USAID ‘Officially’ Gutted, but Administration Overstepped Constitutional Power, Judge Rules 11/03/2025 Sophia Samantaroy USAID staff offload emergency supplies. Secretary of State Marco Rubio announced that 83% of US international aid programs were “canceled” hours before a federal district judge ruled that the administration’s actions were an overreach of the Executive branch’s power. At risk are thousands of lifesaving humanitarian programs. In a refugee camp in Bangladesh, 500,000 Rohynga children depend on food treatment aid for their survival. One-year-old Mariam recovered from severe malnutrition after treatment in a UNICEF camp, but now her mother fears the clinic would shutter. “If you stop providing us with this therapeutic food, my child could die,” she told UNICEF. Thousands of US Agency for International Development (USAID) contracts have been terminated, after Secretary of State Marco Rubio signaled that the six-week review of the aid agency is “officially” complete. The remaining programs overseen by the six-decade-old USAID will now be part of the State Department, Rubio said. Late Monday, a federal district judge said that the Trump administration’s halt of foreign assistance overstepped the Executive branch’s authority. The judge ordered the administration to pay USAID partners for work already completed before 13 February, but stopped short of restoring the more than 10,000 contracts the administration has canceled. Separation of powers A vaccination site in South Africa co-sponsored by USAID. The judge ruled that the administration could not withhold the billions of dollars Congress had already approved for foreign aid, saying the president does not have “unbounded power” in foreign affairs. “The Executive not only claims his constitutional authority to determine how to spend appropriated funds, but usurps Congress’s exclusive authority to dictate whether the funds should be spent in the first place,” Washington DC district’s Judge Amir Ali said. Ali ruled in his preliminary injunction late Monday that Trump could not ignore the $60 billion Congress already allocated for foreign assistance to USAID. Congress alone has the power to allocate funding under the US Constitution. “The constitutional power over whether to spend foreign aid is not the President’s own — and it is Congress’s own,” said Ali. In response to a suit filed by the AIDS Vaccine Advocacy Coalition (AVAC), the Journalism Development Network, and the Global Health Council, Ali ordered the administration to pay aid groups the money owed for work completed up to 13 February, at a pace of at least 300 back payments a day. But he declined to restore contracts the administration canceled, saying it was up to the Trump administration to decide which organizations could win contracts. Ali’s ruling came after the Supreme Court cleared the way for a lower court to rule on the aid freeze. Trump ‘is not king’ “Today’s decision affirms a basic principle of our Constitution: the president is not a king,” said Lauren Bateman, an attorney with Public Citizen Litigation Group and lead counsel representing the two organizations filing suit, in a statement. “But we are painfully aware that, without unwinding the mass termination of foreign assistance awards, winning on the constitutional issues does not avert the humanitarian disaster caused by the Trump administration’s freeze on foreign assistance. And it does not undo the damage that the freeze has already inflicted on millions of vulnerable people across the world. Deaths will continue to mount. “While the courts have an important role to play in standing up for the rule of law, Americans need more than just the courts. We need Congress, which has always supported foreign aid on a bipartisan basis, to assert itself.” Whether Congress will act is yet to be seen, especially as the deadline to fund the federal government looms. The House passed a procedural measure for its funding bill Tuesday along party lines, which critics say is a “blank check” for the Trump administration’s agenda. Republican members of congress have voiced support for a narrower definition of US’s involvement in foreign development programs, and support Elon Musk’s Department of Government Efficiency’s (DOGE) efforts to cut back the federal government. Earlier in February, the House Foreign Affairs Committee held a hearing titled “the USAID Betrayal,” where chair Brian Mast (R-FL) argued that USAID programs “hurt America’s standing around the globe, and I think the fact is clear that America would have been better off if your money had been simply thrown into a fireplace.” ‘Reform’ completed After a 6 week review we are officially cancelling 83% of the programs at USAID. The 5200 contracts that are now cancelled spent tens of billions of dollars in ways that did not serve, (and in some cases even harmed), the core national interests of the United States. In… — Marco Rubio (@marcorubio) March 10, 2025 Rubio’s declaration that thousands of aid contracts were “officially” canceled came after the Trump administration’s six-week battle to gut USAID, calling the move an “overdue and historic reform.” His post was one of the few public comments on the swift dismantling of US policy of soft power and aid in developing countries. “The 5200 contracts that are now cancelled spent tens of billions of dollars in ways that did not serve, (and in some cases even harmed), the core national interests of the United States,” said Rubio on X. He said the remaining 1,000 contracts would be administered directly by the State Department. The Trump administration has made misleading claims that millions of taxpayer dollars were being used for diversity, equity, and inclusion (DEI) initiatives. Funding for many of these activities came through the State Department not USAID, at the request of embassies, according to independent fact checkers. “It’s been run by a bunch of radical lunatics,” Trump said last month. “And we’re going to get them out.” But the dismantling of USAID has meant a freeze on malaria, HIV, and tuberculosis aid, which combined protect millions of people in Africa, Latin America, and Southeast Asia from the leading infectious diseases. “Under President Trump, the waste, fraud, and abuse ENDS NOW,” the White House said in a February statement. Humanitarian groups offer dire warnings UNICEF personnel measure a Rohingya child’s arm for signs of malnutrition. Mariam and her mother are among thousands of Rohingya refugees at risk of malnutrition in the Cox’s Bazar camp, said Rana Flowers, UNICEF representative in Bangladesh. “Children in the world’s largest refugee camp are experiencing the worst levels of malnutrition since the massive displacement that occurred in 2017,” she said at a press briefing in Geneva on Tuesday. Other UN organizations echoed her warning that cuts to humanitarian aid would result in further devastation. The UN Commmision on Human Rights (UNCHR) has already shut down a US-funded program that worked with torture victims and families of disappeared persons. The US represented more than 40% of UNHCR’s budget in Colombia, meaning the agency’s work of “resolving” and “pre-empting” crises is threatened, said Ravina Shamdasani, UNCHR Chief Spokesperson at the Geneva press conference. The agency received USAID suspension letters for all projects in Equatorial Guinea, Iraq and Ukraine, as well as Bangladesh, Colombia, Ethiopia and Peru. ‘No replacement’ for USAID Rana Flowers, UNICEF representative in Bangladesh, speaking about the 500,000 children living in the world’s largest refugee camp. Although the US granted a waiver for UNICEF’s work to prevent malnutrition in refugee camps, there is no guarantee that the agency will be able to continue using the therapeutic food to treat and cure sick children with acute malnutrition. Flowers noted that the agency needs both the waiver and actual funding to continue the work. Funding for malnutrition treatments runs out in June. Unless additional funding is secured, only half of refugee Rohingya children will have access to treatment this year, Flowers warned. Without access to treatment, up to 7,000 children are at risk of severe malnutrition. UNICEF expects an increase in morbidity and mortality in these camps. “There’s no replacement for the valuable partnership with the United States,” said Flowers. “Until now, this community has survived thanks to the solidarity of the international humanitarian community,” she said. “But today, an aid funding crisis risks becoming a child survival crisis.” Additional reporting by Elaine Fletcher. Image Credits: USAID Press Office, USAID, UNICEF/Njiokiktjien. Despite ‘Rising Misogyny’, UN Commission Adopts Declaration on Gender Equity 11/03/2025 Kerry Cullinan Françoise Moudouthe, Chief Executive Officer of the African Women’s Development Fund, “The poison of patriarchy is back and is back with a vengeance,” United Nations (UN) Secretary-General António Guterres told the opening of the annual session of the Commission on the Status of Women (CSW) at the UN in New York on Monday. The CSW takes place amid a major global backlash against women’s rights, from the Taliban banning Afghan women from public life to the Trump administration in the United States pushing back against “diversity, equity and inclusion” (DEI) which has resulted in cuts to research on women’s health. “Misogyny is on the rise, and so, violence and discrimination,” said Sima Bahous, who heads UN Women, noting that “domestic and ODA [official development assistance] allocations to gender equality remain woefully inadequate and, in some cases, are being cut altogether”. Declaration passed despite US, Russian objections The CSW’s political declaration was adopted by consensus on Monday. And despite earlier reports that the US and Russia had tried to purge a clause that encouraged member states from nominating women candidates for the UN Secretary-General position and President of the General Assembly, that clause survived. So did commitments to “gender equality and the empowerment of all women and girls”, and the “accelerated implementation” of the Beijing Declaration and Platform for Action, the first global roadmap for gender equality that was adopted 30 years ago. Bahous also commended the 159 member states that have affirmed their support for the Beijing Declaration in national reports. Despite the backlash, there has also been progress in the past 30 years, she noted: “Today, more girls are in school. More women are in parliaments, in boardrooms, in the judiciary. Maternal mortality has fallen. Legal barriers have been dismantled. Policies to protect and advance women’s rights are advancing. Violence against women and girls is widely recognized as a global scourge.” ‘Calculated cut’ to funds Françoise Moudouthe, Chief Executive Officer of the African Women’s Development Fund, told the opening plenary that “the decision by several governments and philanthropic actors to cut funding for gender equality in the past few years is a calculated blow to women’s access to education, healthcare, economic independence, political participation and bodily autonomy”. “The recent funding cuts by just two governments and two private philanthropic donors to women’s rights organisations were recently estimated to around $730 million per year,” she added. “We must immediately commit to protecting protecting gender equality for all, not with words but with resources,” Moudouthe stressed. Bahous declared that: “We, the champions of gender equality, are not afraid of the pushback. We have faced it before. We have not backed down. And we will not back down.” The proportion of women killed in wars had doubled over the past year alone, added Bahous, pointing to women’s and girls’ rights being “systematically stripping away” by climate change and conflicts in Afghanistan, the Democratic Republic of Congo (DRC), Palestine, Gaza, Haiti, Myanmar, Sudan and Ukraine. Call for sanctions on Taliban Meanwhile, at the UN Security Council meeting happening at the same time, Afghan lawyer Azadah Raz Mohammad urged the body to impose sanctions on all Taliban leaders who have committed human rights violations against Afghan women and girls, and not to lift sanctions, including travel bans, on those who are guilty of such crimes. “If the people of Afghanistan had been able to hold the Taliban accountable in 2001 and earlier, perhaps we would not have witnessed the Taliban’s violent return to power 20 years later,” Mohammad said, concluding: “If impunity is the disease, accountability is the antidote.” She also urged all member states to assist the International Criminal Court to pursue charges against all senior Taliban leaders who have committed acts of “gender persecution and other crimes against humanity, and war crimes” in Afghanistan since 2003. Only Seven Countries Meet WHO Air Quality Standards; Most Polluted are Chad and Bangladesh – Northern India Also Dominates 11/03/2025 Chetan Bhattacharji Air pollution in Delhi, the world’s most polluted capital city, is caused by several factors including traffic, industry and stubble burning. Chad and Bangladesh ranked as the most polluted countries in 2024, while Delhi, India was the most polluted capital city, according to the 2024 World Air Quality report produced by the Swiss-based IQAir. But only seven countries worldwide met WHO air quality guidelines and Africa’s pollution levels remains under-reported. Pollution monitoring also fell victim to President Trump drastic cuts and rollbacks of environmental protections, as US embassies worldwide closed monitoring stations and disabled the US government’s airnow.gov data base. Seventy-four of the 100 most polluted cities and towns are in India, according to the latest World Air Quality Report 2024, a slight improvement from 83 last year. Levels of a key microscopic pollutant, PM2.5, declined 7% across the nation, averaging 50.6 micrograms/cubic metre or 10 times the World Health Organization’s (WHO) safe guideline. Despite having the most polluted cities, India ranked fifth, globally, after Chad, Bangladesh, Pakistan, and the Democratic Republic of Congo in terms of national pollution levels. Globally, only 17% of the almost 9,000 cities surveyed met the WHO air pollution standard, which is an annual average of 5 micrograms/cubic metre of the pollutant PM 2.5. This microscopic particulate matter, containing a cocktail of other pollutants that penetrate the blood and brain barrier, is the most widely tracked measure of air pollution. Nationally, only seven countries: Australia, New Zealand, the Bahamas, Barbados, Grenada, Estonia and Iceland met WHO annual air quality levels, IQAir said. However, a world map of pollution averages shows air pollution is primarily a Global South challenge. Most of the worst affected places are in Asia. Some in Africa, although only 24 out of 54 African countries or territories reported data in 2024. Still, this is a marked improvement since the first of these reports in 2017 had useable data from only three African countries. US State Department closes global air quality monitoring network The rankings were released days after the new Trump administration’s move to shut down air quality monitoring at United States embassies worlwide. In parallel, the State Department deleted 17 years of data from US government’s airnow.gov data base – which had been a valuable source of reliable air quality data in resource-strapped countries like Chad. This is likely to have a “profound” real-world impact on surveillance, according to the report’s scientists. “The information collected at 80 global US embassies and consulates have proven to help protect public health and inform air quality policy… when US embassies began tracking local air pollution, host countries took action,” said Dr Christi Chester Schroeder, IQAir Air Quality Science Manager. “IQAir estimates at least eight countries will completely lose access to all real-time air quality data because of this decision, nearly all of which are in developing countries.” In Asia, Iran and Afghanistan are not included in the report because of a lack of real-time data. The report is based on data from about 40,000 ground-level air quality monitors in 138 countries, although IQAir, a Swiss firm for air quality equipment, does not publicly provide a margin of error for PM2.5 concentrations used in this report. Caption: The world’s top-10 most polluted countries in 2024 Why India isn’t the most polluted While it dominates the top 100 most polluted cities and towns, India’s expansive air quality monitoring network also captures levels in more rural and less polluted aeras – and that brought it’s national average down in comparison to other heavily polluted coutries, experts said. So the reasons Pakistan and Bangladesh ranked higher in overall pollution levels may be related to the limited scope of their air quality monitoring network – which tend to capture urban areas only. Cities with high PM 2.5 concentrations thus have a disproportionate impact on the country’s annual average concentrations. Chad also returned to the 2024 rankings – after being excluded in 2023 for a lack of data. Regional airshed solution for South Asia Either way, the report makes for bleak reading for India and the rest of South Asia. Bangladesh, Pakistan, India and Nepal are ranked at 2, 3, 5 and 7. The capitals of all these countries are also in the top 10 most polluted cities. India continues to lead the region in government monitoring infrastructure, operating more than half of the total stations, the report points out. Despite this, many areas in India remain under-monitored, particularly in smaller cities and rural regions. Cities like Delhi and Lahore frequently experience hazardous conditions with seasonal spikes in pollution leading to emergency measures such as school closures and public space shutdowns. “Air pollution pays no regard to country borders. The trans-boundary nature of air pollution is a serious issue in many regions around the world, and is no different with India and Pakistan,” said Schroeder. “Airsheds need to be treated as regional international issues, not national issues. Cities in India and Pakistan, as well as Bangladesh and Nepal, share common sources of pollution – industrial emissions, agricultural burning, vehicle pollution, dust, etc. Despite years of evidence of trans-boundary pollution, regional cooperation has been underwhelming.” The 20 most polluted cities in 2024. Source: World Air Quality Report,Note: Delhi is the larger area and New Delhi is the capital area within it. The second position is Delhi’s highest ranking since this annual report began eight years ago. One of India’s foremost air quality government scientists, Dr SN Tripathi, believes that in South Asia, India will have to take the lead in proposing and establishing some kind of agreement or arrangement with other countries. Airsheds within India and ability to analyse how air pollution is moving from one region to another. Tripathi, Dean at Kotak School of Sustainability, IIT Kanpur, calls for a “multilateral airshed approach sooner than later to deal with this menace.” Delhi is the air pollution capital The report’s scientists point out that while India’s population is nearly identical to the entire African continent, it has significantly expanded its air quality monitoring network in recent years. Experts say more such data should help in tackling the crisis. The world’s most polluted place is Byrnihat, an industrial town in India’s north-eastern state of Meghalaya. The annual average PM2.5 concentration was 128.2 micrograms/cubic metre. However, 2024’s data puts the main focus back on Delhi. The capital area of New Delhi, which has a municipality separate from the rest of Delhi, was the world’s most polluted capital. The larger area of Delhi ranked second among nearly 9,000 places. This is Delhi’s highest rank since the annual report began in 2017. (Although this is the 7th World Air Quality report, IQAir has produced eight rankings since 2017 ,which have been shared with Health Policy Watch for this article.) In stark contrast to the national decline, the pollution level rose in Delhi by 6% to 108.3 micrograms/cubic metre last year, the highest since 2019. Ironically, that is the year India’s first national clean air programme (NCAP) was launched. The report attributes Delhi’s pollution to vehicular emissions, a leading contributor to fine particulate matter (PM2.5), exacerbated by traffic congestion and fuel adulteration, as well as industrial and construction activities and seasonal burning of agricultural residue. Northern India dominates global ranking All the 74 Indian cities in the top 100 list are in northern India with none from southern India. About 65 of these are in the northern plain called the Indo-Gangetic Plain (IGP), from Punjab in the west to Bengal 2,000 km in the east. This remains a pollution hotspot, where meteorological factors trap pollutants and exacerbate winter smog. The Indian government plans to coordinate air pollution control plans in the IGP with a population of about 600 million as one jurisdiction. While India’s PM 2.5 averages 50.6 micrograms (population-weighted), a back-of-the-envelope calculation of average pollution in the IGP states shows the level of PM 2.5 to be higher by about a fifth. The location of the 74 Indian cities in the top 100 most polluted ranking of 2024 World Air Quality Report. The challenge is that each state is a separate political entity but air pollution obviously moves across political boundaries. Tripathi advocates the airshed approach as the framework “to approach the problem with common or shared resources. To get more bang for the buck.” He estimates that pollution can come down by two-thirds if the burning of waste outdoors and of polluting fuels (like coal, dung and wood) inside homes is stopped. China’s Air Pollution Dips Pollution levels declined in over 320 cities in China, including major cities such as Beijing, Shanghai, Chengdu, Guangzhou, and Shenzhen. But levels rose in almost 130 other cities. Officials have set ambitious goals to lower the national annual average PM 2.5 concentration to below 28 µg/m³ by 2027 and below 25 µg/m³ by 2035. Special attention is being given to the Beijing-Tianjin-Hebei region at the provincial level. Warning for Southeast Asia’s most polluted country Air pollution in Indonesia’s captial of Jakarta. Air pollution in Indonesia decreased by 4% in 2024 compared to the previous year, averaging 35.5 micrograms. However, the report warns of a clean energy challenge. The country is the world’s leading producer of nickel, a vital mineral for clean energy and storage but to extract it takes a lot of energy. And for this, it’s increasing its coal power capacity which grew 15% over a year till July 2024. Coal burning generates two-thirds of Indonesia’s electricity. Despite declining pollution, it remains the most polluted country in Southeast Asia. Vietnam air pollution’s cost In Vietnam, air pollution has been estimated to cause a loss of around 4% of the GDP. Acute air pollution events in Vietnam have severely impacted daily life, with disruptions to air travel leading to flight diversions at multiple airports. In 2024, there was a small reduction in pollution from 29.6 to 28.7 micrograms. Vietnam’s government, international bodies and various organisations are empowering citizens through information campaigns to raise awareness, take preventive action and also expand air quality monitoring for public health action and academic research. Community initiatives are promoting sustainable agricultural practices, such as reducing straw burning, while advocating for responsible household waste disposal to minimize pollution. The cleanest air was found in Hawaii’s Honaka’a, in the United States. It is ranked 8,954th and the PM 2.5 average was one microgram/cubic metre of air. Image Credits: Raunaq Chopra/ Climate Outreach, IQ Air, IQ Air, IQAir, Google maps, Aji Styawan / Climate Visuals. Big Pharma Issues Global ‘Call to Action’ to Address NCD Crisis 11/03/2025 Kerry Cullinan A patient with diabetes attends a check-up at a district hospital in Kigali, Rwanda. Investment in NCD prevention, treatment and care at primary level can save millions of lives. Almost five million lives could be saved annually if low- and middle-income countries (LMICs) invested 1% more of GDP in public healthcare spending – and used at least 40% of this to prevent and treat non-communicable diseases (NCDs). This is according to Airfinity research commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which issued a “Call to Action” on NCDs on Tuesday. The research is based on “implementing existing cost-effective interventions such as cardiovascular disease management, diabetes screening, and respiratory care”, according to the IFPMA. “The data supports growing consensus that more funding is needed to bend the curve on NCDs,” the pharmaceutical body said, “urging collective action across the globe” ahead of the United Nations High-Level Meeting on NCDs in September. NCDs such as cancer, diabetes, cardiovascular disease, lung disease, mental health, and neurological disorders cause almost three-quarters of global deaths. Eight out of 10 premature NCD deaths take place in LMICs Investment in NCD prevention and control could yield an annual seven-fold return in LMICs within a decade, according to 2021 World Health Organization (WHO) calculations. Lifestyle interventions including healthy diet and exercise, and primary healthcare could lead to an expected $230 billion economic gain by 2030, the WHO found. But NCD prevention, early detection, treatment, and control “remain severely underfunded and under-prioritized by both governments and global donors,” according to the IFPMA. “Low awareness” by “decision-makers, affected individuals, and general population” and “fiscal challenges” were the main reasons for the underfunding, according to the WHO and the World Bank. As a result, on average some 60% of treatment costs are being carried by patients in LMICs. These out-of-pocket payments for NCD treatment and care push approximately 100 million people worldwide into extreme poverty every year, according to the NCD Alliance. Access to medicines The IFPMA noted that “over 1,400 medicines have been approved for NCDs in the past 10 years, which have transformed how we fight disease, and are improving the lives of hundreds of millions of people living with chronic conditions” and “a further 9,600 NCD medicines [are] at various stages of research and development”. However, there are “significant barriers and delays in ensuring these medicines and vaccines can reach the people who need them, and there are still NCDs for which there is not adequate treatment”, the IFPMA noted. The IFPMA is working with partners in Access Accelerated to assist governments to identify a “suite of sustainable financing mechanisms” for NCDs including “health taxes, private or community-based health insurance programs, debt-for-health swaps, health savings accounts, performance-based financing (social impact bonds), blended financing, and mobile health financing solutions”. Redirecting existing fossil fuels subsidies and increasing taxes on tobacco, alcohol, and unhealthy foods are options for LMICs to raise finances to address NCDs, the IFPMA report notes. Collective action It called for collective action to enable innovation, mobilise investment, drive implementation and ensure the accountability of government and key stakeholders to improve on prevention, treatment and care of NCDs and mental health. “A political declaration that includes these recommendations can drive a vision for 2050 forward where there are fewer premature NCD deaths, reduced health systems strains, and healthier societies everywhere,” according to the IFPMA. IFPMA Director General Dr David Reddy said that the UN High-Level Meeting “provides a real opportunity to refocus attention on how cross-sectoral partnerships can help increase access to cost-effective medicines and vaccines in a way that can transform – and even save – the lives of millions of people worldwide.” Supporting the call, Dr Kimberly Green, PATH Global Director for Primary Health Care, said that “improving accessibility of essential medicines and health products has been underrepresented in discussions” ahead of the High-Level Meeting. PATH acts as the Secretariat for the Coalition for Access to NCD Medicines and Products. Green said that action is needed to “reduce catastrophic out-of-pocket health costs for people living with these conditions”, and that additional investment was needed to treat NCDs “through strengthened primary health care”. Image Credits: G Lontro/ NCD Alliance, Airfinity, IFPMA. Who Decides? The Contraceptive Conundrum Facing Adolescent Girls in Africa 07/03/2025 Edith Magak Panellists during the session on ‘Reclaiming Control: Let’s Talk About Sexual and Reproductive Health and Rights’ Access to contraception must be lowered to allow teenage girls to make informed decisions about their bodies, relationships, and futures, say key African health stakeholders – including sexual and reproductive health workers and advocates. But are policymakers ready to adopt this change – particularly as the debate over sexual and reproductive health rights becomes ever more fraught and polarized? At the just-concluded Africa Health Agenda International Conference (AHAIC), experts highlighted a troubling contradiction: while contraceptives are widely available across the continent, teenage girls under 18 often cannot access them without parental consent—consent that is not commonly sought, and when it is, frequently denied. Easier to get an abortion than contraception Dr Samukeliso Dube, Executive Director of Family Planning 2030. Rwanda is one of the countries grappling with this issue. According to Dr Clarisse Mutimukeye, Rwanda Chapter Lead for Women in Global Health and Executive Director of Medical Doctors for Choice, laws governing contraceptive access are often more restrictive than those regulating abortion. “In Rwanda, the law allows pregnancy termination up to 22 weeks if the person seeking the abortion is under 18, following an application by their legal representative. But to access contraception, girls under 18 still need parental consent,” she explained. “You can imagine if a girl falls pregnant at 15—she is allowed to seek a safe abortion, but she cannot access contraception beforehand. This is a problem.” This ‘problem’, led to over 39,000 teenage pregnancies in the country in 2022, according to Rwanda’s census. Without access to contraceptives, many girls resort to unregulated and unsafe options, putting their health at serious risk. Alternatively, teenage girls opting to become mothers before they have finished their education or training, risk a lifetime of poverty and dependency on family members and others. Recognising the urgent need for reform, the Rwandan parliament is now considering a new bill that would allow girls as young as 15 to access contraception without requiring parental consent. Teenage mothers getting pregnant ‘again and again’ Although a decline in adolescent birth rates has been observed globally, sub-Saharan Africa continues to have twice the global average. But Rwanda is not alone in facing this challenge. Many African countries, including Kenya, have similar restrictions. Ritah Anindo Obonyo, Executive Director of Community Voices Network in Kenya, said policies drive young girls toward dangerous alternatives. “Teenage girls are unable to access safe contraception, so they’re using emergency contraception as a long-term birth control method, which is not recommended,” she explained. “They are also using ‘Sofia’ or ‘China pills’, which are sold in backstreets and contain unsafe components.” The lack of safe contraceptive options has led to a troubling rise in repeat pregnancies amongst teenage mothers, Anindo observed. “With our organisation, we’re seeing a new trend—teen mothers are getting pregnant again and again. You can imagine what this means for their lives.” Teenage pregnancy has a prevalence rate of over 25% in 24 African countries, a rate that reaches as high as 48% in Niger and 44% in Chad. The Fight for Autonomy For many advocates, the debate over contraception is about more than just access—it is about control over young people’s bodies and futures. Patriarchal systems continue to deny young people autonomy over their reproductive choices, said Dr Samukeliso Dube, Executive Director of Family Planning 2030. “I think patriarchy is exhausting because it manifests in so many different forms. It’s always about control—who can I control at any given time? Let’s control who has access, when they have access, and how they have access.” “Everyone has the right to decide if, when, how many, and with whom they want children. That is a fundamental basic right,” she said. BBC’s Namulanta Kombo(left), in conversation with Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation and Dr Meggie Mwoka, Innovations Manager, Amref Health Africa. With Africa facing dwindling health resources due to aid cuts, experts argue that expanding access to contraception and comprehensive sexual and reproductive health education is one of the most effective ways to both ensure girls’ and womens’ basic reproductive health rights as well as optimising existing funds. Professor Charles Okeahalam, Chairman of Amref Health Africa’s International Board of Directors, stressed the economic and social benefits of investing in women’s reproductive health and education. “If we educate girls and give them more sexual and reproductive health rights, population growth would slow, and with a lower population growth rate, the demand for [healthcare] resources would also decrease,” he said. “But even beyond that, better-educated mothers and empowered women are more capable of caring for their children. Investing in female education—particularly in reproductive health—is an essential part of preventive care and resource management. These are the people most directly involved in providing care within families and communities.” 30 Years After Beijing, Women’s Voices Are Still Being Ignored This year marks the 30th anniversary of the Beijing Declaration and Platform for Action, a landmark commitment by governments to advance gender equality and women’s rights. Yet, female health leaders at AHAIC noted that many of the issues raised in Beijing in 1995 remain unresolved. Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation, reflected on the progress—or lack thereof—since attending the historic conference. “I was present at the meeting in Beijing, and what is intriguing today is that 30 years later, the more things have changed, the more they have remained the same,” she said. “It’s unfortunate that despite some progress, when I attend the Commission on the Status of Women (CSW) year in and year out, we are still discussing the same issues we raised in Beijing.” Image Credits: Edith Magak/HPW, Edith Magak/ HPW, African Union 2022. Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Despite ‘Rising Misogyny’, UN Commission Adopts Declaration on Gender Equity 11/03/2025 Kerry Cullinan Françoise Moudouthe, Chief Executive Officer of the African Women’s Development Fund, “The poison of patriarchy is back and is back with a vengeance,” United Nations (UN) Secretary-General António Guterres told the opening of the annual session of the Commission on the Status of Women (CSW) at the UN in New York on Monday. The CSW takes place amid a major global backlash against women’s rights, from the Taliban banning Afghan women from public life to the Trump administration in the United States pushing back against “diversity, equity and inclusion” (DEI) which has resulted in cuts to research on women’s health. “Misogyny is on the rise, and so, violence and discrimination,” said Sima Bahous, who heads UN Women, noting that “domestic and ODA [official development assistance] allocations to gender equality remain woefully inadequate and, in some cases, are being cut altogether”. Declaration passed despite US, Russian objections The CSW’s political declaration was adopted by consensus on Monday. And despite earlier reports that the US and Russia had tried to purge a clause that encouraged member states from nominating women candidates for the UN Secretary-General position and President of the General Assembly, that clause survived. So did commitments to “gender equality and the empowerment of all women and girls”, and the “accelerated implementation” of the Beijing Declaration and Platform for Action, the first global roadmap for gender equality that was adopted 30 years ago. Bahous also commended the 159 member states that have affirmed their support for the Beijing Declaration in national reports. Despite the backlash, there has also been progress in the past 30 years, she noted: “Today, more girls are in school. More women are in parliaments, in boardrooms, in the judiciary. Maternal mortality has fallen. Legal barriers have been dismantled. Policies to protect and advance women’s rights are advancing. Violence against women and girls is widely recognized as a global scourge.” ‘Calculated cut’ to funds Françoise Moudouthe, Chief Executive Officer of the African Women’s Development Fund, told the opening plenary that “the decision by several governments and philanthropic actors to cut funding for gender equality in the past few years is a calculated blow to women’s access to education, healthcare, economic independence, political participation and bodily autonomy”. “The recent funding cuts by just two governments and two private philanthropic donors to women’s rights organisations were recently estimated to around $730 million per year,” she added. “We must immediately commit to protecting protecting gender equality for all, not with words but with resources,” Moudouthe stressed. Bahous declared that: “We, the champions of gender equality, are not afraid of the pushback. We have faced it before. We have not backed down. And we will not back down.” The proportion of women killed in wars had doubled over the past year alone, added Bahous, pointing to women’s and girls’ rights being “systematically stripping away” by climate change and conflicts in Afghanistan, the Democratic Republic of Congo (DRC), Palestine, Gaza, Haiti, Myanmar, Sudan and Ukraine. Call for sanctions on Taliban Meanwhile, at the UN Security Council meeting happening at the same time, Afghan lawyer Azadah Raz Mohammad urged the body to impose sanctions on all Taliban leaders who have committed human rights violations against Afghan women and girls, and not to lift sanctions, including travel bans, on those who are guilty of such crimes. “If the people of Afghanistan had been able to hold the Taliban accountable in 2001 and earlier, perhaps we would not have witnessed the Taliban’s violent return to power 20 years later,” Mohammad said, concluding: “If impunity is the disease, accountability is the antidote.” She also urged all member states to assist the International Criminal Court to pursue charges against all senior Taliban leaders who have committed acts of “gender persecution and other crimes against humanity, and war crimes” in Afghanistan since 2003. Only Seven Countries Meet WHO Air Quality Standards; Most Polluted are Chad and Bangladesh – Northern India Also Dominates 11/03/2025 Chetan Bhattacharji Air pollution in Delhi, the world’s most polluted capital city, is caused by several factors including traffic, industry and stubble burning. Chad and Bangladesh ranked as the most polluted countries in 2024, while Delhi, India was the most polluted capital city, according to the 2024 World Air Quality report produced by the Swiss-based IQAir. But only seven countries worldwide met WHO air quality guidelines and Africa’s pollution levels remains under-reported. Pollution monitoring also fell victim to President Trump drastic cuts and rollbacks of environmental protections, as US embassies worldwide closed monitoring stations and disabled the US government’s airnow.gov data base. Seventy-four of the 100 most polluted cities and towns are in India, according to the latest World Air Quality Report 2024, a slight improvement from 83 last year. Levels of a key microscopic pollutant, PM2.5, declined 7% across the nation, averaging 50.6 micrograms/cubic metre or 10 times the World Health Organization’s (WHO) safe guideline. Despite having the most polluted cities, India ranked fifth, globally, after Chad, Bangladesh, Pakistan, and the Democratic Republic of Congo in terms of national pollution levels. Globally, only 17% of the almost 9,000 cities surveyed met the WHO air pollution standard, which is an annual average of 5 micrograms/cubic metre of the pollutant PM 2.5. This microscopic particulate matter, containing a cocktail of other pollutants that penetrate the blood and brain barrier, is the most widely tracked measure of air pollution. Nationally, only seven countries: Australia, New Zealand, the Bahamas, Barbados, Grenada, Estonia and Iceland met WHO annual air quality levels, IQAir said. However, a world map of pollution averages shows air pollution is primarily a Global South challenge. Most of the worst affected places are in Asia. Some in Africa, although only 24 out of 54 African countries or territories reported data in 2024. Still, this is a marked improvement since the first of these reports in 2017 had useable data from only three African countries. US State Department closes global air quality monitoring network The rankings were released days after the new Trump administration’s move to shut down air quality monitoring at United States embassies worlwide. In parallel, the State Department deleted 17 years of data from US government’s airnow.gov data base – which had been a valuable source of reliable air quality data in resource-strapped countries like Chad. This is likely to have a “profound” real-world impact on surveillance, according to the report’s scientists. “The information collected at 80 global US embassies and consulates have proven to help protect public health and inform air quality policy… when US embassies began tracking local air pollution, host countries took action,” said Dr Christi Chester Schroeder, IQAir Air Quality Science Manager. “IQAir estimates at least eight countries will completely lose access to all real-time air quality data because of this decision, nearly all of which are in developing countries.” In Asia, Iran and Afghanistan are not included in the report because of a lack of real-time data. The report is based on data from about 40,000 ground-level air quality monitors in 138 countries, although IQAir, a Swiss firm for air quality equipment, does not publicly provide a margin of error for PM2.5 concentrations used in this report. Caption: The world’s top-10 most polluted countries in 2024 Why India isn’t the most polluted While it dominates the top 100 most polluted cities and towns, India’s expansive air quality monitoring network also captures levels in more rural and less polluted aeras – and that brought it’s national average down in comparison to other heavily polluted coutries, experts said. So the reasons Pakistan and Bangladesh ranked higher in overall pollution levels may be related to the limited scope of their air quality monitoring network – which tend to capture urban areas only. Cities with high PM 2.5 concentrations thus have a disproportionate impact on the country’s annual average concentrations. Chad also returned to the 2024 rankings – after being excluded in 2023 for a lack of data. Regional airshed solution for South Asia Either way, the report makes for bleak reading for India and the rest of South Asia. Bangladesh, Pakistan, India and Nepal are ranked at 2, 3, 5 and 7. The capitals of all these countries are also in the top 10 most polluted cities. India continues to lead the region in government monitoring infrastructure, operating more than half of the total stations, the report points out. Despite this, many areas in India remain under-monitored, particularly in smaller cities and rural regions. Cities like Delhi and Lahore frequently experience hazardous conditions with seasonal spikes in pollution leading to emergency measures such as school closures and public space shutdowns. “Air pollution pays no regard to country borders. The trans-boundary nature of air pollution is a serious issue in many regions around the world, and is no different with India and Pakistan,” said Schroeder. “Airsheds need to be treated as regional international issues, not national issues. Cities in India and Pakistan, as well as Bangladesh and Nepal, share common sources of pollution – industrial emissions, agricultural burning, vehicle pollution, dust, etc. Despite years of evidence of trans-boundary pollution, regional cooperation has been underwhelming.” The 20 most polluted cities in 2024. Source: World Air Quality Report,Note: Delhi is the larger area and New Delhi is the capital area within it. The second position is Delhi’s highest ranking since this annual report began eight years ago. One of India’s foremost air quality government scientists, Dr SN Tripathi, believes that in South Asia, India will have to take the lead in proposing and establishing some kind of agreement or arrangement with other countries. Airsheds within India and ability to analyse how air pollution is moving from one region to another. Tripathi, Dean at Kotak School of Sustainability, IIT Kanpur, calls for a “multilateral airshed approach sooner than later to deal with this menace.” Delhi is the air pollution capital The report’s scientists point out that while India’s population is nearly identical to the entire African continent, it has significantly expanded its air quality monitoring network in recent years. Experts say more such data should help in tackling the crisis. The world’s most polluted place is Byrnihat, an industrial town in India’s north-eastern state of Meghalaya. The annual average PM2.5 concentration was 128.2 micrograms/cubic metre. However, 2024’s data puts the main focus back on Delhi. The capital area of New Delhi, which has a municipality separate from the rest of Delhi, was the world’s most polluted capital. The larger area of Delhi ranked second among nearly 9,000 places. This is Delhi’s highest rank since the annual report began in 2017. (Although this is the 7th World Air Quality report, IQAir has produced eight rankings since 2017 ,which have been shared with Health Policy Watch for this article.) In stark contrast to the national decline, the pollution level rose in Delhi by 6% to 108.3 micrograms/cubic metre last year, the highest since 2019. Ironically, that is the year India’s first national clean air programme (NCAP) was launched. The report attributes Delhi’s pollution to vehicular emissions, a leading contributor to fine particulate matter (PM2.5), exacerbated by traffic congestion and fuel adulteration, as well as industrial and construction activities and seasonal burning of agricultural residue. Northern India dominates global ranking All the 74 Indian cities in the top 100 list are in northern India with none from southern India. About 65 of these are in the northern plain called the Indo-Gangetic Plain (IGP), from Punjab in the west to Bengal 2,000 km in the east. This remains a pollution hotspot, where meteorological factors trap pollutants and exacerbate winter smog. The Indian government plans to coordinate air pollution control plans in the IGP with a population of about 600 million as one jurisdiction. While India’s PM 2.5 averages 50.6 micrograms (population-weighted), a back-of-the-envelope calculation of average pollution in the IGP states shows the level of PM 2.5 to be higher by about a fifth. The location of the 74 Indian cities in the top 100 most polluted ranking of 2024 World Air Quality Report. The challenge is that each state is a separate political entity but air pollution obviously moves across political boundaries. Tripathi advocates the airshed approach as the framework “to approach the problem with common or shared resources. To get more bang for the buck.” He estimates that pollution can come down by two-thirds if the burning of waste outdoors and of polluting fuels (like coal, dung and wood) inside homes is stopped. China’s Air Pollution Dips Pollution levels declined in over 320 cities in China, including major cities such as Beijing, Shanghai, Chengdu, Guangzhou, and Shenzhen. But levels rose in almost 130 other cities. Officials have set ambitious goals to lower the national annual average PM 2.5 concentration to below 28 µg/m³ by 2027 and below 25 µg/m³ by 2035. Special attention is being given to the Beijing-Tianjin-Hebei region at the provincial level. Warning for Southeast Asia’s most polluted country Air pollution in Indonesia’s captial of Jakarta. Air pollution in Indonesia decreased by 4% in 2024 compared to the previous year, averaging 35.5 micrograms. However, the report warns of a clean energy challenge. The country is the world’s leading producer of nickel, a vital mineral for clean energy and storage but to extract it takes a lot of energy. And for this, it’s increasing its coal power capacity which grew 15% over a year till July 2024. Coal burning generates two-thirds of Indonesia’s electricity. Despite declining pollution, it remains the most polluted country in Southeast Asia. Vietnam air pollution’s cost In Vietnam, air pollution has been estimated to cause a loss of around 4% of the GDP. Acute air pollution events in Vietnam have severely impacted daily life, with disruptions to air travel leading to flight diversions at multiple airports. In 2024, there was a small reduction in pollution from 29.6 to 28.7 micrograms. Vietnam’s government, international bodies and various organisations are empowering citizens through information campaigns to raise awareness, take preventive action and also expand air quality monitoring for public health action and academic research. Community initiatives are promoting sustainable agricultural practices, such as reducing straw burning, while advocating for responsible household waste disposal to minimize pollution. The cleanest air was found in Hawaii’s Honaka’a, in the United States. It is ranked 8,954th and the PM 2.5 average was one microgram/cubic metre of air. Image Credits: Raunaq Chopra/ Climate Outreach, IQ Air, IQ Air, IQAir, Google maps, Aji Styawan / Climate Visuals. Big Pharma Issues Global ‘Call to Action’ to Address NCD Crisis 11/03/2025 Kerry Cullinan A patient with diabetes attends a check-up at a district hospital in Kigali, Rwanda. Investment in NCD prevention, treatment and care at primary level can save millions of lives. Almost five million lives could be saved annually if low- and middle-income countries (LMICs) invested 1% more of GDP in public healthcare spending – and used at least 40% of this to prevent and treat non-communicable diseases (NCDs). This is according to Airfinity research commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which issued a “Call to Action” on NCDs on Tuesday. The research is based on “implementing existing cost-effective interventions such as cardiovascular disease management, diabetes screening, and respiratory care”, according to the IFPMA. “The data supports growing consensus that more funding is needed to bend the curve on NCDs,” the pharmaceutical body said, “urging collective action across the globe” ahead of the United Nations High-Level Meeting on NCDs in September. NCDs such as cancer, diabetes, cardiovascular disease, lung disease, mental health, and neurological disorders cause almost three-quarters of global deaths. Eight out of 10 premature NCD deaths take place in LMICs Investment in NCD prevention and control could yield an annual seven-fold return in LMICs within a decade, according to 2021 World Health Organization (WHO) calculations. Lifestyle interventions including healthy diet and exercise, and primary healthcare could lead to an expected $230 billion economic gain by 2030, the WHO found. But NCD prevention, early detection, treatment, and control “remain severely underfunded and under-prioritized by both governments and global donors,” according to the IFPMA. “Low awareness” by “decision-makers, affected individuals, and general population” and “fiscal challenges” were the main reasons for the underfunding, according to the WHO and the World Bank. As a result, on average some 60% of treatment costs are being carried by patients in LMICs. These out-of-pocket payments for NCD treatment and care push approximately 100 million people worldwide into extreme poverty every year, according to the NCD Alliance. Access to medicines The IFPMA noted that “over 1,400 medicines have been approved for NCDs in the past 10 years, which have transformed how we fight disease, and are improving the lives of hundreds of millions of people living with chronic conditions” and “a further 9,600 NCD medicines [are] at various stages of research and development”. However, there are “significant barriers and delays in ensuring these medicines and vaccines can reach the people who need them, and there are still NCDs for which there is not adequate treatment”, the IFPMA noted. The IFPMA is working with partners in Access Accelerated to assist governments to identify a “suite of sustainable financing mechanisms” for NCDs including “health taxes, private or community-based health insurance programs, debt-for-health swaps, health savings accounts, performance-based financing (social impact bonds), blended financing, and mobile health financing solutions”. Redirecting existing fossil fuels subsidies and increasing taxes on tobacco, alcohol, and unhealthy foods are options for LMICs to raise finances to address NCDs, the IFPMA report notes. Collective action It called for collective action to enable innovation, mobilise investment, drive implementation and ensure the accountability of government and key stakeholders to improve on prevention, treatment and care of NCDs and mental health. “A political declaration that includes these recommendations can drive a vision for 2050 forward where there are fewer premature NCD deaths, reduced health systems strains, and healthier societies everywhere,” according to the IFPMA. IFPMA Director General Dr David Reddy said that the UN High-Level Meeting “provides a real opportunity to refocus attention on how cross-sectoral partnerships can help increase access to cost-effective medicines and vaccines in a way that can transform – and even save – the lives of millions of people worldwide.” Supporting the call, Dr Kimberly Green, PATH Global Director for Primary Health Care, said that “improving accessibility of essential medicines and health products has been underrepresented in discussions” ahead of the High-Level Meeting. PATH acts as the Secretariat for the Coalition for Access to NCD Medicines and Products. Green said that action is needed to “reduce catastrophic out-of-pocket health costs for people living with these conditions”, and that additional investment was needed to treat NCDs “through strengthened primary health care”. Image Credits: G Lontro/ NCD Alliance, Airfinity, IFPMA. Who Decides? The Contraceptive Conundrum Facing Adolescent Girls in Africa 07/03/2025 Edith Magak Panellists during the session on ‘Reclaiming Control: Let’s Talk About Sexual and Reproductive Health and Rights’ Access to contraception must be lowered to allow teenage girls to make informed decisions about their bodies, relationships, and futures, say key African health stakeholders – including sexual and reproductive health workers and advocates. But are policymakers ready to adopt this change – particularly as the debate over sexual and reproductive health rights becomes ever more fraught and polarized? At the just-concluded Africa Health Agenda International Conference (AHAIC), experts highlighted a troubling contradiction: while contraceptives are widely available across the continent, teenage girls under 18 often cannot access them without parental consent—consent that is not commonly sought, and when it is, frequently denied. Easier to get an abortion than contraception Dr Samukeliso Dube, Executive Director of Family Planning 2030. Rwanda is one of the countries grappling with this issue. According to Dr Clarisse Mutimukeye, Rwanda Chapter Lead for Women in Global Health and Executive Director of Medical Doctors for Choice, laws governing contraceptive access are often more restrictive than those regulating abortion. “In Rwanda, the law allows pregnancy termination up to 22 weeks if the person seeking the abortion is under 18, following an application by their legal representative. But to access contraception, girls under 18 still need parental consent,” she explained. “You can imagine if a girl falls pregnant at 15—she is allowed to seek a safe abortion, but she cannot access contraception beforehand. This is a problem.” This ‘problem’, led to over 39,000 teenage pregnancies in the country in 2022, according to Rwanda’s census. Without access to contraceptives, many girls resort to unregulated and unsafe options, putting their health at serious risk. Alternatively, teenage girls opting to become mothers before they have finished their education or training, risk a lifetime of poverty and dependency on family members and others. Recognising the urgent need for reform, the Rwandan parliament is now considering a new bill that would allow girls as young as 15 to access contraception without requiring parental consent. Teenage mothers getting pregnant ‘again and again’ Although a decline in adolescent birth rates has been observed globally, sub-Saharan Africa continues to have twice the global average. But Rwanda is not alone in facing this challenge. Many African countries, including Kenya, have similar restrictions. Ritah Anindo Obonyo, Executive Director of Community Voices Network in Kenya, said policies drive young girls toward dangerous alternatives. “Teenage girls are unable to access safe contraception, so they’re using emergency contraception as a long-term birth control method, which is not recommended,” she explained. “They are also using ‘Sofia’ or ‘China pills’, which are sold in backstreets and contain unsafe components.” The lack of safe contraceptive options has led to a troubling rise in repeat pregnancies amongst teenage mothers, Anindo observed. “With our organisation, we’re seeing a new trend—teen mothers are getting pregnant again and again. You can imagine what this means for their lives.” Teenage pregnancy has a prevalence rate of over 25% in 24 African countries, a rate that reaches as high as 48% in Niger and 44% in Chad. The Fight for Autonomy For many advocates, the debate over contraception is about more than just access—it is about control over young people’s bodies and futures. Patriarchal systems continue to deny young people autonomy over their reproductive choices, said Dr Samukeliso Dube, Executive Director of Family Planning 2030. “I think patriarchy is exhausting because it manifests in so many different forms. It’s always about control—who can I control at any given time? Let’s control who has access, when they have access, and how they have access.” “Everyone has the right to decide if, when, how many, and with whom they want children. That is a fundamental basic right,” she said. BBC’s Namulanta Kombo(left), in conversation with Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation and Dr Meggie Mwoka, Innovations Manager, Amref Health Africa. With Africa facing dwindling health resources due to aid cuts, experts argue that expanding access to contraception and comprehensive sexual and reproductive health education is one of the most effective ways to both ensure girls’ and womens’ basic reproductive health rights as well as optimising existing funds. Professor Charles Okeahalam, Chairman of Amref Health Africa’s International Board of Directors, stressed the economic and social benefits of investing in women’s reproductive health and education. “If we educate girls and give them more sexual and reproductive health rights, population growth would slow, and with a lower population growth rate, the demand for [healthcare] resources would also decrease,” he said. “But even beyond that, better-educated mothers and empowered women are more capable of caring for their children. Investing in female education—particularly in reproductive health—is an essential part of preventive care and resource management. These are the people most directly involved in providing care within families and communities.” 30 Years After Beijing, Women’s Voices Are Still Being Ignored This year marks the 30th anniversary of the Beijing Declaration and Platform for Action, a landmark commitment by governments to advance gender equality and women’s rights. Yet, female health leaders at AHAIC noted that many of the issues raised in Beijing in 1995 remain unresolved. Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation, reflected on the progress—or lack thereof—since attending the historic conference. “I was present at the meeting in Beijing, and what is intriguing today is that 30 years later, the more things have changed, the more they have remained the same,” she said. “It’s unfortunate that despite some progress, when I attend the Commission on the Status of Women (CSW) year in and year out, we are still discussing the same issues we raised in Beijing.” Image Credits: Edith Magak/HPW, Edith Magak/ HPW, African Union 2022. Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Only Seven Countries Meet WHO Air Quality Standards; Most Polluted are Chad and Bangladesh – Northern India Also Dominates 11/03/2025 Chetan Bhattacharji Air pollution in Delhi, the world’s most polluted capital city, is caused by several factors including traffic, industry and stubble burning. Chad and Bangladesh ranked as the most polluted countries in 2024, while Delhi, India was the most polluted capital city, according to the 2024 World Air Quality report produced by the Swiss-based IQAir. But only seven countries worldwide met WHO air quality guidelines and Africa’s pollution levels remains under-reported. Pollution monitoring also fell victim to President Trump drastic cuts and rollbacks of environmental protections, as US embassies worldwide closed monitoring stations and disabled the US government’s airnow.gov data base. Seventy-four of the 100 most polluted cities and towns are in India, according to the latest World Air Quality Report 2024, a slight improvement from 83 last year. Levels of a key microscopic pollutant, PM2.5, declined 7% across the nation, averaging 50.6 micrograms/cubic metre or 10 times the World Health Organization’s (WHO) safe guideline. Despite having the most polluted cities, India ranked fifth, globally, after Chad, Bangladesh, Pakistan, and the Democratic Republic of Congo in terms of national pollution levels. Globally, only 17% of the almost 9,000 cities surveyed met the WHO air pollution standard, which is an annual average of 5 micrograms/cubic metre of the pollutant PM 2.5. This microscopic particulate matter, containing a cocktail of other pollutants that penetrate the blood and brain barrier, is the most widely tracked measure of air pollution. Nationally, only seven countries: Australia, New Zealand, the Bahamas, Barbados, Grenada, Estonia and Iceland met WHO annual air quality levels, IQAir said. However, a world map of pollution averages shows air pollution is primarily a Global South challenge. Most of the worst affected places are in Asia. Some in Africa, although only 24 out of 54 African countries or territories reported data in 2024. Still, this is a marked improvement since the first of these reports in 2017 had useable data from only three African countries. US State Department closes global air quality monitoring network The rankings were released days after the new Trump administration’s move to shut down air quality monitoring at United States embassies worlwide. In parallel, the State Department deleted 17 years of data from US government’s airnow.gov data base – which had been a valuable source of reliable air quality data in resource-strapped countries like Chad. This is likely to have a “profound” real-world impact on surveillance, according to the report’s scientists. “The information collected at 80 global US embassies and consulates have proven to help protect public health and inform air quality policy… when US embassies began tracking local air pollution, host countries took action,” said Dr Christi Chester Schroeder, IQAir Air Quality Science Manager. “IQAir estimates at least eight countries will completely lose access to all real-time air quality data because of this decision, nearly all of which are in developing countries.” In Asia, Iran and Afghanistan are not included in the report because of a lack of real-time data. The report is based on data from about 40,000 ground-level air quality monitors in 138 countries, although IQAir, a Swiss firm for air quality equipment, does not publicly provide a margin of error for PM2.5 concentrations used in this report. Caption: The world’s top-10 most polluted countries in 2024 Why India isn’t the most polluted While it dominates the top 100 most polluted cities and towns, India’s expansive air quality monitoring network also captures levels in more rural and less polluted aeras – and that brought it’s national average down in comparison to other heavily polluted coutries, experts said. So the reasons Pakistan and Bangladesh ranked higher in overall pollution levels may be related to the limited scope of their air quality monitoring network – which tend to capture urban areas only. Cities with high PM 2.5 concentrations thus have a disproportionate impact on the country’s annual average concentrations. Chad also returned to the 2024 rankings – after being excluded in 2023 for a lack of data. Regional airshed solution for South Asia Either way, the report makes for bleak reading for India and the rest of South Asia. Bangladesh, Pakistan, India and Nepal are ranked at 2, 3, 5 and 7. The capitals of all these countries are also in the top 10 most polluted cities. India continues to lead the region in government monitoring infrastructure, operating more than half of the total stations, the report points out. Despite this, many areas in India remain under-monitored, particularly in smaller cities and rural regions. Cities like Delhi and Lahore frequently experience hazardous conditions with seasonal spikes in pollution leading to emergency measures such as school closures and public space shutdowns. “Air pollution pays no regard to country borders. The trans-boundary nature of air pollution is a serious issue in many regions around the world, and is no different with India and Pakistan,” said Schroeder. “Airsheds need to be treated as regional international issues, not national issues. Cities in India and Pakistan, as well as Bangladesh and Nepal, share common sources of pollution – industrial emissions, agricultural burning, vehicle pollution, dust, etc. Despite years of evidence of trans-boundary pollution, regional cooperation has been underwhelming.” The 20 most polluted cities in 2024. Source: World Air Quality Report,Note: Delhi is the larger area and New Delhi is the capital area within it. The second position is Delhi’s highest ranking since this annual report began eight years ago. One of India’s foremost air quality government scientists, Dr SN Tripathi, believes that in South Asia, India will have to take the lead in proposing and establishing some kind of agreement or arrangement with other countries. Airsheds within India and ability to analyse how air pollution is moving from one region to another. Tripathi, Dean at Kotak School of Sustainability, IIT Kanpur, calls for a “multilateral airshed approach sooner than later to deal with this menace.” Delhi is the air pollution capital The report’s scientists point out that while India’s population is nearly identical to the entire African continent, it has significantly expanded its air quality monitoring network in recent years. Experts say more such data should help in tackling the crisis. The world’s most polluted place is Byrnihat, an industrial town in India’s north-eastern state of Meghalaya. The annual average PM2.5 concentration was 128.2 micrograms/cubic metre. However, 2024’s data puts the main focus back on Delhi. The capital area of New Delhi, which has a municipality separate from the rest of Delhi, was the world’s most polluted capital. The larger area of Delhi ranked second among nearly 9,000 places. This is Delhi’s highest rank since the annual report began in 2017. (Although this is the 7th World Air Quality report, IQAir has produced eight rankings since 2017 ,which have been shared with Health Policy Watch for this article.) In stark contrast to the national decline, the pollution level rose in Delhi by 6% to 108.3 micrograms/cubic metre last year, the highest since 2019. Ironically, that is the year India’s first national clean air programme (NCAP) was launched. The report attributes Delhi’s pollution to vehicular emissions, a leading contributor to fine particulate matter (PM2.5), exacerbated by traffic congestion and fuel adulteration, as well as industrial and construction activities and seasonal burning of agricultural residue. Northern India dominates global ranking All the 74 Indian cities in the top 100 list are in northern India with none from southern India. About 65 of these are in the northern plain called the Indo-Gangetic Plain (IGP), from Punjab in the west to Bengal 2,000 km in the east. This remains a pollution hotspot, where meteorological factors trap pollutants and exacerbate winter smog. The Indian government plans to coordinate air pollution control plans in the IGP with a population of about 600 million as one jurisdiction. While India’s PM 2.5 averages 50.6 micrograms (population-weighted), a back-of-the-envelope calculation of average pollution in the IGP states shows the level of PM 2.5 to be higher by about a fifth. The location of the 74 Indian cities in the top 100 most polluted ranking of 2024 World Air Quality Report. The challenge is that each state is a separate political entity but air pollution obviously moves across political boundaries. Tripathi advocates the airshed approach as the framework “to approach the problem with common or shared resources. To get more bang for the buck.” He estimates that pollution can come down by two-thirds if the burning of waste outdoors and of polluting fuels (like coal, dung and wood) inside homes is stopped. China’s Air Pollution Dips Pollution levels declined in over 320 cities in China, including major cities such as Beijing, Shanghai, Chengdu, Guangzhou, and Shenzhen. But levels rose in almost 130 other cities. Officials have set ambitious goals to lower the national annual average PM 2.5 concentration to below 28 µg/m³ by 2027 and below 25 µg/m³ by 2035. Special attention is being given to the Beijing-Tianjin-Hebei region at the provincial level. Warning for Southeast Asia’s most polluted country Air pollution in Indonesia’s captial of Jakarta. Air pollution in Indonesia decreased by 4% in 2024 compared to the previous year, averaging 35.5 micrograms. However, the report warns of a clean energy challenge. The country is the world’s leading producer of nickel, a vital mineral for clean energy and storage but to extract it takes a lot of energy. And for this, it’s increasing its coal power capacity which grew 15% over a year till July 2024. Coal burning generates two-thirds of Indonesia’s electricity. Despite declining pollution, it remains the most polluted country in Southeast Asia. Vietnam air pollution’s cost In Vietnam, air pollution has been estimated to cause a loss of around 4% of the GDP. Acute air pollution events in Vietnam have severely impacted daily life, with disruptions to air travel leading to flight diversions at multiple airports. In 2024, there was a small reduction in pollution from 29.6 to 28.7 micrograms. Vietnam’s government, international bodies and various organisations are empowering citizens through information campaigns to raise awareness, take preventive action and also expand air quality monitoring for public health action and academic research. Community initiatives are promoting sustainable agricultural practices, such as reducing straw burning, while advocating for responsible household waste disposal to minimize pollution. The cleanest air was found in Hawaii’s Honaka’a, in the United States. It is ranked 8,954th and the PM 2.5 average was one microgram/cubic metre of air. Image Credits: Raunaq Chopra/ Climate Outreach, IQ Air, IQ Air, IQAir, Google maps, Aji Styawan / Climate Visuals. Big Pharma Issues Global ‘Call to Action’ to Address NCD Crisis 11/03/2025 Kerry Cullinan A patient with diabetes attends a check-up at a district hospital in Kigali, Rwanda. Investment in NCD prevention, treatment and care at primary level can save millions of lives. Almost five million lives could be saved annually if low- and middle-income countries (LMICs) invested 1% more of GDP in public healthcare spending – and used at least 40% of this to prevent and treat non-communicable diseases (NCDs). This is according to Airfinity research commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which issued a “Call to Action” on NCDs on Tuesday. The research is based on “implementing existing cost-effective interventions such as cardiovascular disease management, diabetes screening, and respiratory care”, according to the IFPMA. “The data supports growing consensus that more funding is needed to bend the curve on NCDs,” the pharmaceutical body said, “urging collective action across the globe” ahead of the United Nations High-Level Meeting on NCDs in September. NCDs such as cancer, diabetes, cardiovascular disease, lung disease, mental health, and neurological disorders cause almost three-quarters of global deaths. Eight out of 10 premature NCD deaths take place in LMICs Investment in NCD prevention and control could yield an annual seven-fold return in LMICs within a decade, according to 2021 World Health Organization (WHO) calculations. Lifestyle interventions including healthy diet and exercise, and primary healthcare could lead to an expected $230 billion economic gain by 2030, the WHO found. But NCD prevention, early detection, treatment, and control “remain severely underfunded and under-prioritized by both governments and global donors,” according to the IFPMA. “Low awareness” by “decision-makers, affected individuals, and general population” and “fiscal challenges” were the main reasons for the underfunding, according to the WHO and the World Bank. As a result, on average some 60% of treatment costs are being carried by patients in LMICs. These out-of-pocket payments for NCD treatment and care push approximately 100 million people worldwide into extreme poverty every year, according to the NCD Alliance. Access to medicines The IFPMA noted that “over 1,400 medicines have been approved for NCDs in the past 10 years, which have transformed how we fight disease, and are improving the lives of hundreds of millions of people living with chronic conditions” and “a further 9,600 NCD medicines [are] at various stages of research and development”. However, there are “significant barriers and delays in ensuring these medicines and vaccines can reach the people who need them, and there are still NCDs for which there is not adequate treatment”, the IFPMA noted. The IFPMA is working with partners in Access Accelerated to assist governments to identify a “suite of sustainable financing mechanisms” for NCDs including “health taxes, private or community-based health insurance programs, debt-for-health swaps, health savings accounts, performance-based financing (social impact bonds), blended financing, and mobile health financing solutions”. Redirecting existing fossil fuels subsidies and increasing taxes on tobacco, alcohol, and unhealthy foods are options for LMICs to raise finances to address NCDs, the IFPMA report notes. Collective action It called for collective action to enable innovation, mobilise investment, drive implementation and ensure the accountability of government and key stakeholders to improve on prevention, treatment and care of NCDs and mental health. “A political declaration that includes these recommendations can drive a vision for 2050 forward where there are fewer premature NCD deaths, reduced health systems strains, and healthier societies everywhere,” according to the IFPMA. IFPMA Director General Dr David Reddy said that the UN High-Level Meeting “provides a real opportunity to refocus attention on how cross-sectoral partnerships can help increase access to cost-effective medicines and vaccines in a way that can transform – and even save – the lives of millions of people worldwide.” Supporting the call, Dr Kimberly Green, PATH Global Director for Primary Health Care, said that “improving accessibility of essential medicines and health products has been underrepresented in discussions” ahead of the High-Level Meeting. PATH acts as the Secretariat for the Coalition for Access to NCD Medicines and Products. Green said that action is needed to “reduce catastrophic out-of-pocket health costs for people living with these conditions”, and that additional investment was needed to treat NCDs “through strengthened primary health care”. Image Credits: G Lontro/ NCD Alliance, Airfinity, IFPMA. Who Decides? The Contraceptive Conundrum Facing Adolescent Girls in Africa 07/03/2025 Edith Magak Panellists during the session on ‘Reclaiming Control: Let’s Talk About Sexual and Reproductive Health and Rights’ Access to contraception must be lowered to allow teenage girls to make informed decisions about their bodies, relationships, and futures, say key African health stakeholders – including sexual and reproductive health workers and advocates. But are policymakers ready to adopt this change – particularly as the debate over sexual and reproductive health rights becomes ever more fraught and polarized? At the just-concluded Africa Health Agenda International Conference (AHAIC), experts highlighted a troubling contradiction: while contraceptives are widely available across the continent, teenage girls under 18 often cannot access them without parental consent—consent that is not commonly sought, and when it is, frequently denied. Easier to get an abortion than contraception Dr Samukeliso Dube, Executive Director of Family Planning 2030. Rwanda is one of the countries grappling with this issue. According to Dr Clarisse Mutimukeye, Rwanda Chapter Lead for Women in Global Health and Executive Director of Medical Doctors for Choice, laws governing contraceptive access are often more restrictive than those regulating abortion. “In Rwanda, the law allows pregnancy termination up to 22 weeks if the person seeking the abortion is under 18, following an application by their legal representative. But to access contraception, girls under 18 still need parental consent,” she explained. “You can imagine if a girl falls pregnant at 15—she is allowed to seek a safe abortion, but she cannot access contraception beforehand. This is a problem.” This ‘problem’, led to over 39,000 teenage pregnancies in the country in 2022, according to Rwanda’s census. Without access to contraceptives, many girls resort to unregulated and unsafe options, putting their health at serious risk. Alternatively, teenage girls opting to become mothers before they have finished their education or training, risk a lifetime of poverty and dependency on family members and others. Recognising the urgent need for reform, the Rwandan parliament is now considering a new bill that would allow girls as young as 15 to access contraception without requiring parental consent. Teenage mothers getting pregnant ‘again and again’ Although a decline in adolescent birth rates has been observed globally, sub-Saharan Africa continues to have twice the global average. But Rwanda is not alone in facing this challenge. Many African countries, including Kenya, have similar restrictions. Ritah Anindo Obonyo, Executive Director of Community Voices Network in Kenya, said policies drive young girls toward dangerous alternatives. “Teenage girls are unable to access safe contraception, so they’re using emergency contraception as a long-term birth control method, which is not recommended,” she explained. “They are also using ‘Sofia’ or ‘China pills’, which are sold in backstreets and contain unsafe components.” The lack of safe contraceptive options has led to a troubling rise in repeat pregnancies amongst teenage mothers, Anindo observed. “With our organisation, we’re seeing a new trend—teen mothers are getting pregnant again and again. You can imagine what this means for their lives.” Teenage pregnancy has a prevalence rate of over 25% in 24 African countries, a rate that reaches as high as 48% in Niger and 44% in Chad. The Fight for Autonomy For many advocates, the debate over contraception is about more than just access—it is about control over young people’s bodies and futures. Patriarchal systems continue to deny young people autonomy over their reproductive choices, said Dr Samukeliso Dube, Executive Director of Family Planning 2030. “I think patriarchy is exhausting because it manifests in so many different forms. It’s always about control—who can I control at any given time? Let’s control who has access, when they have access, and how they have access.” “Everyone has the right to decide if, when, how many, and with whom they want children. That is a fundamental basic right,” she said. BBC’s Namulanta Kombo(left), in conversation with Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation and Dr Meggie Mwoka, Innovations Manager, Amref Health Africa. With Africa facing dwindling health resources due to aid cuts, experts argue that expanding access to contraception and comprehensive sexual and reproductive health education is one of the most effective ways to both ensure girls’ and womens’ basic reproductive health rights as well as optimising existing funds. Professor Charles Okeahalam, Chairman of Amref Health Africa’s International Board of Directors, stressed the economic and social benefits of investing in women’s reproductive health and education. “If we educate girls and give them more sexual and reproductive health rights, population growth would slow, and with a lower population growth rate, the demand for [healthcare] resources would also decrease,” he said. “But even beyond that, better-educated mothers and empowered women are more capable of caring for their children. Investing in female education—particularly in reproductive health—is an essential part of preventive care and resource management. These are the people most directly involved in providing care within families and communities.” 30 Years After Beijing, Women’s Voices Are Still Being Ignored This year marks the 30th anniversary of the Beijing Declaration and Platform for Action, a landmark commitment by governments to advance gender equality and women’s rights. Yet, female health leaders at AHAIC noted that many of the issues raised in Beijing in 1995 remain unresolved. Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation, reflected on the progress—or lack thereof—since attending the historic conference. “I was present at the meeting in Beijing, and what is intriguing today is that 30 years later, the more things have changed, the more they have remained the same,” she said. “It’s unfortunate that despite some progress, when I attend the Commission on the Status of Women (CSW) year in and year out, we are still discussing the same issues we raised in Beijing.” Image Credits: Edith Magak/HPW, Edith Magak/ HPW, African Union 2022. Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Big Pharma Issues Global ‘Call to Action’ to Address NCD Crisis 11/03/2025 Kerry Cullinan A patient with diabetes attends a check-up at a district hospital in Kigali, Rwanda. Investment in NCD prevention, treatment and care at primary level can save millions of lives. Almost five million lives could be saved annually if low- and middle-income countries (LMICs) invested 1% more of GDP in public healthcare spending – and used at least 40% of this to prevent and treat non-communicable diseases (NCDs). This is according to Airfinity research commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which issued a “Call to Action” on NCDs on Tuesday. The research is based on “implementing existing cost-effective interventions such as cardiovascular disease management, diabetes screening, and respiratory care”, according to the IFPMA. “The data supports growing consensus that more funding is needed to bend the curve on NCDs,” the pharmaceutical body said, “urging collective action across the globe” ahead of the United Nations High-Level Meeting on NCDs in September. NCDs such as cancer, diabetes, cardiovascular disease, lung disease, mental health, and neurological disorders cause almost three-quarters of global deaths. Eight out of 10 premature NCD deaths take place in LMICs Investment in NCD prevention and control could yield an annual seven-fold return in LMICs within a decade, according to 2021 World Health Organization (WHO) calculations. Lifestyle interventions including healthy diet and exercise, and primary healthcare could lead to an expected $230 billion economic gain by 2030, the WHO found. But NCD prevention, early detection, treatment, and control “remain severely underfunded and under-prioritized by both governments and global donors,” according to the IFPMA. “Low awareness” by “decision-makers, affected individuals, and general population” and “fiscal challenges” were the main reasons for the underfunding, according to the WHO and the World Bank. As a result, on average some 60% of treatment costs are being carried by patients in LMICs. These out-of-pocket payments for NCD treatment and care push approximately 100 million people worldwide into extreme poverty every year, according to the NCD Alliance. Access to medicines The IFPMA noted that “over 1,400 medicines have been approved for NCDs in the past 10 years, which have transformed how we fight disease, and are improving the lives of hundreds of millions of people living with chronic conditions” and “a further 9,600 NCD medicines [are] at various stages of research and development”. However, there are “significant barriers and delays in ensuring these medicines and vaccines can reach the people who need them, and there are still NCDs for which there is not adequate treatment”, the IFPMA noted. The IFPMA is working with partners in Access Accelerated to assist governments to identify a “suite of sustainable financing mechanisms” for NCDs including “health taxes, private or community-based health insurance programs, debt-for-health swaps, health savings accounts, performance-based financing (social impact bonds), blended financing, and mobile health financing solutions”. Redirecting existing fossil fuels subsidies and increasing taxes on tobacco, alcohol, and unhealthy foods are options for LMICs to raise finances to address NCDs, the IFPMA report notes. Collective action It called for collective action to enable innovation, mobilise investment, drive implementation and ensure the accountability of government and key stakeholders to improve on prevention, treatment and care of NCDs and mental health. “A political declaration that includes these recommendations can drive a vision for 2050 forward where there are fewer premature NCD deaths, reduced health systems strains, and healthier societies everywhere,” according to the IFPMA. IFPMA Director General Dr David Reddy said that the UN High-Level Meeting “provides a real opportunity to refocus attention on how cross-sectoral partnerships can help increase access to cost-effective medicines and vaccines in a way that can transform – and even save – the lives of millions of people worldwide.” Supporting the call, Dr Kimberly Green, PATH Global Director for Primary Health Care, said that “improving accessibility of essential medicines and health products has been underrepresented in discussions” ahead of the High-Level Meeting. PATH acts as the Secretariat for the Coalition for Access to NCD Medicines and Products. Green said that action is needed to “reduce catastrophic out-of-pocket health costs for people living with these conditions”, and that additional investment was needed to treat NCDs “through strengthened primary health care”. Image Credits: G Lontro/ NCD Alliance, Airfinity, IFPMA. Who Decides? The Contraceptive Conundrum Facing Adolescent Girls in Africa 07/03/2025 Edith Magak Panellists during the session on ‘Reclaiming Control: Let’s Talk About Sexual and Reproductive Health and Rights’ Access to contraception must be lowered to allow teenage girls to make informed decisions about their bodies, relationships, and futures, say key African health stakeholders – including sexual and reproductive health workers and advocates. But are policymakers ready to adopt this change – particularly as the debate over sexual and reproductive health rights becomes ever more fraught and polarized? At the just-concluded Africa Health Agenda International Conference (AHAIC), experts highlighted a troubling contradiction: while contraceptives are widely available across the continent, teenage girls under 18 often cannot access them without parental consent—consent that is not commonly sought, and when it is, frequently denied. Easier to get an abortion than contraception Dr Samukeliso Dube, Executive Director of Family Planning 2030. Rwanda is one of the countries grappling with this issue. According to Dr Clarisse Mutimukeye, Rwanda Chapter Lead for Women in Global Health and Executive Director of Medical Doctors for Choice, laws governing contraceptive access are often more restrictive than those regulating abortion. “In Rwanda, the law allows pregnancy termination up to 22 weeks if the person seeking the abortion is under 18, following an application by their legal representative. But to access contraception, girls under 18 still need parental consent,” she explained. “You can imagine if a girl falls pregnant at 15—she is allowed to seek a safe abortion, but she cannot access contraception beforehand. This is a problem.” This ‘problem’, led to over 39,000 teenage pregnancies in the country in 2022, according to Rwanda’s census. Without access to contraceptives, many girls resort to unregulated and unsafe options, putting their health at serious risk. Alternatively, teenage girls opting to become mothers before they have finished their education or training, risk a lifetime of poverty and dependency on family members and others. Recognising the urgent need for reform, the Rwandan parliament is now considering a new bill that would allow girls as young as 15 to access contraception without requiring parental consent. Teenage mothers getting pregnant ‘again and again’ Although a decline in adolescent birth rates has been observed globally, sub-Saharan Africa continues to have twice the global average. But Rwanda is not alone in facing this challenge. Many African countries, including Kenya, have similar restrictions. Ritah Anindo Obonyo, Executive Director of Community Voices Network in Kenya, said policies drive young girls toward dangerous alternatives. “Teenage girls are unable to access safe contraception, so they’re using emergency contraception as a long-term birth control method, which is not recommended,” she explained. “They are also using ‘Sofia’ or ‘China pills’, which are sold in backstreets and contain unsafe components.” The lack of safe contraceptive options has led to a troubling rise in repeat pregnancies amongst teenage mothers, Anindo observed. “With our organisation, we’re seeing a new trend—teen mothers are getting pregnant again and again. You can imagine what this means for their lives.” Teenage pregnancy has a prevalence rate of over 25% in 24 African countries, a rate that reaches as high as 48% in Niger and 44% in Chad. The Fight for Autonomy For many advocates, the debate over contraception is about more than just access—it is about control over young people’s bodies and futures. Patriarchal systems continue to deny young people autonomy over their reproductive choices, said Dr Samukeliso Dube, Executive Director of Family Planning 2030. “I think patriarchy is exhausting because it manifests in so many different forms. It’s always about control—who can I control at any given time? Let’s control who has access, when they have access, and how they have access.” “Everyone has the right to decide if, when, how many, and with whom they want children. That is a fundamental basic right,” she said. BBC’s Namulanta Kombo(left), in conversation with Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation and Dr Meggie Mwoka, Innovations Manager, Amref Health Africa. With Africa facing dwindling health resources due to aid cuts, experts argue that expanding access to contraception and comprehensive sexual and reproductive health education is one of the most effective ways to both ensure girls’ and womens’ basic reproductive health rights as well as optimising existing funds. Professor Charles Okeahalam, Chairman of Amref Health Africa’s International Board of Directors, stressed the economic and social benefits of investing in women’s reproductive health and education. “If we educate girls and give them more sexual and reproductive health rights, population growth would slow, and with a lower population growth rate, the demand for [healthcare] resources would also decrease,” he said. “But even beyond that, better-educated mothers and empowered women are more capable of caring for their children. Investing in female education—particularly in reproductive health—is an essential part of preventive care and resource management. These are the people most directly involved in providing care within families and communities.” 30 Years After Beijing, Women’s Voices Are Still Being Ignored This year marks the 30th anniversary of the Beijing Declaration and Platform for Action, a landmark commitment by governments to advance gender equality and women’s rights. Yet, female health leaders at AHAIC noted that many of the issues raised in Beijing in 1995 remain unresolved. Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation, reflected on the progress—or lack thereof—since attending the historic conference. “I was present at the meeting in Beijing, and what is intriguing today is that 30 years later, the more things have changed, the more they have remained the same,” she said. “It’s unfortunate that despite some progress, when I attend the Commission on the Status of Women (CSW) year in and year out, we are still discussing the same issues we raised in Beijing.” Image Credits: Edith Magak/HPW, Edith Magak/ HPW, African Union 2022. Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Who Decides? The Contraceptive Conundrum Facing Adolescent Girls in Africa 07/03/2025 Edith Magak Panellists during the session on ‘Reclaiming Control: Let’s Talk About Sexual and Reproductive Health and Rights’ Access to contraception must be lowered to allow teenage girls to make informed decisions about their bodies, relationships, and futures, say key African health stakeholders – including sexual and reproductive health workers and advocates. But are policymakers ready to adopt this change – particularly as the debate over sexual and reproductive health rights becomes ever more fraught and polarized? At the just-concluded Africa Health Agenda International Conference (AHAIC), experts highlighted a troubling contradiction: while contraceptives are widely available across the continent, teenage girls under 18 often cannot access them without parental consent—consent that is not commonly sought, and when it is, frequently denied. Easier to get an abortion than contraception Dr Samukeliso Dube, Executive Director of Family Planning 2030. Rwanda is one of the countries grappling with this issue. According to Dr Clarisse Mutimukeye, Rwanda Chapter Lead for Women in Global Health and Executive Director of Medical Doctors for Choice, laws governing contraceptive access are often more restrictive than those regulating abortion. “In Rwanda, the law allows pregnancy termination up to 22 weeks if the person seeking the abortion is under 18, following an application by their legal representative. But to access contraception, girls under 18 still need parental consent,” she explained. “You can imagine if a girl falls pregnant at 15—she is allowed to seek a safe abortion, but she cannot access contraception beforehand. This is a problem.” This ‘problem’, led to over 39,000 teenage pregnancies in the country in 2022, according to Rwanda’s census. Without access to contraceptives, many girls resort to unregulated and unsafe options, putting their health at serious risk. Alternatively, teenage girls opting to become mothers before they have finished their education or training, risk a lifetime of poverty and dependency on family members and others. Recognising the urgent need for reform, the Rwandan parliament is now considering a new bill that would allow girls as young as 15 to access contraception without requiring parental consent. Teenage mothers getting pregnant ‘again and again’ Although a decline in adolescent birth rates has been observed globally, sub-Saharan Africa continues to have twice the global average. But Rwanda is not alone in facing this challenge. Many African countries, including Kenya, have similar restrictions. Ritah Anindo Obonyo, Executive Director of Community Voices Network in Kenya, said policies drive young girls toward dangerous alternatives. “Teenage girls are unable to access safe contraception, so they’re using emergency contraception as a long-term birth control method, which is not recommended,” she explained. “They are also using ‘Sofia’ or ‘China pills’, which are sold in backstreets and contain unsafe components.” The lack of safe contraceptive options has led to a troubling rise in repeat pregnancies amongst teenage mothers, Anindo observed. “With our organisation, we’re seeing a new trend—teen mothers are getting pregnant again and again. You can imagine what this means for their lives.” Teenage pregnancy has a prevalence rate of over 25% in 24 African countries, a rate that reaches as high as 48% in Niger and 44% in Chad. The Fight for Autonomy For many advocates, the debate over contraception is about more than just access—it is about control over young people’s bodies and futures. Patriarchal systems continue to deny young people autonomy over their reproductive choices, said Dr Samukeliso Dube, Executive Director of Family Planning 2030. “I think patriarchy is exhausting because it manifests in so many different forms. It’s always about control—who can I control at any given time? Let’s control who has access, when they have access, and how they have access.” “Everyone has the right to decide if, when, how many, and with whom they want children. That is a fundamental basic right,” she said. BBC’s Namulanta Kombo(left), in conversation with Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation and Dr Meggie Mwoka, Innovations Manager, Amref Health Africa. With Africa facing dwindling health resources due to aid cuts, experts argue that expanding access to contraception and comprehensive sexual and reproductive health education is one of the most effective ways to both ensure girls’ and womens’ basic reproductive health rights as well as optimising existing funds. Professor Charles Okeahalam, Chairman of Amref Health Africa’s International Board of Directors, stressed the economic and social benefits of investing in women’s reproductive health and education. “If we educate girls and give them more sexual and reproductive health rights, population growth would slow, and with a lower population growth rate, the demand for [healthcare] resources would also decrease,” he said. “But even beyond that, better-educated mothers and empowered women are more capable of caring for their children. Investing in female education—particularly in reproductive health—is an essential part of preventive care and resource management. These are the people most directly involved in providing care within families and communities.” 30 Years After Beijing, Women’s Voices Are Still Being Ignored This year marks the 30th anniversary of the Beijing Declaration and Platform for Action, a landmark commitment by governments to advance gender equality and women’s rights. Yet, female health leaders at AHAIC noted that many of the issues raised in Beijing in 1995 remain unresolved. Dorothy Nyong’o, Managing Trustee of the Africa Cancer Foundation, reflected on the progress—or lack thereof—since attending the historic conference. “I was present at the meeting in Beijing, and what is intriguing today is that 30 years later, the more things have changed, the more they have remained the same,” she said. “It’s unfortunate that despite some progress, when I attend the Commission on the Status of Women (CSW) year in and year out, we are still discussing the same issues we raised in Beijing.” Image Credits: Edith Magak/HPW, Edith Magak/ HPW, African Union 2022. Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Mpox Testing Rate Plummets to 17% in DRC 06/03/2025 Kerry Cullinan Dr Ngashi Ngongo, Africa CDC led on mpox. Only 17% of suspected mpox tests in the the Democratic Republic of Congo (DRC) had been tested in the past week – a drop of almost 10%, Dr Ngashi Ngongo, the Africa Centres for Disease Control and Prevention (Africa CDC) lead on mpox, told a media briefing on Thursday. Only seven of the DRC’s 26 provinces in are reporting on mpox cases, and efforts to address the epidemic are being undermined by conflict and the withdrawal of aid from the United States, he added. “With the US aid freeze, there is no money for the transportation of specimens,” said Ngongo. However, Africa CDC is assisting the country to decentralise its laboratory services to make testing available close to outbreaks. The country’s laboratories have been expanded from two to 21 between last July and February. “But the target was to reach 56 laboratories to be able to get all the health zones to have laboratories to then eliminate the need to transport samples,” said Ngongo, adding that the ongoing conflict, particularly in eastern DRC, had affected plans. Some two million people are displaced in the DRC due to conflict – most recently in the east, and health players have requested a humanitarian corridor to restore health services to North and South Kivu which have been taken over by M23 rebels. In better news, some 300,000 people have been vaccinated against mpox over the past 10 days in the DRC capital of Kinshasa – over half the target. The vaccination uptake has increased significantly since health authorities changed its focus from contacts and key populations to anyone living in geographic hotspots, said Ngashi. However, the new variant of mpox Clade 1A has also been identified in Kinshasa. The variant now has one of the same genes as Clade 1B that is linked to higher transmissibility, and this could also increase the infectiousness of Clade 1A. Ebola in Uganda Five cases of Ebola – three confirmed and two probable – have been reported in Uganda over the past week. The new outbreak was first identified in a four-year-old child, and has no apparent link to the outbreak involving nine people three weeks’ ago. However, genomic testing has established that it is the same strain. In that outbreak, a nurse was thought to be the index case but as she lived in a city and had no contact Ebola-carrying animals, the usual source of outbreaks, investigations are ongoing to see whether there is another index case, said Ngongo. Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Huge Risk of Drug-Resistant Tuberculosis in Wake of Abrupt US Funding Cuts 06/03/2025 Kerry Cullinan In Pakistan, a healthcare worker listens to a child’s lungs for signs of pulmonary tuberculosis. Years of progress against tuberculosis, the world’s most deadliest infectious disease are being derailed by the abrupt funding cuts by the United States to the sector, according to a survey of 180 affected organisations released late Wednesday. As many as a quarter of the 180 survey respondents from 31 countries have had to close in the past few weeks, and 25% have cut back on TB treatment for those already on medication – massively upping the risk of a global explosion of drug-resistant TB. “Countless people having TB, including its resistant forms, face the imminent threat of losing access to essential medications – further risking an increase in transmission and drug resistance development of mammoth proportions,” according to the TB Community Coordination Hub, which compiled the survey. Virtually all the projects surveyed had received US “stop work” orders and half reported that their ability to deliver TB services has been “severely” impacted by the orders. Impact of US ‘stop work’ orders on TB projects surveyed Over three-quarters (78%) have laid off staff, and community health workers (CHW) have borne the brunt of the layoffs. Half the organisations reported having to lay off their entire community-based staff. CHW “ensure timely diagnosis and treatment for people with TB and drug-resistant TB”, according to the hub. As a result of the collapse of funding for CHW, almost half the projects (46%) have stopped TB screening and outreach and 29% are unable to start people with TB on treatment. USAID has been the largest bilateral donor in the TB sector, having invested over $4.7 billion since 2000, saving over 79 million lives. ‘We won’t walk away without a fight’ “[We] strongly condemn this callous, abrupt and totally one-sided act that is unprecedented, and calls upon the US Administration to take immediate measures to restore funding and support projects globally that are crucial to contain and prevent a resurgence of this deadly disease”, the hub added. The hub also calls on all countries, global TB leadership and donor organisations to “take urgent measures to gear up alternate funding to enable uninterrupted TB treatment and care to those in need, while upholding commitments to End TB as a global health security priority and a crucial indicator of Sustainable Development Goal 3”. “Our survey reveals the devastating impact of the US funding cuts on civil society, technical organisations and TB community networks at local and national levels,” said Dr Robyn Waite, part of the hub’s secretariat. “Now, with termination contracts in place, our findings are but a glimmer of the escalating crisis. As TB activists and advocates, we are shocked and struggling to deal with the fallout. But let’s be clear – we will not walk away without a fight.” No support for ‘most vulnerable’ In Thailand, a patient with multi-drug resistant TB receives his daily treatment. Atul Shengde, the National Youth Coordinator of the Global Coalition of TB Advocates in India, said that the cuts meant that his organisation “can no longer reach the most vulnerable – children, women, sex workers, injecting drug users, transgender people, and migrant workers”. “Previously, when patients struggled with the harsh side effects of TB medication, we were there to support them and keep them on treatment. Now, that critical support system is gone. The voices that once guided people through TB care have been silenced, and without them, I fear we will see TB spread even faster,” warned Shengde. Impact of US stop work orders on projects surveyed “In southern African countries, we’re hearing devastating stories: people avoiding TB centers out of stigma attached to lining up in queues, a woman forced to share half of her medication with the husband to ensure continuation, a young person skipping doses to stretch limited supplies, and a patient receiving near-expired drugs,” said Bruce Tushabe of the AIDS and Rights Alliance for Southern Africa (ARASA). “In the absence of community healthcare workers and other technical staff, we will continue to hear these gruesome stories of stigma, treatment disruptions, and a rise in multi-drug resistant tuberculosis.” Timur Abdullaev, a board member of TBpeople Global, said that the US funds cut had caught the TB community off guard and also revealed that “some essential elements of national TB programs appeared to be run fully by USAID”. “Unfortunately, we see exactly the same overly confident reliance on the Global Fund,” warned Abdullaev. “Protecting the lives of a country’s citizens is the responsibility of the country, not that of external donors or technical partners. Not being prepared for the loss of an external donor – even as large as USAID – and the failure to respond quickly to the resulting crisis is simply criminal.” ‘Devastating impact’ Dr Tereza Kasaeva, WHO’s Global TB Programme director, The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, around a -quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of the Global Programme on TB and Lung Health, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID, Southern Africa/Flickr, Stop TB Partnership, USAID Asia. US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
US Supreme Court Clears Path for District Judge to Rule on Aid Freeze 05/03/2025 Kerry Cullinan USAID staff offload emergency supplies. The United States Supreme Court has declined to intervene in the Trump administration’s freeze on foreign aid, referring the matter back to a District Court Judge who had earlier issued a temporary restraining order against the freeze. Judge Amir Ali issued the order on 13 February ordering the US administration to resume payments for work already done on Congress-approved contracts that were in place before Trump took office. Ali ruled that Trump and his officials were “temporarily enjoined” from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025”. He also prevented them from “issuing, implementing, enforcing, or otherwise giving effect to terminations, suspensions, or stop-work orders” related to these financial awards. However, hours before the order was due to go into effect on 26 February, Trump’s legal team turned to the Supreme Court, claiming that Ali lacked the authority to make such a ruling. Chief Justice John Roberts then issued an administrative stay of the order to enable the Supreme Court to consider the matter. Wednesday’s Supreme Court ruling – with five judges in favour and four against – simply directs Ali to “clarify what obligations the government must fulfill to ensure compliance with the temporary restraining order, with due regard for the feasibility of any compliance timelines”. Ali’s ruling was made in response to court action by three civil society organisations – the AIDS Vaccine Advocacy Coalition (AVAC), Journalism Development Network and the Global Health Council – challenging Trump’s Executive Order (14169), which immediately stopped all congressionally appropriated foreign assistance funding pending future review. Return to court The plaintiffs return to court on Thursday (6 March) where they will argue for a temporary injunction against the aid freeze. A spokesperson on behalf of the plaintiffs told Health Policy Watch that they are encouraged by the Supreme Court’s ruling today. “But each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” added the spokesperson. “Thousands of jobs all over the US have already been lost, with more likely to come. Hundreds of businesses – primarily small businesses, the backbone of our economy – face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.” The plaintiffs’ lead counsel, Lauren Bateman, an attorney with Public Citizen Litigation Group, stated on Wednesday that the Supreme Court ruling “confirms that the administration cannot ignore the law. To stop needless suffering and death, the government must now comply with the order issued three weeks ago to lift its unlawful termination of federal assistance.” During the earlier court hearing, the plaintiffs detailed some of the effects of the freeze on foreign aid dispensed by the US Agency for International Development (USAID) and the State Department. It has disrupted critical health programmes including maternal and child health programs; infectious disease prevention including against malaria and HIV, and clinical trials. Plaintiffs were also forced to lay off staff in response to the freeze. In its defence, Trump’s legal team claimed that life-saving health programmes had been given waivers. But this is no longer the case as the majority of USAID has been dismantled and life-saving projects were issued with permanent termination letters last week. AVAC executive director Mitchell Warren AVAC executive director Mitchell Warren appealed for support for the case: “These are immensely challenging times for all of us, and it is easy to be paralysed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.” Earlier, Warren described the funding freeze as harmful to global health and security: “In the name of economic efficiency, they are destabilizing public health, diplomatic relationships, communities, and economies.” Devastating setback for tuberculosis The World Health Organization (WHO) said on Wednesday that the 2025 US funding cuts will have “a devastating impact on TB programmes, particularly in low and middle-income countries that rely heavily on international aid, given the U.S. has been the largest bilateral donor”. The US has provided approximately $200–$250 million annually in bilateral funding for the TB response at country level, approximately one-quarter of international donor funding for TB, according to the WHO. “These cuts put 18 of the highest-burden countries at risk, as they depended on 89% of the expected U.S. funding for TB care. The African region is hardest hit by the funding disruptions, followed by the South-East Asian and Western Pacific regions.” Dr Tereza Kasaeva, WHO’s Director of Global Programme on TB and Lung Healt, said that “any disruption to TB services – whether financial, political, or operational – can have devastating and often fatal consequences for millions worldwide”. This was proven during the COVID-19 pandemic, she added, when “service interruptions led to over 700,000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures”. Image Credits: USAID Press Office. RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
RFK Affirms Measles Vaccine But Says Decision to Vaccinate is ‘Personal’ 04/03/2025 Kerry Cullinan Robert F Kennedy Jr, Trump’s pick for US Health Secretary. Amid the worst measles outbreak in the United States in a decade, vaccine sceptic Robert F Kennedy Jr, the Trump administration’s Health and Human Services (HHS) Secretary, has affirmed that vaccines protect children. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote in an opinion piece published by Fox News on Monday. He declared that “the decision to vaccinate is a personal one” rather than advising parents to ensure that their children are vaccinated against measles. He also asserted that “good nutrition remains a best defense against most chronic and infectious illnesses”. The Texas Department of State Health Services has confirmed 146 measles cases since late January and one death of an unvaccinated child, the first measles-related death of a US child in over a decade. Seventy nine of the confirmed cases were unvaccinated while the vaccine status of 62 others is unknown. “Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths,” wrote Kennedy. While affirming that HHS would ensure vaccines are “readily accessible for all those who want them”, Kennedy noted that the US Centers for Disease Control and Prevention (CDC) “has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection”. The CDC noted in a statement last month that “supportive care, including vitamin A administration under the direction of a physician, may be appropriate”. Vitamin A has been shown to reduce the risk of death from measles by 87% in children younger than two years old, and reduce the length of time the child suffers from diarrhea and fever, according to the Cochrane Review. In his first address to HHS staff on 18 February, Kennedy said the he would investigate the childhood vaccine schedule as part of the Make America Healthy Again Commission set up by Trump that Kennedy is chairing. “Nothing is going to be off limits,” Kennedy said, adding that the commission would investigate the health impacts of pesticides, food additives, microplastics, antidepressants and the electromagnetic waves emitted by cellphones and microwaves. Last week, the Food and Drug Administration cancelled an advisory committee meeting to discuss the composition of annual flu shots, which then have to be cultured. The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
The $40 Question: Can Africa Close the Health Financing Gap? 04/03/2025 Edith Magak Safiya Shuaibu (Nigeria Health Watch), Professor Mamadou Samba, Côte d’Ivoire’s Director General of Public Health and Hygiene, Aminata Wurie (Resilience Action Network Africa) and Roche’s Johnpaul Omollo. KIGALI, Rwanda – On average, African Health Ministers only have $40 per capita for health expenditure in comparison to $4,000 that ministers in many high-income countries have. How the continent can provide the maximum level of healthcare with such limited resources is one of the key questions that delegates to the Sixth Africa Health Agenda International Conference (AHAIC) in Kigali are trying to answer. There is consensus that aid is no longer a reliable solution in light of overnight funding cuts by the United States, and more incremental cuts from Europe. South-South solidarity and drawing more effectively on domestic resources are emerging as likely solutions. ’“To be honest, we cannot afford healthcare for everyone, but we can afford health, which will reduce our overall healthcare costs,” admitted Amref Health Group CEO, Dr Githinji Gitahi. Prevention Over Treatment The first short-term solution to manage the $40 well is by focusing on the basics and prioritizing prevention over treatment. “The foundation of health is clean water for everyone. It is sanitation for everyone. It is access to nutritious food to reduce the risk of non-communicable diseases. It is a strong emphasis on immunization. If we prioritize these, we will save significantly on future healthcare costs,” Gitahi explained. More investment in community health workers than expensive medical equipment like PET scans and MRI machines is also prudent. “Health is built at home – hospitals are there to repair,” he added. “We need to redesign our health systems to make prevention, primary care, and community health the core pillars.” Increasing the $40 However, even with careful management and efficiency, stakeholders agree that $40 is simply not enough. “We need political action now. Within our national budgets, health is not at the forefront. How many countries have actually reached the commitment of allocating 15% of their national budget to health? Just two – South Africa and Cape Verde,” said Aminata Wurie, project manager at Resilience Action Network Africa (RANA). This year, only one out of the 55 African countries allocated more than 5% of GDP to health while only two out of 55 countries have met the 15% Abuja Declaration commitment. Last month, Rwandan President Paul Kagame, the African Union’s (AU) Champion on Domestic Health Financing, hosted a High-Level Health Financing Conference in Addis Ababa to discuss alternative domestic sources of health funding. One of the key outcomes was a mandate for the Africa Centre for Disease Control and Prevention (Africa CDC) to develop a framework for domestic health financing. Africa CDC’s Dr Claudia Shilumani confirmed that efforts are already underway: “We are working with the African Medicines Agency and other partners to create a framework that will outline tangible actions governments can take to increase health sector funding. This will be presented to heads of state in the coming months for a decision.” Meanwhile, Rwanda is already setting an example by integrating existing health financing mechanisms to support long-term goals. In response to health system funding cuts, they have reassessed spending priorities to ensure critical programs remain operational. For example, instead of discontinuing workforce training, they have shifted many in-person trainings to online platforms and redirected the funds to essential programs. Public-private partnerships More attention is also being paid to public-private partnerships (PPPs) and innovative financing models to ensure the long-term sustainability of health programs. The pharmaceutical company Roche has committed to significantly increasing access to diagnostic testing across Africa, aiming to conduct over 3.4 billion tests by 2031 and reach more than 500 million people with quality diagnostics. “Reaching these ambitious goals, especially as Africa’s population continues to grow exponentially, cannot be done alone. Public-private collaboration is key,” said Johnpaul Omollo, Roche’s head of policy and government affairs. “First, we must ensure decentralisation – this is where localization plays a crucial role. As we expand local production, we must also understand what the market truly needs and identify the most essential products we can manufacture locally,” he added. South-South vaccine partnerships Another area where increased partnerships and collaboration will be essential is in vaccine distribution. The US withdrawal from the World Health Organization (WHO) might mean disruptions to vaccine distribution, which could delay availability and hinder efforts to achieve widespread immunity. However, vaccine manufacturers like Serum Institute of India (SII) – the biggest generic producer in the world – are stepping up their efforts to ensure the continued supply of life-saving vaccines. Speaking with Health Policy Watch on the sidelines of the conference, the company highlighted its partnerships with African manufacturers to promote local vaccine production. “We are collaborating with South Africa’s Aspen and Egypt’s Vacsera to establish fill-and-finish vaccine facilities within the continent,” said Anil Kulkarni, SII’s Senior Manager of International Business and Product Management. “In the coming years, we plan to expand these partnerships to more African countries.” SII has also committed to maintaining affordable vaccine prices to ensure that African countries can continue to get vaccines despite global funding challenges. But health experts stress that, for local pharmaceutical production to succeed, it will require a coordinated effort across multiple sectors. “The success of local production will require all hands-on deck. This means the private sector must be involved in understanding community needs, governments must create an enabling policy environment, and supply chains must be strengthened to ensure medicine accessibility,” said Omollo. Charles Okeahalam, president of Amref’s Board, described the current challenges facing Africa’s health systems as a wake-up call for the continent. “If we improve ourselves and systems by just 20%, we could see an 80% improvement in healthcare outcomes. The challenge is real but not as difficult as it might appear.” Image Credits: Edith Magak. Posts navigation Older postsNewer posts