Wild Poliovirus Transmission Persists in Afghanistan and Pakistan 05/02/2026 Arsalan Bukhari Polio cases are falling, but persistent transmission in Afghanistan and Pakistan, vaccine-derived outbreaks elsewhere, and funding gaps keep global eradication at risk. Polio remains a public health emergency of international concern despite a continued decline in case numbers, according to the World Health Organization’s (WHO) Director-General report presented to the Executive Board. The report warns that progress toward eradication remains fragile. Some 38 cases of wild poliovirus type 1 had been reported globally by 22 October 2025, down from 62 during the same period in 2024. All cases occurred in Afghanistan and Pakistan, the only two countries where wild poliovirus remains endemic. Environmental sampling has continued to detect the virus beyond core transmission areas, including during the low-transmission season, suggesting silent spread even where no clinical cases are immediately visible. Transmission concentrated in endemic reservoirs WPV1 cases in Pakistan and Afghanistan Wild poliovirus type 1 persists in a small number of reservoirs, particularly in southern Afghanistan, and the southern area of Khyber Pakhtunkhwa in Pakistan, the report notes. In Afghanistan, operational and communication strategies are being adjusted to improve coverage. Supplementary immunization improved markedly in the eastern region in early 2025, contributing to reductions in transmission. Vaccination teams continue to use site-to-site approaches in the south, supported by transit posts and advocacy for house-to-house vaccination to reach missed children. Pakistan is implementing the Polio National Emergency Action Plan 2024–2025 with a phased strategy aimed at restoring an emergency posture, closing operational gaps and sustaining high immunity. While high-level political commitment and intensified supervision have improved performance, subprovincial variation persists in parts of Khyber Pakhtunkhwa, Quetta and Karachi. Both countries are applying risk-categorization models to identify and reach migrants, mobile groups and other missed children, while strengthening coordination along virus corridors and addressing surveillance gaps. Microplanning, targeted campaigns, fractional-dose inactivated poliovirus vaccine and expanded subnational surveillance are part of these efforts. The Global Polio Eradication Initiative (GPEI), which leads implementation with national authorities, says its 2026 Action Plan will prioritize the low-transmission season to interrupt remaining chains of spread and close immunity gaps among persistently under-immunized populations. Vaccine-derived poliovirus outbreaks in low-coverage areas Vaccine-derived polio persists in low-coverage regions, with cases across 13 countries and new detections signalling ongoing cross-border spread. Beyond the two endemic countries, circulating vaccine-derived poliovirus remains a persistent challenge where routine immunization coverage is weak. WHO reported 151 cases of circulating vaccine-derived poliovirus type 2 across 13 countries as of late October 2025, compared with 182 cases across 16 countries a year earlier. Despite the decline, transmission continues in northern Nigeria, the Lake Chad Basin, the Horn of Africa, particularly south and central Somalia, Ethiopia and Yemen. Health experts say these outbreaks occur when weakened strains of the oral polio vaccine circulate for prolonged periods among under-immunized children, allowing the virus to mutate and spread. Some countries have recorded progress. Madagascar’s outbreak of circulating vaccine-derived poliovirus type 1 was declared closed in May 2025. In the Democratic Republic of the Congo, cases have fallen sharply in recent years following targeted responses, dropping to a single case in 2025. Limited detections of circulating vaccine-derived poliovirus type 3 were reported in Guinea, Cameroon and Chad, with outbreak responses underway. New environmental detections, including in Papua New Guinea and several European countries, underscore the risk of international spread through travel, population movement and surveillance gaps. Vaccination tools and integration expand Polio efforts are shifting toward new vaccines and integrated routine immunization to reach zero-dose children and strengthen health systems. While the standard oral polio vaccine remains the primary tool in eradication efforts, new products include the expanded use of the novel oral polio vaccine type 2 and combination formulations. With support from Gavi, the vaccine alliance, Senegal and Mauritania became the first countries to introduce the hexavalent vaccine into routine immunization schedules this year. WHO partners are also emphasising the integration of polio activities into broader health services. Coordination between GPEI, the Essential Programme on Immunization and Gavi has been strengthened to reach zero-dose children with multiple vaccines and to align polio assets with routine immunization systems. Addressing the Executive Board, a Gavi representative urged countries to promote integrated approaches to reaching zero-dose and under-vaccinated children with life-saving vaccination and primary health care, particularly in humanitarian and complex emergency settings, and to accelerate the transition of polio programme infrastructure into national systems to ensure long-term resilience. Humanitarian pressures complicate delivery In the Eastern Mediterranean Region, which includes both the endemic countries, ongoing crises continue to strain health services. Regional Director Hanan Balkhi told the board that the region carries nearly half of the world’s humanitarian burden and accounted for 40% of attacks on health care last year. She said WHO responded to 62 outbreaks in 2025 and delivered supplies to crisis settings, including Gaza and Sudan, but funding cuts have reduced the regional health emergency workforce by about half. Millions of treatments are now at risk, while clinic closures in Afghanistan and disruptions in Sudan have limited access to essential services. Cross-border collaboration between Pakistan and Afghanistan continues, supported by regional oversight and diplomatic engagement, to sustain polio eradication activities. Although the Polio Eradication Strategy has been extended through 2029, financing remains a constraint. Donors have pledged $ 4.7 billion of the $ 6.9 billion required, leaving a $ 2.2 billion shortfall. The Director-General’s report cautions that sustained political commitment, stronger routine immunization systems and adequate resources will be essential to interrupt remaining transmission and secure a lasting polio-free world. Image Credits: GPEI, RAJA IMRAN BAHADR / Unsplash.. $9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. WHO to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
$9.42 Billion for Global Health as US Foreign Aid Bill Passes 04/02/2026 Sophia Samantaroy A baby is being weighed, measured and vaccinated in the health center of Gonzagueville, a suburban of Abidjan, in the South of Côte d’Ivoire. The US is the largest single contributor to global health funding. The US House of Representatives passed a more than $1 trillion spending package, bringing an end to a five-day partial government shutdown over Department of Homeland Security funding. Among the allocations is a $9.42 billion package for global health programs – signaling strong bipartisan support and maintaining significant global health aid. The Fiscal Year 2026 (FY26) National Security-State Department Appropriations Bill maintains funding for global health at a substantially higher level than envisaged by the Trump administration, in an apparent bipartisan rejection of the administration’s proposed cuts. The $9.42 billion package agreed to by the US House and Senate, and signed into law by the President, is lower than the $12.4 billion allocation in 2024 and 2025 – but it is still $5.7 billion more than requested last September by US President Donald Trump in his America First Global Health Strategy. Although the administration requested major cuts to foreign aid, Congress’s version of the bill preserves flagship global health programs like President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight TB, AIDS and Malaria, and HIV/AIDS programs previously administered through USAID – and reasserts Congress’s role in government spending. The global health allocations are part of a larger $51.4 billion foreign aid spending package for the 2026 fiscal year. That foreign aid bill, while a 16% cut from 2024, is nearly $20 billion more than what the Trump Administration initially requested. The broader bill also includes $5.4 billion in funding for humanitarian assistance and comes as the Trump administration moves forward on a $11 billion plan for direct bilateral assistance to developing country governments – some of which would also be dedicated to health. Funding for HIV/AIDS, malaria, TB, family planning Of the $9.4 billion, some $5.88 billion is dedicated to fighting HIV/AIDS – with about $4.5 billion allocated to PEPFAR (not named here), and the rest to Global Fund, UNAIDS, and related activities. (This chart is from the Jan 2026 Senate version of the Act.) Of the $9.42 billion earmarked in the bill specifically for global health programs, some $5.9 billion would be allocated to HIV/AIDS – with $1.25 billion channeled through the Global Fund, $45 million for UN AIDS, and $4.6 billion through PEPFAR, the flagship US program founded in 2003. This represents $200 million more for PEPFAR, and a $400 million decrease (24%) for the Global Fund from FY25 levels. And while less than the $7.1 billion level of support to these organizations under the Biden administration in FY24, it’s a major increase from the $2.9 billion for HIV/AIDS requested by Trump. At the same time, the Bill also calls for PEPFAR, founded by former US President George Bush, to transition to a largely self-reliant program of national governments over the coming years. Other global health priorities still see strong funding: $795 million is dedicated to malaria, and $379 million for tuberculosis; $85 million is earmarked for polio. Some $575 million for family planning and reproductive health services are also included in the funding package – despite the historic reticence of some conservatives to fund such programs, and the fact that the Administration requested no funds for these programs. And although the administration has ordered a US withdrawal from the UN Population Fund (UNFPA), Congress allocated $32.5 million for the organization, as part of the family planning funds. The bill does stipulate that the agency cannot spend these funds on China – and that if the Trump administration makes good on its plan to withdraw from UNFPA, the money should then be transferred to other global health programs. Allocations earmarked for “Global Health Security,” are $615.6 million for organizations like Pandemic Fund and the Coalition for Epidemic Preparedness Innovations (CEPI). While global health security overall was cut by about 12% from FY25, these funds could also be used in the event of a public health emergency. Funds will also go to neglected tropical diseases (NTDs; $109 million) and nutrition ($165 million). US to continue funding Gavi despite federal anti-vaccine rhetoric Over 1.7 million COVID-19 vaccine doses arrived in Ghana during the pandemic as part of the Gavi-organized Covax program. In late January the US froze all funds to Gavi, the Vaccine Alliance, over concerns that the organization, which procures and delivers life-saving vaccines, provides vaccines with the preservative thimerosal. And while the US FDA has stated that the preservative “has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines,” the US plans to withhold the $300 million already allocated by the Biden administration but not yet paid, as well as any new funds. Despite this, the newly passed FY26 bill does include another $300 million for a US contribution to Gavi. The Administration had requested Gavi funds be eliminated. New ‘National Security Fund’ also includes health components In another twist, support for family planning, reproductive health and countering child marriage is also supported through a new National Security Fund of $6.77 billion that Congress aims to create – to “combat China’s influence” among other things. The fund, which also includes monies for clean cook stoves, a Young African Leaders Initiative, peace process monitoring, trade capacity building, and assorted other priorities, specifies that at least 15% of the fund should go to the African continent. This story is a follow up to a 15 January piece, which can be found here: US Congressional Leaders Agree to $9.4 Billion for Global Health – Countering Trump Proposal for Deeper Cuts Image Credits: UNICEF, Senate Appropriations. Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. WHO to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Conflicts and Vaccine Hesitancy Undermine Global Immunization Efforts 04/02/2026 Disha Shetty Ongoing conflicts combined with vaccine hesitancy are derailing global immunization efforts, in turn worsening the spread of communicable diseases. Ongoing conflicts and vaccine hesitancy are undermining efforts to immunize all children, according to a report tabled at the World Health Organization’s Executive Board meeting. Over 120 million people were displaced by conflicts in 2024 alone, according to the WHO. Countries will have to put in significant efforts to achieve the 2030 target of averting 50 million vaccine-preventable deaths between 2021 and 2030. “Over the next five years, Gavi will invest nearly 3 billion US dollars in fragile countries, about 35% of our programmatic resources,” a representative from the vaccine alliance Gavi told the EB. “We urge member states to continue investing in routine immunization, reach zero-dose children, and strengthen outbreak preparedness and response,” the representative said. There has been some progress in addressing Neglected Tropical Disease (NTDs) and Tuberculosis (TB), though the gains are precarious, the WHO warned. Between 2015 and 2021, the disease burden due to NTDs decreased from 17.2 to 14.1 million disability-adjusted life years, according to another report tabled. The global number of people falling ill with TB declined for the first time since the COVID-19 pandemic in 2024 and stood at 10.7 million. Around 8.3 million people accessed care that year, the highest number since WHO began monitoring, a report on TB noted. Globally, the net reduction in incidence rate between 2015 and 2024 was around 12.3%. Anti-vaccine narratives Immunization strategies are often poorly tailored to conflict settings. Apart from the worsening humanitarian crisis, particularly in Ukraine, Gaza, and Sudan, there is growing vaccine hesitancy. The anti-science sentiment and politicization of science and public health risk are undermining trust in immunization and threatening progress, the WHO’s report said. “Misinformation has become a major constraint, and we note with concern that some anti-vaccine narratives are amplified through coordinated influence operations, even by state actors,” a representative from Ukraine said. “To regain momentum, Ukraine emphasizes strengthening primary health care and making continuous catch-ups a permanent, everyday function of the health system, rather than just a periodic campaign,” the representative added. Immunization strategies are often poorly tailored to conflict settings, with coverage declining sharply during crises, WHO said. Despite the COVID-19 pandemic, vaccinations averted over four million deaths annually between 2021 and 2024. Immunization to control NTDs In 2024, 1.4 billion people required interventions against NTDs, a 36% decrease from 2010. The estimated mortality from NTDs between 2015 and 2021 dropped from 139,000 to 119,000. Immunization and eradication drives against NTDs have met with success. In 2024, over 880 million people were treated for at least one neglected tropical disease, 99% through mass drug administration interventions. WHO acknowledged nine countries for eliminating at least one neglected tropical disease in 2023. “The implementation context has changed radically, with the COVID-19 pandemic, humanitarian crises, climate change, and the fact that financing has dwindled. All of these things have made our health systems more fragile. It is important that we recommit the whole world to this agenda, and that Africa be placed at the heart of vaccine equity,” said Cameroon on behalf of the African Union. TB’s precarious gains WHO’s ongoing Executive Board session in Geneva. TB remains one of the leading causes of death from an infectious agent. With funding cuts from the Trump administration and a drop in overall development assistance for health, the risk that hard-won gains may be reversed is high. Russia advocated for a flexible and adaptable strategy to end TB. “We have to look at what, in fact, works in countries. We need to have separate strategies that include tailor-made approaches and that promote efforts to achieve those goals that have been set for high burden TB countries where there are few resources and where there are emergency situations,” the representative from Russia said. Africa (25%) had the highest TB burden, followed by South-East Asia (34%) and Western Pacific (27%), the WHO’s report found, noting the high cost of treatment remains a huge area of concern. Globally, the net reduction in incidence rate between 2015 and 2024 was only 12.3%, well below the End TB Strategy milestone of a 50% reduction by 2025. Push for more funding, collaboration Routine immunization is often disrupted in conflict zones, threatening the resurgence of communicable diseases. Member states expressed the need for greater international collaboration and for countries to take responsibility for their citizens in the changing funding landscape. “There is also a change of the global health architecture, which means that we need to have more coordinated efforts between countries, and we need to make sure that we have more technical support and financial support,” a representative of Cuba said. Canada expressed similar sentiments. “Strengthening country ownership and accountability is crucial, particularly in the context of funding constraints. Recognizing that immunization is a cornerstone of resilient health systems, we call on all partners to align investments with country-led priorities,” the Canadian representative said. Countries also urged using data more effectively for targeted immunization, sharing data across borders for better coordination, and integrating immunization in maternal and post-natal care programmes. Image Credits: WHO/X, WHO/X, WHO/X, WHO/X. Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. WHO to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Q&A: How Can Humanitarians Navigate the New Expanded Global Gag Rule? 04/02/2026 Irwin Loy Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org. Image Credits: Center for Reproductive Rights, Gayatri Malhotra/ Unsplash. Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. WHO to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Pro-abortion demonstrators in the US This story was originally published by The New Humanitarian. Chaos, confusion, and more ethical dilemmas: Humanitarians are still trying to understand the impacts of a sweeping expansion to the so-called “global gag rule” on US funding. The Trump administration expanded the on-again, off-again anti-abortion care directive known as the Mexico City policy to include nearly all foreign assistance, including humanitarian funding sent through UN agencies and international and local aid groups. The rules – announced on 23 January and published last week – also slap vague bans on programmes related to diversity and equity, and gender identity. The gag rule’s impacts are clear: more backstreet abortions, more unwanted pregnancies, and higher school dropout rates for girls, among them. Harsher rules will extend more harm to trans people and others in the LGBTQI+ community, and to racialised communities and others already on the margins in emergencies, aid groups warn. For humanitarians, the move injects more chaos into emergency responses: Will they over-comply and over-interpret the rules – cutting more than they need to and undermining others that provide reproductive care or protective services for marginalised groups? Will they choose between US funding and other donors – making them even more dependent on one volatile government? Several aid officials have said that their organisations were still weighing the implications – especially with $2 billion in recently announced US funding in the backdrop. But the risks are inevitable, say reproductive health advocates, who have hard-won lessons from previous gags. “There’s a lot of stigma, there’s a lot of chilling,” said Sarah Shaw, associate director of advocacy at MSI Reproductive Choices, an organisation providing abortion and contraception services globally. “Organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go.” MSI is among the non-profits who have refused to sign on to all versions of the global gag rule. Shaw and Beth Schlachter, MSI’s senior director of US external relations, explained what humanitarians can expect from the expanded global gag rule. They warned of “chaotic” disaster response scenarios, spoke of the “chilling” effect on over-complying with vague rules, and offered advice on what humanitarian groups who choose to sign should prioritise. Q: In previous iterations, humanitarians have stayed on the sidelines because they felt they didn’t need to get involved. How would you describe the reaction from humanitarian organisations in the past, compared to what everyone’s facing now? Beth Schlachter: I think everyone stays away from this if they don’t have to be involved. So, no shame on the humanitarians, but it’s one of those “you’re not going to stand up for it unless you have to”, because life is hard enough with the work that you do and you don’t have time or resources for it, and so then when it does hit you, you’re like, “Oh damn, look at that.” Sarah Shaw: I would agree with that. It’s no criticism on other sectors, but why would you engage in this toxic fight that you will never win unless you have to? Can you talk about the impacts you’ve seen? Shaw: As an abortion provider, we’ve been impacted by every iteration of this, and this is probably my fourth global gag rule I think in my life. So based on past experience, you know what the impacts of this are. It means that a lot of organisations have to choose. They have to choose between their abortion programming or their US funding. And to be honest, for most organisations, they will choose their US funding because it will probably be a much bigger part of the organisation’s ability to survive. For MSI, because we are an abortion provider, we will always choose our abortion provision. So we’ve always had to relinquish our US funding. This time round, we didn’t have as much because we learned our lesson under Trump One. We diversified our funding base, and so [for] Trump Two we were less reliant. But our Zimbabwe programme were incredibly reliant and, for them, it was probably nearly half of their funding for family planning work. They had 10 outreach teams – these are mobile teams that will go at regular intervals to visit communities to provide family planning services. And these are communities that won’t have access to any other provider… We didn’t have time to fundraise to fill the gap or to negotiate with other partners to pick up some of the work. So for those communities, it’s disastrous and it’s a breach of trust as well. For a lot of women, accessing contraception is a big leap of faith, because there will be community stigma, there will be opposition in the family. And then, for the people that convinced them to do it and told them that it was a good thing, to just not show up is really damaging. So as a result of that, we’re going to see more unintended pregnancies, more unsafe abortions, more girls dropping out of school. I mean, this is what’s so nonsensical about it. They claim it’s to reduce abortion, but all it does is reduce access to family planning, which increases the need for abortion. Can you talk about the risk of over-compliance: organisations that over-interpret the rules? Shaw: [The global gag rule is] incredibly complicated and badly communicated. And this time around, it’s just off-the-scale complicated, to be quite honest. Even the abortion part alone is way more complex than it’s ever been, and then you’re factoring in the other aspects as well. This causes a lot of confusion. So generally, the safe place to be is to over-interpret, over-implement. I totally understand why organisations do that, because it’s either that or risk collapse which is not an option. But the result of that is there’s a lot of stigma, there’s a lot of chilling. We will have organisations that used to refer women to us for services will stop doing that. So those women will have nowhere to go. Our teams have reported being excluded from critical policy conversations and technical working groups; have their access to data limited; commodities as well. I remember last time around in one country – and I’m not going to name them because it’s not fair – but we were a sub[-grantee] on another INGO’s project and our role in the project was to deliver family planning services. And that sub came up – the day after the global gag rule was announced – with a truck and started taking all the USA-branded contraceptives out of our pharmacy, saying “Oh you can’t use this because of the global gag rule,” which isn’t true, because we got them from the national government. It’s just this over-interpretation; this chilling. We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US then are they going to be able to meet the needs of people who are in an immediate crisis? Schlachter: So you imagine the complexity of that, and now, if you report on humanitarian situations, you know how challenging it is to operate. If the largest providers of assistance in any particular situation, the ones who are on the ground, have not signed the global gag rule, or this doesn’t apply to them, then they may not be able to work with those other entities there who do. And it causes fracture about who can provide services and which services then could be provided… We know that in times of crisis that the rates of rape and sexual violence escalate against women, children, against men. So if you have organisations who don’t know what they can or cannot provide when it comes to abortion without potentially violating their agreement with the US – and potentially losing tens of millions of dollars or hundreds of million dollars – then are they going to be able to meet the needs of people who are in an immediate crisis? It introduces more complexity, more chaos in the situation that’s already chaotic and just creates a situation where fewer people are going to have access to resources. The new version of the global gag rule includes all multilateral aid, including through UN agencies. Schlachter: We know that even though the US isn’t funding UNFPA [the UN’s sexual and reproductive health agency], the partners who work with UNFPA would be affected because [the rule covers] all multilateral assistance. And so that gets complex as well because UNFPA is the cluster lead for the minimum initial service package for reproductive health in crisis settings and for [sexual and gender-based violence] in crisis settings. So, again, it creates [a] fracture of who can work with whom and who’s providing what resources to others. We don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. If UNFPA is not under [the global gag rule], but other UN partners are, then can UNFPA work with other UN entities in the time of a crisis? We don’t yet know. So it’s just creating unnecessary chaos. They’re just trying to stigmatise abortion and deny services to women and girls. So we don’t yet know how humanitarians are going to deal with this because they’ve never had to deal with it before. Can you expand on other examples of the over-compliance risk? Shaw: Supply chains are a big risk. Over the years, our supply chains have become incredibly integrated. I think this time round, because it’s so complicated, folks are going to try a lot harder to try and firewall between abortion-related commodities, and contraception commodities, or reproductive health commodities. So definitely a big risk is that countries will just stop procuring abortion commodities or stop distributing them because they won’t want to distribute them in the same vehicles with the same driver that’s on a US government project payroll. I think that’s a big risk. Similarly, with who receives these commodities – particularly in countries where there’s scarcity and maybe where the government is less concerned about reproductive health and maybe the government has given indications that they are ideologically aligned with the Christian nationalist agenda of the current US administration – there’s a risk that they will start to deprioritise certain implementing partners because they will maybe be seen not to be aligned with their agenda. Schlachter: Sarah, as you’re talking, I was thinking of one way this could really cause a problem as well, particularly in natural disasters or when people are displaced and health workers are displaced along with everybody else. If the global gag is applied through government sites and services, the folks who are healthcare workers themselves in addition to the commodities. And then humanitarian entities come in and try to work with them – as you would in any humanitarian situation – then you have a challenge of who’s gagged by what and who can work with whom. Why would you even be talking about that? There’s an earthquake. There’s somebody who’s been raped. You need to help the people, not check their credentials on the global gag. Can I even be a partner with you or not? Shaw: Exactly. Schlachter: So, how is that going to play out? I hope people just help people, as they would, and figure it out later. Shaw: It’s just putting an incredibly complicated administrative layer in a situation that is not able to deal with administration. You just need to do services when you’re in a humanitarian crisis, and the risk is – and the chilling is – that providers will just refuse to do anything that is not deemed safe. By that, I mean providing services for certain communities – like the LGBTQI community or trans people – or providing reproductive health services. There’s a risk even [with] post-abortion care: Post-abortion care is permitted, but it’s still going to come with that stigma. So there’s a real risk that people will just get turned away because providers will refuse to provide because they’ll be frightened. They don’t want to lose their jobs; they don’t want to lose their license. For those organisations that choose to sign the global gag rule, what advice do you have? Shaw: Really take care to develop very clear communications and guidance – for their partners on the ground, but also their sub-grantees as well – on what this means and where the red lines are. Because often the communications around this are very poor. They’re not in local language, or it will take the US government a year, two years to get around to doing the French and Lusophone translations, let alone African local languages. And in all that time there’s just all this confusion and chilling growing. Also: Really focus on what they can do. By fixating on what we can’t do, we just frighten people, so just really emphasise what they can do and continue to do… For example, be very clear that, yes, you can’t refer for abortion, but if a woman comes and says that she’s had an unsafe abortion and she needs treatment, you can and must treat her. Because the risk is that there will just be a complete carte blanche: “No, we’re not doing anything like that.” So, you know, looking at the things they can do. [The rules] very clearly say abortion as a method of family planning is not permitted. So that means if a woman’s life is at risk or she’s had an unsafe abortion, then you can provide a service. So, really focus on that. Because a lot of the time people think it’s just a carte-blanche ban on abortion and it’s not. Similarly, you know, for rape survivors. If a woman comes and says she’s been raped, well they are permitted to provide her a service. And I think that nuance, that’s what gets lost. The further down you get, the more that nuance is lost. The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org.
Almost 40% of Cancers Could be Prevented by Curbing Tobacco, Infections and Alcohol 03/02/2026 Kerry Cullinan In Sierra Leone, students receive the HPV vaccine to protect them against cervical cancer. Almost 40% of global cancer cases could be prevented, according to a new global study from the World Health Organization (WHO) and its International Agency for Research on Cancer (IARC), published in Nature Medicine on Tuesday. The study attributed some 7.1 million cancer cases in 2022 to 30 “modifiable risk factors”. Tobacco was the leading preventable cause of cancer, globally responsible for 15% of all new cases, followed by infections (10%) and alcohol consumption (3%). Three cancer types – lung, stomach and cervical cancer – accounted for nearly half of all preventable cancer cases in both men and women, globally. Lung cancer was primarily linked to smoking and air pollution, stomach cancer was largely attributable to Helicobacter pylori infection, and cervical cancer was overwhelmingly caused by human papillomavirus (HPV). Gender and regional differences Around 45% of new cancer cases in men could be prevented in comparison to 30% in women, according to the study, which draws on data from 185 countries and 36 cancer types. In men, smoking accounted for an estimated 23% of all new cancer cases, followed by infections at 9% and alcohol at 4%. Among women globally, infections accounted for 11% of all new cancer cases, followed by smoking at 6% and high body mass index at 3%. There were also geographical differences. Preventable cancers for women ranged from 24% in North Africa and West Asia to 38% in sub-Saharan Africa. Among men, 57% of cancers in East Asia were preventable, while only 26% were in Latin America and the Caribbean at 28% “This is the first global analysis to show how much cancer risk comes from causes we can prevent,” said Dr Andre Ilbawi, WHO Team Lead for Cancer Control, and author of the study. “By examining patterns across countries and population groups, we can provide governments and individuals with more specific information to help prevent many cancer cases before they start.” The WHO urged countries to develop “context-specific prevention strategies that include strong tobacco control measures, alcohol regulation, vaccination against cancer-causing infections such as human papillomavirus (HPV) and hepatitis B, improved air quality, safer workplaces, and healthier food and physical activity environments”. Europe recognises air pollution as cancer agent Meanwhile, air pollution will be added to the European Code Against Cancer for the first time. “Air pollution raises our overall cancer risk by 11% and risk of death from cancer by 12%. Poor air quality is the largest environmental threat to human health, killing more people than tobacco, so it’s significant progress that air pollution is now recognised in the latest European Code Against Cancer,” said Nina Renshaw, head of health at the Clean Air Fund. “This vital change means that institutions and governments across the EU and the World Health Organization’s wider European region now have an even clearer mandate to reduce dangerous air pollution, and in doing so, protect people’s health. “With 99% of people worldwide currently breathing harmful air – contributing to respiratory diseases, strokes, heart attacks, and dementia, as well as stillbirths and miscarriages – it’s essential to address the interconnections between air quality and urgent health challenges. “Clean air measures positively impact public health almost immediately, resulting in reduced hospitalisations – and ultimately in fewer people developing chronic health conditions such as lung cancer.” Image Credits: Gavi. WHO to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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 to Consider Extending Definition of NCDs to Include Liver and Blood Diseases 03/02/2026 Kerry Cullinan Dr Jeremy Farrar, WHO Assistant Director-General. Proposals to include steatotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday. Egypt, which sponsored the resolution on steatotic liver disease (formerly known as fatty liver disease), told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”. The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”. Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”. Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state. NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands. Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise. The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse. Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”. During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. UN Declaration on NCDs NCD Alliance representative Mina Pécot-Demiaux addresses the EB. Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM). The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it. Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”. The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care. It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services. However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”. Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives. Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Countries are Significantly Off-Track to Meet Global Mental Health Targets 03/02/2026 Disha Shetty Resources allocated to mental health services have not increased since 2020, according to the WHO Director General’s latest report on mental health. Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting. Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021. Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found. On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted. Countries discussed a range of responses. “It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said. “We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added. The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced. New pressures on mental health disorders WHO wants mental health to be managed in a community set-up and is pushing countries to do so. Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found. Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data. Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents. “We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments. One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report. Millions of alcohol and drug-use deaths WHO Director General Tedros Adhanom Ghebreyesus addressing the 158th session of WHO’s Executive Board in Geneva. In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO. The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders. Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help. “Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.” Members of the European Union raised concern over tobacco products being aggressively marketed to children online. “Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union. Growing recognition of the impact of mental health WHO EB’s ongoing 158th session in Geneva While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders. Germany drew attention to the impact of climate change on all NCDs, including mental health. Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk. “Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers. Image Credits: Unsplash, WHO/X, WHO/X. Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Brain Health Is Not an Abstract Policy Issue, It Is a Lived Reality 31/01/2026 Health Policy Watch George Vredenburg and Rajinder Dhamija “You start with, as in my case, with the loss of three generations of my family to various forms of Alzheimer’s or dementia.” Those were the words of George Vradenburg. For him, brain health is not an abstract policy issue. It is a lived reality that mirrors a fast-growing global crisis. This issue was the focus of a recent episode of the Global Health Matters podcast, hosted by Dr. Garry Aslanyan. An estimated 57 million people worldwide are living with dementia, Vradenburg said, but that figure captures only those with symptoms. The scale is far larger. Disease processes often begin decades earlier, placing hundreds of millions more at risk. “The problem is by and large, now two thirds to three quarters of the people with dementia are in the global south, and that number and percentage is going to increase in the next 25 years,” Vradenburg said. The economic and social toll is enormous, already exceeding trillions of dollars globally. Families shoulder much of the burden, facing years of emotional strain and financial loss. Read related article: Unlocking ‘Brain Capital’ in the Brain Economy – Davos Initiative Aims to Make Brain Health a Development Indicator In India, neurologist Rajinder Dhamija sees brain health as a challenge that spans generations. “One of three of us will develop a brain disorder at one point of our life,” he said. Children face neurodevelopmental conditions and infections. Young adults confront rising rates of stroke and mental illness. Older adults are living longer, often with multiple chronic brain-related conditions. India’s numbers are stark. More than 330 million people are expected to be over the age of 60 within two decades. Dementia alone costs the country billions each year. Yet specialist care remains scarce. “We have less than one neurologist per million population in India, around 3,000 neurologists at present,” according to Dhamija. Both experts argued that brain health must be reframed beyond hospitals and clinics. Prevention, education, nutrition, and primary care deliver far greater returns than crisis response. “Prevention at the primary level yields much more results than the investing in terms of a large infrastructure,” Dhamija said. India has begun piloting district brain health clinics that combine screening, treatment, rehabilitation, and data collection to inform national policy. Globally, new tools may further expand access. Vaccines for Alzheimer’s are now in clinical trials. Low-cost screening using mobile phones and artificial intelligence could bring early detection to underserved communities. The stakes are high. As Dhamija put it, “brain health… is very essential, not only for the healthy societies and healthy countries, but also for a smooth economic development and the social development of any nation.” See more Global Health Matters episodes on Health Policy Watch. Image Credits: Global Health Matters Podcast. Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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.
Why Africa Wants to Lead its own Health Research Agenda 31/01/2026 Health Policy Watch In the latest episode of Trailblazers with Garry, Garry Aslanyan visits Accra, Ghana, to speak with Professor John Owusu Gyapong, Secretary General of the African Research Universities Alliance. Gyapong took on the role in 2024, leading efforts to strengthen research collaboration across African universities. His work focusses on building capacity within the continent and supporting locally driven research agendas. Earlier in his career, when much of global health funding and attention centred on malaria, Gyapong chose to study neglected tropical diseases. These illnesses, he explains, had major social and economic consequences but received far less attention. Now, as a researcher and educator, Gyapong continues to emphasise the importance of African-led solutions and long-term investment in young scientists. The conversation touches on leadership, research priorities, and why universities play a critical role in shaping Africa’s health future. Watch the full episode: Trailblazers with Garry is part of Global Health Matters. Listen to more Global Health Matters shows on Health Policy Watch. Image Credits: Global Health Matters Podcast. Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. 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
Latest US Restrictions on Aid ‘Bully’ Recipients to Accept ‘Extremist Ideology’ 29/01/2026 Kerry Cullinan Kenyan women at a family planning clinic. Global health organisations have reacted with anger to the new US foreign aid policy, which prohibits all aid recipients, bar military, from performing or promoting abortion, “gender ideology”, or “diversity, equity and inclusion” (DEI). “Catastrophic”, “bullying”, “draconian” and “ideologically driven” – are some of their reactions to the Promoting Human Flourishing in Foreign Assistance (PHFFA) policy, announced by US Vice-President JD Vance at an anti-abortion event last Friday evening. The policy’s three parts were published in the Federal Register on Tuesday as Protecting Life in Foreign Assistance, Combating Gender Ideology in Foreign Assistance and Combating Discriminatory Equity Ideology in Foreign Assistance Rules. The new rules apply to all foreign and US NGOs and “international organisations”, including multilateral UN agencies still funded by the US and bodies such as the Global Fund to Fight AIDS, TB and Malaria. However, in countries that allow abortion, governments and parastatals (government agencies) will need to place any US funds in “a segregated account” to ensure they’re not used for abortions and related activities. Governments and parastatals “may” also be required to agree that they won’t use US funds to promote or engage in “gender ideology” or DEI. The US State Department defines “gender ideology” activities as those that provide or promote “sex rejecting procedures” (defined broadly to include puberty blockers, hormones, surgeries); promote or counsel social transition; use materials that discuss changing one’s sex or pronoun usage not aligned with biological sex; lobby foreign governments on gender identity issues; and support drag queen workshops, performances, or similar activities”. Aid recipients are also compelled to agree to US officials visiting their offices unannounced to inspect their documents and activities, and to speak to people receiving their services. This is potentially a violation of patient confidentiality. Imposing ‘extremist ideology’ Since 1984, successive Republican governments have imposed a “Global Gag Rule” (also known as the Mexico City Policy) on foreign NGOs receiving global health aid, barring them from using this money – or even money they have raised from other sources – for any abortion-related activities, including referrals. However, the second Trump administration is the first to extend this to all non-military foreign assistance, including humanitarian assistance, and to widen the scope to include US NGOs, international organisations and – potentially – governments. “Bullying countries into complying with anti-rights and extremist ideology is despicable and unacceptable. The imperialist goals of this administration are on full display in these conditions to foreign assistance,” Anu Kumar, CEO of the global reproductive justice organisation, Ipas, told a media briefing this week. In 2024, $39.8 billion in US foreign aid was dispensed over 160 countries, with the largest share (41%) going to multilateral agencies, according to KFF. “This is tens of billions more than the amount of global health assistance subject to the policy under the first Trump administration’s previously expanded policy ($7.3 billion in 2020),” notes KFF. This “catastrophic expansion” is going to be especially harmful to “women, young people, girls and LGBTQI+ people”, added Ipas senior researcher Jamie Vernaelde. “There is an agenda here from the US government to push these ideologies across to other countries, both through direct government-to-government funding, but also forcing multilateral organisations to be subject to the ideology of one specific country.” Impact on Kenya The bilateral Memorandums of Understanding (MOU) that the US has signed with 15 African countries as part of its “America First Global Health Strategy” all contain a clause compelling countries to comply with the Global Gag Rule. “What we’ve realised is this inclusion of the Global Gag Rule in the MOUs was basically a Trojan horse, in the sense that now the governments have signed, they are obligated to implement these expanded conditions, for example, on gender ideology,” said Ipas’s Kenya director, Dr Musoba Kitui. Kitui said that 40,000 health workers had already lost their jobs in his country since the closure of the US Agency for International Development (USAID), leading to the “weakening of the health system”. Many African governments “are very, very desperate” to inject resources into their health systems since the closure of USAID, and were willing to sign bilateral MOUs with the US, despite some of the unfavourable conditions, said Kitui. Kenya’s MOU would be complex to implement, and there is “no way the US can monitor compliance without seeing patient records,” added Kitui, highlighting a concern about patient privacy which has resulted in the MOU being challenged in court. However, “this MOU grants US personnel diplomatic immunity, insulating them from any local courts against judicial processes for any violations of data privacy, or even crippling the health system for that matter”, he added. “Sexual and reproductive health is not a diplomatic bargaining chip. It’s a fundamental human right. Essential health care services must be separate from political agendas. What is really important is to protect the progress that we have made over the years, including in countries like Kenya,” Kitui stressed. Impact on humanitarian aid South Sudanese women survivors of violence shared their stories with a visiting UN delegation. The narrow redefinition of US global aid will affect survivors of gender-based violence who need access to rape kits and emergency contraception. Dr Jean-Claude Mulunda, who heads Ipas work in the Democratic Republic of Congo (DRC), said that his organisation assisted displaced people in camps with family planning services, abortion care and also supports survivors of gender-based violence (GBV). With the demise of USAID, “rape kits” for GBV survivors containing medicine to protect women and girls against sexually transmitted infections and pregnancy are no longer available. “Ipas is trying, with our limited funds, to buy unit-by-unit, the different medicines in these kits,” said Mulunda. “Many women who are victims of rape can’t access abortion care, even though the country has signed the Maputo Protocol which allows access to abortion in case of rape.” The more onerous aid conditions are going to make it even harder for displaced women to access sexual and reproductive services. “The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services,” warned Médecins Sans Frontières (MSF) in its reaction to the new policy. “In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.” The new policy, PHFFA, “escalates a pattern established across both Trump administrations: the systematic subordination of scientific evidence and patient needs to ideological and political objectives,” added MSF. “Versions of the Global Gag Rule have been introduced by Republican administrations since 1984, and extensive research has repeatedly documented that the policy disrupts health services and causes cascading adverse health outcomes in low- and middle-income countries, with the chilling impact enduring even when the policy has been rescinded,” MSF noted. MSF added that the State Department’s definitions of “gender ideology” and “discriminatory equity ideology” are so broad “that it is likely to result in barring or limiting access to essential health services for LGBTQIA+ individuals, women and girls, racial and ethnic minorities, and other marginalized groups”. ‘Abdication of decency’ US Vice President JD Vance addressing the March for Life last Friday, where he announced the new policy. “President Trump and his anti-abortion administration would rather let people starve to death in the wake of famine and war than let anyone in the world get an abortion – or even receive information about it,” said Rachana Desai Martin, chief US program officer at the Center for Reproductive Rights. “People are already dying because of this administration’s slashing of foreign assistance. Now, they’re making it harder for doctors and aid workers to provide food, water, and lifesaving medical care. This isn’t about saving lives – it’s a stunning abdication of basic human decency,” Martin added. “Trump’s expansion [of the Global Gag Rule] continues on a path of instrumentalising those most marginalised. It marks increasing attempts to capture global health and human rights with a deeply regressive act of imperialism masquerading as foreign policy,” said Mina Barling, International Planned Parenthood Federation’s global director of external relations. “This is yet another attack on national sovereignty and colonial intervention through the curtailing of sexual and reproductive rights.” “The dismantling of USAID has already caused widespread harm: more than 45 million women and girls have lost access to contraceptive care and clinics around the world have been forced to close,” said Marieke van der Plas, executive director of the Dutch reproductive rights organisation, Rutgers. “Now, the Trump administration is further reshaping global health policy through new government agreements that embed ideological conditions and deepen political control.” The Senate Foreign Relations Democrats said in a statement: “By blocking US funding to any entity that does not conform to his extreme ideological agenda, the administration is exporting MAGA culture wars overseas and turning lifesaving aid into a political tool. “This order goes far beyond anything we’ve seen before. It will shrink global resources to fight disease, respond to humanitarian crises and protect women and girls from violence, while forcing many of our trusted partners to shut their doors or betray their missions. In doing so, it also leaves Americans more vulnerable to infectious diseases and health threats that do not respect borders.” Image Credits: saac Billy/ UN Photo, KFF. Posts navigation Older postsNewer posts