A teacher at a school in Mozambique teaches local students about the health benefits of contraception.

The World Health Organization (WHO) has issued its first update in 13 years to guidelines aimed at preventing adolescent pregnancies, identifying child marriage as a primary driver behind millions of early pregnancies that endanger girls’ lives and futures.

The document published Thursday by the UN health agency pinpoints uptake and access to safe contraception, barriers to girls’ right to education, child marriage laws and access to sexual and reproductive health services broadly as fundamental to reducing early pregnancies, which endanger adolescents around the world.

“Early pregnancies can have serious physical and psychological consequences for girls and young women, and often reflect fundamental inequalities that affect their ability to shape their relationships and their lives,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO.

The global crisis affects millions of girls, with devastating health consequences rippling across generations, particularly in regions torn by conflict and instability. Pregnancy and childbirth complications rank among the leading killers of girls aged 15-19 worldwide.

Over 21 million girls between 15 and 19 become pregnant annually in low and middle-income countries, the WHO review found. Half of those pregnancies are unintended, while 55% lead to abortions—often performed in unsafe conditions, carrying life-threatening risks.

Maternal conditions are among the top causes of disability-affected life years and mortality globally, according to UNICEF.

Health dangers from pregnancy are intensified for mothers aged 10-19, who face significantly higher risks than women in their twenties, including dangerous high blood pressure conditions like eclampsia, post-childbirth uterine infections and systemic infections.

The health consequences extend to their infants as well. Babies born to adolescent mothers have higher rates of low birth weight, premature birth and serious neonatal conditions compared to those born to older mothers. 

“Adolescents who give birth face higher risks of maternal and infant mortality compared with older women, while early pregnancies can restrict adolescents’ choices, limiting their educational and economic prospects,” Allotey said. “These limitations often perpetuate cycles of poverty and inequality.”

“Tackling this issue means creating conditions where girls and young women can thrive—by ensuring they can stay in school, be protected from violence and coercion, access sexual and reproductive health services that uphold their rights, and have real choices about their futures,” Allotey added. 

Child brides: one every three seconds

One in five young women worldwide were married before their 18th birthday. Levels are highest in sub-Saharan Africa.

An estimated 12 million girls marry before age 18 annually — approximately one every three seconds — according to Girls Not Brides, a coalition of over 14,000 international and human rights organizations. In low- and middle-income countries, nine out of ten adolescent births occur among girls married before turning 18.

“Early marriage denies girls their childhood and has severe consequences for their health,” said Dr Sheri Bastien, Scientist for Adolescent Sexual and Reproductive Health at WHO.

Though child marriage rates declined from 25% in 2010 to 19% in 2020, progress remains slow and is reversing in conflict zones. The prevalence has increased by 20% in Yemen and South Sudan amid ongoing conflicts.

About 650 million women alive today were married as children, with one in 20 girls worldwide wed before age 15.

The situation is most dire in fragile states, where Save the Children reported last year that a girl is married every 30 seconds. Global humanitarian crises from Sudan to Yemen, Gaza and Myanmar have only accelerated since that report, leaving millions of girls at heightened risk of dangerous pregnancies.

Child marriage not only leads to early pregnancies before girls’ bodies are fully developed, but also often restricts their access to adequate healthcare. Girls who marry before 15 are 50% more likely to experience intimate partner violence than those who marry later, creating additional health complications.

The issue forms part of a broader pattern of gender inequality. In regions where both female genital mutilation and child marriage are common practices, girls face compounded health risks. Countries including Sudan, Somaliland, Sierra Leone, Burkina Faso and Ethiopia report the highest rates of girls subjected to both practices.

Stark global divide in adolescent pregnancy crisis 

Girls living in rural areas are more likely to marry in childhood than girls in urban areas.

Progress region to region remains starkly uneven. Sub-Saharan Africa has far and away the highest prevalence of births to girls aged 15-19, with over six million occurring in 2021 alone, in addition to 332,000 births for girls between 10 and 14 years old. The best-performing region, Central Asia, saw just 68,000 adolescent births that same year.

This divide is also reflected in maternal death rates. Seventy percent of global maternal deaths in 2020 — over 200,000 — occurred in sub-Saharan Africa, where girls who reach age 15 face a one in 40 chance of dying from pregnancy-related complications in their lifetimes. In Chad, the country with the highest rate of maternal mortality, a 15-year-old girl has a one in 15 chance of dying of maternal causes.

Divides by income, culture and class can also occur within countries, undermining the representativeness of national-level statistics. The WHO cites examples of Zambia, where adolescent pregnancy rates vary from 14.9% in the capital region of Lusaka, to 42.5% in its Southern Province.

According to Save the Children’s 2024 Global Girlhood Report, the ten countries with the highest child marriage rates are either fragile or extremely fragile states. Eight of the top ten “fragility-child marriage hotspots” are in Africa, with Central African Republic, Chad, and South Sudan facing the most severe crises. In extremely fragile countries, almost 558,000 girls give birth before their 18th birthday, often without access to skilled birth attendants who could save their lives if complications arose. 

While worldwide adolescent birth rates have declined, the overall birth rate remains high. In 2021, an estimated 12.1 million girls aged 15–19 years and 499,000 girls aged 10–14 years gave birth globally, according to WHO.

“Ensuring that adolescents have the information, resources and support to exercise their sexual and reproductive health rights is not only a matter of health – it is a matter of justice,” concluded Allotey. “All adolescents need to be empowered to make choices that lead to healthier, more fulfilling lives.” 

Despite the heightened risks for girls worldwide, only 0.12% of all humanitarian funding between 2016 and 2018 was directed toward addressing gender-based violence, according to Save the Children.

Education as a shield

The WHO identifies education as a crucial human right and shield against adolescent pregnancies.

Among the WHO’s strongest recommendations is removing gender barriers to education, with evidence showing each additional year of secondary education reduces a girl’s likelihood of marrying as a child by six percentage points. 

Multiple randomized controlled trials from Kenya, India and Zimbabwe reviewed by WHO present strong evidence that that life skills curricula and support to remain in school effectively reduce child marriage rates.

“Quality education represents our strongest defense against early marriage and pregnancy,” WHO researchers noted in the guidelines. 

“These limitations often perpetuate cycles of poverty and inequality,” said Allotey. “In many parts of the world, adolescents – whether married or unmarried – lack access to the information and resources necessary to make informed decisions about their sexual and reproductive health. This leaves them vulnerable to early pregnancies and unprepared to navigate the physical, emotional and social changes that follow.”

While 50 million more girls enrolled in school between 2015 and 2023, completion rates for secondary education lag significantly behind primary education, with only 61% of girls finishing upper secondary school worldwide compared to 89% completing primary education.

Economic interventions also show promise according to the WHO guidelines. Programs focused on improving livelihood skills, financial literacy and economic autonomy demonstrated significant impact on reducing child marriage while increasing girls’ employment and control over resources.

“Education is critical to change the future for young girls, while empowering adolescents – both boys and girls – to understand consent, take charge of their health, and challenge the major gender inequalities that continue to drive high rates of child marriage and early pregnancy in many parts of the world,” Bastien said.

Beyond Legal Solutions

Child marriage–fragility hotspots where girls face high rates of child marriage and the challenges associated with fragility. / Save the Children 2024

The WHO also conditionally recommends implementing laws restricting marriage before age 18, though with important caveats. Criminalizing child marriage can produce unintended consequences, potentially driving the practice underground, which can make reporting more difficult for the child brides who are victims of sexual assaults, the guidance suggests. 

The evidence reviewed by WHO on worldwide child marriage laws suggests that legal restrictions show inconsistent results in reducing marriage rates without addressing underlying social factors.

“Laws alone are insufficient without addressing root causes,” concludes the report, citing the need for comprehensive frameworks tackling gender inequality.

Both the UN Convention on the Elimination of All Forms of Discrimination Against Women and the Convention on the Rights of the Child call for eliminating harmful practices affecting children’s health, but organizations like Girls Not Brides warn that punitive approaches without corresponding social support can harm the very girls they aim to protect.

“Progress is uneven,” Allotay said. “We must sustain efforts to ensure that the most vulnerable groups of adolescent girls are not left behind.” 

Image Credits: The Hepatitis Fund.

A rollout of the malaria vaccine in Western African countries with a special focus on immunising children is an important step towards eliminating the disease.

After the World Malaria Report 2024 was published, the global community confronted an undeniable and uncomfortable truth: while malaria affects entire communities, its burden is not equally distributed.

Women, particularly in malaria-endemic regions, are disproportionately impacted. Their physical, social and economic health suffers more than others’ as they bear the brunt of caregiving responsibilities, suffer barriers to accessing healthcare, and face the compounding effects of climate change on disease transmission.

Malaria is a preventable and treatable disease, yet the global tally of malaria deaths has risen in recent years. In 2023, the death count reached 597,000, up from 574,000 in 2018, in part due to antimalarial drug resistance, health systems weakening during COVID-19, and funding shortfalls.

But the hardship that malaria causes goes beyond countries grappling with staggering death counts. The disease leaves profound and lasting indirect impacts on communities –  falling disproportionately on women and girls.

The hidden costs of malaria on women and girls

Pregnancy weakens malaria immunity, increasing infection risk. For expectant mothers, malaria can cause severe anemia, pregnancy loss, premature birth, underweight newborns, or maternal death. / World Malaria Report 2024.

The fight against malaria is hindered by deeply rooted gender inequalities.

Women spend four times as many days on caregiving compared to men – a stark reality exacerbated by recurring malaria infections within families as poverty traps women in cycles of economic dependency and limits opportunities for education and employment.

Women’s contributions to the global health system are estimated to be around 5% of global GDP. But around 50% of this work is unrecognised and unpaid. In malaria-endemic regions, this labour often takes the form of informal caregiving, as women provide care in up to 83% of malaria cases.

For community health workers, 70% of whom are women, the imbalance is even larger. Female health workers spend significantly more unpaid hours than their male counterparts, despite forming the backbone of malaria detection, treatment, and prevention efforts in rural areas.

Women and girls often lack decision-making power in their households, preventing them from accessing life-saving interventions like insecticide-treated nets or seeking timely healthcare. Cultural norms can dictate who uses a bed net or who receives care first, often leaving women and girls at greater risk.

Malaria is a leading cause of death amongst adolescent girls in malaria-endemic countries. Many are forced to leave school to care for sick family members or themselves, disrupting their education and increasing their vulnerability to early marriage or exploitation. Without targeted interventions, these gendered gaps will continue to undermine global malaria eradication efforts.

Climate change is catalysing inequality and disease

Number of internally displaced people by endemic malaria region. Women and children face higher vulnerability during conflicts, natural disasters, and humanitarian crises. / World Malaria Report 2024

The accelerating effects of climate change are making the fight against malaria even harder.

Rising temperatures and shifting rainfall patterns are expanding the habitats of malaria-transmitting mosquitoes, bringing the disease to new regions and intensifying its prevalence in existing hotspots. These environmental changes disproportionately harm women, who already face barriers to health information and services.

Pregnant women are particularly vulnerable. In 2023, in 33 moderate-to-high transmission countries in the WHO African Region, there were an estimated 36 million pregnancies, of which 12.4 million (34%) were infected with malaria.

Malaria during pregnancy exponentially increases risks to both mother and child, including anaemia, stunted growth, and severe illness. The consequences ripple across generations, perpetuating cycles of poor health and poverty.

A gendered approach to malaria elimination

Four-year-old Aitano Valentina of Guatemala City proudly holds her health booklet after receiving DPT and Polio vaccination. For the first time in history, the number of under-five deaths has fallen below 5 million.

To accelerate progress against malaria and address these inequities, we must adopt a gender-responsive strategy that empowers women and girls as agents of change. Investing in women has far-reaching benefits – not just for malaria elimination but for broader health, economic, and societal outcomes.

When women are empowered with resources, time and decision-making agency, malaria outcomes improve. Research shows that households where women have greater bargaining power are 16 times more likely to use mosquito nets effectively, reducing malaria transmission.

It is equally important to address the structural barriers limiting women’s participation in the health workforce. Only 25% of women in the global health sector hold senior roles, despite making up 70% of the workforce. Providing pathways for professional advancement and fair compensation is essential to sustaining their contributions and ensuring a resilient healthcare system.

Change won’t happen by itself

WHO-recommended malaria vaccines are in the process of being rolled out across Africa, with over 10 million doses delivered in the first year of routine immunisation programmes in 2024.

Addressing the impact of malaria on women and girls can contribute to both malaria eradication efforts and gender equality progress. Action is overdue.

But if we commit now to putting economic resources in the hands of women, challenging gender norms, power imbalances and discriminatory laws, we can achieve a double dividend.

This should see us increase women’s economic ability to take charge of their health, the representation of women in leadership roles within malaria programs, research, and policymaking, ensuring interventions reflect the realities faced by women and girls.

Fair wages, adequate training, and professional development opportunities for female health workers are equally critical to building a robust and sustainable health workforce.

Malaria interventions must also account for gender dynamics, ensuring equitable access to tools such as insecticide-treated nets and addressing the unique barriers faced by pregnant women and adolescent girls. Closing the gender data gaps is another essential step to enable a deeper understanding of malaria’s full impact on women and girls, and to facilitate more effective and targeted solutions.

The fight against malaria is at a crossroads. With intentional investment in gender-focused strategies, we can eliminate this disease within a generation while empowering women and girls to lead healthier, more prosperous lives.

The World Malaria Report 2024 leaves no room for doubt; achieving this vision will require bold leadership, innovative solutions, and an unwavering commitment to leaving no one behind.

By placing women and girls at the centre of the malaria response, we can create a ripple effect of positive change that extends far beyond health, building stronger, more equitable communities worldwide.

About the authors

Dr. Jemimah Njuki is the Chief of Economic Empowerment at UN Women.

Lizz Ntonjira is the co-chair of the Zero Malaria Campaign Coalition & Author, #YouthCan. 

Image Credits: WHO, UNICEF 2024 , WHO.

Dr Monika Kosinka, WHO lead on the economic and commercial determinants of health.

KUALA LUMPUR, Malaysia – The healthcare sector in India produced 32 billionaires in 2022 – more than any other sector in an extraordinary demonstration of corporatisation, according to Abhay Shukla, co-convenor of Jan Swasthya Abhinyan, the People’s Health Movement in India.

Massive investment in healthcare by private companies since the 1990s, particularly in “corporate, profit-driven hospitals”, has sent non-essential procedures and treatments skyrocketing. 

For example, 48% of births in private hospitals are now Caesarian sections, in comparison to 14% in public health in India, said Shukla. The World Health Organization (WHO) recommends a rate of 10-15%.

“Two out of three Caesareans taking place in India are medically unnecessary. This is huge. We’re talking about hundreds of millions of women,” said Shukla, addressing a symposium on the growing influence of powerful private actors (PPAs) on global health, convened by the United Nations University International Institute for Global Health (UNU-IIGH) and Third World Network in Kuala Lumpur.

Unnecessary thrombolysis for stroke patients, additional cancer treatments and getting higher-paid consultants to perform basic procedures that could be done by frontline ER physicians to enable higher billing, are other examples of what the corporatisation of health has done to Indian healthcare.

Private equity and venture capital (PEVC) investment in Indian healthcare (as a percentage of PEVC total investment in India) doubled from 5% during 2017-2019 (pre-Covid years) to almost 10% during 2020-2023, with a record 18% in 2023.

Initially focused on pharmaceutical investment, investment in healthcare services has boomed since 2006, when the government made it easier for foreign direct investment in Indian companies. Healthcare investment boomed during COVID-19, rising to $413 million in 2021 (vs $160 million in 2019/20).

Private equity and venture capital (PEVC) investment in India’s health sector.

“The treating doctors are like spare parts in a big machine. They can be replaced at will by the corporate management. If they fulfil targets and if they are generating profits, they stay. If they are not generating profits, they go,” said Shukla.

Deaths driven by four industries

While India provides a jarring example of how corporate interests are subverting health services, the negative impact of a range of industries on health is better known.

One-third of global mortality is caused by four industries: tobacco, fossil fuel (air pollution) alcohol, and big food, said Dr Monika Kosinka, WHO lead on the economic and commercial determinants of health.

“For the region that we are in, the Western Pacific, the figure goes up to 48% mortality  attributable to these four interests,” she added.

“While businesses and private markets play a key role in producing and supplying the goods and services we consume every day, powerful corporations with commercial interests have also played a key role in driving consumption of health-harming products, blocking regulations to protect health or the environment and aggravating health inequalities between and within countries,” said Kosinka.

WHO Malaysia Representative Dr Rabi Abeyasinghe added that many corporate interests wanted the WHO to focus narrowly on medical concerns rather than taking a holistic view of health.

“They want us to be the World Medical Organization not the World Health Organization,” said Abeyasinghe.

Concentrated power and health

Prof Sharon Friel of the Australian National University mapping the influence of the fossil fuel industry.

“Looking at powerful private actors in global health governance and accountability is both important and necessary,” stressed conference co-convenor Dr David McCoy of UNU-IIGH. 

“Many people working in global health will perhaps find it odd that we’re looking at powerful private actors and accountability. They’re more used to having conferences that talk about HIV or universal health coverage, or global health financing. 

“But what you’ll be hearing throughout this symposium is the evidence that demonstrates the link between concentrated power and wealth and its impacts on health and health governance,” stressed McCoy 

“Whether it’s about the unethical and deceitful marketing of commercial milk formula or challenging the abuse of intellectual property rights to keep essential medicines out of the reach of millions of people with HIV, or the truth around the causal relationship between fossil fuels and global warming, there is a long history of public health having to engage with the politics of the world,” said McCoy.

The growing influence of private actors, including big philanthropy, on the UN and its organisations was also raised.

Barbara Adams pointed to how the increase in voluntary contributions by countries and donors, rather than member states’ assessed contributions, has slanted financial allocations to earmarked issues rather than core funding.

UNU-IIGH director Dr Revati Phalkey emphasized the urgency of the situation: “This symposium comes at a critical juncture. While painful budget cuts are being made to the WHO and many vital health programmes, private entities with commercial interests appear to be gaining more influence in the health sector. This raises urgent questions about accountability.”

‘Tax the rich’

Oxfam mapping of the increase in billionaires’ wealth.

“The extreme concentration of wealth in the hands of so few in today’s global economy is itself an existential threat to good global health governance,” said Oxfam’s Anna Marriott.

She pointed out that taxing the ultra-wealthy appropriately would provide enough money to address global health and poverty needs.

“In 2022, the 10 richest men in the world doubled their fortunes during the pandemic while the incomes of 99% of humanity fell,” said Marriott.

“In 2023, the richest 1% grabbed nearly twice as much new wealth as rest of the world put together, while poverty increased for the first time in 25 years,” she said. This year, billionaire wealth has “surged three times faster in 2024”.

“This much wealth and power in the hands of so few is intolerable,” Marriott stressed, urging participants to support “global movements’ and multilateral efforts from the global South to tax extreme wealth to raise urgently needed revenue for health”.

The symposium concluded with a powerful call for accountability in the system of global health governance, demanding that systems be established to prioritise public interest and hold powerful private actors responsible for their impact on health. 

Suggestions include greater transparency, stronger regulatory frameworks, more monitoring of private actors and greater collaboration between governments, civil society, and international organisations. 

Dr Jean Kaseya, Director General of Africa CDC.

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

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

Mpox in DRC, 17 April 2025

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

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

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

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

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

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

One human case of anthrax

One person has been identified with anthrax in Uganda. 

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

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

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

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

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

Health financing

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

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

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

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

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

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

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

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

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

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

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

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

Compensation has stagnated in OECD countries.

Growing demands on nurses’ time

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

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

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

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

Threats to safety and low pay are major threats

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

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

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

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

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

Violence against nurses is a global issue.

Report’s recommendations

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

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

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

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

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

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

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

Global shortage of nurses reaching record numbers.

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

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

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

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

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

Savings obtained from investments outweigh the costs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tanzania on behalf of Africa.

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

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

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

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

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

Germany addresses the final session of the INB.

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

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

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

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

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

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

Sharing pandemic products

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

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

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

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

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

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

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

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

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

Recognition of human-animal connection

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

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

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

Research and development

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

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

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

Impact on young people

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

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

Success of multilateralism

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

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

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

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

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

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

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

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

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

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

Image Credits: Kerry Cullinan.

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

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

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

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

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

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

Climate change hotspots

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

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

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

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

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

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

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

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

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

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

Impact of funding cuts to NOAA now visible

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

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

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

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

Progress on some fronts

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

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

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

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

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

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

US Health Secretary Robert F Kennedy Jr.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Measles in the US, 9 April 2025

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

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

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

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

Mixed messages and mass lay-offs hamstring response

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

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

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

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

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

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

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

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

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

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

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

MAHA backlash

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

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

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

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

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

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

Funding chaos shutters disease surveillance labs

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

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

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

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

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

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

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

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

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

Image Credits: CBS, CDC.

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

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

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

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

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

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

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

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

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

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

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

Image Credits: Thiru Balasubramaniam.

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

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

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

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

Why the gap?

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

What needs to change?

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

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

Image Credits: TDR Global Health Matters.