Record heat levels in Asia are affecting rainfall, causing heatwaves, and accelerating the rate of glacier melt.

Asia, the world’s most populous continent, is warming twice as fast as the rest of the world, according to the latest State of the Climate in Asia 2024 report by the World Meteorological Organization (WMO) released on Monday.

In 2024, Asia’s average temperature was about 1.04°C above the average for 1991 to 2020, ranking as the warmest or second warmest year on record, depending on the dataset.

Sea surface temperatures were the highest on record, and as a result, sea level rise on the Pacific and Indian Ocean sides of the continent exceeded the global average, heightening flooding risks for low-lying coastal areas.

The heat has also adversely affected the marine ecosystem and coastal communities that depend on the oceans for their income.

“The State of the Climate in Asia report highlights the changes in key climate indicators such as surface temperature, glacier mass and sea level, which will have major repercussions for societies, economies and ecosystems in the region. Extreme weather is already exacting an unacceptably high toll,” said WMO Secretary-General Celeste Saulo at the launch of the report.

This heat has also caused rainfall patterns to change, and widespread heatwaves. In the central Himalayas and Tian Shan in Kyrgyzstan, 23 out of 24 glaciers suffered mass loss, leading to an increase glacial lake outburst floods and landslides and heightened  long-term risks for water security.

In addition, extreme rainfall and tropical cyclones that are worsening with high temperatures have wreaked havoc in the region.

The warming trend for Asia between the years 1991–2024 was almost double that during the 1961–1990 period.

Pace of warming has quickened

In 2024, Asia’s average temperature was about 1.04°C above the 1991–2020 average. The warming trend between the years 1991–2024 was almost double of that during the 1961–1990 period, indicating that the pace of warming has quickened.

Asia is warming so fast because it is the continent with the largest land mass, extending all the way to the Arctic, and land is warming more than the ocean, according to the report.

Prolonged heatwaves were reported across Asia in countries like China, Japan and the  Republic of Korea. Myanmar set a new national temperature record of 48.2°C in 2024, testing the limits of human endurance.

Rising ocean heat, melting glaciers

Most of the ocean area of Asia was affected by intense marine heatwaves , with the Northern Arabian Sea and the Pacific Ocean particularly affected, according to the report.

“Average sea surface temperatures increased at a rate of 0.24°C per decade, which is double the global mean rate of 0.13°C per decade,” the report said.

“During August and September 2024, nearly 15 million square kilometres of the region’s ocean was impacted – one tenth of the Earth’s entire ocean surface, about the same size as the Russian Federation and more than 1.5 times the area of China.”

This heat has also affected glaciers. The Himalayan region is often called the ‘Third Pole’ as it has the largest reservoir of frozen fresh water outside of the two poles. Ice cover here spans an area of around 100,000 sq km or roughly the size of Egypt.

Reduced snowfall during the winters coupled with hot summers is leading these life-sustaining glaciers to melt at a record pace. Billions of people living downstream in countries like India, Bangladesh, Nepal and China are affected as some of the world’s largest rivers – including the Ganga, Brahmaputra and the Yangtze – originate from these glaciers.

Glaciers in other mountain ranges in Asia are also melting at a faster rate. “Urumqi Glacier No.1, located in the eastern Tian Shan, recorded its most negative mass balance since measurements began in 1959,” the report read.

In addition to this, extreme events like cyclones and erratic rainfall have caused widespread damage across the region, the report said.

India’s Kerala state reported 350 deaths following extreme rainfall that triggered landslides on 30 July last year. The following month, floods in Nepal killed 246 people and caused $94 million damage to property.

In China, nearly 4.8 million people were affected by drought, which is estimated to have cost more than $400 million in direct losses.

The elephant in the room

What the report did not mention was Asia’s toxic air which, apart from worsening health indicators, has also been pushing up rates of glacier melt.

Nearly all of the world’s most polluted 50 cities in 2024 are in Asia, particularly in the densely populated Indo-Gangetic plain, which includes Pakistan, India and Bangladesh, according to data from IQAir, a Swiss air quality technology company.

Black carbon, or the soot left behind after the incomplete combustion of fossil fuels,  drives higher rates of glacier melt as it settles on ice, darkens the surface and causes higher absorption of sunlight. When in the air, black carbon absorbs sunlight and traps the heat, warming the air further.

Silver lining: Early warning systems

However, amidst the largely grim scenario, there was a silver lining. The report mentioned the case study of Nepal, nestled in the Himalayas, which has invested in early warning systems and managed to save lives. Climate monitoring helped officials to anticipate extreme weather events and reduce damage.

WMO has been pushing countries to invest in early warning systems for extreme weather events like floods and cyclones, which can anticipate risk and prepare communities to respond to climate change. This helped them protect lives and livelihoods.

“The work of National Meteorological and Hydrological Services and their partners is more important than ever to save lives and livelihoods,” Saulo said.

Image Credits: WMO, WMO.

Soroka Medical Center healthworkers survey the aftermath of Thursday’s Iranian missile attack.

The World Health Organization decried Thursday’s direct hit by Iran on one of Israel’s largest hospitals, Soroka Medical Center, which put the 1200-bed facility serving most of the country’s southern region largely out of operation. 

In an X post, WHO Director General Dr Tedros Adhanom Ghebreyesus also deplored the deaths of three Iranian Red Crescent Society health workers three days ago, following an Israeli airstrike on Tehran three days ago. 

The Iranian missile packed with 400 kilograms of explosives destroyed a surgical wing on the sixth floor of the massive facility – sending a large plume of smoke up in the air. 

“This morning’s attack on Soroka Medical Center in Israel — the only major hospital in the south — resulted in dozens of patients being injured, some severely; 250 patients being evacuated to other health facilities; and damage to the facility, leaving it only partially functional,” said the Director General in his post, early Thursday evening. 

Some 40 people at the hospital were treated for largely minor injuries, thanks to the fact that patients and operations had already moved underground – including those in the affected wing only yesterday, Israeli authorities said. 

But the widespread destruction at the sprawling complex, including collapsed walls, shattered windows, and hundreds of broken computers and medical devices, led to the evacuation of most patients from the hospital, which serves over one million people in Israel’s southern region, including the Negev community of 250,000 Bedouin citizens.   

Israel protests WHO’s silence

Soroka Medical Center at the time of Thursday’s Iranian missile attack.

On Thursday afternoon, Israel’s Ambassador to Geneva, Daniel Meron, posted a video in front of the WHO headquarters, protesting the WHO’s silence over the attack that had happened around 6 a.m. Geneva time.  

“Where is the condemnation of WHO?”  asked Meron. “It is not a military site. It is a civilian hospital…. and the Iranians are targeting time after time, civilian targets in Israel. I am waiting for a condemnation and the selective silence of WHO is deafening,” he said, an oblique reference to the many WHO statements calling out Israel’s  destruction of Gaza’s health facilities, during its grinding 20-month war on Hamas.

When the WHO response came 12 hours later, the WHO Director General was careful to balance his comments, noting two attacks on health facilities experienced by Iran during the week-long Israeli assault on Iran’s nuclear and missile capabilities, as well as energy, telecom and oil infrastructure.  

“Following an airstrike on Tehran three days ago, three Iranian Red Crescent Society health workers were killed while reportedly rescuing injured people,” Tedros added. “On the same day, a hospital in Kermanshah was impacted by a nearby explosion, causing damage to the intensive care unit. As a result, around 15 staff and patients were injured.

“We call on all parties to protect health facilities, health personnel and patients at all times,” said Tedros, adding his signature slogan, “The best medicine is peace.”

Israelis and Iranian civilians both caught up in the exchanges 

Pride flag waves on one side and Israeli flag, on the other, of buildings hit by Iranian missile attack in central Israel Thursday.

The war began with a surprise attack by Israel early Friday, 13 June, on Iran’s nuclear infrastructure, with Israel saying that the Islamic Republic was on the verge of completing the development of a nuclear weapon.

According to independent human rights observers, an estimated  639 Iranians have died so far in the conflict – the lower numbers published by the regime is only partial data, they say. Meanwhile, 24 Israelis have died in daily waves of Iranian missile attacks – from missile that evaded Israel’s “Iron Dome” air defense system.  

Suburban Tehran building destroyed in Israeli airstrike on 13 June, the first day of attack on Iran.

“The Islamic Republic has targeted residential areas in Tel Aviv, Jerusalem, Haifa, and elsewhere. Casualties would be far higher if not for the high percentage of Islamic Republic attacks that have been intercepted by the Israeli Defense Forces, as well as the presence of an extensive system of shelters and warning sirens throughout Israel,” noted the New York City-based Center for Human Rights in Iran. The group called for an immediate cease-fire by both sides.

Thursday’s early morning missile blast that hit Soroka hospital was part of the largest volleys to penetrate the countru’s defenses since the first day of the war. Explosives hit four other sites in the Tel Aviv area cities of Holon and Ramat Gan, destroying multi-story buildings, and leading to dozens of injuries, six seriously. 

Some 35,000 homes in Israel have been damaged in the war so far, with 1000 more Israeli families displaced on Thursday from high-rises and neighborhoods that suffered the worst impacts of the half-ton Iranian missiles. 

Meanwhile, dozens of Iranian residential buildings have suffered hits and hundreds of thousands of Iranians have fled the capital of Tehran, and other strategically-placed areas, following Israeli warnings to evacuate areas near key military and government assets.  

Gazans languish in conflict and hunger

Smoke rises up from Gaza City as the Israeli-Hamas conflict lingers on.

While the world focuses on the Israel-Iran war, only a few dozen kilometers away from Soroka hospital, besieged Gaza continues to languish in the throes of the ongoing Israeli battle with Hamas forces, along with persistent food and fuel shortages. Some 53 Israeli hostages also remain in Hamas captivity, and time is running out for the estimated 20 still believed to be alive after more than 621 days living underground on meager rations and with minimal medical care, their families warn. 

Gaza’s drinking water supplies are dangerously low, UNICEF’s James Elder warned in a press briefing on Friday, saying. “Currently just 40 per cent of drinking water production facilities remain functional in Gaza (87 out of 217). Without fuel, every one of these will stop operating within weeks. Since all the electricity to Gaza was cut after the horrific attacks of 7 Oct 2023, fuel became essential to produce, treat and distribute water to more than two million Palestinians.

“If the current more than 100-day blockade on fuel coming into Gaza does not end, children will begin to die of thirst. Diseases are already advancing and chaos is tightening its grip.”

Earlier this month, heavy Israeli attacks in southern Gaza forced two key hospitals,  Al Nasser and Al Amal, to curtail or halt most services, with Al Amal rendered largely accessible to new patients.  Meanwhile, the Israeli military issued fresh evacuation orders to several neighborhoods in northern Gaza, while food distribution sites of the Israeli-backed Gaza Humanitarian Foundation (GHF) have seen continued chaos – and death.

In the latest incident, on Tuesday, lethal Israeli fire allegedly killed several dozen people near food distribution points, according to eyewitness reports and Gaza’s Hamas health authorities.  GHF, meanwhile, accused Hamas of killing eight Palestinian aid workers last week in an ambush of a bus transporting some two dozen team workers. 

In a statement on Wednesday, the UN Human Rights Office, OCHCR, called upon Israel to cease the use of lethal force around the GHF food distribution sites. 

“We are horrified at the repeated incidents, continuously reported in recent days across Gaza, and we call for an immediate end to these senseless killings,” said the  OCHCR statement. 

–Updated Friday 20.6.2025

Image Credits: Emmanual Fabian/Times of Israel, Emmanuel Fabian/Times of Israel , Israel Public Television, x/@DavidShoebridge, © UNOCHA/Olga Cherevko.

A mixture of corn, soy, wheat, sugar and oil is prepared to feed malnourished children and pregnant and lactating women in Abu Shouk camp for Internally Displaced Persons in Sudan’s North Darfur region.

Better nutrition is crucial to breaking the cycle of poverty affecting millions of people across the world. As international development funding faces unprecedented strain, private sector partnerships are a key piece of the jigsaw to close the nutrition funding gap. With the right approach, we can leverage private sector resources and innovation for mutually beneficial partnerships that drive impact at scale.

Access to good nutrition is essential for communities to thrive. It is deeply linked to global challenges such as poverty, climate change, gender inequality, education inequity, and food insecurity. When we address malnutrition, we save lives, strengthen economies, and break cycles of poverty.

Yet, nutrition remains the “orphan” sector of global health. It receives less than 1% of overseas development assistance, and progress in reducing stunting has plateaued due to a combination of factors including armed conflicts, climate shocks, the lasting impact of COVID-19, and rising living costs. 

Recent cuts to development aid have also raised serious concerns about further backsliding, pushing more people into hunger and poverty. The numbers are stark: 733 million people face hunger globally, and nearly half of deaths among children under five are linked to malnutrition.

With official development assistance shrinking and governments facing growing fiscal pressure, it’s clear that traditional funding sources alone cannot close the $128 billion global nutrition financing gap. This is where the private sector must play a greater role.

Finding shared purpose

At this year’s Nutrition for Growth summit, we saw real commitment from private sector actors, some relatively new to the space, as part of the nearly $28 billion raised towards the Sustainable Development Goals. 

While the private sector is not expected to replace traditional funding, its capital, innovation, and influence offer much-needed hope. We must seize this momentum. 

But aligning efforts between the nutrition and private sectors isn’t always straightforward. Projects that appeal to businesses often differ from those prioritised by development actors. The private sector tends to be drawn to initiatives that align with profit margins, brand identity, or short-term impact goals. 

In contrast, nutrition’s biggest challenges, such as reducing stunting, require long-term, systemic change and solutions that don’t deliver quick returns and directly attributable impact metrics.

Further complicating matters, the private sector is far from monolithic. Stakeholders range from food and beverage companies to agribusinesses, the healthcare sector, foundations, philanthropic organisations and high-net-worth individuals, each with their own motivations and priorities. Partnering effectively means understanding these differences and finding shared purpose.

Match-funding

The Power of Nutrition has spent a decade mobilising financing to address malnutrition in Africa and Asia. Through a catalytic match-funding model, we’ve leveraged $647 million in investments for 26 programmes, with 68% of funding coming from private sources. Partnerships with organisations like Unilever, Cargill, the PVH Foundation, and the Aliko Dangote Foundation have helped elevate the role of private capital in tackling global malnutrition.

While creativity and innovative thinking are key to developing tailored partnerships, we also recognise the importance of being targeted about who to engage with.

Not all private sector funding aligns with our mission, and we have a robust assessment process to ensure that any partner supports, rather than undermines, the long-term credibility and impact of our work. For example, we don’t work with companies that market breast milk substitutes, and we advocate for all partners to adhere to the International Code of Marketing of Breastmilk Substitutes.

One of our programmes in India, with partners including Cargill and Unilever, focuses on improving maternal and child nutrition. It promotes diet diversity during pregnancy, early initiation and continuation of breastfeeding, and timely complementary feeding with locally available foods. These partnerships go beyond funding as they support long-term behaviour change through community-based solutions.

Smart investing – not charity

To better understand what drives successful private sector engagement, we recently partnered with academics at the London School of Economics and Political Science (LSE) to evaluate how to make private sector engagement in nutrition financing more effective.

The evaluation identified key challenges – including difficulties in measuring impact and concerns about greenwashing – but also revealed valuable lessons. One thing was clear: economic arguments resonate best with the private sector.

Fortunately, we can prove that better nutrition boosts workforce productivity and human capital. In 95 low- and middle-income countries, childhood stunting costs the private sector at least $135.4 billion in sales annually. The same study found that every dollar spent in reducing stunting can yield up to $81 in economic returns. 

In Bangladesh, The Power of Nutrition’s partnership with the government, apparel company PVH Corp, and civil society is delivering results for maternal and child nutrition, showing that investment can offer both immediate benefits and long-term gains.

The programme, running in 20 PVH Corp suppliers’ garment factories, includes the setup of new safe breastfeeding spaces and breaks, childcare provision, the distribution of multiple micronutrient supplements and paid maternity leave. 

Based on the programme’s results, in line with their corporate and social responsibility targets, PVH Corp has now established a new partnership with The Power of Nutrition to work on a programme in India.

But a strong business case alone isn’t enough. The  evaluation by leading academics from LSE highlighted that, to build lasting partnerships, we need to:

  • Foster collaboration through a convening body, which helps to align incentives, pool resources, and facilitate joint action through tailored partnerships.
  • Expand nutrition investment through innovative financing mechanisms including private equity, venture capital, and non-traditional philanthropic sources.
  • Ensure transparency and impact by aligning investments with corporate goals, backed by strong accountability frameworks and clear metrics.

We know this approach works. In Ethiopia, a multi-sectoral nutrition programme brought together government, private sector and community actors across climate, health, and education to strengthen nutrition outcomes. The result: holistic interventions that combine maternal care, growth monitoring, deworming, cooking demonstrations, and behaviour change communications.

This integrated model avoids the inefficiencies of isolated efforts. Now, instead of having to go back and forth to health facilities to access different services, a parent or caregiver can access information, services and support in an integrated way, either at the community level or in fewer visits to a health centre. To date, the programme has reached over 7.4 million women and provided 1.2 million children with vitamin A and deworming treatments.

The private sector brings capital, reach, and innovation. The development sector offers expertise, networks, and accountability. By aligning these strengths through co-investment and shared outcomes, we can shift the trajectory of global nutrition. This isn’t charity, it’s smart, long-term investing. Without a mindset shift, malnutrition will continue to steal futures and undermine prosperity for generations.

Shelley Pigott, Director of Strategic Engagement at The Power of Nutrition. Shelley has over 20 years’ experience developing multi-million-dollar partnerships with organisations such as UNICEF UK and Save the Children. She is a board member of Medair UK and advises on sustainable income growth.

Dr Lucy Kanya, Assistant Professorial Research Fellow at LSE Health (London School of Economics and Political Science), specialises in health economics and policy. She has led evaluations of health financing programs in sub-Saharan Africa and recently authored a study on The Power of Nutrition’s private sector engagement (2015–2025).

 

  

 

Image Credits: UNICEF/Njiokiktjien, Flickr – UN Photo.

US Health Secretary Robert F Kennedy appearing before the Senate Health, Education, Labor and Pensions Committee in May.

While many public health experts have criticised United States Health Secretary Robert F Kennedy Jr for undermining vaccines, several think his focus on chronic illness and big food has potential – although they are sceptical of whether he will employ proven methods to improve citizens’ health.

Obesity, and associated problems of cardiovascular disease, diabetes and hypertension, have steadily increased over the past two decades in the US (with a brief dip in 2023), and the consumption of ultra-processed food (UPF) is a major driver of this. 

“Nearly 70% of an American child’s calories today come from ultra-processed foods (67%), and over two-thirds of all calories consumed by American children are ultra-processed grains, sugars, and fats,” according to the recent Make America Health Again (MAHA) report.

Last week, Kennedy met lawmakers from Arkansas, Idaho and Utah when they announced that they would no longer allow low-income families who benefit the Supplemental Nutrition Assistance Program (SNAP) to use the food aid buy junk food and sugary drinks.

This is part of a drive by the US Department of Agriculture, which administers SNAP, and six states have adopted waivers qualifying what SNAP beneficiaries can buy. One-in-five US children were beneficiaries of SNAP in 2023, according to the MAHA report.

Kennedy’s Department of Health and Human Services announced last week that it aims to launch “a series of bold, edgy national campaigns” to make people aware of the links between ultra-processed food and diabetes and “challenge individuals to adopt disciplined, lifelong habits – centered on eating real food, physical fitness, and spiritual growth.”

Correct analysis – but no proven interventions

Global food policy expert Professor Barry Popkin told Health Policy Watch that the MAHA report “addressed ultra-processed food quite correctly and appropriately”.

“As for actions and next steps, they will come out in a month or two with a policy document, which will show us what Acts and laws they are addressing,” said Popkin, distinguished professor at the Gillings School of Global Public Health at the University of North Carolina (UNC).

Dr Tom Frieden, CEO of Resolve to Save Lives and a former director of the Centers for Disease Control and Prevention (CDC), agrees that the MAHA report “correctly identifies serious health threats from unhealthy foods, environmental toxins, and insufficient physical activity among children”. 

Frieden also notes that the report’s “emphasis on reducing industry influence is important recognition of inappropriate commercial influence in health policy”. 

But Frieden says that it “overlooks proven cost-effective interventions that reduce chronic diseases, including front-of-package warning labels, restrictions on marketing unhealthy products to children, taxes on sugar-sweetened beverages and tobacco, and comprehensive tobacco control measures. 

Since August 2021,  Argentinian ultra-processed food companies have had to add warning labels to their products that are high in salt, sugar and other harmful ingredients.

“Countries implementing these policies have healthier kids, yet the report dismisses such regulatory approaches,” adds Frieden, whose organisation has extensive global experience in saving lives by addressing high blood pressure and unhealthy food.

“The report makes a compelling case for government intervention to address inappropriate corporate influences, then paradoxically rejects the regulatory solutions its own data supports.”

Frieden also criticises the report for failing to address tobacco use, the US’s leading preventable cause of death; advocating for voluntary industry agreements that have “repeatedly failed”, and not mentioning how primary healthcare can detect and manage chronic diseases.

MAHA: An opportunity and risk

Popkin and UNC colleague Dr Lindsey Smith Tallie describe the MAHA movement as “arguably the largest, most energised movement to date to address the USA’s twin epidemics of obesity and type 2 diabetes” in a recent article in The Lancet.

The growing focus on nutrition and NCDs is “long overdue” as poor diet has been a leading cause of death and disability in the US “for decades”, with 20% of children and 42% of adults living with obesity, they note.

“Over half of Americans consume sugary drinks on a daily basis, whereas approximately two-thirds of daily calories come from ultra-processed foods” but there has been “virtually no progression in policy to address poor diets”, they add.

But they acknowledge that while MAHA has “tremendous potential to transform the food system”, it also “carries serious risks unless policies are based on science”.

They point to Kennedy’s “record of denying or contradicting scientific evidence” and note that he may not be free of conflict-of-interests (he has close links with Big Wellness groups that stand to benefit from his policies).

They also warn that the Trump administration’s slashing of National Institute of Health funding will cripple biomedical research. 

New York City letter

New York City, a global leader in anti-tobacco and other campaigns to address NCDs,  has also weighed in on the MAHA report via a six-page letter to the MAHA Commissioner in May.

It urged the Food and Drug Administration to finalise sodium reduction targets and establish new added sugar reduction targets.

Michelle Morse, NYC’s Acting Health Commissioner, also offered the city’s expertise in promoting healthy food.

The city has paired its 1.5 million annual SNAP beneficiaries with farmers’ markets to offer incentives to both consumers and food producers. However, Morse warned that the Trump administration’s changes to SNAP “will make it harder for families to buy the foods they need to stay healthy. It is also critical thatthe federal government doesn’t place undue administrative burdens that may lessen the efficiency orincrease the cost of this effective and economy boosting program.”

“We encourage the administration to support evidence-backed policies, to lean on the expertise that exists within state and local health departments, and to consider the potential ramifications that budget cuts may have on the goal of reducing chronic disease,” the letter concludes.

Politicization of food policy?

Popkin and Smith question whether Kennedy and the Trump administration will be able to overcome massive opposition from the food industry to regulate the food environment.

They also stress that “transparent, rigorous, and conflict-free scientific processes are used, even if the outcomes do not align with the preferred policy positions”.

Otherwise, there is the risk of a greater politicization of food and nutrition policy to the detriment of everyone,” they warn.

Kevin Hall, one of the NIH’s most senior scientists studying nutrition, metabolism and  neuroscience, announced his “early retirement” in April, saying that his research had been censored “because of agency concerns that it did not appear to fully support preconceived narratives of my agency’s leadership about ultra-processed food addiction”. His attempts to discuss his concerns with NIH leaders were ignored.

Meanwhile, Frieden warns: “Real progress demands systematic implementation of proven interventions, including through policies, regulations, and comprehensive programs like the CDC programs that Secretary Kennedy just dismantled.”

Image Credits: Thomas Kelley/ Unsplash, C-Span, Global Health Policy Incubator .

Panel discussion members Eloise Todd (moderator), Ambassador Amprou, Ambassador Ambassador Umej Bhatia, Colombia’s Juliana Tenorio Quintero and the South Centre’s Viviana Muñoz-Tellez.

Mistrust undermined the pandemic agreement talks – but, ironically, the Trump administration’s withdrawal from the World Health Organization (WHO) galvanised member states to reach agreement, according to Ambassador Anne-Claire Amprou, co-chair of the talks.

“There was a lack of trust. That means that when member states wanted to make a proposal, sometimes it created suspicion – not because of the content but because of the delegation that put the proposal on the table, and that was not always very easy to navigate,” Amprou told a meeting in Geneva on Tuesday.

But after the US withdrew from the WHO on 20 January,  “we could feel that member states wanted to preserve the WHO, to preserve multilateralism, and I think that it helped to have a sense of compromise at the end,” she said.

The meeting, convened by the Geneva Graduate Institute’s Global Health Centre, the Pandemic Action Network (PAN) and the Global Preparedness Monitoring Board (GPMB), reflected both on the process of reaching on the agreement and on the road ahead.

Ambassador Umej Bhatia of Singapore credited Amprou with bringing trust to the negotiations when she became co-chair in July 2024, replacing Roland Driece of the Netherlands.

“Building trust requires folks to say: ‘Look, I’m going to come here and I’m going to put all the ego to the side and work on something important for humanity,” he said, crediting the women leaders in the talks for being particularly helpful. 

Bhatia also thanked “the president of a very big power” for pushing delegates over the line.

The pandemic agreement is the “first major agreement” where the US is absent and that “spurred” member states to ensure that they championed and protected multilateralism, he added.

While the agreement is symbolically important for multilateralism, it is also important because it is “a global acknowledgement of the importance of equity and inclusivity” – although that depends on getting PABS  [the annex on a Pathogen Access and Benefit Sharing system] done,” Bhatia stressed.

Negotiations on how a PABS system will work still has to be negotiated, and this is expected to be concluded by next year’s World Health Assembly (WHA).

Ambassador Anne-Claire Amprou and WHO Director-General Dr Tedros at the conclusion of the pandemic agreement talks.

COVID broke trust

Juliana Tenorio Quintero, Minister Plenipotentiary of Colombia’s Mission in Geneva, ascribed the lack of trust between member states to what happened during COVID-19, when developing countries could not get timely access to medical countermeasures.

She added that the pandemic agreement is “huge” – “like five agreements in one”. Talks were hard because there was a lack of expertise in crafting global health law treaties, member states were involved in the parallel process of negotiating the Intergovernmental Health Regulations (IHR), were under pressure from non-state actors – as well as the lack of trust and geopolitical context.

“Right at the end of the two years, we discovered that informal negotiations are the key to unlock negotiations,” said Quintero.

She also said that the personal commitment of delegates needs to continue to complete the next phase: “We became a family after many days and nights together – perhaps sometimes a dysfunctional family, as one colleague told me – but in any case, a family committed to deliver an instrument that served mankind.”

Three hundred days until deadline

WHO legal officer Steven Solomon said that the PABS annex had to be completed by 17  April 2026 if it was was to be passed by next year’s WHA.

“If you’re counting days, that’s 300 days. If you’re counting weeks, that’s 43 weeks and three days,” said Solomon.

An Intergovernmental Working Group (IGWG), which still needs to be set up, will manage the next phase of negotiations.

The South Centre’s Viviana Muñoz-Tellez said the two next steps – negotiating PABS and implementation – would determine whether the agreement enables global collaboration.

Muñoz-Tellez also called for “meaningful spaces for getting the inputs of all sorts of non-state actors” because we know that “industry will definitely be on top of PABS”, but we really need to get other parties to be involved.

Amprou said that the preparatory work for the implementation should start as soon as possible, in parallel to negotiations on the annex, which she thought should be a short document.

“I think that this negotiation should be much more technical than political. We know the political positions of different member states,” said Amprou.

Bhatia said that the PABS talks involved both national and hard commercial interests, which made reaching agreement very difficult.

He urged the PABS annex to emphasize “scientific collaboration”, describing it as under threat in a world where there’s a lot of anti-science sentiment.

Quintero said that the agreement’s technology transfer “lacks ambition”, and also called for an implementation committee. 

Closing the discussion, Norwegian Ambassador Angell-Hansen, said that the nationalisation of production benefits, in particular vaccines, posed a threat to the legal certainty of the agreement and it is “very important to have a maximum water-tight legal text on this”.

During the COVID pandemic, India prohibited the export of vaccines which were due to have been supplied to the global vaccine platform, Gavi, for global distribution.

“It is important that the PABS system works in a simple, transparent and fair manner,” said Angell-Hanson, who is a GPMB board member. 

“Here, I would like to make a special reference to the position paper that industry from both north and south jointly developed, and I would encourage them to develop this paper further and in very concrete ways.”

Image Credits: Thiru Balasubramaniam.

NIH main campus in Bethesda, Maryland
NIH building main campus in Bethesda, Maryland.

The Trump administration’s cancellation of hundreds of National Institutes of Health (NIH) grants “represents racial discrimination”, and were null and void, ruled United States District Court Judge William Young on Monday.

This follows the cancellation of some 2,100 NIH research grants valued over than $12bn based on their links to “diversity, equity and inclusion” or “gender ideology”, since Donald Trump assumed office in January.

“I am hesitant to draw this conclusion, but I have an unflinching obligation to draw it – that this represents racial discrimination. And discrimination against America’s LGBTQ community,” said Young, who was appointed by Republican President Ronald Reagan.

“I’ve sat on this bench now for 40 years. I’ve never seen government racial discrimination like this.”

A range of organisations including the American Public Health Association (APHA),  American Civil Liberties Union, United Automobile, Aerospace and Agricultural Implement Workers of America (UAW), Center for Science in the Public Interest and Ibis Reproductive Health launch a court challenge to to grant cancellations in April.

Their central argument was that the NIH had not been motivated by science but “vague” new criteria in terminating the grants

“The ideologically motivated directives to terminate grants alleged to constitute DEI, ‘gender ideology,’ or other forbidden topics were, in fact, arbitrary and capricious, and have now been ruled unlawful,” said Peter G Lurie, president of the Center for Science in the Public Interest, one of the plaintiffs.

Ibis described the ruling as “a major victory for public health”, describing the NIH’s directives that led to the cancellation of grants to be “based on sweeping, politically driven criteria.”

Young has ordered the reinstatement of grants previously awarded to the organizations and 16 Democratic-led states that filed the lawsuit.

The federal government intends to appeal the ruling.

Image Credits: NIH.

Economic insecurity is impacting on people’s family choices.

Economic insecurity is a major factor driving declining fertility globally, according to the 2025 State of World Population report produced by the United Nations Population Fund (UNFPA).

Financial worries – including job insecurity, housing and childcare costs – were key factors influencing over half of those interviewed to opt for fewer or no children, according to UNFPA.

A quarter of respondents also cited health issues, including difficulty in conceiving,  while 19% said fears about the future including climate change, were impacting their decision to have children.

Some 14,000 people – women and men – across 14 countries representing almost 40% of the global population were interviewed for the report, which was released last week.

The countries covered (from lowest to highest fertility rates) were: Korea, Thailand, Italy, Germany, Hungary, Sweden, Brazil, Mexico, United States, India, Indonesia, Morocco, South Africa and Nigeria.

People from Korea (58%) and South Africa (53%) were most concerned about economic insecurity, followed by Thailand and Morocco.

“Vast numbers of people are unable to create the families they want,” said Dr Natalia Kanem, Executive Director of UNFPA. 

Lack of choice

“The issue is lack of choice, not desire, with major consequences for individuals and societies. That is the real fertility crisis, and the answer lies in responding to what people say they need: paid family leave, affordable fertility care, and supportive partners,” she added.

UNFPA describes the fertility crisis as a “crisis in reproductive agency – in the ability of individuals to make their own free, informed and unfettered choices about everything from having sex to using contraception to starting a family”. 

The human population is projected to peak within the century, and a quarter of people currently live in a country where the population size is estimated to have already peaked. 

However, one in three adults surveyed had also experienced an unintended pregnancy, and 20% of people reported being pressured to have children when they didn’t want to.

The most marginalised people have experienced few of the advances in sexual and reproductive health and rights, according to the report. UNFPA data over the past five years shows that about 10% of  women are unable to decide whether to use contraception, and roughly one quarter are unable to say no to sex. 

The report warns against simplistic or coercive responses to declining birth rates – such as baby bonuses or fertility targets – noting that these policies are largely ineffective and can violate human rights.

It cites Romania’s 1966 ban on abortion and contraception as a warning. While the ban led to an immediate increase in total fertility rate from 1.87 births in 1966 to 3.59 in 1967, “by 1970, the fertility rate had fallen below three” and the consequences were “grave”.

“By the time the policy ended in 1989, Romania had the highest maternal mortality rate in Europe, some 87% of which was attributable to unsafe abortion, as well as vast numbers of abandoned children,” according to the report.

Instead, UNFPA urges governments to empower people to make reproductive decisions freely, including by investing in “affordable housing, decent work, parental leave, and the full range of reproductive health services and reliable information”. 

It advocates for “a tailored mix of economic, social, and political measures” to help people to have the families that they want.

Image Credits: Jaya Banerji/MMV.

Yellow fever vaccination Americas
Yellow fever cases has surged this year in the Americas, mostly due to spillover events from animals.

The region of the Americas has seen eight times the number of yellow fever cases this year, compared to the same period in 2024. The vaccine-preventable, viral, mosquito-borne disease has surged as cases “spillover” from animals, according to a Pan American Health Organization (PAHO) rapid risk assessment.

Dense jungles in Colombia and Brazil have seen the most sylvatic – or “jungle” – yellow fever cases originating from an animal host. In these areas, unvaccinated humans can be infected from mosquitoes that are carrying the virus after biting infected monkeys and other primates.

Brazil, Bolivia, Colombia, Ecuador, and Peru have reported 221 confirmed human cases of yellow fever, and 89 deaths. Brazil accounts for nearly half of these cases and deaths.

These countries typically see jungle cases each year, but the combination of increased spillover events and a persistent unvaccinated population has meant there is now a risk of urban outbreaks. Almost all cases and deaths reported this year and last were in unvaccinated people.

PAHO has denoted the public health risk of yellow fever as high, even though a single dose of the vaccine is enough to provide life-long protection.

Prior to the COVID-19 pandemic, vaccine rates in the 12 countries in the region prone to yellow fever were quite high, ranging between 57-100% in young children, according to PAHO. But rates have dropped to below the recommended 95% coverage in 10 out of the 12 countries with circulating yellow fever, leaving a “substantial proportion” of the population unprotected, according to PAHO. 

Symptoms like fever, muscle pain, headache, nausea, and vomiting occur three to four days after a mosquito bite. Roughly 15% of patients will develop a toxic, hemorrhagic phase. The mortality rate of this type of yellow fever is over 50%. 

Yellow fever transmission
Sylvatic, or “jungle,” yellow fever is fueling transmission in the Amazon region.

While recent vaccination campaigns have increased the number of people protected, fewer vaccine suppliers, cost, and the long process to make the vaccine means that there’s a limited global supply. “Current supplies [are] unable to cover demand in the Americas and in Africa,” said PAHO in a statement.

This has led countries to consider splitting doses among multiple people, so that each jab is one-fifth the normal dose. This smaller dose provides immunity for up to 12 months.

Historically notorious, but preventable disease

Yellow fever has a long history in the Americas, with periodic epidemics crippling cities and rural areas alike in the 19th and 20th centuries. 

But following the introduction of an effective vaccine, most cases remained concentrated in the Amazon and mountainous regions in Brazil, Colombia, Ecuador, and Peru. But this year, Colombia and Brazil have detected cases outside the typical Amazon region, in the state of São Paulo in Brazil and the department (state) of Tolima in Colombia.

This increase in yellow fever is primarily due to the reactivation of the jungle transmission cycle in the Amazon region, according to a recent PAHO epidemiological alert.

The expansion of cases beyond the typical regions points to an increase in human-forest interaction in forest edges.

“These areas provide ideal conditions for canopy-dwelling mosquitoes to transmit the disease to human populations from non-human reservoirs,” said PAHO in its alert.

While this year marks a concerning surge, it still hasn’t reached the levels of epidemics of the past decade, such as in 2016, said Dr Andrea Vicari, unit chief of infectious hazards at the World Health Organization (WHO).

Vaccine hesitancy delays containment

In Colombia, all yellow fever deaths have been of unvaccinated people. 

“All mortality has been among people not vaccinated,” said Dr Diana Pava, director of the Colombian National Institute of Health, told a PAHO briefing. The populations most affected are older adult men who work in the agricultural sector. 

Few, if any children catch yellow fever because the vaccine is “obligatory,” Pava noted. Children receive the jab with their measles, mumps, and rubella (MMR) vaccine. The same isn’t true for older generations, hence the concentration of cases in adults 65 and older.

Yellow fever 2023-2025 map Americas
Yellow fever has now been detected in new regions in Brazil and Colombia, impacting unvaccinated older adults.

Colombia’s rising cases highlight the difficulties in reaching older, rural, and isolated communities for vaccination. 

“In the rural areas, the beliefs may be different, or they don’t want the vaccine,” Pava said.

Colombia’s health ministry is concentrating its outreach efforts on these areas, especially because any outbreak, even in a remote area, could lead to cases in more populated regions.

For Brazil, which has seen over one hundred cases this past year, challenges include high vector density, and outright vaccine refusal out of fear, said Dr Daniel Ramos, arbovirus coordinator for the Brazilian Ministry of Health. Despite this, Ramos praised Brazil’s high vaccination rate, which has protected Brazilians even with increased circulation of the disease in animals.

Need to monitor animal hosts

Changing ecological conditions have also made it easier for yellow fever to jump from non-human primates like monkeys, to people.

Urbanization, “edge” habitats, and ecosystem fragmentation are all connected to a greater risk of yellow fever spread, noted Vicari. 

As a result, PAHO and health ministries have flagged the need to monitor yellow fever not only in humans, but in animals too. Tracking monkey deaths serves “an early warning to identify yellow fever circulation,” said PAHO in its alert. This could then alert officials to vaccinate people nearby. 

“While vaccination is certainly a key action, it must be integrated within a balanced response,” said Vicari, such as animal surveillance, clinical management, risk communication, vaccine stock management, and even contingency planning for potential urban outbreaks.

Image Credits: PAHO, PAHO.

A mother at Tygerberg Hospital in Cape Town with her newborn.

The quest for new treatment options for newborns with drug-resistant sepsis took another step forward this week with the enrollment of the first baby in a trial of a combination of three older antibiotics.

It is the second part of a clinical trial by the Global Antibiotic Research and  Development Partnership (GARDP) to evaluate various antibiotic combinations for newborn babies with sepsis.

The first part of the trial, called NeoSep1, was launched in 2023 and it tested two antibiotics – fosfomycin and flomoxef. In this part of the trial, a third antibiotic, amikacin, has been added to the first two antibiotics.

The two combinations will be ranked against five commonly used antibiotic regimens for neonatal sepsis with the overall goal of identifying the optimal treatments to reduce neonatal deaths. 

Baby One was enrolled at Tygerberg Hospital in Cape Town, and GARDP aims to reach 3,000 newborn babies in hospitals across nine countries in Africa and Asia by 2028.

Neonatal sepsis affects up to three million babies a year globally, and 250,000 babies in Africa alone die from sepsis every year. The crisis is exacerbated as an increasing number of newborns are becoming resistant to recommended antibiotic treatments.

“Newborn babies are particularly vulnerable to infections, yet appropriate antibiotic treatments are often not available, especially in African countries,” said Sally Ellis, Children’s Antibiotics Project Leader for GARDP.

“If a baby picks up a serious infection, it can be a matter of life and death. New antibiotic treatments are sorely needed. GARDP’s clinical trial on neonatal sepsis hopes to help fill the treatment gap, so that babies with sepsis stand a better chance of survival and a good outcome.”

NeoSep1 is sponsored by the GARDP in collaboration with the Medical Research Council Clinical Trials Unit at University College London; City St George’s at the University of London, and the paediatric science research grou,p Penta.

The trial is part of a five-year project by a consortium of African and European partners called SNIP-AFRICA, which aims to reduce mortality among newborns with sepsis in hospitals in Africa.

Image Credits: Global Antibiotic Research and Development Partnership (GARDP).

WHO Director-General Dr Tedros Adhanom Ghebreyesus (centre) applauding the vote on the pandemic agreement in Committee A, flanked by Committee A chair, Namibian Health Minister Dr Esperance Luvindao (left) and his Deputy Director-General, Dr Mike Ryan.

The World Health Assembly (WHA) adoption of the Pandemic Agreement sent a powerful message: Multilateralism remains alive and countries can still find common understandings on collective problems. Many steps still need to be completed, and thus the agreement will not be open for signature for at least another year, as negotiations continue on contentious issues around an Annex on the Pathogen Access and Benefit-Sharing System (PABS). This sixth issue of the Governing Pandemics Snapshot explores the trade-offs made in a final agreement and the steps remaining for it to be ready for parties’ signature, setting off the countdown for it to enter into force.

The 78th World Health Assembly (WHA) adoption of the Pandemic Agreement (PA) on 20 May was the end of an arduous three-year negotiating process. But it also marked the beginning of another round of difficult negotiations on an annex for Pathogen Access and Benefit Sharing (PABS). 

The agreement will not be open for signature for at least another year as negotiations continue on the PABS Annex. It must be signed by at least 60 countries for it to enter into force, a process that could take years.

This article reviews the tense 11th hour debates and tradeoffs that led to the final agreement, as well as the next steps to expect in the PABS negotiations. 

Tone shifts in late negotiations

In 2025, the International Negotiating Body (INB) met twice. The 13th meeting of the INB took place on from 17 to 21 February, based on a new text proposed by the Bureau, a group of six country representatives leading the process. 

The list of unresolved articles was long and included some of the most contentious issues that had seen little convergence over the previous years: prevention and One Health, technology transfer, PABS, supply chain and logistics, and governance elements in Chapter III. 

This was also the first session held without the participation of the United States, following the announced withdrawal from the World Health Organization (WHO) after the inauguration of the second Trump administration. Against this backdrop, progress was made – albeit slowly.

Some observers suggested that the absence of the US, combined with a heightened sense of urgency due to mounting pressures on the global health architecture and ongoing funding cuts, might have contributed to a more constructive attitude of delegation and a shift in tone. 

Ambassador Pamela Hamamoto, leader of the US delegation during the Biden administration.

The resumed session of INB13 – the final meeting on the INB calendar – took place on from 7 to 11 April, with nightly sessions stretching into the early hours of the morning on each day of negotiations. 

Progress was steady. Negotiators gradually cleared all remaining articles, reaching consensus on the framework for the PABS System – including a fixed commitment for each participating manufacturer to share a percentage of real-time production during pandemics, one of the key requests of developing countries – followed by agreement on prevention and One Health (see Ricardo Matute’s piece for an analysis of this topic). 

One by one, key issues began to fall into place during an extenuating week of negotiations. 

On the final day, negotiators worked continuously for over 24 hours to achieve full consensus. However, one final point of contention remained: Article 11 on technology transfer. Divisions persisted between countries favoring a strictly voluntary approach and those advocating for stronger obligations, including mechanisms to compel access to manufacturing know-how for pandemic-related health products during crises. 

With consensus on the full text within reach, the meeting was suspended around 9am on Saturday 12 April, after 24 hours of deliberation, and scheduled to resume on Tuesday 15th.

In the early hours of April 16th, the text was fully greened – culminating in an emotional and symbolically powerful moment. 

The deadlock on technology transfer was resolved by inserting a footnote defining the expression “as mutually agreed” after each reference in the text. (A more detailed analysis of the outcome of this compromise is provided by Ellen ‘t Hoen in the Snapshot.)

Adoption survives a surprise last-minute vote 

Following the green-lighting of the text in April, the INB transmitted the final draft of the agreement along with a draft resolution that was agreed upon shortly after the finalization of the agreement, to the 78th World Health Assembly (WHA) for formal adoption. 

The PA was the first item for consideration in Committee A, one of the main committees of the WHA focusing on programmatic and technical issues, and with a consensus ready text, agreement should have been straightforward. 

Yet, a last-minute curveball came from Slovakia, which unexpectedly called for a vote. A statement released by the Slovak Prime Minister Robert Fico claimed that the agreement “violates the principle of the sovereignty of the member states and disproportionately interferes with the area of human rights.” 

Despite this challenge, member states overwhelmingly showed support for this hard-won treaty: the final vote recorded 124 in favor, zero objections and 11 abstentions. A number of countries were absent from the meeting or had their right to vote suspended due to their arrears in assessed contributions. 

The following day, the text moved to the plenary session, where it was adopted by consensus, surrounded by cheers and a surge of emotion in the room.

Key officials of the Intergovernmental Negotiating Body celebrate after the WHA adopts the pandemic agreement on 20 May 2025.

Several crucial steps before entry into force

Negotiators deliberately designed the PA’s architecture to accommodate further negotiations, particularly those required to operationalize the PABS System. 

Although the PA includes a dedicated article on PABS, it merely establishes the system’s foundational principles. The specifics — such as how benefits will be shared and what obligations apply to countries and companies — remain to be determined. 

To this end, the WHA mandated the creation of an Intergovernmental Working Group (IGWG), open to all WHO Member States, to negotiate the elements necessary to operationalize the PABS System in the form of an annex to the agreement that will have to be adopted separately by the WHA.

A consequential addition was made to Article 33 on signature: the PA will only be open for signature once the PABS Annex has been adopted by the WHA. 

The IGWG is scheduled to hold its first meeting no later than 15 July 2025, during which it will presumably determine the composition of the Bureau that will lead the next phase of negotiations, and its program of work. It is unclear whether former INB Bureau members will be reappointed or if new leadership will step in. 

The IGWG must present the outcome of its work – whatever this may be – to the 79th WHA in May 2026. This leaves less than a year to resolve one of the agreement’s most complex and contentious components. (A detailed analysis of what to expect from these negotiations is addressed by Adam Strobeyko in another piece of this Snapshot.)

Should consensus prove elusive, it will fall to the WHA to decide how to proceed. 

Importantly, the IGWG’s mandate extends beyond finalizing the Annex. It is also tasked with laying the groundwork for the agreement’s implementation and eventual entry into force. 

These tasks include drafting the rules of procedure for the Conference of the Parties, establishing financial rules and a draft budget; defining the structure and functions of the Global Supply Chain and Logistics Network; suggesting reporting obligations; and proposing details on the functioning of the implementation mechanism for the PA. (These institutional and procedural issues are explored further by Gian Luca Burci in in Snapshot.)

Once the annex is adopted, the PA will be open for signature and ratification. It will require ratification by at least 60 countries to enter into force — a process that could take years. 

As many analysts have indicated, the adoption of this historic agreement marks not an endpoint but rather a beginning. As negotiations continue on the PABS Annex and the operational structures needed to implement the agreement, the focus must now shift to ensuring that these ambitious commitments are translated into real-world impact, strengthening global preparedness and response to future pandemics.

This is one of six article in the latest Governing Pandemics Snapshot produced by the Global Health Centre at the Geneva Graduate Institute.

Daniela Morich is Senior Manager and Adviser at the Global Health Centre, Geneva Graduate Institute. 

Ava Greenup is Project Associate of the Governing Pandemics Initiative at the Global Health Centre, Geneva Graduate Institute.

Image Credits: WHO.