the platforms which will stop an outbreak from becoming a pandemic.

“We need to invest in regional resilience today because it will take time,” said Sirleaf. “Don’t wait. Start now to build regional capacities for research, development, and manufacturing of pandemic countermeasures. ”

“Recently announced cutbacks to global health funding have devastating implications for global health security,” added Clark. “Currently, countries will need to scramble for the funds required in the event of another pandemic emergency. Leaders should be investing now in pandemic preparedness and emergency response – domestically, regionally, and internationally. We can’t afford another pandemic, but we can afford to prevent one.”

Dame Barbara Stocking, chair of the Panel for a Global Public Health Convention, described the agreement as “a breakthrough in global collaboration – helping countries better prevent, detect, and respond to future pandemics” but highlighted that “there’s still work to do on surveillance for both humans and animals, and on government preparedness”.

Thulare also sees the agreement as a triumph for multilateralism in the face of the rise of “very conservative governments, not just in the US, but also in Europe and elsewhere”.

“We have to make sure that we save this multilateral space, and we also save the WHO, which is the most neutral arbiter – especially in pandemics,” Thulare added.

Germany noted that the pandemic agreement “has the potential to become a milestone for multilateralism and global solidarity”, and pledged that it “has been and will remain, a committed and reliable partner for the World Health Organisation and an advocate of pandemic prevention, preparedness and response”.

United States President Donald Trump removed the US from the WHO – and explicitly from the negotiations upon assuming office in January, while Argentina also dissociated itself from both the WHO and the agreement.

However, 191 countries remained in the process – including those at war with one another, making consensus even more commendable.

Image Credits: Kerry Cullinan.

Europe is the world’s fastest warming continent and the year 2024 was its warmest on record.

Europe is the world’s fastest-warming continent and 2024 was the warmest year on record, with record temperatures in the central, eastern and southeastern regions, according to the latest European State of the Climate 2024 report published jointly by the World Meteorological Organization (WMO) and Copernicus Climate Change Service (C3S).

Severe storms and flooding claimed 335 lives last year and affected around 413,000 people. Scientists also reported that the east was extremely dry, while the west witnessed warm and wet conditions.

“This report highlights that Europe is the fastest-warming continent and is experiencing serious impacts from extreme weather and climate change. Every additional fraction of a degree of temperature rise matters because it accentuates the risks to our lives, to economies and to the planet. Adaptation is a must,” WMO Secretary-General Celeste Saulo said in a press statement.

The report has a silver lining. The proportion of electricity generation by renewables in Europe reached a record high in 2024, and now stands at 45%.

This is the eighth annual report, released in April every year, and the second that has been published jointly with Copernicus, the European Union’s earth observation program.

Climate change hotspots

In 2024 Europe saw climate impacts ranging from heatwaves to wildfires.

Europe experienced the most widespread flooding since 2013. Almost one-third of the continent’s river network experienced flooding that exceeded the ‘high’ flood threshold.

The continent saw both hot and cold extremes. The numbers of days with ‘strong’, ‘very strong’ and ‘extreme heat stress’ were all the second highest on record.

Nearly 60% of Europe saw more days than average with at least ‘strong heat stress’. But there was a record low number of days with at least ‘strong cold stress’ too.

“These extreme events led to an estimated 18 billion euros of damages, 85% of which is attributed to flooding,” said Samantha Burgess, deputy Director of C3S during a press conference to discuss the report’s key findings.

Last year was the warmest ever for Europe with record-high annual temperatures in almost half of the continent.

All European regions saw a loss of ice due to record temperatures. Glaciers in Scandinavia and Svalbard saw their highest rates of mass loss on record. In September, fires in Portugal burned around 110,000 ha (1100 km2) in one week, representing around a quarter of Europe’s total annual burnt area. An estimated 42,000 people were affected by wildfires in Europe.

“We observed the longest heatwave in southeastern Europe and record glacier mass loss in Scandinavia and Svalbard, an archipelago between Norway and the North Pole. But 2024 was also a year of marked climate contrasts between eastern and western Europe,” Carlo Buontempo, C3S director said during the press conference.

While the entire continent is not a climate change hotspot, experts said that some areas within Europe do fit those criteria.

“A good example of this is the Mediterranean region, which is widely recognized as a climate change hotspot with above average warming, a projected decrease in precipitation, rising drought, risk wildfires and strong socio economic and ecological vulnerabilities. Similarly, the alpine region in Europe is also experiencing above average warming and sensitive changes in the cryosphere,” Burgess said.

Impact of funding cuts to NOAA now visible

In recent months the United States government has cut funding to the country’s climate monitoring system, the National Oceanic and Atmospheric Administration (NOAA).

This has affected scientists who have been laid off from their jobs and has also limited the number of observations NOAA makes around the world. Scientists acknowledged that this has affected the quality of the report that uses data from multiple data sources.

“Observations are absolutely fundamental to monitor what we’re doing, and NOAA is providing a lot of observations. What we’ve seen since March is that there has been a drop in the number of observations delivered by NOAA due to funding cuts,” said Florence Rabier, Director-General of European Centre for Medium-Range Weather Forecasts or ECMWF.

“Any observation loss is a loss for climate monitoring, for calibration of satellite, for verification of forecasts. So, in terms of both science and observations for weather and climate, I think it would indeed have an impact on the whole community,” she told the press conference.

Progress on some fronts

Cities across Europe have been focusing on initiatives to respond to climate change.

The report spotlighted some progress that was made by cities and countries. In 2024, Europe generated 45% of its electricity needs from renewables, up from 43% in 2023.

The number of EU countries where renewables generate more electricity than fossil fuels has nearly doubled since 2019, rising from 12 to 20, according to reports.

In addition, around 51% of European cities have adopted climate adaptation plans, which is almost double the 26% in 2018. Urban areas are responsible for 70% of all carbon emissions globally and the United Nations has pushed for cities to take action as they can play a big role in our response to the climate crisis.

Around 100 scientists in Europe and around the world worked on this report, and WMO head Saulo emphasized the need for continued action: “Every fraction of a degree matters. Climate adaptation is not the future option. It’s a very real necessity now, today, not tomorrow.”

Image Credits: Unsplash, European State of the Climate 2024 report.

US Health Secretary Robert F Kennedy Jr.

The United States federal government’s response to the rapidly spreading measles outbreak has faced steep criticism after Health and Human Services (HHS) Secretary Robert F Kennedy Jr (RFK Jr) falsely claimed the vaccine’s protection “waned quickly” and hasn’t been “safely tested.” 

While Kennedy endorsed the measles vaccine as the most effective way to protect against the disease, he has simultaneously sowed doubt in multiple statements. 

Meanwhile, a second unvaccinated US child has died from measles, a highly contagious but vaccine-preventable virus. 

More than 712 patients have been affected as of 10 April, according to the Centers for Disease Control and Prevention (CDC). 

The outbreak is quickly becoming the largest, and deadliest, in recent US history, threatening the country’s measles elimination status, which it has enjoyed since 2000.

Since then, slipping vaccination rates have meant communities have lost the herd protection needed (a vaccination rate of at least 95%) to keep cases from spiraling out of control. Prior to this outbreak, a child hadn’t died from measles since 2003 in the US.

Public health experts – pediatricians, epidemiologists, and government officials -– and Kennedy’s anti-vaccine supporters have criticized HHS for its contradictory and misleading statements.

“RFK Jr has stated that the measles vaccination routinely causes deaths, which is not true. The truth is that measles vaccination has prevented more than 60 million deaths globally. Vaccinating your children not only protects them, but also entire communities,” said Dr Tom Frieden, former CDC Director during the Obama administration and CEO of Resolve to Save Lives.

 “Measles has historically killed between one and three people per 1,000 cases, and those that died were usually immunocompromised. This year is different: two of the three deaths have occurred in healthy children,” noted W Brian Byrd, Public Health Director in Tarrant County, Texas, in a social media post.

“Most of us believe this outbreak is larger than what is being reported.”

Cases spread to Oklahoma, Ohio, Pennsylvania, Indiana, Arkansas

The US measles outbreak began in West Texas in late January, concentrated in unvaccinated children and adolescents. Three measles-related deaths have been reported – two unvaccinated children and one unvaccinated adult.

Since the outbreak began, 11% of the 712 cases have been hospitalized, according to the CDC. The World Health Organization (WHO) reported a 17% hospitalization rate. 

Measles is the most contagious infectious disease, causing high fever, runny nose, and a full-body rash. There is no specific treatment for measles. 

While the epicenter of the outbreak remains Western Texas and New Mexico (90% of cases combined), a total of 25 jurisdictions – including Indiana, Ohio, Michigan, Pennsylvania, and Arkansas – have reported cases, some for the first time in years.

Measles in the US, 9 April 2025

Across the country, childhood vaccination rates have dipped to 92.7%, several points lower than the 95% threshold the WHO stipulates will maintain herd immunity. 

In Gaines County, Texas, the epicenter of the outbreak, the vaccination rate is around 82%.

The measles, mumps, and rubella (MMR) vaccine is proven safe and effective, according to the CDC, with rare side effects. Despite this, counties across the country have struggled with falling vaccination rates.

“Talking to the community, they really stopped vaccinating about 20 years ago, which is in line with what we’ve seen in other communities across the United States,” said Katherine Wells, director of public health of a West Texas city.

Mixed messages and mass lay-offs hamstring response

Entire disease communication teams were dismantled during the HHS’s recent sweeping purge of scientists, regulators and public health experts. 

The “reduction in force” (RIF) notices terminated over 10,000 HHS employees across divisions and agencies, including those responsible for communicating with the public about health emergencies. All agency press officers were fired.

In addition, scientists studying vaccine hesitancy recently lost their National Institutes of Health (NIH) funding.

“Eliminating communications staff from CDC means we all have less information on how to protect ourselves from health threats,” said Friedan. 

Jeremy Kahn, Food and Drug Administration (FDA) media relations director, was one of the many communications personnel removed. 

“Whether explaining the nuances of a medication recall or providing guidance during emerging health concerns, our communications helped Americans make informed decisions based on facts rather than fear. There is no question that this delicate balance of transparency and reassurance made tangible differences in public health outcomes,” he said in a LinkedIn post.

In the meantime, Kennedy appeared on several media platforms to discuss his department’s response.

This included claiming that the US’s response should be the “model for the rest of the world,” incorrectly comparing the US’s number of cases to the total cases from Europe’s 44 countries.

Kennedy also claimed that cases were slowing, directly contradicting Texas health officials’ projections that the surge in cases would probably last until the end of the year.

“We think these cases are undercounted,” Dr Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security said at a press conference with Texas health officials, as reported by Politico. “So, you can’t say something is flattening if you don’t know the denominator of cases.”

In a CBS interview, Kennedy made several other claims that have been debunked by health experts: that vaccines were developed without placebos and that they were tested for “three or four days.” Both statements are misleading, according to vaccine experts.

MAHA backlash

Not only has Kennedy’s comments sparked backlash from the public health community, but also from his own ardent anti-vaccine “Make America Healthy Again” (MAHA) following.

After Kennedy posted that vaccines were the most effective way to prevent disease, Del Bigtree, the communications head of his presidential campaign and anti-vaxx advocate wrote on X: “Your post got cut off. The MMR is also one of the most effective ways to cause autism.” 

However, numerous studies have debunked the claim that the vaccine causes autism. 

“Health freedom” advocate Dr Mary Talley Bowden, who gained a following over her support of ivermectin, replied to the post with “I’m sorry, but we voted for challenging the medical establishment, not parroting it.” Ivermectin is a treatment for parasites that was promoted by anti-vaxxers and alternative health advocates as a treatment for COVID-19, although studies have found has little effect on the virus.

But Kennedy’s fluctuating position and mixed messaging appear to be jeopardizing the response to the outbreak, especially in getting more children vaccinated. 

“That’s the way to stop it. This only ends with immunity,” said Jennifer Nuzzo, director of the Pandemic Center at The Brown University School of Public Health, in a statement to NPR. 

Funding chaos shutters disease surveillance labs

Health professionals – including those working on outbreak investigation, maternal mortality, and vector-borne disease – across HHS’s 13 divisions saw mass layoffs as the Trump administration attempts to reduce the size of the federal workforce.

Measles surveillance and messaging were not the only HHS functions crippled in the past weeks.Part of HHS’s unprecedented purge of employees was the closure of the preeminent CDC laboratory dedicated to tracking sexually transmitted diseases (STDs) which affect one in five Americans.

The CDC lab was only one of three globally that tracks particularly notorious drug-resistant STDs.

Leading STD experts, including David C. Harvey,, executive director of the National Coalition of STD Directors, called the lab closure “alarming” and a “critical loss of an essential health function that the federal government should be providing to protect the health of all Americans.”

“The lab closure removes one of the critical tools we use to protect people from drug-resistant infections at the same time our ability to prevent STIs has been set back by massive cuts and layoffs,” Harvey told the news site Healio. 

“We are urging Secretary Kennedy to reinstate these labs and staff in order to protect the public against the ongoing STI epidemic and other infectious diseases.”

It’s not only the US that will be forced to limp its way through outbreaks.

The US was the sole funder of the World Health Organization’s global measles and rubella network of more than 700 laboratories. These key labs face “imminent shutdown” in the wake of US funding cuts, the WHO director general  said to the media last month. Without “Gremlin,” the global surveillance network, outbreaks would not be detected, said Dr Kate O’Brien, WHO director at the department of immunization, vaccines and biologicals.

Surveillance plays a crucial role in understanding disease burden and trends – as well as in identifying outbreaks, like measles. Without public health laboratories, and the staff to communicate during an outbreak, “we are flying blind,” said Dr Tom Frieden, during a podcast interview. 

Image Credits: CBS, CDC.

Jubilant and exhausted members of the INB pose after marathon pandemic agreement talks finally result in unity.

World Health Organization (WHO) member states are very close to agreeing on the entire pandemic agreement – and may even have been able to clinch a deal on Saturday had they not been exhausted after negotiating from Friday morning right through until  9am on Saturday morning, according to sources.

Anne-Claire Amprou, co-chair of the Intergovernmental Negotiating Body (INB), told Associated Press  that “we have an accord in principle” – and indeed they almost do.

By sunrise on Saturday morning, the entire draft pandemic agreement had been agreed on – bar the vexing question of whether technology transfer related to the production of pandemic products should always be voluntary, reported by Health Policy Watch.

Several negotiators also need to get new mandates from their principles before they regroup at the final formal talks on Tuesday where the text expected to be approved for presentation at the World Health Assemby (WHA) next month.

The one outstanding issue involves whether technology transfer for producing pandemic-related health products shall be both “voluntary” and on “mutually agreed terms”, according to a footnote in Article 11.

Thirty legal experts argue in a letter sent to negotiators earlier in the week that the use of “voluntary” will undermine countries’ “sovereign right … to implement legislation within their jurisdiction, and equity in pandemic preparedness and response”.

Several countries have laws allowing non-voluntary measures under exceptional circumstances, including the United States Defense Production Act, and Germany’s Act on the Protection of the Population in Case of an Epidemic Situation of National Significance, passed in 2020 in response to the COVID-19 pandemic.

The INB Bureau proposed on Wednesday that the footnote should read: “For the purposes of this Agreement, transfer of technology refers to an agreed process where technology is transferred on mutually agreed terms. This understanding is without prejudice to and does not affect the measures that Parties may take in accordance with their domestic or national laws and regulations, and compliant with their international obligations”.

Brazil has since proposed a compromise, which reads:  “For the purposes of this agreement, ‘as mutually agreed’ means willingly undertaken and on mutually agreed terms, without prejudice to the rights and obligations of the Parties under other international agreements.”

This compromise appears likely to have struck the right note with member states and it looks as if Tuesday will see text of the entire agreement “greened” to show total agreement – positive news for global pandemic prevention, preparedness and response after three long and tough years of negotiations.

Image Credits: Thiru Balasubramaniam.

Half of the world’s population has no access to any kind of oral care and lives with untreated oral disease every day, according to Dr. Habib Benzian, a dentist and professor of epidemiology and health promotion at New York University.

“There’s no other disease group that affects so many people,” Benzian said.

In fact, oral health issues impact 3.5 billion people globally.

Benzian spoke on the most recent episode of Global Health Matters with Dr. Garry Aslanyan, alongside Bulela Vava, a dentist and president of the Public Oral Health Forum in South Africa. The discussion centred around the World Health Organization’s new global oral health strategy and action plan for 2023 to 2030. The plan calls for everyone to have access to essential oral health services—prevention, care, and rehabilitation—by 2030. However, the vision remains far from being realised.

Why the gap?

Benzian and Vava pointed to several barriers. One is the historical professionalisation of oral health as a separate field, which has led to its exclusion from broader health systems. Another is the framing of oral health as a private responsibility rather than a public health issue, keeping it out of many government-funded healthcare programs. There is also a widespread complacency and a lack of awareness that oral diseases affect overall health and should be taken seriously.

What needs to change?

Advocacy, the speakers agreed. Benzian noted that oral health professionals are often trained in clinical settings and focus on treating individual patients rather than driving systemic change. Yet, as Aslanyan said, the real challenge is for “us all to see our role not only as providers of care, but as mobilisers of community agency.”

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: TDR Global Health Matters.

Africa CDC headquarters
Africa CDC’s head office in Addis Ababa, Ethiopia.

Amid bleak global economic and development aid trends, Africa’s Centres for Disease Control and Prevention (Africa CDC) is piloting innovative financing solutions and doubling down on efforts to get member states to invest more domestic funds in health.

A week ago, Africa CDC launched a new financing guide for member states and on Friday the continental body announced that it was starting to implement the first phase, which will focus on “updating national health financing plans in 30 countries, piloting innovative revenue mechanisms, and launching transparency dashboards”. 

The strategy urges governments to allocate at least 15% of national budgets to health, as agreed by the 2001 Abuja Declaration, which was adopted during another crisis: the HIV and tuberculosis pandemics.

Its proposals on innovative financing include “solidarity levies on airline tickets, alcohol, and mobile services, while exploring how Africa’s US$95 billion in annual diaspora remittances can support national health priorities”, according to the body. 

Finally, it proposes blended financing to “unlock public and private capital for critical investments in infrastructure, digital health, and local production of vaccines and medical supplies”.

Phase 2 (2026–2030) will scale successful approaches and aims to ensure that at least 20 countries can finance 50% or more of their health budgets through sustainable domestic sources.

“Africa cannot continue outsourcing its health security,” said Dr. Jean Kaseya, Director General of Africa CDC. “This strategy is not about aid—it’s about ownership. We are building a future where Africa invests in its people, drives its own health agenda, and responds to crises with speed, strength, and self-reliance.”

Mpox continues to rise

Professor Yap Boum of the Incident Management Support Team

Meanwhile, at the Africa CDC briefing on Thursday, Professor Yap Boum, the Africa CDC’s deputy head of the Incident Management Support Team, reported that Uganda’s mpox outbreak is continuing to spread, increasing by 30% in the past week (from 190 to 247 confirmed cases).

Boum attributed the spread of Clade 1b to complex sexual networks, including sex workers with multiple daily clients.

“Mpox, specifically the Clade 1b strain, is sexually transmissible. Yesterday, Uganda’s incident manager informed us that there are sex workers who have up to 10 clients per day,” said Boum.

“Sexual networks remain the key driver of the outbreak [in Uganda], with cases spreading in slums, semi-urban, and urban areas. Last week, Mbarara City and Masaka City accounted for 50% of daily incidence,” Boum noted.

Unlike the Democratic Republic of Congo (DRC), however, Uganda is managing to test all its suspected mpox cases, 60% of which have been positive.

Uganda has also faced Ebola and Crimean-Congo hemorrhagic fever (CCHF) outbreaks in the past month.

While mpox cases in the DRC decreased slightly over the past week, the burden is likely underestimated because of challenges with testing, which has been adversely affected by the withdrawal of US funding and conflict in North and South Kivu.

Kinshasa was also affected by torrential rains in the past week that resulted in the Limete Health Center and other health facilities being submerged under water, damaged roads and power and water outages across multiple health facilities in Kinshasa.

However, testing in the DRC has risen over the past week from 18.4% of suspected cases to 21.7%, largely as a result of decentralised laboratory services. Three new Gene Xpert testing machines have been deployed and 26 laboratories are now functional.

Image Credits: Africa CDC .

Dr Tedros Adhanom Ghebreyessus

Health services worldwide have been “severely disrupted” by the United States slashing aid, and the World Health Organisation (WHO) is radically reducing its operations following the US withdrawal from the global body – but there has been no formal engagement between the WHO and the White House.

WHO Director-General Dr Tedros Adhanom Ghebreyessus revealed this at a press conference on Thursday, reporting that three-quarters of the over 100 countries had reported “severely disrupted” services, a quarter had closed health facilities and a quarter were charging patients more for services.

The US owes the WHO $260 million in membership fees for 2024-25. The Biden administration failed to pay fees last year and the US is liable for this year’s fees as it is obliged to give a year’s notice of its withdrawal form the body. 

But there has been no formal engagement between the WHO and the White House since Trump issued an executive order on 20 January withdrawing from the WHO, said Tedros.

“I hope there will be some formal engagement, or a very honest and candid dialogue for the US to come back to the World Health Organisation. It’s in the best interest of the US to stay in WHO. It’s a health security that keeps the US safe and the rest of the world safe,” he added.

Ongoing talks between the remaining 192 WHO member states on a pandemic agreement, expected to conclude this week, would “set the rules of the game” in a future pandemic to ensure that the world is safer, added WHO Deputy Director-General Dr Mike Ryan.

“The great thing about an international rules-based system is we all agree how the game is played, and we really do need to play a better game in the next pandemic, and this is the way to do it,” added Ryan.

The US has pointedly removed itself from the pandemic agreement negotiations, erroneously claiming that a pandemic agreement will infringe on its soverignty.

Prioritise the poorest

In response to the loss of US aid, countries are “revising budgets, cutting costs and strengthening fundraising and partnerships,” said Tedros, reporting on efforts by South Africa, Nigeria and Kenya to increase their domestic allocations to health.

He advised countries to prioritise their poorest citizens, protecting them from being impoverished by additional health spending, and to resist cutting public health spending, instead improving efficiency.

“Absorb as much of the impact as possible through efficiency gains in health systems, including.. improving procurement, minimising overheads, pooling purchasing of goods and services, and using health technology assessment to guide decisions on which services and products provide the biggest health gains,” Tedros advised.

Countries can also increase revenue by introducing or increasing taxes on products that harm health, including tobacco, alcohol and sugary drinks, he added.

Unpaid WHO membership fees

Dr Mike Ryan

The WHO is in the midst of intense reprioritisation following the loss of around a quarter of its budget. It faces a gap of $2,5 billion for the 2025/27 period, according to a recent Health Policy Watch report.

Ryan, who chairs the WHO prioritisation committee, said that the pain being experienced at WHO was a “ha’penny space” in “the hierarchy of suffering”.

“However, we recognise that we’re in a situation where, with the advice and with cooperation with our member states, we need to contract the amount of money we absorb as an organisation to do the work we do,” said Ryan.

“We’re approaching that very, very responsibly in terms of cost containment, resource mobilisation” and prioritisation of activities, he said.

“We have to have a new budget on the table for the World Health Assembly [next month]… and there will have to be a new set of priorities, and obviously an organisational design that can deliver that.”

Aside from $260 million hole left by the US withdrawal, other member states owe the WHO $193 million in unpaid membership fees (called “assessed contributions”), according to a report compiled for the World Health Assembly next month.

The voting privileges of Afghanistan, Central African Republic, Comoros, Dominica, Lebanon, Sierra Leone, Somalia, South Sudan, Sudan, Venezuela and Yemen remain suspended as a result of unpaid fees.

Algeria, Bolivia, Cameroon, Grenada, Iran, Myanmar, Panama and Saint Lucia may also lose their voting rights as a result of unpaid fees for 2024 and 2025.

Gaza blockade

A child forages in Gaza rubble.

Tedros also condemned Israel’s “complete blockade” of Gaza since the breakdown of the ceasefire on 2 March, in which it has prevented all food and medicine from entering into Gaza.

“In the past week, 75% of UN missions within Gaza have been denied or impeded. This blockade is leaving families hungry, malnourished, without clean water, shelter and adequate health care, and increasing the risk of disease and death,” said Tedros.

During the ceasefire, WHO had been able to resupply the health system and its warehouses but those supplies “will run out in two to four weeks unless the siege is lifted”, he added.

“Some 180,000 doses of routine childhood vaccines, enough to protect 60,000 children under the age of two, have not been allowed to enter leaving newborns and young children at risk,” said Tedros.

“Since the breakdown of the ceasefire, almost 400,000 people are estimated to have been displaced again with no safe place to go, and almost 1500 people have been killed, including 500 children,” said Tedros.

“The health system is only functioning partially and is overwhelmed. Meanwhile, healthcare continues to be attacked. On the 23 March, the Israeli army attacked a medical and emergency convoy, killing 15 health and humanitarian workers.”

On Wednesday, WHO assisted in evacuating 18 patients and 29 companions to Norway, Malta, Luxembourg and Romania but “more than 10,000 other patients are still awaiting evacuation” for medical treatment.

“WHO calls for the urgent lifting of the aid blockade, the protection of healthcare and embedded humanitarian access across Gaza, the immediate resumption of daily medical evacuations, the release of hostages still detained in Gaza, and above all, a ceasefire,” Tedros concluded.

Image Credits: UNICEF/UNI501989/Al-Qattaa.

A technician works on production of medicines.

Patients will face costlier medicine and European and Indian drug companies face billion-dollar losses if US President Donald Trump’s threat issued late Tuesday of “a major tariff on pharmaceuticals” produced outside his country is realised.

However, amid chaos on the financial markets, Trump back-pedalled on Wednesday and announced a 90-day pause on all tariffs except for China – where he announced a 125% tariff on Chinese goods.

Trump’s threat was made a few hours after major European pharmaceutical companies met with European Commission (EC) President Ursula von den Leyen, urging her to negotiate with the US or they would face supply chain issues, according to Euro News.

The European Federation of Pharmaceutical Industries and Associations (EFPIA) issued a “stark warning to President von der Leyen that unless Europe delivers rapid, radical policy change then pharmaceutical research, development and manufacturing is increasingly likely to be directed towards the US,” in a statement on Tuesday.

Eighteen EFPIA member companies identified “as much as 85% of capital expenditure investments (approximately €50.6 billion) and as much as 50% of R&D expenditure (approximately €52.6 billion) potentially at risk” in an industry survey. 

“This is out of a current combined total of €164.8 billion in investments planned for the period 2025-2029 in the EU-27 territory. Over the next three months, companies that responded estimate that a total of €16.5 billion ie. 10% of the total investment plans is at risk,” the federation noted.

‘Little incentive to invest in Europe’

“In addition to the uncertainty created by the threat of tariffs, there is little incentive to invest in the EU and significant drivers to relocate to the US,” the federation warned, noting that the US “now leads Europe on every investor metric from availability of capital, intellectual property, speed of approval to rewards for innovation.

They called on von der Leyen to develop a competitive EU market that “rewards innovation”, stronger intellectual property provisions, and “policy coherence across environmental and chemical legislation to secure a resilient manufacturing and supply chain of medicines in Europe”.

“Europe needs to make a serious commitment to invest in a world-class pharmaceutical ecosystem, or at best, risk being reduced to a consumer of other region’s innovation.”

Pharma giants Bayer, Novartis, Novo Nordisk, Roche and Sanofi are based in Europe. Their shares all tumbled by around 5%, while US pharma companies’ shares fell by 3-6 %, according to Reuters. Shares in the UK-based AstraZeneca and GSK also lost value.

Costly to relocate

The share price of US pharmaceutical giants including Pfizer, Johnson & Johnson, Eli Lilly, Bristol-Myers Squibb, Gilead and AbbVie also lost value. These have significant European manufacturing capacity, based primarily in Ireland and it would be costly to relocate.

Han Steutel, head of the German Association of Research-Based Pharmaceutical Companies (VFA), said that moving production to the US could cost billions of dollars and take five to 10 years to set up.

“It will be devastating for patients if medication is no longer available as they cannot easily switch from one drug to another, like with other commodities,” Steutel told CNBC.

‘We are a global industry in terms of research and development and production,” said Steutel. “Unlike with generic companies, the active [pharmaceutical] ingredients for patented drugs are solely produced in Europe or the US,” he said.

“If a company has a plant producing this in Europe it’s not going to set up another plant in the US or vice versa because it would just make the production process inefficient,” he noted.

Huge losses for Indian companies

​​However, 90% of API for US medicines are manufactured outside that country – by 2021, mostly in India (48%), followed by Europe (22%) and China (13%). 

Indian companies face potentially huge cost increases from tariffs on pharmaceutical products as the US is their biggest market – worth $8.7 billion in 2024, according to the Pharmaceuticals Export Promotion Council of India.

Some 45% of US generics are made in India and tariffs would cause price hikes that would affect both patients and companies outside the US.

However, given Trump’s last-minute flip-flop on tariffs, uncertainty is only certain element of the US’s global trade war.

Image Credits: AMR Industry Alliance.