The ECDC chief said the move is part of a broader strategy to increase global public health cooperation before the next pandemic.

The European Centre for Disease Prevention and Control (ECDC) will sign an official memorandum of understanding with its Japanese counterpart next month, the director of Europe’s largest public health agency announced Wednesday.

“Next month I will sign a cooperation agreement with the Japanese Center for Disease Control,” said Pamela Rendi-Wagner, who took over the agency in June.

Her remarks came at a closed-door press briefing on pandemic preparedness at the European Health Forum in Gastein, Austria. She said the deal was part of a wider European effort to expand global cooperation within and outside the EU to better prepare for future pandemics.

“Scientists [globally] need to understand each other before the crisis, not during the crisis,” Rendi-Wagner said. “We learned our lessons from the pandemic.”

The ECDC chief added that the agency has deepened its ties with many other centres for disease control globally since the COVID-19 pandemic, including a four-year partnership with Africa CDC signed in 2021 with financial support from the European Commission.

The memorandum of understanding with Japan will add the country to a list of CDCs that have signed such agreements with the European agency, including those in the United States, China, Mexico, the United Kingdom and South Korea.

ECDC collaborators without official agreements include regional CDCs in Africa, the Caribbean and Gulf states, as well as Israel, Singapore, Thailand and Australia.

In her closing remarks, the ECDC chief warned global public health authorities that the window to prepare for the next pandemic “will close” and urged immediate action.

“Only joint and cooperative preparedness will allow us to cope with pandemics in the future,” Rendi-Wagner said.

Image Credits: ECDC.

Clinician monitors telehealth platform
A clinician monitors a Pan-American Health Organization-developed telehealth platform in Trinidad and Tobago.

Investing in as little as $0.24 per patient per year in digital health interventions – telemedicine, mobile messaging, and chatbots – could significantly lower the burden of non-communicable diseases (NCDs), says a new report from the World Health Organization (WHO) and the International Telecommunication Union (UTI). These interventions could avert 2 million deaths and 7 million acute events and hospitalizations over the next decade. 

The report comes as the United Nations General Assembly meets in New York City this week. 

Non-communicable diseases cause 74% of all deaths globally and are on track to cost $30 trillion in lost productivity by 2030. 

The newly released publication highlights the promise of digital health interventions in tackling this growing crisis, especially through expanded healthcare access. Behavioral choices fuel many NCDs, says the report, and digital health could enable individuals to “take control of their own health and well-being” through personalized health content delivery.

Digital health interventions proved to be powerful tools in managing NCDs during the COVID-19 pandemic, from electronic vaccine passes to telemedicine, but the report warns that the rollout of these technologies requires widespread access, and guardrails to protect patient data. 

“The future of health is digital,” said WHO director-general Tedros Adhanom Ghebreyesus and Doreen Bogdan Martin, ITU secretary-general in a statement. “We must work together to promote universal access to these innovations and prevent them from becoming another driver of inequality. While the new technologies hold great potential, strong governance, ethics, digital skills and equity are essential to realize their potential and to avoid risks such as unethical data collection and biases encoded in artificial intelligence.”

Chat bots, telemedicine, online counseling could “close gap” of NCD care

Digital health benefits for NCDs
Th report found that up to 2 million lives could be saved in the next decade if countries invest in less than 25 cents per patient yearly.

Chronic conditions typically require long-term management, which is often unavailable at primary health care level in many low- and middle-income countries. 

So digital health solutions “can help patients to track their symptoms, manage their medications and monitor their progress over time,” the WHO report notes.

Patients, healthcare providers, and the public can use these tools for diagnosis, treatment and management and for disease prevention through diet and  lifestyle interventions. 

Digital health interventions span a host of technologies, including: online programs for patient education; mobile apps, virtual reality, and other telehealth and telemedicine technologies for rapid diagnosis and treatment; connected and wearable devices for monitoring health conditions; as well as online peer support and counseling. Meanwhile, the health sector is incorporating artificial intelligence and big data-enabled apps to diagnose, monitor, and support NCDs. 

“The digital revolution has the potential to unleash a health revolution,” said Bogdan-Martin at the report release, on the margins of the UN General Assembly’s Summit for the Future in New York City. 

Digital tools can support individuals in understanding their risk factors for NCDs, WHO said in a statement. “Four major risk factors linked to our everyday environment – tobacco use, unhealthy diet, the harmful use of alcohol and physical inactivity – drive responses in our bodies that also increase NCD risk: raised blood pressure, obesity, raised blood glucose and raised cholesterol.” 

Mental health conditions – prevention and treatment

The report warns that in addition to NCDs, mental health conditions present a looming concern – and one that is in dire need of more healthcare coverage, including through digital solutions. In 2019 alone, nearly a billion people lived with a mental disorder, of whom only a “fraction” received care. These conditions account for the largest proportion of years lived with disability, and lead to a higher risk of premature death. 

With expanded healthcare delivery options, argues the report, people with mental health conditions are more likely to seek timely care. For a person living with dementia, for example, a service like mobile messaging with a doctor provides discreet access to support. 

These measures can continue to optimize health service delivery and influence health-related behavior, especially when it comes to preventing and managing NCDs, says the report.

COVID-19 pandemic shed light on digital health potential

digital health strategies for NCDs
Digital health can help prevent non-communicable diseases through education, monitoring, and increased access to care.

With healthcare systems disrupted during the COVID-19 pandemic, many providers switched to offering digital services when possible. Health systems quickly turned to online counseling, telemedicine, and digital vaccine records to continue providing care.

“Although interest in digital health grew during and after the pandemic, few solutions have scaled successfully,”  Alexey Kulikov, deputy head of secretariat for the UN NCD Task Force, told Health Policy Watch. “A key challenge has been the use of siloed, monolithic systems that lack integration with broader digital infrastructure, making them hard to manage. The report promotes ‘smart’ investments in digital health, emphasizing a whole-of-government, collaborative approach that focuses on interoperability and cross-sector integration for long-term success.”

Now, for patients in rural or underserved areas, the benefits of digital health measures means telemedicine is here to stay to overcome the barriers to accessing health care, including geographical distance, transport and cost.  “Additionally, digital health contributes to environmental sustainability by reducing the need for travel through
telemedicine and virtual care, thereby lowering healthcare’s carbon footprint,” noted Kulikov.

While significant progress has been made in combating NCDs, the integration of digital health technologies into mainstream health systems remains a “challenge,” the WHO said in a statement. For countries still developing internet infrastructure, digital health programs must first overcome internet access issues, and begin developing digital health strategies. 

Only 60% of countries have such a strategy, and many are slow to integrate new technologies into existing health infrastructure, the WHO notes. Which is why the report highlights the urgency for country-level investments in digital infrastructure.  

“We call for greater collaboration between the health and tech sectors, including the development of strong digital public infrastructure, essential for the delivery of digital health services that can benefit people everywhere without leaving anyone behind,” said Bodgan-Martin.

Image Credits: PAHO, WHO , WHO.

Over 130 United Nations member states convened in New York City Sunday and Monday for a long-anticipated Summit of the Future  that aimed to press the “reset button” on stalled global development goals and polarized geopolitical debate.

The event, held  just ahead of the annual debate in the U.N. General Assembly, kicked off with the adoption of the “Pact for the Future,” alongside two key annexes: a “Global Digital Compact” and the “Declaration of Future Generations.”

The non-binding declarations cover the world’s most critical global issues, including: peace and security, sustainable development, climate change, digital cooperation, human rights, gender equality, and empowering youth and future generations.

The pact outlines 56 specific “actions” that member states need to take, underscoring the growing complexity of threats to global peace, highlighting the dangers of nuclear conflict, and confirming the core principles of the United Nations.

A central promise of the pact is accelerating progress on the 2030 Sustainable Development Goals (SDGs), which aspire to universal healthcare access, the eradication of extreme poverty and hunger, the promotion of gender equality, climate and environmental sustainability and the expansion of education worldwide.

“With so much dividing us and with so many wars going on, I think we can salute yesterday’s agreement and that we came together and be able to agree on ambitious targets,” said Norwegian Prime Minister Jonas Gahr Støre, speaking at Monday’s session.

“The pact for the future provides a vision for this across all the UN’s three main pillars that should be solutions… First, we have reaffirmed our commitment to international law, including human rights… Those who deliberately breach it must be held accountable.”

Address climate change and transform energy systems

“Second, we urgently need to address climate change, cut emissions, transform our energy systems and protect the environment,” he said, noting that addressing climate also requires increasing climate finance and investments and providing provide sufficient and timely debt relief to deeply indebted low- and middle-income countries.

The pact also calls for the global community to work towards an inclusive, open and secure digital future for all, he noted, pointing out that “some 2.6 billion people remain excluded from the digital world. For too many people also they lack access to electricity.”

Finally, he called for “preventive diplomacy and peace building” to be at the center of global efforts on sustainable development, including “a more transparent, inclusive and effective Security Council with great limitations to the use of veto,” as well as a greater presence of under-represented groups in global governance.

Is this pact a genuine path forward, or is it another lofty rhetoric exercise?

Despite the bright notes, many critics question the real-world impact the pact will have, in light of the world’s geopolitical polarization and stalled progress already seen on most SDGs.

“It was great to see people clapping for the new Pact, but the lagging SDGs problem is not one of planning but rather execution.  Let’s clap louder for results,” Peter Singer, a former top advisor to Director General Tedos Adhanom Ghebreyesus, told Health Policy Watch. “That means complementing SDGs with GSD (Getting Sh*t Done): better governance, scaling innovation, and translating data into delivery.”

Only 17% of the 2015 SDG targets are on track to reach the 2030 Goals, Singer pointed out in a blog published just ahead of the Summit.

“Rather than critically examine why the SDGs are off track and support countries to overcome these obstacles, the U.N. comes up with a new list of things it wants to accomplish,” Singer continued. “But if you failed to accomplish the last thing you promised and now do not critically examine the underlying reasons for that failure, why would anyone believe you could accomplish the next big thing?

“This is the same for health as it is for every SDG.  SDGs are fought and won in countries, but the UN can start by ‘cleaning its house from the inside out.’”

Guterres hails the pact as ‘step-change’

Defying the doubters, U.N. Secretary-General Antonio Guterres hailed the adoption of the Pact for the Future, at the start of the two-day summit as a “step-change towards more effective, inclusive, networked multilateralism.

“Excellencies, throughout my life, whether as an activist or at the United Nations, I have learned that people never agree on the past. To rebuild trust, we must start from the present and look toward the future,” Guterres said.

U.N. Secretary-General Antonio Guterres
U.N. Secretary-General Antonio Guterres

The pact, negotiated over the past nine months, represents the fruits of a dialogue launched in 2020 as the United Nations marked its 75th anniversary with a “global conversation” on people’s hopes and fears for the future. That dialogue set the stage for what would eventually become the Summit of the Future four years later.

Guterres had long championed the need for both the summit and the pact, emphasising that global crises have exposed the urgent necessity for U.N. reform and the transformation of international financial systems. These crises include ongoing conflicts in Russia/Ukraine, Israel/Gaza, and Sudan, insufficient progress on climate change, mounting national debt, and the unregulated rise of new technologies.

“I called for this Summit because 21st-century challenges require 21st-century solutions: frameworks that are networked and inclusive, drawing on the expertise of all humanity,” Guterres said in his opening speech on Sunday “Our world is heading off the rails, and we need tough decisions to get back on track.”

Specifically, he has called for major reforms to global institutions, including changes in the structure and rules governing the 15-member U.N. Security Council, where constant vetos by Russia, China and the United States of initiatives backed by rivals have progressively weakened the clout of the global body.  Guterres has also stressed the importance of redesigning multilateral finance and developing a system of global governance over the use of artificial intelligence.

Philemon Yang, President of the 79th U.N. General Assembly
Philemon Yang, President of the 79th U.N. General Assembly

Cameroon’s Philemon Yang, President of the 79th U.N. General Assembly, echoed these sentiments as he opened the event, saying, “We stand at a crossroads of global transformation, facing unprecedented challenges that demand urgent, collective action.” He continued, “The commitments embodied in the pact and its annexes reflect the collective will of member states. They must guide our actions to promote international peace and security, accelerate the sustainable development goals, foster just and inclusive societies, and ensure technologies serve the common good of humankind. We must move forward together in a spirit of solidarity and multilateral cooperation.”

Throughout the summit’s two days of speeches and presentations, delegates discussed the pressing need for a transformed United Nations capable of addressing today’s intertwined political, social, economic, and ecological crises. Key issues raised included failing to meet sustainable development and climate change goals, rising global military expenditures, and the need for debt relief to low-income nations that cannot afford to provide basic services.

Nearly half of the world’s population live in countries spending more on debt than health or education

“Our delivery and commitments made on sustainable development and climate change have been so much less than what was committed,” said Michael D. Higgins, President of Ireland. “The failure to achieve peace, eliminate acute global poverty, hunger or the consequences of climate change and biodiversity loss have been accompanied by a return to an arms race. Last year, global military expenditure increased by 6.8% to $2.44 billion, the highest ever recorded.”

Michael D. Higgins, President of Ireland
Michael D. Higgins, President of Ireland

Some 3.2 billion people live in nations that spend more on debt interest payments than on essential services like education and healthcare, Higgins added. Along with gaps in basic social services, the debt burden also leaves them with insufficient resources for making capital investments in the energy transition and sustainable development.

Charles Michel, President of the European Council
Charles Michel, President of the European Council

“We need to make our international financial architecture more effective and more inclusive,” agreed Charles Michel, President of the  European Council, the European Union’s governing body.

“Developing Countries need more private and public money now. We must also tackle that problem because we cannot accept that low- and middle-income countries must choose between fighting poverty and fighting climate change. They must do both, and we must support them to do both.”

Reforms in the UN Security Council

Kuwait, meanwhile, stressed the need for reforms to the U.N. Security Council, including fairer geographic distribution of Security Council membership.

Crown Prince of the State of Kuwait, Sabah Al-Khalid Al-Sabah
Crown Prince of the State of Kuwait, Sabah Al-Khalid Al-Sabah

“We agree with the Secretary General when he said that it is impossible to put the future for our children and grandchildren through an order or a system that was built by our forefathers without taking into account the future of young people,” said the Crown Prince of the State of Kuwait, Sabah Al-Khalid Al-Sabah.

“We are required today to work on introducing serious and practical changes to the global economic governance system, to networks of financial security, to international tax cooperation. We must reform multilateral development banks and address the problem of sovereign debts.”

Harnessing Technology

The challenges and opportunities presented by new technologies, particularly artificial intelligence, was another topic at the center of discussion.  Member states also stressed the importance of ensuring more equitable access to digital tools essential to education, healthcare, poverty alleviation and sustainable development.

“We believe that science and technology are foundations of a sustainable environment. Therefore, we are working on the digital transformation of our economy and providing an integrated and comprehensive database to support decision-making,” said Mohammed Shia’ Al Sudani, the Prime Minister of Iraq. This requires equitable access to AI tools and the capacity to benefit from AI and other digital technologies in a “responsible and moral way” he emphasized.

Jamaica's Prime Minister, Andrew Holness
Jamaica’s Prime Minister, Andrew Holness

Jamaica’s Prime Minister, Andrew Holness, expressed similar sentiments, adding that “admittedly, new technologies, such as artificial intelligence and robotics, create new challenges to security and some livelihoods. However, they also create important opportunities, especially for young people, and hold great potential to empower generations, transform economies, and solve complex challenges. So great is the potential, in fact, that we must emphasise the importance of international cooperation to address the challenges and harness the opportunities, especially for the benefit of people in developing countries.”

War and peace: Addressing ‘double standards’

The ongoing destruction of war in regional hotspots, particularly Ukraine and Gaza served as a grim backdrop to discussions.

garbage accumulates in gaza, raising risk of polio
Garbage accumulates in Gaza, contaminating water supplies and raising the risk of polio.

Kuwait’s Al-Sabah called for ‘universal adherence’ to international law and conventions, and the elimination of double standards. He pointed to the situation in Gaza as an example of the U.N. Security Council’s failure to prevent aggression and highlighted the damaging consequences of inconsistent enforcement of international law.

He further urged the international community to prioritise reforming global governance, and to establish a more inclusive, effective, transparent, and accountable Security Council.

Qatar, a key player in the Israel-Hamas negotiations over a ceasefire in exchange for a release of Israeli hostages still held by Hamas, also referred to the Gaza conflict, stressing that development cannot be achieved without solid peace, security, and stability foundations.

“Qatar maintains its efforts in mediation to prevent and resolve conflicts in a peaceful manner,” said Prime Minister Sheikh Mohammed bin Abdulrahman Al Thani.

“We reiterate our call to reach a ceasefire agreement and to release all hostages,” Al Thani said. “We call on the international community to take a clear and decisive stance against violations of international humanitarian law and human rights law.”

Japan, meanwhile, addressed the “increasingly dire situation” around nuclear disarmament and non-proliferation, nearly 80 years after American nuclear bombing raids on the Japanese cities of Hiroshima and Nagasaki.

“No matter how difficult the path to a world without nuclear weapons may be, we cannot stop our progress,” said Japan’s Prime Minister, Fumio Kishida.

Call to action on adolescent health

Another aspect of Summit emphasis was the future of the world’s youths. And related to that, WHO issued a call on the summit margins for greater attention to the mental, sexual and reproductive health of adolescents.

“Promoting and protecting the health and rights of young people is essential to building a better future for our world,” said Tedros in one of Monday’s breakout sessions, that saw the launch of a WHO report on adolescent health.

The WHO report found that least one in seven adolescents globally now suffer from a mental disorder; close to one in 10 teenagers is obese; and sexually transmitted infections are on the rise.

“Failing to address the health threats that adolescents face – some long-standing, some emerging – will not only have serious and life-threatening consequences for young people themselves but will create spiralling economic costs,” Tedros pointed out.

He condemned efforts to restrict young people’s access to sexual and reproductive healthcare, and sex education, which he said were a result of the recent pushback against gender equality and human rights in some countries and societies.

He emphasised that policies imposing strict age limits on young people’s access to vital reproductive health services, will only boomerang, leading to more HIV/AIDS and other sexually transmitted infections, as well as other spiraling health impacts on societies.

There are around 1.3 billion adolescents globally today – more than ever before.

“Adolescents are powerful and incredibly creative forces for good when they are able to shape the agenda for their wellbeing and their future,” said Rajat Khosla, executive director of the Partnership for Maternal, Newborn and Child Health, which co-hosted the launch of the WHO report. “Leaders must listen to what young people want and ensure they are active partners and decision-makers.”

Image Credits: Screenshot, UNRWA , Reproductive Health Supplies Coalition/ Unsplash.

The chairs of the One Health congress, Marietjie Venter and Misheck Mulumba, with a representative from Singapore, which hosted the last congress.

CAPE TOWN – Drug-resistant pathogens have been found in the Kuwaiti sea, soil and rivers in South Africa, Nigerian poultry, Ugandan pigs and numerous other sites, according to scientists at the eighth global One Health congress held in Cape Town over the past four days.

This evidence was presented on the eve of Thursday’s United Nations High-Level Meeting on Antimicrobial Resistance (AMR), where global leaders are due to adopt a political declaration aimed at addressing the alarming possibility that drug resistance will render many antibiotics useless in coming years – leaving humans vulnerable to death from common germs.

Around three-quarters of antibiotics are used on animals and AMR can only be addressed if urgent changes are made to agricultural practices, particularly in low and middle-income countries (LMICs), focusing on the overuse of antibiotics, and the management of wastewater.

This underscores the importance of a One Health response, which means developing an integrated approach to human, animal and environmental health.

Sewage is a major source of AMR

Mary Chibwe reported on high levels of AMR in a South African river.

Sewage is a major source of AMR, yet farmers in many countries use untreated wastewater to irrigate their crops. This spreads pathogens to vegetables and the animals and humans that eat them.

Lack of sanitation is also driving AMR. Researcher Mary Chibwe painted an alarming picture of a South African river teeming with pathogens in the places where people lived alongside it in shacks. With no sanitation, everything ends up in the water – including human and animal faeces, used nappies, trash and unfinished medicine, said Chibwe.

“Industrial effluents are also contributing to AMR, through the discharge of heavy metals, residues and other pollutants,” she added.

Chibwe’s research found 87,5% of water samples were positive for Campylobacter, a bacteria that causes diarrhoea, in parts of the Swartkops River where there was high human activity. (The river flows near the biggest city in South Africa’s Eastern Cape province.)

Some 81% of these samples contained Campylobacter multi-drug resistant gene B, and 62,5% were resistant to tetracycline.

China’s Chendi Zhu reported an “alarming” level of AMR in E-coli samples.

China’s Chendi Zhu reported on a study in Guangxi region, home to half a million people. Samples of E-coli were collected from slaughterhouses, local markets, households, farms and hospitals.

“The overall rate of multi-drug resistance was an alarmingly high 87,3%,” he reported. “The high multi-drug resistance rate highlights the critical need for integrated surveillance and intervention strategies that encompass human, animal and environmental health.”

Other studies and posters showed antibiotic-resistant Salmonella in poultry being sold in Ghana and Nigeria, drug-resistant pathogens in pigs in Uganda, and many other alarming examples of how widespread AMR is.

Wild animals are not exempt

Even wild animals are not exempt from AMR. Ghana’s Winnifred Offih-Kyei reported on research on the carcasses of 60 wild animals at a bushmeat market in the Ashanti region. Some 522 bacteria were isolated, and there was an almost total resistance (97%) to Ampicillin, with high resistance to Cefotaxime (84.6%) and Tetracycline (78.2%).

“Wildlife are important reservoirs of AMR,” said  Offih-Kyei. “The continuous consumption of bushmeat may heighten AMR and limit the effective treatment of bacterial infections in both humans and animals.”

Around 60% of emerging infectious diseases come from animals, while three-quarters of the 30 new human pathogens detected in the last 30 years originated in animals, according to the World Health Organization (WHO).

Yewande Alimi, head of One Health and AMR at the Africa Centres for Disease Control and Prevention, told the congress that outbreaks of zoonotic diseases on the continent have jumped from 63% to about 85% in the past decade.

“We are faced with a multi-faceted crises dealing with several other health issues, economic issues, and this is why the One Health approach is important,” said Alimi.

Managing animal, human and environmental health has become more and more important. Thus in 2022, the FAO, WHO, UN Environmental Program (UNEP) and the World Organization of Animal Health (WOAH) formalised their leadership of One Health, now known as the Quadripartite.

Thanawat Tiensen, the Food and Agricultural Organization (FAO)’s Director of Animal Production and Health, speaking via a video message.

Thanawat Tiensen, the Food and Agricultural Organization (FAO)’s Director of Animal Production and Health, described AMR as “a silent pandemic with devastating effect on food production, ecosystems and economies”. 

“FAO is leading the fight against AMR with a 10-year global initiative to reduce the need for antimicrobials on farms for a sustainable agri-food system transformation,” said Tiensen.

In addition, FAO’s international AMR antimicrobial resistance monitoring system called InFARM, helps countries to collect and analyze AMR surveillance and monitoring data, primarily from livestock, fisheries and agriculture, he added.

Strengthening countries’ One Health efforts

Maria Van Kerkhove, interim Director of Epidemic and Pandemic Preparedness and Prevention.

The WHO’s Maria Van Kerkhove, interim Director of Epidemic and Pandemic Preparedness and Prevention, told the congress on Monday that the WHO has identified 18 pathogens that have the potential to cause epidemics and pandemics. These include mpox, dengue, Heniparviruses and Nipah.

The WHO is building a dashboard to map the emergence and spillover potential of these pathogens, which will eventually include diagnostic resources, available healthcare systems services and reporting capacity.

“Our aim is partly efficacy. Working with governments to say: ‘You do know the risks that are there, but how do you consider the following based on the changes that we’re seeing in terms of climate, in terms of urbanization, in terms of displaced people, so that governments can anticipate and be ready.”

WHO is building a data dashboard focusing on 18 pathogens with epidemic and pandemic potential.

There is also a global arbovirus initiative focusing on dengue, chikungunya, yellow fever and Zika and a global focus on respiratory threats, added Van Kerkhove. 

“We would like a world that is on alert. We don’t want every individual on alert. We need governments to be on alert and across different sectors, looking at different legal aspects, looking at financial aspects. So that, where we can prevent, we do and when we can’t, that we mitigate as much as we can. 

“These spillovers that we see happening, which will continue to happen, don’t amplify. And all of this is based on a foundation of science, trust, transparency and collaboration,” she concluded.

Dr Tedros Adhanom Ghebreyesus

Not enough progress was made at the 11th round of the World Health Organization (WHO) pandemic agreement negotiations, conceded Dr Tedros Adhanom Ghebreyesus, the global body’s Director-General on Friday.

“I know you have made progress, but I also know that from what you have been saying, it’s not as good as what we wanted,” Tedros told delegates at the Intergovernmental Negotiation Body (INB) at the end of the two-week-long talks.

According to the latest draft of the pandemic agreement, the most controversial part of the agreement – developing a pathogen access and benefit-sharing (PABS) system (Article 12) – will now be addressed via a separate “instrument”.

The provisions governing the PABS system – described as a “multilateral system for safe, transparent, and accountable, access and benefit sharing for pathogens with pandemic potential” – will be developed by the Conference of the Parties (COP). This COP will be set up after the World Health Assembly has adopted the pandemic agreement.

The COP has also been given responsibility for defining “pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions” for PABS. 

All these details will be contained in a PABS instrument – and no deadline for its finalisation has been set. The COP itself has to be set up within a year of the adoption of the pandemic agreement, so it could be years before any PABS system comes into being.

Some observers have described the current document as “pandemic agreement lite” as it defers many key decisions. Delegates appear to have accepted this deferment, as text dealing with it is “greened” in the draft agreement, indicating its acceptance.

Tedros told the INB that he believed it was still possible for the pandemic agreement to be adopted by the end of the year at a special session of the World Health Assembly (WHA) in December.

However, the next round of negotiations set for 4-15 November, will determine whether this is realistic. Procedurally, 12 November is the latest date by which a December special WHA can be called.

However, the INB Bureau will hold informal meetings with member states during the course of October to try to reach consensus on key articles.

Will Africa trade deferring PABS details for speed?

African member states are anxious for the speedy adoption of the agreement, which currently includes support for “local manufacturing” and technology transfer to help member states to prepare for, and mitigate against, another pandemic.

While the Africa Group has pushed hardest for a PABS system in which countries are rewarded for sharing pathogen information, it may be prepared to accept deferring the PABS system details in exchange for early adoption of a pandemic agreement.

The spectre of the US elections this November and the possibility of a Donald Trump victory is also causing jitters amongst some member states. Trump previously froze the US contribution to the WHO, which severely affected its operations.

On 11 September, the US Congress passed the No WHO Pandemic Preparedness Treaty Without Senate Approval Act, which was introduced by Republicans who claim that the pandemic agreement will undermine US national sovereignty. 

This is despite all iterations of the pandemic agreement affirming member states’ national sovereignty in pandemics.

At the close of the INB meeting on Friday, the representative from Argentina – which now has a far-right government – asserted that the pandemic agreement should ensure no “interference with national regulations and legislation”. 

“My country firmly believes that we need to implement an International instrument to tackle pandemics but this must be designed respecting the sovereignty of all states. Without exception, we must maintain the capacity to legislate and apply our own laws within our jurisdictions as we see fit, with regard to the health of our citizens,” said Argentina, which has resisted joining regional positions on the pandemic agreement with other Latin American countries.

Tedros has previously described the notion that the agreement threatens nations’ sovereignty as “misinformation”, but it hasn’t stopped right-wing groups and parties globally from portraying the agreement as a “globalist power-grab”.

Their campaigning is part of growing nationalist populist rhetoric against international bodies and human-rights-oriented agreements.

This has also been evident in negotiations over the UN’s Summit of the Future starting on Sunday. The UN is due to adopt a Pact for the Future, but this has been watered down by conservative countries – particularly regarding the right to health, gender equity and human rights.

Happier stakeholders

INB co-chairs Ambassador Anne-Claire Amprou and Precious Matsoso

One aspect of INB11 that is different and, by most accounts better, has been the daily consultations with officials stakeholders at the start of each day.

These stakeholders include patient advocates, the pharmaceutical industry, NGOs and academics, who have long complained at being shut out of the talks.

“We’ve seen [stakeholders] engage in the corridors, but this time, it was different, because they also participated in the meeting,” said INB co-chair Precious Matsoso.

“They were able to provide their advice as best as possible, and I must say that there’s a lot of goodwill and there’s a lot of commitment.”

Nina Jamal, Head of Pandemics at the global animal welfare organisation FOUR PAWS, thanked the INB Bureau “for transparency towards relevant stakeholders, increased openness and constructive proposals by member states, promoting successful negotiations”.

Michelle Childs, Policy Advocacy Director for the Drugs for Neglected Diseases initiative (DNDi), said that her organisation welcomed the sharing of the draft texts and daily briefings.

“These help to improve the ability of stakeholders to follow and input and counter misinformation about what is actually being discussed. We encourage further steps to enhance transparency, including making stakeholder interventions publicly available,” added Childs.

‘Messy middle’

The Pandemic Action Network said “progress efforts [were] bumping into the messy middle”, adding that while engagement with stakeholders was better, they want more transparency and access to the actual negotiations.

Matsoso said progress had been made on “research and development, regulatory systems strengthening, One Health, pandemic prevention and technology , supply chain networks and a new system for increased access to pathogens of pandemic potential and sharing of benefits, such as vaccines, diagnostics and treatments”.

“Following nearly three years of negotiations, countries are now focused on the remaining and most critical elements of the draft agreement to protect the world from future pandemics,” Ms Matsoso said.

Matsoso added that “we are going to find a solution in our life time.”

Africa CDC Director-General Dr Jean Kaseya

African heads of state from countries affected by mpox will meet virtually on Sunday to address the “worrying” increase of the virus – with 2,912 new cases and 14 deaths recorded in the past week, the Africa Centres for Disease Control and Prevention reported at a media briefing on Thursday.

“Mpox is not under control in Africa. We still have this increase of cases that is becoming worrying for all of us. In many countries, we have different clades [so] the mpox outbreak is a combination of many outbreaks in one,” Africa CDC Director-General Dr Jean Kaseya told the media briefing.

Clade 1A and Clade 1B are both circulating in Kinshasa, the capital of the Democratic Republic of Congo (DRC) which is worst affected by mpox. 

However, because the continent’s surveillance, testing and laboratory systems are not strong enough, “we cannot confirm that we don’t have this kind of joint circulation of clades” across the continent, Kaseya admitted.

Of the 29,152 suspected mpox cases identified since the beginning of the year, only 6,105 have been confirmed by laboratory testing.

In the past week, Morocco in North Africa reported its first mpox cases, which means that mpox now affects all regions of the continent, said Kaseya.

Japan donates three million vaccines

On Wednesday, the government of Japan signed an agreement with the DRC to donate three million KM Biologics’ LC16 vaccines which, unlike Bavarian Nordic’s MVA-BN vaccine, are authorised for children. Around 40% of the continent’s suspected mpox cases are in children.

However, health workers will need special training to vaccinate people with LC16, which requires a similar process to that of smallpox, said Dr Mike Ryan, the World Health Organization’s (WHO) global head of health emergencies.

“The LC 16 vaccine is not delivered by the same method as the MVA vaccine, and that does introduce complexity to the training and logistics,” Ryan confirmed at a WHO global press conference on Thursday.

“The LC16 is given the same way the previous smallpox vaccination was done, which is scraping intradermally on the skin. That’s quite a skilled technique, and that will take time, and that hasn’t been used in vaccination programs for decades now.” 

Rwanda meanwhile started its vaccination campaign earlier in the week, but it has only received 1,000 donated so far vaccines.

The DRC will start its vaccination campaign in the first week of October, while the Africa CDC expects to soon dispatch vaccines to South Africa, Uganda, Burundi “and any other country that will be in need”. 

It is also establishing an expert technical review committee to assist countries to develop “strong vaccination campaign plans”, said Kaseya.

Isolating at home or hospital?

Burundi, despite having 1,600 case, has recorded zero deaths. However, Dr Ngashi Ngongo, Africa CDC Chief of Staff, told the media briefing that all Burundi’s cases were hospitalised and in isolation.

Dr Maria Van Kerkhove, WHO’s interim director for epidemic and pandemic preparedness and prevention, stressed that it is “really important that cases do isolate, but there are options for where they can isolate”.

“If there’s an indication of clinical severity, if they have a risk of developing severe disease, it’s important that they get appropriate clinical care, so isolation in a hospital is helpful,” said Van Kerkhove.

“But we do have guidance for isolation at home. For people who are presenting mildly, and people who aren’t at risk of developing severe disease, home care is completely appropriate,” she added.

“It is really important that the scabs are covered, that we use good hand hygiene, that the close physical contact between caregivers is done appropriately so that we can prevent onward spread,” said Van Kerkhove.

“Also, it is really critical to clean bed linen and clean clothes, etcetera and that’s very difficult in many different contexts.”

Dr Maria Van Kerkhove, WHO Director for epidemic and pandemic preparedness and prevention.

WHO Director-General Dr Tedros Adhanom Ghebreyesus told the briefing that the mpox virus “is being spread primarily through close personal contact, including sex and within families, through caring for young children, breastfeeding and sharing clothing or bedding”. 

“The response to the outbreak is made more difficult by the context with insecurity in the affected areas and concurrent outbreaks of other diseases, including measles and chicken pox,” added Tedros.

In comparison to a year ago, there has been a 177% increase in cases and a 38.5% increase in deaths in Africa, and the Africa CDC has committed to developing an open-access dashboard that is regularly updated with information about the spread of the virus.

Image Credits: Africa CDC.

Tomnjong Thadeus under a bed net with his three-year-old daughter Gabriella at their home in Soa, Cameroon. Gabriella and her mother have both had malaria and the family now sleeps under nets.

Global Fund investments have reduced deaths in HIV, tuberculosis and malaria by 61% and saved 65 million lives since 2002 – while simultaneously improving health service delivery, according to its annual Results Report released on Thursday. 

The past year (2023) has brought significant wins: a 55% reduction in the price of bedaquiline, the main treatment for drug-resistant TB and a 25% cut in the cost of TLD, the preferred first-line HIV treatment.

It has also introduced new dual-active ingredient insecticide-treated mosquito nets that are 45% more effective against malaria.

These wins are the result of what The Global Fund terms “marketing-shaping”: using its substantial buying power to encourage manufacturers to lower prices. 

While The Global Fund focusses on the three priority diseases, its impact has been far wider. 

‘’In 2023, we invested $1.8 billion, the highest amount ever in a single year, to strengthen health and community systems,” Executive Director Peter Sands told a media briefing on Wednesday.

“In this grant cycle period, [2024- 2026] we’re looking at investing around $6 billion in supporting countries to deliver better health outcomes, through pandemic preparedness, through stronger systems and through accelerating their journey towards universal health coverage.”

One significant area of investment, health facilities’ oxygen supplies, has assisted around 22 million patients with respiratory illnesses.

Peter Sands, Executive Director of The Global Fund.

Reducing health system pressure

The report also quantifies for the first time how its focus on the three diseases has alleviated stress on countries’ health services.

Currently, it supports 25 million people on antiretroviral medication – and this has saved around 1.66 billion hospitalisation days and 1.36 billion outpatient visits, which translates into   a saving of around $85 billion. 

“Where the three diseases absorb over 50% of health system resources, the impact of reducing their burden on overall health system performance can be dramatic,” said Sands. “It means lower infant and maternal mortality and fewer deaths from acute trauma and other conditions.

“In addition, our continued investments in community health workers, labs, supply chains, disease surveillance systems and other health system components better prepare countries to prevent, detect and respond to other diseases like mpox or future pandemics.” 

Nurse Everlyne Esige examines an pregnant mother at Vihiga Hospital in Kenya. A partnership between The Global Fund, Takeda Pharmaceuticals and the Liverpool School of Tropical Medicine has trained health care workers to integrate HIV, TB and malaria services into antenatal and postnatal care

Climate change challenges

The Global Fund invests 70% of its funding in the 50 most climate-vulnerable countries, and its operations have been affected by changing climate – from floods disrupting services to rising temperatures “cooking” valuable medicines. 

However, the most significant impact is on malaria.

“There are two different things going on, said Sands. “One is the gradual rise in temperatures, which means that communities and places that were previously not subject to malaria, often because of higher altitudes which were too cold at night for the mosquitoes, are now becoming susceptible to malaria.”

The second, which is more difficult to predict, is “the impact of climate change on the frequency of extreme weather events, leading to cyclones and flooding” such as seen in Malawi and Pakistan – and resulted in surges in malaria.

But addressing malaria is “particularly challenging”, added Sands, because it is surging in conflict zones there is  “increased resistance both of mosquitoes to insecticides and to the most commonly used treatments”.

To support countries to adapt to the impact of extreme weather and climate events, it restructured grants and offered access to emergency funds in countries such as Zambia, Kenya and Somalia. 

The Fund has also established partnerships with the World Bank and the Green Climate Fund that have “significant expertise and resources around both climate mitigation and adaptation”, said Sands. 

He stressed that very little funding has gone to climate adaptation in health and “we need to work together to respond more effectively to what’s happening, because, if anything, it appears to be happening faster and more significantly than projected”.

Human rights barriers

Lucy Mukasia, a clinician at Kibera Health Centre in Nairobi, Kenya, sorts antiretroviral medicines. But stigma and discrimination are still significant barriers preventing people with HIV from getting care.

In HIV, human rights barriers like punitive laws, stigma, discrimination and violence, including gender-based violence, prevent people from getting HIV prevention, testing, treatment and care. 

“The fight against diseases is as much a fight for justice and equity as it is a biomedical fight,” said Sands. “Even the most innovative biomedical tools will fail if those who most need them can’t get them.” 

To tackle human rights and gender-related barriers to accessing health services, the partnership expanded the Breaking Down Barriers initiative, which aims for inclusivity and equity in healthcare delivery. 

“Our model is anchored by a partnership that thrives on inclusive governance, making us a global movement of civil society, governments, private sector partners, technical partners and communities affected by the three diseases in more than 100 countries,” said Sands. “That partnership came to count enormously as we responded to the many challenges we faced in the year.”

Image Credits: Vincent Becker/ Global Fund, Brian Otieno /Global Fund, Brian Otieno/ Global Fund.

Robert Yates from the London School of Hygiene and Tropical Medicine.

GENEVA – Ensuring that universal health coverage (UHC) protects cancer patients and tackling commercial interests driving cancer were two issues in the spotlight of the World Cancer Congress.

Speakers stressed that they need to make their mark at the United Nations (UN) High-Level Meeting (HLM) on Non-Communicable Diseases (NCDs) in 2025, ensuring a bold rethinking of how healthcare is financed and protected from commercial interests.

The HLM will adopt a political declaration that will determine how NCDs including cancer are addressed to 2030, according to the WHO.

Speakers addressing the plenary called for the intersection of money, politics, and public health commitments to be addressed. 

Universal Health Coverage

“Universal health coverage (UHC) is not just a health goal; it’s a political strategy that leaders can rally behind,” said Robert Yates from the London School of Hygiene and Tropical Medicine. 

UHC aims to ensure that everyone can access essential health services without facing financial ruin and for cancer patients, often burdened by exorbitant treatment costs, this is not just a lofty ideal but a lifeline, Yates explained.

“There is no other way of financing this other than through a predominantly publicly financed health system,” Yates stressed. 

“If we’re serious about UHC, we have to be serious about increasing levels of domestic public financing and making sure that resources are allocated as efficiently and equitably as possible.” 

He urged advocates to focus their efforts on high-level policymakers, particularly ministers of finance and heads of government, to secure the necessary funds.

Cancer care, Yates argued, is central to the UHC agenda, from preventive measures like the HPV vaccine to advanced treatments. 

He pointed to the cost-effectiveness of many cancer interventions as a compelling argument for public investment, citing examples like the inexpensive HPV vaccine that can prevent cervical cancer. “We need to sell the broader benefits of investing in cancer care, including the economic advantages,” Yates said. “It’s about convincing politicians that this is what their populations want – and it’s politically popular.”

The economic impact of cancer and other NCDs extends far beyond individual patients, straining healthcare systems worldwide. 

Bente Mikkelsen,  the World Health Organization’s (WHO) Director of NCDs, said that only 28% of countries have integrated cancer care into their UHC plans. The consequence? Many patients face catastrophic out-of-pocket expenses, plunging families into poverty.

“We have to stop relying solely on international funding and look at sustainable domestic financing,” Mikkelsen urged. 

“Unless cancer is part of the UHC agenda, we will continue to see out-of-pocket payments driving people into poverty.” She emphasized that the link between poverty and NCDs forms a vicious cycle, as low-income individuals are more likely to suffer from these diseases and less able to afford treatment.

‘Voluntary actions don’t work’

Another significant barrier to addressing NCDs is the influence of commercial interests, highlighted Anna Gilmore, Co-Director of the Centre for 21st Century Public Health at the University of Bath

“What’s causing disease and killing us is increasingly the products of commercial organisations – tobacco, alcohol, ultra-processed foods,” Gilmore said. “And the greatest barrier to preventing disease is the practices of those same corporations.”

Gilmore pointed to the WHO Framework Convention on Tobacco Control’s Article 5.3 as a model for protecting public health policies from harmful corporate influences. Article 5.3 specifically requires governments to protect their public health policies from the commercial and other vested interests of the tobacco industry. 

It recognizes the fundamental conflict between public health and the tobacco industry’s profit motives, and it sets out guidelines to limit interactions with the industry, ensure transparency, and prevent conflicts of interest.

“The tobacco industry has a long history of trying to undermine public health efforts through lobbying, funding misleading research, and positioning itself as a partner in health initiatives,” Gilmore explained. 

“Article 5.3 is a critical tool in countering these tactics, as it explicitly calls for excluding the tobacco industry from policy-making processes and ensuring that their influence does not interfere with public health objectives.”

The guidelines under Article 5.3 recommend that governments avoid any partnership or interaction with the tobacco industry unless strictly necessary and ensure that any such interactions are transparent and accountable​. This model is cited as an effective way to protect public health from the influence of industries that profit from products harmful to health.

Fabio Gomes, Regional Advisor at the Pan-American Health Organization.

Fabio Gomes, Regional Advisor at the Pan-American Health Organization, echoed these concerns, highlighting how Latin American countries have started regulating harmful products and practices. 

“Countries have realized that we cannot move forward without regulating the products that are killing us,” he said, pointing to successful policies like warning labels on unhealthy foods and restrictions on marketing aimed at children. 

The regulation of these products is seen as essential to protect public health from the influence of powerful commercial interests that prioritize profit over people’s well-being.

The panellists stressed that confronting commercial interests is critical in the broader fight against NCDs. They noted that implementing measures similar to Article 5.3 for alcohol, sugary drinks, and ultra-processed foods manufacturers, could significantly advance public health protections. 

Gilmore highlighted how corporations often resist regulations that could prevent millions of deaths annually, such as taxes on tobacco or restrictions on unhealthy food marketing. She believes that regulations are vital in reducing the influence of industries that stand in the way of effective NCD prevention strategies. 

“Voluntary actions don’t work, regulation will always be essential,” she said.

A political battle for health

While calling for increased public financing and highlighting the need for high-level political advocacy to ensure cancer care becomes a priority within health agendas worldwide, Yates and others highlighted the need for the key players to be confident in directly reaching out to politicians such US Vice Presidential candidate Tim Waltz, who had personal experience of how financially devastating cancer can be on a family.

“We need to get political,” Yates stated. He urged cancer advocates to directly engage with ministers of finance and heads of government to secure funding for cancer services. He argued that integrating cancer care into UHC could drive broader political support, given its strong public appeal and the significant economic benefits associated with early intervention and prevention.

With the United Nations High-Level Meeting on NCDs approaching in 2025, the panellists emphasised the need to secure commitments from political leaders to increase funding and regulatory measures that could significantly impact global health outcomes.

Preserving cancer research integrity

Christoph Plass, Division Head at the International Journal of Cancer

One of the Congress panels addressed fraud in cancer research. Fraudulent science, including data manipulation, plagiarism, and paper mills, have been a persistent problems, particularly exacerbated by the influx of ‘fake’ papers post-COVID-19. 

Christoph Plass, Division Head at the International Journal of Cancer, highlighted the troubling trend of cell line misidentification in cancer research, which leads to inaccurate research findings. 

He emphasized the need for cell line authentication and research resource identifiers (RRIDs) to ensure the reliability of the data presented. His team found that many rejected manuscripts for cell line issues were published elsewhere without corrections—a practice that threatens the credibility of published research.

Julie Stacey, Editor-in-Chief of eBioMedicine, said that smaller journals often lack the resources for thorough peer review and investigative rigour, leading to the publication of flawed or fraudulent research. Larger journals have better systems in place but are not immune to these problems, often relying on whistleblowers to identify misconduct.

Sonali Johnson, from the Union for International Cancer Control (UICC), underscored how fraudulent research erodes public trust in science and medical research, making it harder to advocate for cancer control initiatives. 

Misinformation is especially harmful in cancer research, where public understanding is already limited. Fraudulent findings can lead to patients pursuing ineffective treatments, delaying necessary care, and wasting valuable resources. Johnson also pointed out that commercial interests from industries such as tobacco and fossil fuels manipulate science to promote their products, often creating confusion and mistrust about cancer-related risks.

The panellists agreed on the need for stricter editorial policies, transparency in research funding, and a stronger focus on ethical education for junior and senior researchers alike. The session emphasized that journals must take responsibility for maintaining the highest standards of research integrity, while funding bodies and institutions need to enforce stricter compliance measures to avoid the pitfalls of fraudulent science.

The session concluded with a call to action for the cancer research community to adopt more rigorous authentication processes, promote open science initiatives, and foster a culture of accountability.

Geneva, Switzerland—The 2024 World Cancer Congress opened Tuesday in Geneva, bringing together more than 2,000 delegates from more than 120 countries. Its convener said the congress underscores a global commitment to combating the growing burden of cancer.

World Cancer Congress kicks off in Geneva
World Cancer Congress kicks off in Geneva

Hosted by the Union for International Cancer Control (UICC), the congress aims to foster collaboration amongst cancer and health experts through a diverse three-day program of discussions, presentations, and networking opportunities.

UICC president, Prof Jeff Dunn, welcomed the delegates and highlighted the importance of international collaboration in the fight against cancer.

“We are here to share, learn, and strengthen our bonds in this shared quest to control cancer,” he said.

Despite global disruptions, he said the participants’ turnout reflects the urgency of addressing the rising cancer burden worldwide.

Dunn, a cancer survivor himself, spoke of his personal journey with mantle cell lymphoma, emphasising the role of community support in his recovery. He praised the congress partners, including the World Health Organisation (WHO), the International Agency for Research on Cancer (IARC), and various cancer societies.

The opening ceremony featured addresses from notable global health leaders. Dr Elisabete Weiderpass, director-general of IARC, highlighted the alarming increase in cancer cases, projecting that new cancer cases could rise by 77% by 2050, particularly in low- and middle-income countries. She stressed the importance of preventive measures, such as tobacco control and HPV vaccination, and addressing environmental and lifestyle risk factors to curb this trend.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus, addressing the congress via video message, acknowledged the progress made in implementing national cancer programs but called for more political leadership and faster action. He emphasised the need for countries to work towards achieving the Sustainable Development Goals related to non-communicable diseases, including cancer. European Union Health Commissioner Stella Kyriakides also delivered a message outlining Europe’s commitment through the EU’s Beating Cancer Plan, which includes initiatives ranging from cancer prevention to improving the quality of life for cancer survivors.

Global Impact of Cancer Orphaning and Mortality Disparities

New research plays a significant role at the congress and will be showcased throughout the event, with some highlights already shared during Tuesday’s opening press conference.

Researchers, for example, explored how many children worldwide have been orphaned by losing their father to cancer. Losing one or both parents can leave children at a lifelong disadvantage in terms of health, support, and education.

The study, conducted by the IARC in France, follows a 2022 report that found one million children lose their mother to cancer each year. This new research aimed to estimate the global number of children who become fatherless due to cancer-related deaths amongst men. The team found that in 2020, 5.5 million men died from cancer, leading to around 1.4 million new paternal orphans, amongst which 75% were due to paternal deaths occurring above 45 years old.

The latest findings also emphasised the disproportionate impact on regions such as Asia and Africa, showing a significant link between development levels and the number of new orphans.

The research also underscored the urgent need for strategies to reduce preventable cancer deaths and provide better support for affected children.

A separate first-of-its-kind study shared at the congress quantifies the socioeconomic burden of ovarian cancer across 11 countries and highlights the significant disparities between countries and income groups.

“An estimated 3.4 million cancer deaths could be avoided annually If every country had the same success in addressing cancer as the best-performing countries, with stomach, lung, breast, and colourectal cancers having the most potentially avoidable deaths,” the UICC said in a statement on the study. “The highest disparities in cancer mortality occur in sub-Saharan Africa and Southeast Asia.”

Researchers are also releasing an IARC assessment on the pandemic’s impact on cancer diagnosis and stage distribution. The study, based on data from population-based cancer registries in seven countries, found significant reductions in melanoma, breast, prostate, and lung cancer incidence, particularly during the early months of lockdown. These trends highlight the importance of preparing for future pandemics and the need to address screening and healthcare access disruptions, according to the UICC.

AI And Other Advancements

Artificial intelligence and other new technologies in healthcare that can transform patient care and enhance diagnostics and treatments are also being explored—both from the standpoint of the advancements they can provide and challenges like data privacy.

A prospective five-country observational study of the performance of a new artificial intelligence-based tool for cervical pre-cancer screening in the African region—Malawi, Rwanda, Senegal, Zambia, and Zimbabwe — was announced to be released on Wednesday. The study involved more than 24,000 women and evaluated the performance of an AI-based tool, Automated Visual Evaluation (AVE).

AVE showed significantly higher sensitivity (60.1%) than the other tools it was compared to.

“The study concludes that AVE could enhance cervical pre-cancer detection in resource-limited settings, supporting broader cervical cancer elimination efforts despite some trade-offs in specificity,” the UICC said.

Challenges of Cancer Care in Conflict Zones

WHO’s Andre Ilbawi provided insights into the plights of cancer patients in Gaza.
WHO’s Andre Ilbawi provided insights into the plights of cancer patients in Gaza.

Another focus of the event was cancer care during humanitarian crises. Key sessions, including some on Tuesday, addressed the challenges of providing care in places such as Sudan, Gaza and Haiti.

Andre Ilbawi, a cancer lead at the WHO, painted a stark picture of the challenges faced by cancer patients in Gaza in one session. He said that as conflict rages, the already fragile health system struggles to cope, leaving cancer patients in a precarious position.

“The first step in areas of conflict is preparedness,” Ilbawi explained, emphasising that proactive measures, such as setting up funds and protocols for evacuating critically ill patients, are crucial in these volatile environments.

Just last week, the WHO evacuated around 100 Gaza patients in one of its most significant efforts to date to the United Arab Emirates medical treatment.

Ilbawi noted that the recent conflict in Gaza has laid bare the vulnerabilities of healthcare systems in conflict zones. From a lack of essential medicines to disrupted care pathways, he argued that cancer patients in Gaza face enormous barriers to accessing treatment.

“Cancer was one of the complicated issues in NCDs and humanitarian crises,” Ilbawi said, underscoring the compounded effects of war, displacement, and systemic neglect on cancer care.

The need for coordinated international responses was a recurring theme in the session labelled “Leaving No One Behind: Advancing Equity for Refugees, Displaced People, and Underprivileged Communities.” Carlos Rodriguez-Galindo of St. Jude Children’s Research Hospital discussed how the global oncology community can and must mobilise rapidly in crisis situations. He drew parallels between the response efforts in Ukraine and Gaza, where international and regional oncology groups have worked together to ensure continuity of care for cancer patients.

“In Gaza, having boots on the ground made a significant difference,” Rodriguez-Galindo explained. “St. Jude’s had staff dedicated to tracking every cancer patient, knowing their names, diagnoses, and treatment needs, and coordinating with local and international bodies to ensure they received the necessary care.” This immediate response was instrumental in managing patient care during a chaotic and dangerous time, providing a model for supporting other conflict zones.

However, Ilbawi highlighted that the situation in Gaza differs significantly from other crises due to its protracted nature and the severe restrictions on movement.

“What worked well in Ukraine did not necessarily translate to Gaza,” Ilbawi pointed out. For example, while patient evacuations were managed relatively smoothly in Ukraine, Gaza’s complex political and security landscape has made similar efforts much more challenging.

Ilbawi stressed that the solution to these challenges lies in emergency response and in building sustainable, long-term healthcare solutions that integrate cancer care into the broader health system. He emphasised that parallel health systems—where refugees and local populations receive different levels of care—are not sustainable and do not serve anyone’s interests.

“Eventually, cancer care must be fully integrated into national health systems,” Ilbawi argued. “The humanitarian response can no longer be seen as a temporary fix; it needs to be part of a broader strategy that strengthens the entire health infrastructure.”

He pointed to the need for ongoing international collaboration and investment to build resilient health systems that can withstand the pressures of conflict and provide equitable care for all.

The panellists called for a united global effort to address the healthcare needs of cancer patients in conflict zones. They stressed the importance of multilateralism and upholding international agreements that protect health workers and patients in times of crisis.

“We must honour decades of international law and agreements that govern the protection of healthcare in conflict,” Ilbawi said. “These are not just policies—they are lifelines.”

The UICC announced that the next World Cancer Congress will be held in Hong Kong in 2026. Future leaders’ summits are planned in Australia and other potential locations in low- and middle-income countries.

Image Credits: WHO/G. Reboux, Paul Adepoju.

The 11th meeting on the Intergovernmental Negotiating Body (INB) is currently underway in Geneva.

The latest draft of the World Health Organization’s (WHO) pandemic agreement shifts key decisions to the Conference of the Parties (COP) – a body that will be set up after the World Health Assembly (WHA) has adopted the agreement.

The draft, developed by the WHO Bureau overseeing the Intergovernmental Negotiating Body (INB) talks, was distributed to delegates late on Monday.

Details about how to implement the contentious Pathogen Access and Benefit Sharing (PABS) system (Article 12) – a mechanism to share information and benefits about pathogens with pandemic potential – is one of those kicked down the road.

“The provisions governing the PABS system, including definitions of pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions, shall be developed and agreed in an instrument in accordance with Chapter III,” according to the draft.

Chapter III deals with institutional arrangements to bring the pandemic agreement into effect, primarily via a COP convened by the WHO “not later than one year after the entry into force of the WHO Pandemic Agreement”. 

The PABS system will also need to be recognised under the Nagoya Protocol, according to the new draft.

‘Lots of blanks’

Provisions for “pandemic prevention and surveillance” (Article 4) have also been kicked down the road to the COP, which will be charged with further developing these, “taking into consideration a One Health approach”.

In the One Health section (Article 5), the onus rests entirely on countries to develop and integrate measures governing animal and human health.

“This new text sets up a pandemic agreement ‘lite’ where there are lots of blanks left to fill in after the agreement,” says Elliot Hannon, Spark Street senior researcher and an observer at the negotiations.

“The Bureau’s new suggested language really shows they’re taking out the most contentious issues, particularly on PABS, and leaving the details to be worked out later. The aim, of course, is to meet their deadline and to produce some kind of agreement on PABS,” he added.

Hannon also pointed out that the language in the new draft had softened from terms like “hereby establish”, to “agree to establish”. 

“Almost all of the changes are designed to not have to deal with the intricacies of PABS right now. The same goes for Articles 4 and 5 on ‘prevention, surveillance’ and ‘One Health’,” he added.

“This is, obviously counter to what many Global South or developing economy countries are interested in and demanding, as they see the PABS system as a key ball game,” said Hannon.

New tech transfer definition

The draft introduces new two definitions:  “The transfer of technology is understood to mean non-coercive transfer and on mutually agreed terms,” according to the new text. 

“This understanding is without prejudice to other measures that parties may take pursuant to their domestic and/or national legislation, provided that such measures are consistent with their relevant international obligations regarding intellectual property,” it adds.

Meanwhile, it defines “know-how” as the “knowledge and skills required to manufacture products”.

“Negotiators are struggling to find compromise language on technology transfer,” noted Knowledge Ecology International director Jamie Love.

“Everyone knows it is important, but there is a lot of industry lobbying that is making it difficult to reach agreement.”

The 11th meeting of the INB ends on Friday. Negotiators have until May 2025 to reach agreement but keep getting stuck on PABS.