·         PABS negotiations – round 7 (wrap-up)

·         Ebola emergency

·         More on PPPR & GHS

·         AMR

·         Global Health reform, future of development cooperation (& post-2030 brainstorm)

·         WHO DG race

·         Extraordinary AU summit on Health (Accra, 21-22 July)

·         More on Global Health Governance & Financing/Funding

·         UHC & PHC

·         Global Tax Justice

·         Run-up to the AIDS conference in Rio

·         Trump 2.0, US Global Health Strategy & bilateral health agreements

·         Polio

·         UN HL meeting on improving Road safety

·         Commercial & Digital Determinants of Health, and more on NCDs

·         SRHR

·         Child Health

·         Human Resources of Health

·         Planetary Health (and Climate/health)

·         Access to Medicines, Vaccines & other health technologies

·         Migration & Health

·         Some more reports & publications

·         Miscellaneous

PABS negotiations (round 7: wrap-up)

The latest PABS round ended last Friday (17 July). Below you find excellent coverage & analysis (with focus on the two models) from colleagues from Geneva Health Files, Health Policy Watch.

Then we also feature a few new academic articles re PABS.

WHO Member States continue negotiations on the Pathogen Access and Benefit Sharing Annex

https://www.who.int/news/item/20-07-2026-who-member-states-continue-negotiations-on-the-pathogen-access-and-benefit-sharing-annex

(20 July) WHO Press release (after this 7^th round, which ended on 17 July).

“…During the meeting, Member States further streamlined the draft text while continuing consultations on more complex issues to move closer to consensus. Discussions focused on several interrelated elements of the PABS system, including the contractual arrangements underpinning the framework, the structure of the laboratory networks responsible for the sharing and handling of pathogens with pandemic potential and their sequence information, and the definition of benefits arising from pathogen sharing….”

PS: “… The IGWG will hold its eighth meeting from 14-18 September 2026.”

GHF – Game On: Africa Group Vs The EU. Competing Models For The Pathogen Access Benefit Sharing System

P Patnaik; Geneva Health Files;  

(17 July) (must-read) “In today’s edition, we bring you the emerging story of two competing models for a new Pathogen Access Benefit Sharing System. …”  “The complex, but political negotiations on a new Pathogen Access Benefit Sharing system at the WHO, may have got a much-needed shot in the arm this week…..”

“The Intergovernmental Working Group set up to negotiate the PABS mechanism, reviewed two models this week, on how such a system can be structured. It appears to have revitalised these technical negotiations to a small extent. The models, each proposed by developed and developing countries separately, do not have much in common, and run on different assumptions and scale. And yet, in their differences, they may provide fuel towards these negotiations….”

“Both the models were formal submissions to the IGWG and were considered at a plenary session on July 15th. One is a “Federated Model” of accessing PABS materials and sequence information, submitted by the Africa Group. The second, is a submission by the EU on a hybrid model for PABS – one that has been informally discussed over the last few months, but it was the first time that it was owned and presented by the bloc, sources said.  In this story, we discuss these different models, but also bring you the back story….”

HPW  – Pandemic Talks Consider Two Opposing Models for Pathogen Sharing

https://healthpolicy-watch.news/pandemic-talks-consider-two-opposing-models-for-pathogen-sharing/

Analysis by HPW – with some more info on these two different models. “Two largely opposing proposals for a pathogen access and benefit-sharing (PABS) system – the last outstanding piece of the World Health Organization’s (WHO) Pandemic Agreement – were tabled during the seventh round of negotiations, which ended on Friday. Africa consolidated behind a “federated” model, while the European Union and its developed-country allies backed a “hybrid” model….”

“…Regional nodes in a ‘federated’ system: Algeria, speaking for the WHO Africa region plus Egypt, Somalia, and Sudan (the Africa Plus Group), described the “federated” model as “architecture built around sovereign national and regional nodes, interconnected through a WHO-hosted metadata index and catalogue with unique, persistent identifiers, ensuring end-to-end traceability of biological materials and pathogen sequence information”. This means that every party getting access to pathogen information could be tracked throughout the system. “It conditions access on binding benefit-sharing commitments at the point of use, and treats digital sequence information and physical materials with parity,” said Algeria at the closing session. In other words, parties that want access to pathogen material will need to sign contracts that commit them to sharing any benefits. Algeria’s representative added that African capitals were still consulting on the design features that will “give practical effect to the federated model”, and hoped to return to the negotiating table “with firm compositions and concrete textual proposals”….”

“… The European Union finally put a proposed “hybrid model” to the Intergovernmental Working Group (IGWG) that is conducting the talks, although the proposal has been discussed for several months. The “hybrid” proposal consists of a mix of mandatory and voluntary measures for sharing pathogen information and benefits that flow from this information.  It envisages both a global WHO-controlled PABS system working through the WCLN with some benefit-sharing commitments, and national processes where countries can share pathogen material with groups and laboratories outside the formal PABS system according to mutually agreed terms….”

·         Related:  HPW – Pandemic Talks: What Are The Two Models for Sharing Pathogens?

Didactic (must-read) on the two models.

“Two practical – and contrary – proposals were tabled at pandemic talks last week, detailing how information about dangerous pathogens should be shared. Health Policy Watch is sharing the two options – Africa’s Federated Model and the European Union’s Hybrid Model – to enable all interested parties to interrogate them before the next round of talks from 14-18 September….”

PS: the article also features the respective views of Third World Network and KEI.

On the latter: “Knowledge Ecology International (KEI) has long been critical of countries linking access to PABS samples or data to the Pandemic Agreement’s equity provisions.  KEI wants negotiators to “delink the primary equity obligations from conditions attached to access to the PABS materials and data” – for two main reasons.   “It is important for the information about the pathogens to be shared widely and quickly, and for the information to be used with other data, in a broader eco-system of databases and research tools,” KEI asserts. “Secondly, there will be plenty of cases where researchers won’t need the PABS to get access to pathogens or their [digital sequencing information], and in those predictable cases, companies will have little or no incentive to be legally bound to the concessionary sharing of production,” KEI argues.  Instead, it proposes that the PABS annex includes an obligation on governments to “require that any manufacturer seeking to register or sell pandemic-related products provide evidence of a legally binding agreement with the WHO that addresses access to such products.   “This agreement would be separate from any agreement they may have regarding PABS material or data. The access provisions would be consistent with Article 12, Paragraph 6, of the Pandemic Agreement.”…”

·         See also TWN – WHO: Working group considers conceptual design of PABS system

PS: “The WHO Secretariat, on its own accord, also advanced a model, claimed to be an amalgamation of all the models and proposals presented by the various groups. According to sources from both developed and developing countries, there was little interest in the Secretariat’s model, which highlights sharing of PABS materials and sequence information outside of the PABS system….”

Lancet GH (Comment) – PABS deferred: the rise of bilateralism and future of pandemic governance

Nelson Aghogho Evaborhene, Arush Lal et al;  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00183-X/fulltext

“… According to the warning given by the Independent Panel for Pandemic Preparedness and Response, the absence of a finalised PABS framework leaves the world inadequately prepared for future pandemic threats. However, the political window for securing consensus continues to narrow as bilateral arrangements governing pathogen access, genomic data, financing, and medical countermeasures expand across Africa, Asia, and Latin America. The longer the PABS negotiations take, the more these bilateral arrangements can harden the operational architecture of pandemic governance….”

“…Although negotiations have yielded important areas of convergence, PABS sits at the intersection of competing normative regimes—including public health, trade, and sovereignty—making consensus within a single multilateral instrument particularly difficult to achieve….”

“Meanwhile, the growing use of bilateral arrangements linking health assistance, financing, and strategic cooperation to access pathogen and genomic data, biological materials, and in some cases critical minerals is beginning to create parallel governance systems. Although bilateral health cooperation is not new, the current scenario is distinguished by the extent to which these agreements are increasingly shaping the operational rules, incentives, and political architecture of pandemic governance itself. Over time, such arrangements might not only bypass multilateral systems operationally but also reduce reliance on collectively negotiated multilateral frameworks, such as the Pandemic Agreement, gradually displacing their political and institutional relevance and potentially weakening the collective bargaining power of low-income and middle-income countries.

The result is an increasingly fragile and fragmented architecture for pandemic governance and a deeper challenge for negotiating PABS. If states can negotiate pathogen access, financing, and strategic cooperation outside the multilateral system, the incentives to find compromise within PABS might diminish over time…”

Computer Law & Security Review – When science meets sovereignty: Pathogen digital sequence information between state control and commons-oriented access and benefit-sharing

Adam Strobeyko; https://www.sciencedirect.com/science/article/pii/S2212473X26000908?via%3Dihub

“The rapid and reliable sharing of pathogen digital sequence information (DSI) is essential for genomic surveillance and the development of health products. Such sharing occurs largely through specialized databases governed by their own policies. However, in the absence of agreed international rules, an increasing number of states have sought to assert sovereign control over DSI via domestic Access and Benefit-Sharing (ABS) legislation. As pathogen DSI governance gains prominence, the rules governing its use are poised for change. The recently agreed WHO Pandemic Agreement and multilateral mechanism under the UN Convention on Biological Diversity aim to balance open access to DSI with fair and equitable benefit-sharing. The advancement and reduced costs of sequencing technologies, coupled with limitations of existing international legal framework, prompt a reevaluation of principles best suited for the regulation of pathogen DSI and benefit-sharing. In this article, I first conceptualize sovereignty and commons-oriented approaches to DSI regulation. I map out and compare international ABS frameworks applicable to pathogens. I describe policies of the leading pathogen DSI databases, INSDC and GISAID. Drawing on a review of 14 domestic ABS laws, I identify common patterns and divergent approaches to regulating pathogen DSI.  I argue that the concept of sovereignty is ill-adapted to govern large-scale transboundary data flows and that a joint stewardship model is needed. I propose commons-oriented design elements for a future multilateral ABS system: providing standardized downstream benefit-sharing obligations, metadata disclosure and notification requirements, proportionate traceability, preserving interoperability of databases, and clear scope, conflict, and enforceability rules to reduce fragmentation across legal regimes.”

Ebola emergency

With first some key messages from WHO/Africa CDC and then other analysis & news snippets.

Reuters – Aid group says seven Americans quarantining at Kenya Ebola facility after US travel ban

Reuters;  

(17 July) “The seven are quarantining for 21 days at Kenya isolation facility; US says the asymptomatic group moved there voluntarily; Samaritan’s Purse aid worker infected with Ebola in Congo this month.”

PS: “Washington’s new policy says American citizens returning from the Democratic Republic of Congo, where there is an Ebola outbreak, ​must spend three weeks in a third country before entering the United States….”   “The bio-isolation unit, built by the U.S. government on an ​air force base in central Kenya for Americans exposed to the virus in Democratic Republic of Congo or Uganda, has angered many Kenyans who accuse the U.S. of offloading the health risk of caring for patients….”

FT – Ebola death toll rises to 930, as outbreak spreads at record pace

https://www.ft.com/content/f2125fe6-0d51-47f2-b4b3-def15179da1e?syn-25a6b1a6=1

(20 July) “Africa Centres for Disease Control and Prevention and partners plan trial of two existing jabs.”

“The Ebola outbreak in the Democratic Republic of Congo has killed at least 930 people, the country’s health ministry said on Monday, adding urgency to efforts to find a vaccine to counter the disease’s rapid spread.  The Africa Centres for Disease Control and Prevention (CDC) is developing a possible trial on whether the Bundibugyo pathogen driving the crisis can be combated by jabs against other ebolavirus species….”

“The Ebola outbreak is the fastest-growing ever by some measures, more than two months after the World Health Organization declared it a public health emergency of international concern. The WHO said last week that more than 80 per cent of new cases were not on known contact lists, suggesting that track and trace protocols were missing many chains of transmission.”

“… The Africa CDC and partners are planning a trial of a two-vaccine combination on frontline health workers in eastern Congo, the health body has said. The first dose would be of the Ervebo vaccine, while the second would be an experimental jab against the Sudan ebolavirus species. The proposal is expected to be submitted as soon as Tuesday for approval by the Africa CDC’s executive committee. The approach would have the practical advantage that Ervebo already has regulatory approval. The experimental vaccine, developed by the international biomedical research non-profit IAVI, was used during a Sudan pathogen outbreak in Uganda last year…..”

·         Related:  GHF – Ebola Update: More than 2,000 cases, with 80% of new cases detected outside of contact lists  (21 July)

Geneva Health Files with extensive coverage of the WHO briefing of July 16.

UN News – DR Congo: Ebola outbreak still expanding, WHO sees signs of stabilization

https://news.un.org/en/story/2026/07/1167983

(21 July)   “In the Democratic Republic of the Congo (DRC), UN health teams and partners are still racing to contain the rapidly expanding Ebola outbreak, despite ongoing insecurity in eastern areas where the virus has taken hold. As of 19 July, the DRC Government has recorded 2,423 confirmed cases, including 967 deaths and 469 recoveries. “

Overall the situation is still rather dire. Some of the more uplifting news, though: “…Dr. Baldé (WHO) described a recent visit to Kisangani in Tshopo province where WHO is implementing a collective strategy by deploying rapid response teams. The results are encouraging. “No secondary cases have been detected so far in Kisangani,” he said. “Currently, all five cases are imported from Ituri province. We intend to roll out a similar rapid response plan in…Katwa, Butembo and other emerging areas”, he added. … To tackle any chains of transmission, the UN health agency is also working on a new project which aims to reinforce control measures through the River Congo, “a crucial transit route requiring rapid implementation of control measures”, the WHO official explained.  … “

“… Despite the challenges, WHO has reported some encouraging signs, such as in Mongbwalu, where the outbreak was first detected. “Mongbwalu is currently showing some signs of stabilization with a similar trend in Goma, North Kivu province,” noted the WHO Incident Manager. …”

Stat – Congo’s Ebola outbreak has killed over 1,000 people

https://www.statnews.com/2026/07/22/congo-ebola-outbreak-1000-deaths/

(22 July)  “The situation is further complicated by some health workers going on strike.”

Africa CDC messaging:  “ More than 1,000 people have died in the Ebola outbreak in Congo, according to Africa’s top health body, a grim toll in the fastest Ebola outbreak in history, as conflict, community resistance and an uneven response fuel its spread.   Speaking at a health summit in Ghana on Wednesday, Dr. Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, said 1,031 deaths have been confirmed.  “These are people dying. They are dying because we don’t have vaccines, we don’t have medicine, we don’t have funding,” he added.”

PS: “A humanitarian worker involved in the response, speaking on condition of anonymity because he was not authorized to speak publicly, cited poor coordination between response agencies, delays in transferring patients to treatment centers and waits of more than four days for some Ebola test results….”  “At times, it’s unclear who is doing what and where,” the worker said. The delays have led some patients to leave health facilities before they can be diagnosed, increasing the risk of further transmission, the worker said….”

“Africa CDC head Kaseya called for intensified efforts to slow the outbreak on the first day of the health summit in Ghana on Tuesday. “If we do not stop this outbreak today, it could become one of the worst Ebola outbreaks the world has ever documented,” Kaseya said….”

“Less than 9% of the contacts of confirmed patients who are expected to be traced are currently being monitored, far below the level needed to contain the outbreak, according to Africa CDC. More than 60% of deaths are occurring in the community before patients can receive care.

Pierre Akilimali, the Ebola response incident manager at the National Public Health Institute of the Democratic Republic of the Congo, said the high number of community deaths suggests many infections are not being detected or isolated in time, allowing the virus to continue spreading….”

Bloomberg – “Walking Ebola” helps Explain Why Congo’s Outbreak Is So Hard to Stop — and How to Treat It

Bloomberg;  

(gated) “Some doctors call it “walking Ebola” — symptoms of the rare Bundibugyo strain appear to worsen slowly, leaving patients sick enough to spread the virus but not so unwell to stop them moving through their communities”….”

Lancet Comment – Pregnancy as exclusion criterion in Ebola research: not again

L Schwartz, R Ravinetto et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01367-X/fulltext

“As the 2026 Bundibugyo virus (Orthoebolavirus bundibugyoense) Public Health Emergency of International Concern progresses, we draw attention to key lessons from the 2014–16 Ebola (Orthoebolavirus zairense) outbreak in Guinea, Liberia, and Sierra Leone. One crucial learning was that women and gender-diverse people who were pregnant or breastfeeding were systematically excluded from most interventional trials. Exclusion has historically been the norm for protecting fetuses and those who are pregnant, however, if applied without contextualised justification, exclusion can harm instead of protect….”

“… As clinical trials develop, we urge researchers and sponsors to make all reasonable efforts to include participants who are pregnant, or to ground their exclusion through risk–benefit assessments and equity. These efforts would align with some clinical trials conducted during further outbreaks, when pregnancy was not an exclusion criterion…”

Telegraph – To prevent the next Ebola outbreak, we must invest in local expertise

N Gilbert (PATH) & P Piot;  https://www.telegraph.co.uk/global-health/science-and-disease/to-prevent-the-next-ebola-outbreak-we-must-invest-in-local/

“By letting local experts lead and investing in strong systems we can detect and prevent outbreaks earlier.”

“…. Indeed, one of the biggest misconceptions about Ebola is that African countries lack the technical capability to respond. The opposite is true. The Democratic Republic of the Congo has some of the world’s leading Ebola experts, mostly based in the Institut National de Recherche Biomédicale, their expertise built through decades of hard experience. National laboratories can sequence viruses within days. Public health professionals have accumulated knowledge that few others possess. The only missing piece is sustained investment in resilient health systems that can function during times of crisis as well as calm…”

NYT –  Why Epidemics Breed Rage at Health Workers

https://www.nytimes.com/2026/07/20/magazine/ebola-health-workers.html

“Some people have fought Ebola containment measures in the Democratic Republic of Congo. Scholars have seen similar responses across societies and throughout history.”

Wellcome (Policy Brief) – Enabling an effective global research response to the Ebola Bundibugyo virus (BDBV) outbreak

Wellcome;

“…. coordinated global response is critical to deploy the resources of the global community in the most effective way. This policy brief sets out three principles that we believe should guide this: 1. Response and research priorities must be set through processes grounded in leadership provided by African governments. Africa CDC and WHO must work closely to ensure effective prioritisation, coordination and regional alignment. 2. Existing coordination mechanisms should be used to strengthen the alignment of research efforts and prevent fragmentation. 3. Research into medical countermeasures must be an integral part of the response from the outset. Immediate action is needed to ensure equitable and timely access to products shown to be effective….”

Science – Rapid spread of Ebola spurs ‘remarkably’ quick drug and vaccine trials

https://www.science.org/content/article/rapid-spread-ebola-spurs-remarkably-quick-drug-and-vaccine-trials

“Pioneering studies are underway to address massive outbreak of rare Bundibugyo virus in the Congo.”

“On 15 July, the first ever trial of an Ebola drug to protect people who aren’t sick but have been exposed to the virus was launched. Two weeks earlier, a trial of drugs to treat patients had begun. And a phase 1 study of a vaccine candidate kicked off in Oxford, U.K., on 13 July. “It’s remarkable to see these clinical trials up and running this quickly,” says Isaac Bogoch, an infectious disease expert at Toronto General Hospital.  But the factors that are fueling the rapid spread of the virus in the DRC also complicate the trials. …”

Stat – New study supports testing of Merck’s Ebola vaccine in DRC outbreak

https://www.statnews.com/2026/07/22/new-study-supports-testing-of-mercks-ebola-vaccine-in-drc-outbreak/

“Experts hope the vaccine, designed to target another species of the virus, could offer some protection.”

“New data from a study in humans provides additional support to the idea that Merck’s Ebola vaccine Ervebo, licensed to target the Zaire species of ebolaviruses, could also offer some protection against another species currently circulating in a rapidly expanding outbreak in the Democratic Republic of the Congo.  The new paper, published Wednesday in the New England Journal of Medicine after previously having been posted online before peer review, is one of a growing number of studies pointing to the possibility that the vaccine could be used to target the Bundibugyo species of ebolaviruses. “

“These studies are in turn fueling an increase in calls to study use of Ervebo in the outbreak zone in the DRC, an idea that the World Health Organization has expressed lukewarm support for to date. The WHO’s vaccination efforts have prioritized testing Bundibugyo-specific vaccines, but those vaccines are still months away from being ready to be put into clinical trials in the outbreak zone. …. In an email Wednesday, the WHO said its vaccines expert panel committee, the Strategic Advisory Group of Experts on Immunization, would study the idea further at its next meeting in early October. …”

PS: “An international stockpile of vaccines controlled by the United Nations Children’s Fund (UNICEF), WHO, and other partners contains 500,000 Ervebo doses. Merck said via email that it shares the WHO’s concerns that the evidence supporting the possibility of cross-protection against the Bundibugyo virus is “very limited” and said doses from the stockpile can be released only at the request of UNICEF….”

And a link:

·         Telegraph – Maternal mortality doubles in Ebola outbreak zone as mothers avoid hospitals

“The number of women dying in childbirth has doubled in the region at the centre of the Ebola outbreak as expectant mothers avoid hospitals, the United Nations Population Fund (UNFPA) has said….”

More on PPPR & GHS

Nature Africa –  Africa’s pandemic preparedness improves, but safety gaps remain

https://www.nature.com/articles/d44148-026-00210-z

“A new Africa-specific health security index finds strong gains in laboratories and disease surveillance since 2021, but biosecurity, biosafety and systems for delivering vaccines and treatments continue to lag.”

“The 2026 Africa Health Security Index, released today, found that the scores of 52 of Africa’s 54 countries improved by at least one point between 2021 and 2026. The continental average rose from 32.4 to 41.5 out of 100, with the largest gains in disease detection and reporting following the COVID-19 pandemic. Produced by the Science for Africa Foundation, the Nuclear Threat Initiative (NTI), the Brown University Pandemic Center and partners, the assessment measures six dimensions of health security using publicly available data.  An African reference group advised on the framework, leading to changes to 21 questions, while researchers at the University of the Witwatersrand and the University of Tunis El Manar independently reviewed the data. Because it relies on publicly available evidence, the index measures documented capacity rather than predicting how a country will perform during an actual outbreak….”

·         For more on the new index, see  https://ghsindex.org/africa/ .

PS: “… The Index provides data to inform commitments that will be made at the 2026 United Nations (UN) High Level Meeting on Pandemic PPR and highlights key outcomes from initiatives such as the Africa Forward Summit, the G7 One Health Summit in Lyon, the future of the Global Preparedness Monitoring Board, the High Level Independent Panel, the Joint Finance and Health Task Force, the Pandemic Fund, and the World Health Organization (WHO) Pandemic Agreement. …”

Lancet Infectious Diseases (Comment) – Beyond vaccines: closing the critical gap in diagnostics and therapeutics for outbreak response

Dr Tedros, Jean Kaseya, Chikwe Ihekweazu et al   https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00378-6/fulltext

“.. Over the past decade, an impressive architecture has emerged to support vaccine development, evaluation, procurement, and deployment. Public, philanthropic, and multilateral actors have created pathways that reduce commercial uncertainty and provide manufacturers with confidence that successful products will have a viable route to market. This model, with important roles for the Coalition for Epidemic Preparedness Innovations, the WHO R&D Blueprint for Epidemics, and GAVI, the Vaccine Alliance, has strengthened global preparedness. No equivalent ecosystem exists for therapeutics and diagnostics. .. … The challenge now is to systematically extend a vision beyond vaccines and develop equally robust mechanisms for therapeutics and diagnostics….”

They conclude: “… The next generation of preparedness requires an equally ambitious ecosystem for diagnostics and therapeutics—one that connects global scientific leadership with strong regional institutions. WHO’s R&D Blueprint for Epidemics, Africa CDC’s DAC, the Continental Research Agenda, regional manufacturing initiatives, the African Pooled Procurement Mechanism, and strengthened regulatory systems each address crucial components of this pathway. The challenge now is to integrate them into a coherent ecosystem that takes innovation from discovery to equitable access. “

Plos GPH – Beyond benchmarking: Using WHO’s NPHA capability framework as a driver of institutional reform

Geoffrey Namara,  Chikwe Ihekweazu et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006882

“…Two landmark legal reforms have since reshaped global expectations: the 2024 amendments to the International Health Regulations (IHR) and the 2025 WHO Pandemic Agreement. Both call for stronger national coordination and clearer institutional accountability but offer limited guidance on the institutional arrangements needed to deliver on these commitments. That gap is precisely what the WHO Framework for health emergency preparedness and response capabilities for national public health agencies (NPHAs) attempts to fill….”

“The framework’s contribution: Defining capability alongside form: The framework addresses both what NPHAs could look like and what they must be able to do….”

“… The framework makes a timely and substantive contribution to global health security architecture. By defining what national public health agencies must be able to do, it shifts the policy conversation from institutional existence toward institutional function, and from gap identification toward the conditions required to close those gaps. Its value, however, depends on how it is used….”

“… Realising that value depends on treating the framework not as a benchmarking instrument but as a reform agenda — a basis for asking, in each country, whether the institutional arrangements in place are sufficient. NPHAs are central to that agenda where they exist, but the framework acknowledges that building effective EPR governance is incremental, context-dependent, and requires sustained political commitment across multiple institutions. What it offers is a precise, evidence-grounded description of functional, accountable EPR capability. For countries that want to close the gap between their preparedness plans and their response capacity, that clarity is where the work begins…”

AMR

JAMA Pediatrics – Childhood Antimicrobial Resistance With Global Forecasts

JAMA Pediatrics; 

Via Stat:  Antimicrobial resistance in children is worsening

“Antimicrobial resistance among children has substantially risen globally over the last two decades, largely due to Gram-negative bacteria that cause infections like sepsis and pneumonia, per a study published yesterday in JAMA Pediatrics. Researchers also projected that two of these bacteria — Acinetobacter baumannii and Klebsiella — are projected to reach 82% and 35% resistance to last-resort antibiotics by 2035….” “The analysis was based on more than 106,000 samples from minors in 82 countries. Infants, those in the ICU, and regions with few health care resources were particularly affected by the increased resistance. The results align with existing estimates from WHO, the study authors write. In order to make pediatric-specific data more accessible to clinicians, they created an interactive dashboard based on the data….”

Lancet Public Health (Comment) – Being AWaRe: benchmarking antibiotic use

Marianne AB van der Sande et al; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00146-5/fulltext

Comment linked to a new research article in the Lancet Public Health (see below).

“In this issue of The Lancet Public Health, Aislinn Cook and colleagues present modelled estimates of optimal antibiotic use for 186 countries, territories, and areas (CTAs). The authors first estimated optimal antibiotic use, both overall and by WHO Access, Watch, Reserve (AWaRe) category, using publicly available data on disease burden and antibiotic resistance. Then, accounting for socioeconomic characteristics, they identified benchmark CTAs for each of four clusters of CTAs, grouped by income. Benchmarking by cluster should enable individual CTAs in each cluster to compare their antibiotic use to that of a contextualised reference, which could help support and operationalise the 2024 UN General Assembly target that, by 2030, at least 70% of total antibiotic use is from the Access group. However, Cook and colleagues also make a strong case for not only assessing the distribution of antibiotic use by AWaRe category but also considering total use adjusted for infectious disease incidence, as this measure gives a better indication of potential overuse or underuse and should help ensure that antibiotic use is matched to actual needs….”

Lancet Public Health – Estimating optimal levels of WHO Access, Watch, Reserve (AWaRe) antibiotic use in 186 countries, territories, and areas on the basis of clinical infection and resistance burden

(by A Cook et al) https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00103-9/fulltext

(the abovementioned paper)  “Ensuring appropriate access to essential antibiotics is a crucial public health goal. The 2024 UN General Assembly agreed that 70% of global antibiotic use should be from the Access group of the WHO Access, Watch, Reserve (AWaRe) system. A standard method to estimate optimal national-level antibiotic use based on burden of disease, resistance, and local context is needed to inform national policies. We aimed to develop and apply a burden-adjusted framework for estimating expected optimal national levels of AWaRe antibiotic use, in total and by AWaRe group….”

Global Health Reform, future of development cooperation (& post-2030 brainstorm)

President John Mahama Addresses the High-Level Panel of the Accra Reset | Dakar, 2026

https://www.linkedin.com/pulse/president-john-mahama-addresses-high-level-hag8f/

“In a powerful video message delivered on behalf of the Presidential Council and Guardians Circle of the Accra Reset, H.E. President John Dramani Mahama addressed the High-Level Panel convened in Dakar, Senegal — calling on global leaders to seize a defining moment in the history of international development and health cooperation….”

“… Pointing to the Institut Pasteur de Dakar — which has manufactured yellow fever vaccines since 1937 and today produces vaccines at scale under African leadership — President Mahama grounded the Accra Reset’s vision not in distant aspiration but in lived history: “We do not view health sovereignty as a future wish. We hold it as a memory to reclaim and an inheritance we intend to expand.”…”

“He made three direct requests of the panel: (1)  Be specific — anchor recommendations to clear dates, thresholds, and consequences; (2) Write for the citizen — judge every proposal by whether it shortens the distance between a boardroom commitment and a fully stocked clinic; (3) Seize attention — let recommendations stand out “like a beacon, bold, sharp, and impossible to ignore”…”

PS:  The 19-member expert panel used the Dakar plenary session to directly tackle structural bottlenecks in global health financing, innovation, and governance. This session served as the primary drafting ground for their highly anticipated final recommendations (principal report, to be delivered at UNGA in September).

HPW – Vital Signs: Reading Critical Developments in Global Health

Mukesh Kapila;  https://healthpolicy-watch.news/vital-signs-reading-critical-developments-in-global-health/

The author, on LinkedIn: “I am starting a new column called “Vital Signs” with Health Policy Watch. It is about recent critical developments shaping global health that catch my eye. Especially the politics behind the headlines around institutions, governance, policies and financing. And any key scientific advancements that impress me as potential game changers in medicine and public health. Given my background, there will be a focus also on health emergencies in disasters and wars.”

“Here is the first edition. It turns on a single word that has done more work than any pill or potion this year: “self-reliance.” As the Global Fund drives “transitions” and WHO absorbs deep budget cuts, agencies are recasting donor retreats as strategic reform. My quarrel is not with country ownership — an excellent goal — but with its timing and its honesty. Transition dictated by the rhythm of donor budgets rather than the readiness of national systems is not empowerment; it is abandonment with better branding. “

Kapila is reflecting among others on the Global Fund Board meeting of last week.

““Self-reliance” is the term of art for a donor withdrawal that recipient countries did not choose and, in many cases, cannot yet absorb.  ….”

Kapila concludes: “There is a defensible take on this moment, and intellectual honesty requires stating it. Leaner institutions can be more focused; co-financing can deepen national commitment; even a brutal shock can force overdue reform that comfort would have deferred indefinitely.  But reform under fiscal duress has a habit of protecting the powerful and exposing the vulnerable, and the test of this transition will not be the elegance of the strategy documents. It will be whether a child in Ituri, or a cholera patient in Kordofan, is more or less likely to be reached next year than last. The throughline of the week is a system negotiating its own contraction while insisting the contraction is a strategy. Some of it may yet prove to be. But the honest verdict on “self-reliance” will not be found in a board communiqué or a replenishment total. It will be found in the outbreak data—and this week, in eastern Congo and Sudan, those data were not reassuring….”

Devex- Can the World Bank model for fighting poverty work to fund health?

https://www.devex.com/news/can-the-world-bank-model-for-fighting-poverty-work-to-fund-health-112980

“…Pete Baker, acting director of the global health policy program at the Center for Global Development, laid out in a recently published paper an idea for a dedicated health fund contained within the World Bank, roughly mimicking the governance, structure, and processes of the International Development Association, the bank’s dedicated funding arm for low-income countries….”

“… the World Bank “has been saying for a while they want to do more on health,” Baker said. In 2024, for example, the bank announced its goal of helping countries deliver quality and affordable health services to 1.5 billion people by 2030.  “But I haven’t seen kind of a big plan for that. Like, how is that going to work?” he added. “And so we were trying to look at that as well, and this came together as I think a great solution.”…”

PS: “…. It also proposed redirecting donor funding earmarked for health systems strengthening from Gavi and the Global Fund to the IDA Health Window — at least in the near term. “They’re facing budget cuts, and any conversation which involves them losing functions is going to make them worried. But we also have to … realize that there’s no way we’re going to have Gavi and Global Fund in 2040 … after all these changes in sovereignty and all this push towards NCD burden and so on,” Baker said.  “We’re going to need a shift in time to a broad-based support to health systems approach. That’s going to have to happen at some point. Gavi has very much accepted this and said, ‘we know we have to sunset at some point, and this is our kind of Leap proposal.’ I think the Global Fund [is] a couple of steps behind realizing that change is going to come eventually,” he added….”

“… Baker said there’s a lot of interest in the proposal among those working on health at the World Bank, and they are likely thinking through similar ideas. But in the end, it’s the bank’s funders that will get to decide whether to establish an IDA Health Window.

Mike Reid (blog)  – Leadership Without Hegemony

on Substack;

“The future of the WHO, the importance of interdependence, rethinking global health governance.”

“…How should we organize collective action in a world where power is becoming more diffuse, where no single country can credibly underwrite the global health system, and where artificial intelligence, pandemics, antimicrobial resistance, climate change and migration are creating forms of interdependence that no nation can manage alone?… Our argument is that the next chapter of global health must be built on interdependence rather than dependence. That requires rethinking the way global governance is done…”

A Sunrise for UNAIDS?

Ben Plumley, Emily Bass et al;  on Substack;  

“Why the world still needs a joint program built for the epidemic that hides in the most private of human behaviors.”

Authors list three reasons.

“First, UNAIDS, and particularly the Secretariat, is the outward-facing voice of the global response to HIV — the entity willing to speak truth to power about the need for a genuinely comprehensive, solidarity-driven response that combines biomedical evidence with behavioral science and with policy and societal change for the people most affected….. Second, the UNAIDS Secretariat must continue to be a vital country-level presence. Its country directors have built relationships with communities, governments, donors, and civil society that no other UN or multilateral agency can replicate….. Third, the UNAIDS Secretariat and its Co-Sponsor WHO have established a unique symbiotic partnership that produces the highest-quality HIV surveillance data in the world, along with other key institutions around the world (particularly national agencies and, until 2025, PEPFAR)…”

CGD – We Advised Different Governments on Aid Spending. Now We’re Calling for Radical Simplification

R Glennerster & D Karlan; https://www.cgdev.org/blog/we-advised-different-governments-aid-spending-now-were-calling-radical-simplification

“As former chief economists of the US and UK foreign aid agencies, our jobs were to advise on the most effective ways for money to be spent. Now, as global aid budgets shrink and donor countries reconsider their approaches, we are calling for a radical simplification in how we do the portion of aid that focuses on service and transfer policies. By omission, we are not declaring efforts to improve macroeconomic outcomes such as growth as unimportant. The world is a big place, and there is no corner solution to the world’s problems….”

“…. To advance our call for simplified aid, we’ve joined with like-minded partners to launch the Smart Buys Alliance and promote the adoption of the world’s most cost-effective development interventions….”

PS: The Smart Buys Alliance is co-hosted by a consortium of leading research and policy organisations committed to evidence-based development. 

Globalization & Health (Editorial) – From rupture to recourse: building a new economic order for health

R Labonté;  https://link.springer.com/article/10.1186/s12992-026-01231-x

Labonté starts his Editorial from Carney’s Davos speech. 

“… Ironically, perhaps tragically, we also now live in an era where there is a plethora of broadly similar alternative political economy models…..”

With a good mapping of these  various models (eg: Council of Economics of Health for All, Global Justice report, Mazzucato’s ideas; …)

Labonté then concludes, sounding a bit more optimistic than I am about the potential of progressive ecosocial justice movements:

« Returning to Carney’s Davos speech and “not waiting around for a world we wish to be”, what is missing in most of our present political responses to our ongoing geopolitical mess is precisely that: failing to declare what type of world (and the structuring of its political economy) that we actually need. In the absence of proclaiming the insights of the rich economic alternatives now on well-studied offer, the interests of the multibillionaire few will continue directing political choices in their favour, and we will default to what former Colombian president, Gustavo Petro, one of the few leaders to call our for a radically different economic model, described as the “suicidal model of capitalism”.   Deepening geopolitical crises are likely to bring us pivotal moments of evolution, revolution, or environmental necessity. As these moments swell and repeat, it will take the mobilization of progressive ecosocial justice movements to pivot politics in a wellbeing economy direction of sufficiency and habitability. We have enough of the why, and now also of the how. It will take courage to advance these ideals, and there will be personal risks in speaking out against the actions of autocrats and oligarchs. But it must be done. »

WHO DG race

Global Policy –  The Next WHO Director-General in an Age of Fragmentation

Nelson Aghogho Evaborhene https://www.globalpolicyjournal.com/blog/22/07/2026/next-who-director-general-age-fragmentation

“As the WHO begins selecting its next Director-General, the qualities required for effective leadership are evolving. In an increasingly fragmented global health landscape, the next Director-General will need political stewardship, strategic coordination, and the ability to rebuild institutional trust.”    Evaborhene elaborates on these three key criteria.

He concludes: “…. Success will therefore be judged not only by the agreements negotiated under the next Director-General’s leadership, but by the ability to convene, coordinate, and sustain trust across an increasingly decentralised global health architecture where authority is exercised across multiple institutions. In this context, the next Director-General’s greatest legacy may not be negotiating new agreements, but ensuring that the reforms already underway are fully implemented, adequately financed, and translated into a stronger, more resilient WHO.”

Extraordinary AU summit on health (21-22 July, Accra)

Extraordinary Session of the AU Assembly on Ending AIDS by 2030 and addressing preventable maternal deaths, communicable and noncommunicable diseases endemic to the continent and strengthening health systems by 2030

https://au.int/en/newsevent/extraordinary-session-au-assembly-ending-aids-2030

“The Extraordinary Session of the African Union Assembly on Health convenes pursuant to the decision of the 38th Ordinary Session of the Assembly of Heads of State and Government, held in Addis Ababa, Ethiopia, which called for a dedicated summit to address Africa’s evolving  health priorities. Building on previous Assembly decisions and continental commitments, the Summit will consider a fully costed AU Roadmap to 2030 and Beyond to sustain the HIV/AIDS response, strengthen resilient health systems, and enhance health security across the continent….

Theme: Advancing Justice, Equity and Universal Health Coverage: Ending AIDS, TB, Improving Maternal Health, and Addressing Endemic Non-Communicable and Neglected Tropical Diseases and Conditions in Africa

Check out the main objectives.  The summit is structured in two phases (first day: technical discussions; second day: high-level segment, also including a declaration).

·         Concept note: https://au.int/sites/default/files/conceptnotes/ENGLISH%20Concept%20Note_0.pdf

African Leaders Push for ‘Health Sovereignty’ at AU Extraordinary Summit in Accra

https://www.modernghana.com/news/1513027/african-leaders-push-for-health-sovereignty-at.html

(23 July). Check out some of the key messages by various leaders.

Related: AUC Chairperson called for a decisive shift from commitments to implementation in advancing Africa’s health agenda

AU leaders commit to ending AIDS by 2030, strengthen health systems

https://gna.org.gh/2026/07/au-leaders-commit-to-ending-aids-by-2030-stregthen-health-systems/

With some of the key messages of the Accra Declaration adopted at the summit. 

Among others, they endorsed the AU roadmap to 2030 and beyond as Africa’s framework for sustaining the fight against HIV/AIDS, malaria and TB; improving maternal and child health; and accelerating UHC through domestic financing.

Do read on for the other main messages.

·         And some more links:

Mahama hosts African leaders for AU Summit on Universal Health Coverage and Disease Control

Mahama urges African leaders to secure continent’s health sovereignty

More on Global Health Governance & Finance/Funding

Gates Foundation – Gates Foundation Concludes External Review

https://www.gatesfoundation.org/ideas/media-center/press-releases/2026/07/external-review

“ The Governing Board of the Gates Foundation has approved a series of recommendations based on findings by WilmerHale, the law firm retained to conduct a review of past foundation engagements with Jeffrey Epstein…”

“…The review confirmed that the foundation’s primary engagement with Epstein from 2011-2014 involved two matters. The first was a proposed donor advised fund (DAF) that would pool contributions from high-net-worth individuals to support global public health. Ultimately, the foundation decided not to continue pursuing the DAF when it became clear that the donors and philanthropic partners he promised would not materialize.   The second matter involved the International Peace Institute (IPI), a nonprofit Epstein introduced to the Chair. The foundation subsequently provided grant funding to IPI, following internal diligence and review, for polio eradication support….”

“The Board unanimously approved the following set of actions to strengthen the foundation’s governance and internal processes going forward:  ……

PS: from the exec summary: “…Mr. Gates was aware of reputational concerns related to Epstein’s prior conviction and sentencing for a sex-related offense when he began conversations with him in 2011. Foundation staff working on the potential DAF raised on multiple occasions the risks of associating with Epstein because of his prior conviction, and those concerns were raised to senior leadership, including Mr. Gates…..”

·         See also FT –  Bill Gates was warned about Epstein links by staff of his charitable foundation 

“Independent review finds talks with late sex offender continued for more than three years despite concerns.”

“Bill Gates and senior leaders of his charitable foundation received multiple warnings from staff about the risks of working with convicted child sex offender Jeffrey Epstein to raise money for global health, an external review has found.  The Gates Foundation pursued its effort to collaborate with the late financier for more than three years but there was no evidence employees knew of his ongoing crimes, according to a summary of the report published on Tuesday.  “

“Gates will remain chair of the $89bn foundation he continues to finance, after completion of the review by law firm WilmerHale, which was commissioned by chief executive Mark Suzman. The foundation has announced several organisational changes that it said were aimed at improving its governance and internal processes.”

“…The review found that Gates was “aware of reputational concerns” related to Epstein’s 2008 guilty plea for soliciting a minor when the two men began conversations in 2011. …”

“… Among the governance changes implemented by the Gates Foundation is the creation of a centralised vetting process for prospective funding facilitators with connections to Gates or members of the organisation’s senior leadership team or governing board. It will also create a process for flagging organisational risks on projects introduced by any of those people to be escalated as needed to the chief executive….”

·         See also AP – The Gates Foundation met with Epstein about 30 times despite staff concerns, an external review says

·         And via the Guardian:

“Gates said in a statement on Tuesday that “completing this review is an important step in providing the clarity that partners, employees, and grantees deserve as well as strengthening our oversight with additional policies going forward. “The work the foundation does to save lives and unlock opportunities so people everywhere can lead healthier, more productive lives, is more important than ever,” he said. “We are committed to ensuring trust and transparency are never compromised.””

·         WSJ  –  Bill Gates’s Personal Emails Weren’t Part of Epstein Review

“Lawyers found no evidence of wrongdoing at Gates Foundation; footnote shows limit of their review.”

“Lawyers investigating the Gates Foundation’s ties to Jeffrey Epstein didn’t have access to Bill Gates’s personal communications or review interactions with the billionaire’s private office, where two longtime employees had deep ties to the sex offender.  The scope of the probe by lawyers at WilmerHale was disclosed in a footnote to the report’s summary, which was released after a five-month review. …”

Coefficient Giving – Increasing Our 2026 Allocation to GiveWell’s Recommendations to $1 Billion

https://coefficientgiving.org/research/increasing-our-2026-allocation-to-givewells-recommendations-to-1-billion/

“Seven months ago, we committed $175 million for 2026 to GiveWell’s recommendations, which we think represent the gold standard for evidence-backed, cost-effective global health giving. In partnership with Good Ventures, the foundation of Cari Tuna and Dustin Moskovitz, we’re now increasing that commitment to $1 billion for 2026.  This $1 billion will nearly double the cumulative funding we have previously committed to GiveWell’s recommendations over the last decade. Based on GiveWell’s estimates, we believe that funding has saved over 100,000 lives….”

PS: “Coefficient Giving is a philanthropic funder and advisor. …. Our founding and most significant partnership is with Good Ventures, for whom we serve as outsourced foundation staff. Good Ventures is a philanthropic foundation created by Cari Tuna and Dustin Moskovitz. …”

India to Host the Sixteenth BRICS Health Ministers’ Meeting in Chandigarh from 22–24 July

https://www.pib.gov.in/PressReleasePage.aspx?PRID=2287325&reg=1&lang=1

Ahead of the meeting: “Three-Day BRICS Health Programme to Feature Senior Officials’ Meeting, Health Ministers’ Meeting and Dialogue on Digital Health & AI. Nine Priority Areas to Guide BRICS Health Cooperation under India’s Chairship.  Health Ministerial Declaration to Reinforce BRICS Commitment to Global Health.”

“As part of its BRICS Chairship 2026, India is set to convene the Sixteenth BRICS Health Ministers’ Meeting in Chandigarh from 22–24 July 2026, bringing together Health Ministers and senior health officials from BRICS member countries to deepen cooperation on health security, digital health, pandemic preparedness and equitable access to quality healthcare….”

“… Building upon the work undertaken during previous BRICS Chairships, India has retained the existing priorities while introducing two new priority areas—BRICS Mission for Healthy Lifestyle and Promotion of Mental Wellness, reaffirming its commitment to preventive and promotive healthcare….”

“Under its BRICS Chairship 2026, India has structured the BRICS Health Track around the following nine priority areas: BRICS TB Research Network; Collaboration among BRICS Medical Products Regulatory Authorities; BRICS Integrated Early Warning System for Prevention and Response to Mass Infectious Diseases; Digital Health Architecture for Continuum of Care, including Access to Healthcare in Remote Areas; BRICS Mission for Healthy Lifestyle; Promotion of Mental Wellness; Traditional, Complementary and Integrative Medicine (TCIM); Fight against Diseases Driven by Social Determinants of Health (DD-SDH); BRICS Network of National Public Health Institutes….”

·         Press release after the BRICS health ministers meeting:  16th BRICS Health Ministers’ Meeting Concludes Successfully under India’s BRICS Chairship 2026  

With among others: BRICS Health Ministers Unanimously Adopt 16th BRICS Health Ministerial Declaration; the establishment of the BRICS Network of Centres of Excellence on Mental Wellness (to be coordinated by NIMHANS, as a major institutional initiative to strengthen research, promote mental well-being and narrow treatment gaps across member countries); the adoption of the Operational Framework to Fight against Diseases Driven by Social Determinants of Health (DD-SDH) and the Operational Framework for the BRICS Network of National Public Health Institutes….  And much more.

HPW –  Unitaid’s Opaque Leadership Search Advances Amid Plunging Budgets, Calls for Reform

https://healthpolicy-watch.news/unitaid-leadership-search/

“Unitaid is quietly searching for its next leader behind closed doors amidst growing demands for transparency. Whoever takes the helm of the market-shaping agency will inherit an organisation that faces acute financial shortfalls and mounting pressure for institutional reform. As Unitaid celebrates its 20th anniversary, severe cuts to the agency’s funding threaten to disrupt the downstream rollout of its market-shaping breakthroughs. Founding member France emphasises its continued support, with French Minister Éléonore Caroit assuring Health Policy Watch that this commitment remains steadfast. “

“…Within the global health ecosystem, the agency has a unique function in pre-shaping markets by clearing intellectual property barriers and negotiating early access agreements to de-risk innovations – for example, by securing $40-a-year generic pricing for the HIV prevention injection lenacapavir and helping to develop flavoured HIV and TB medicines for children. “Put simply, Unitaid’s comparative advantage is identifying and addressing the bottlenecks that stand between innovation and impact,” explained a Unitaid spokesperson. “We can invest early, test delivery approaches, generate evidence and help create the conditions for scale.” After clearing initial market barriers, heavyweight procurement entities such as Gavi and the Global Fund to Fight AIDS, Tuberculosis and Malaria step in.”

“To execute this mission, the Geneva-based agency operates with about 110 employees and an annual investment budget of $300 million, totalling a $1.5 billion commitment through 2027. Alongside private philanthropy, its budget relies overwhelmingly on public funding from core donor governments, including France, the United Kingdom (UK), Brazil, Chile, Japan, Norway, the Republic of Korea, and Spain….”

PS: “Unitaid was established in 2006 by France, Brazil, Chile, Norway, and the UK as a collaborative initiative hosted by the WHO. As the primary architect, France became the agency’s dominant donor, contributing more than $2 billion, which accounts for roughly 56% of the organisation’s overall funding since its inception. … Heavily championed by former French President Jacques Chirac, the agency was built on an “innovative financing” model powered by the world’s first solidarity tax on airline tickets and financial transactions, rather than relying solely on traditional official development assistance….”

“The United States has not contributed to Unitaid, preferring instead to channel funds through its own bilateral assistance programmes, such as the US President’s Emergency Plan for AIDS Relief (PEPFAR)…. …The lack of direct US funding insulates Unitaid’s core budget from Washington, but the agency remains vulnerable to global political shifts because it relies heavily on buyers like the Global Fund to purchase and deploy its innovations at scale. Consequently, Unitaid’s executive board and the agency’s 2025 internal analysis warn that US aid cuts and shrinking global health financing threaten the downstream rollout of its market-shaping breakthroughs, placing half its scale-up products at heightened risk…..”

“…The agency has raised just $696 million towards its five-year goal of $1.5 billion, according to the civil society delegation to Unitaid’s executive board. At its July board meeting, Unitaid forecast that it will raise just $140 million this year – less than half of its $300 million target – as major donors like France and the United Kingdom have slashed their contributions…..”

Hundreds of leaders, experts and organisations urge future UN Secretary-General to commit, act and deliver on gender equality as the United Nations faces historic test

Globe News wire

(23 July) “As of today, over 200 current and former heads of state, UN leaders, organisations, advocates, practitioners, and researchers from all regions of the world are calling on the next United Nations Secretary-General to commit, act and deliver on five concrete actions to advance gender equality across the UN system during their tenure.  The open letter, coordinated by Global 50/50 and published on the same day as the UN Townhall with Secretary General candidates, warns that the United Nations is facing a critical test of its commitment to gender equality at a moment of rising global backlash against women’s rights, shrinking civic space for feminist movements, and growing pressure on funding for gender equality programmes.”

Science – U.K. government details plan for dramatic aid cuts to African nations

Science

See also last week’s IHP news. “Some countries face reductions of more than 90%, new report reveals, raising fears of devastating impacts on global health and education.”

“ the U.K. Foreign, Commonwealth & Development Office (FCDO) finally published its country-by-country funding plans as part of its annual report. African nations shoulder the biggest cuts, with reductions amounting to more than 90% by 2029 for Malawi, Mozambique, Kenya, and Tanzania….”

Telegraph – Burnham’s plan to restore UK aid spending

https://www.telegraph.co.uk/global-health/climate-and-people/burnhams-plan-to-restore-uk-aid-spending/

“A roadmap for returning the UK to spending 0.7 per cent of Gross National Income (GNI) on international aid will be drawn up as part of a major shake-up of the Foreign, Commonwealth and Development Office (FCDO), The Independent reported….”

“Ed Miliband is set to be named Foreign Secretary and put in charge of overhauling Britain’s international development aims, as well as prioritising climate goals, senior Labour sources said….”

·         And via  Devex :    “The U.K. has a new minister for international development: Scottish Member of Parliament Kirsty McNeill. McNeill has extensive experience in the NGO world, having served eight years as Save the Children’s executive director of policy, advocacy, and campaigns. In a statement responding to the appointment, U.K. NGO network Bond called on McNeill to lay out a road map for bringing U.K. aid spending back up to 0.7% of gross national income, and to take advantage of the country’s turn at the G20 presidency next year “to champion much-needed reforms to the global financial system.”

PMNCH launches Global Campaign to finance women’s, children’s and adolescents’ health: Lives in Balance: Finance the Promise

PMNCH

“As aid falls at the steepest rate on record and global health governance is redesigned without naming them, PMNCH launches a two-year campaign to mobilize domestic resources and defend the development assistance that remains.”

“… The PMNCH Financing Campaign responds to this moment on two fronts. The first is domestic: working with national partners to strengthen domestic resource mobilization for women’s, children’s and adolescents’ health (WCAH) in five initial countries, Malawi, Nigeria, Senegal, Tanzania and Zambia, and subsequently expanding to the wider group of ten. Support is phased and country-owned, moving from budget analysis and needs assessment, through parliamentary engagement and public advocacy, to expenditure tracking and shared learning across countries. The second is global: defending and expanding donor commitments through the Global Fund’s GC8, Gavi’s next funding cycle, the World Bank and Global Financing Facility, and debt relief measures that free up fiscal space for health, building directly on various health financing commitments made in 2025….”

CGD (blog) – Priming the Pump for a Successful IDA22

K Mathiasen et al;   https://www.cgdev.org/blog/priming-pump-successful-ida22

“IDA’s next replenishment, launching soon, will be among the most consequential multilateral negotiations this decade and IDA22 deliberations will need to show strong ambition. Today, most low-income countries (LICs) remain heavily dependent on IDA, having been battered by repeated shocks, including COVID-19, the war in Ukraine, the conflict in the Middle East, and numerous disasters exacerbated by climate change (see Figure 1). Meanwhile, bilateral aid is shrinking while poor debt dynamics continue to limit the potential for growth-generating investments….”

“…  With this blog and the accompanying paper, we aim to spur debate well before negotiations launch in early 2027 (IDA22 would take effect for a three-year cycle starting in July 2028). Our hope is that stakeholders will coalesce around a series of reforms to address deficiencies in the current model that have led to a surfeit of IDA-eligible countries above the income threshold, constraining allocations for countries most in need, and support an increased allocation of World Bank resources for concessional finance to help meet rising demand. Meeting these objectives would require changes at both IDA and IBRD, the World Bank’s arm that lends to more creditworthy countries. In our paper, we make the case for three interrelated proposals:

1. a more robust, rules-based IDA graduation process;
2. updated creditworthiness assessments at the IBRD to support an increase in the pace of IDA graduations; and
3. the introduction of a new semi-concessional financing instrument for lower-middle-income countries (LMICs) funded through IBRD net income.  …”

BMJ GH (Commentary) – Making experts accountable in global health

V Ridde et al;  https://gh.bmj.com/content/11/7/e025094

“Unaccountable experts influence the choice of health policies. The dissemination of expert-driven neoliberal ideas on health financing has adverse consequences. The social and individual responsibility of experts should be better considered. An international and multidisciplinary directory of experts should be established (background, career paths, reports and results). Urgent need to organise a process of accountability for global health experts….”

“… Drawing on examples of the commodification of health in Africa, at the heart of the global effects of neoliberal ideas, this commentary aims to highlight the social and individual responsibilities of global health consultants. Indeed, in line with the 2023 Lusaka Agenda, the governance of global health policies requires major changes….”

The Global Health Paradox – Nobody Sees Global Health Whole

Habib Benzian ; https://habibbenzian.substack.com/p/nobody-sees-global-health-whole?r=ap2ly&utm_campaign=post&utm_medium=web&triedRedirect=true

“Neither do I.”             A few excerpts:

“Nobody sees global health whole. Not governments, not the World Health Organization, not philanthropies, not researchers, not civil society, not consultants. And certainly not me. For a long time, I assumed the problem was incomplete information. The solution seemed obvious enough: better data, stronger evidence, more transparency, more voices at the table, reading more. Assemble enough pieces and a clearer picture would eventually emerge.  I no longer think that is the central challenge. Global health does not suffer from a shortage of maps. It suffers from an abundance of them.”

“The WHO map shows disease burdens, mandates, and institutional processes. The donor map shows investments, risks, and returns. The government map shows budgets, sovereignty, and domestic political realities. The researcher’s map shows evidence gaps. The activist’s map shows power. The consultant’s map shows deliverables, milestones, and timelines.  None of these maps is wrong. But they are not maps of the same thing. They are drawn at different scales, for different purposes, by people accountable to different realities. And this helps explain something that puzzled me for years: some of the most persistent disagreements in global health occur among intelligent, experienced, well-intentioned people who often share access to the same information….

“The goal may not always be agreement. It may be something more modest and more useful: understanding where another person’s map begins, and where yours ends….

“I was reminded of all of this during this year’s World Health Assembly in Geneva. Moving between formal sessions, side events, and corridor conversations, I kept encountering remarkably similar exchanges. People agreed that global health was entering a period of serious disruption. They agreed that old assumptions were being challenged, that something consequential was in motion. What they disagreed on was almost everything else: what had failed, what deserved preservation, what transformation meant, and who should define it….”

UHC & PHC

P4H – Designing Blended Finance: The Do’s and Don’ts for aspiring Health-System Fund Architects

R Singhal & K Chalkidou;  https://p4h.world/en/designing-blended-finance-the-dos-and-donts-for-aspiring-health-system-fund-architects/

“As development aid contracts sharply, a practical UHC-focused guide to designing blended finance fund for health-system investment: five steps to structure the capital stack, sequence the raise, match instruments to assets, and govern for independence…..”

“…In an attempt to more systematically explore the best (and worst) practices (from a Universal Health Coverage (UHC) perspective) in designing innovative financing tools, in this post we tackle issues specific to designing a blended fund (typical for public private financing) for health systems investment, along five key steps ….”

CGD (blog) – From Paper to Action: How Systematic Monitoring Can Help Health Benefits Packages Deliver on Their Promise

A Gheorge et al ; https://www.cgdev.org/blog/paper-action-how-systematic-monitoring-can-help-health-benefits-packages-deliver-their-promise

“Health Benefits Packages (HBPs) can be a strategic tool to advance Universal Health Coverage. But their impact depends not only on the services included, but also on whether people effectively receive those services with adequate quality and financial protection. It also depends on the factors behind implementation gaps. While there is no shortage of guidance for using evidence-informed priority-setting approaches, less attention has been paid to monitoring whether, how, and why HBPs deliver (or not) in the real world. This gap matters, particularly in the context of stagnating progress towards Universal Health Coverage, because it leaves policymakers in the dark: Are HBPs delivering on the promise made to the population? If not, why, and what corrective action can be taken?…”

“Today, we launch two papers that aim to bridge this gap: a conceptual framework for HBP monitoring (HBPM) and an HBPM maturity assessment tool (HBPM MAT), which includes two case studies in Argentina and Chile that demonstrate its application and potential….”

See:

·         Health Benefits Packages Monitoring: A Global Public Good

·          Health Benefits Package Monitoring Maturity Assessment Tool (HBPM MAT): Operational Manual and Case Studies in Argentina and Chile

CGD (Policy Paper) – Decentralisation of Financing for Essential Medicines and Health Supplies: Finding the Best Fit

S Witter, P Baker et al;  https://www.cgdev.org/publication/decentralisation-financing-essential-medicines-and-health-supplies-finding-best-fit

“Essential medicines are central to quality primary health care, yet availability in public facilities across low- and middle-income countries averages only 8–41 percent. The core problem is not logistics alone but weak supply chain financing: too often, it is slow, unpredictable, fragmented, inflexible, insufficient, and donor dependent.”

“One important decision which impacts the effectiveness of supply chain financing is whether to conduct supply chain financing functions at a central or decentralised level. This paper uses country evidence, literature review, and expert consultation to consider this question for each of the functions identified in the conceptual framework developed under the remit of the Center for Global Development’s Working Group on Improving the Financing of Supply Chains….”

Check out the findings.

BMJ GH – Beyond elimination: reframing measles vaccination strategies

L Monnaie et al ;   https://gh.bmj.com/content/11/7/e021240

« The current worldwide measles pandemic poses a challenge to longstanding efforts to eliminate the disease using mass vaccination in the Global North and the Global South.  But the focus on eliminating measles alone to achieve costly verified national and regional elimination targets has undermined an equally important shift—incorporating the social drivers of health in public policy. Given the current and impending funding cuts to the WHO and GAVI, it is essential to reframe the goals of measles programmes to achieve high coverage rates, limit measles-related fatalities, suffering and disability and address the poverty, overcrowding and malnutrition that contribute to endemic measles. Reframing measles control to incorporate primary healthcare ideals into local, national, regional and global public health policy and practice is urgently required….”

“… Although modelling demonstrates the cost-effectiveness of elimination programmes, their reliance on supplementary immunisation activities (SIAs) and enhanced epidemiological surveillance to achieve or maintain elimination certification raises questions about the broader, unmeasured costs and impacts of elimination-based policies on local healthcare systems and on global public health. Revisiting the history and ramifications of elimination’s pursuit, this commentary argues for the urgent necessity of reframing the goal of measles control programmes to incorporate the social drivers of health and a primary healthcare (PHC) centred approach….”

Global Tax justice

Project Syndicate – The Good, the Bad, and the Ugly in Global Tax Negotiations

José Antonio Ocampo; https://www.project-syndicate.org/commentary/un-tax-negotiations-must-overcome-euro-hesitancy-trumpian-obstruction-by-jose-antonio-ocampo-2026-07

“Ongoing negotiations at the United Nations offer the international community the best chance that it will have to ensure that global taxation authority is assigned fairly. With multinationals and the ultra-rich abusing the current system to minimize their tax payments, finalizing a new convention is an urgent priority.”

“On August 3, negotiators at the United Nations will resume work on a Framework Convention on International Tax Cooperation. This is the first attempt to write the rules of international taxation in a forum where all countries have an equal say, so what happens in New York will determine whether the world finally gets a taxation framework capable of reaching multinational corporations and the ultra-rich….

With the respective positions of Brazil, India, EU countries, US, …

New Economics Foundation – The case for G20 coordination on wealth taxes

L Byrne;  https://neweconomics.org/2026/07/the-case-for-g20-coordination-of-wealth-tax

“The question is no longer whether we can tax extreme wealth effectively – it’s whether we can afford not to.”    Excerpts:

“A G20 opportunity to lead: At the G20 in 2027, the UK has an opportunity to move this debate forward. This would be a statement of partnership to Brazil, which used its G20 to commission a report on the design of a global wealth tax, receiving the backing of all G20 countries at the time. It would also be a meaningful response to the initiative from the G20 presidency of South Africa, which commissioned leading experts, chaired by Joseph Stiglitz, to write on economic inequality. The UK ‒ respected for institutional design and coordination – could capitalise on this momentum and help solve the problem of designing a tax that both works and helps transform domestic resource mobilisation in countries both rich and poor….”

“Where taxes go wrong: Designing a wealth tax is harder than many advocates admit. The failures of earlier European wealth taxes offer important warnings. The question today is not whether wealth should be taxed more effectively. The question is how to do so in ways that are economically credible, administratively workable, and politically sustainable. Fortunately, the emerging work led by Gabriel Zucman and the EU Tax Observatory points towards a new approach that is different from old models that failed….”

“…The emerging Zucman framework ‒ like the approach of the UK Wealth Tax Commission ‒ starts from a very different premise. Stop trying to build a traditional annual wealth tax on broad sections of society. Instead, target only the extreme apex of wealth where tax regressivity is now most severe. … That means very high thresholds ‒ perhaps €100m or more in net wealth ‒ combined with extremely broad tax bases and very limited exemptions…..

“…Zucman’s most important innovation emerges. …. Historically, wealth taxes operated as standalone annual levies on assets. Critics argued this amounted to double taxation because income had already been taxed once before being accumulated into wealth.  The modern proposal is different. Instead of a standalone wealth tax, the proposal increasingly centres on a minimum effective tax floor for ultra-high-net-worth individuals. The principle is simple: total taxes paid each year should equal at least a minimum percentage of total wealth….”  “If taxes are already paid through income tax, capital gains tax, inheritance tax, and corporate tax exceed the threshold, no additional liability arises. But if an ultra-wealthy individual has legally structured their affairs so that their effective tax burden collapses towards zero, a top-up tax applies. This is a profoundly important shift because it reframes the argument away from ​“punishing wealth” and towards defending the integrity of the tax system itself….”

PS: “…Perhaps the most critical question, however, is this: What choice do we have? Across economies, rich and poor, the fiscal pressures of the next two decades will intensify. Richer countries face challenges from rising defence spending. Climate adaptation will demand vast investment. Health systems face demographic strain. AI will likely produce both enormous wealth concentration and major labour market disruption simultaneously. In poorer countries, the giants blocking the road to the 2030 SDG’s are unlikely to magically shrink. And in rich and poor countries alike, there is a wider question, not of envy, but of fairness.”

“… The question is no longer whether we can tax extreme wealth more effectively. The question now is whether democracies can afford not to…..”

Run-up to the AIDS conference in Rio

NYT – 1,700 H.I.V. Treatment Sites Closed After Trump Aid Cuts, a Study Finds

https://www.nytimes.com/2026/07/21/health/hiv-trump-cuts-pepfar.html

“New research also shows that children and high-risk adult populations have been particularly affected.”

“The Trump administration’s cuts to the largest global H.I.V. program last year resulted in sharp drops in both prevention efforts and treatment for the people most at risk from the disease, according to the first large survey of organizations that had received the funds.”

“The findings show a grimmer picture of the impact of the cuts than the State Department’s data, released in April, which seemed to suggest that the program had helped to treat about as many people last year as it had in 2024….”

“To comply with the administration’s policies, the new survey, conducted by the H.I.V. charity amfAR, found, three-quarters of the organizations stopped providing services to those at highest risk from H.I.V. — sex workers, men who have sex with men, transgender people and people who inject drugs. The results are scheduled to be presented next week at a large international AIDS conference in Rio de Janeiro.”

“A second study, conducted by a multinational group of scientists, which will also be presented at the conference, found that the cuts had disproportionately affected children with H.I.V. The program, called the President’s Emergency Plan for AIDS Relief, or PEPFAR, supported treatment for about 77,000 fewer children in 2025 than it had the previous year, representing a 14 percent decline, the study found…..”

·         See also  Devex – Study finds cuts and ‘political ideology’ fundamentally changed PEPFAR

“The first large-scale survey of PEPFAR implementing partners since the Trump administration took office last year documents the impact of award terminations and policy restrictions.”

“The first large-scale survey of implementing partners of the U.S. President’s Emergency Relief Plan for AIDS Relief, or PEPFAR, since the Trump administration took office last year found that over half of them had at least one of their awards terminated, and more than 80% were asked to restrict their work to comply with American policy restrictions as a condition to continue receiving funding.  This primarily included administration policies around eliminating diversity, equity, and inclusion programming, and the expansion of the Mexico City policy. At least 3% of the organizations had permanently closed….”

“The survey was released in the lead-up to the 26th International AIDS Conference, which will take place next week in Rio de Janeiro, Brazil — the world’s largest convening of those working in the HIV/AIDS sector. Researchers gathered data from 166 country-level implementing partners in 46 countries.”

“…The survey found two principal U.S. policies that impacted PEPFAR implementing partners: an executive order dating to the beginning of U.S. President Donald Trump’s first term, and an expansion of a decades-old policy governing foreign aid spending….”   Do read on.

Devex –  In ongoing trials, twice-yearly HIV prevention drug saw just one case

https://www.devex.com/news/in-ongoing-trials-twice-yearly-hiv-prevention-drug-saw-just-one-case-112990

“As lenacapavir is rolled out in 10 African countries, new findings indicate that the twice-yearly injection is highly effective for people who adhere to it. Also important: It is extremely popular.”

“With the twice-yearly injectable form of HIV prevention now rolling out in 10 countries across sub-Saharan Africa, new evidence from clinical trials to be presented at the upcoming International AIDS Conference found that the medication, known as lenacapavir, retains its effectiveness over time. In two different ongoing trials of lenacapavir involving thousands of people globally, just one person developed HIV while adhering to the regimen of one injection every six months…”

Plos Med –Optimising scale-up of injectable lenacapavir for HIV pre-exposure prophylaxis in South Africa: A modelling study and economic evaluation

Lise Jamieson  et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004882

Concluding: “Delivering LEN to persons with elevated HIV risk in South Africa is more cost-effective than existing oral PrEP and can speed up HIV incidence reduction. Prioritising uptake among groups at highest risk is essential to maximise impact and cost-effectiveness.”

Trump 2.0 & US Global Health strategy & bilateral health agreements

Via AVAC:

“Foreign Assistance After USAID : Devex published a comprehensive analysis of the US Administration’s evolving foreign assistance architecture in the 18 months since the dismantling of USAID. In line with the recent reflections from global health leaders, the piece concludes that US foreign assistance is coalescing around three priorities: humanitarian response, global health and commercial diplomacy. These pillars are being delivered through a smaller, more centralized system that emphasizes bilateral partnerships, country burden-sharing and funding through a limited number of “trusted, vetted” implementing partners. …”

“IMPLICATIONS: How this new architecture will function in practice is in question. Emily Bass reports that the US Department of State is increasingly relying on sole-source, fixed amount awards (FAAs) issued under a broad class waiver to support the transition. While the approach may help sustain HIV and other health services as the Administration finalizes bilateral health implementation plans, it raises questions about transparency, competition and oversight. FAAs tie payments to predefined milestones as opposed to actual costs, so they shift financial and operational risk to the organizations responsible for delivering programs. Whether these enlisted organizations can take on these risks while maintaining essential HIV health services is a major question to be answered.”

Emily Bass – No Bids, Big Risks: State’s New Slew of Sole-Source Global Health Awards

Emily Bass; On Substack

“In which we are reminded: unicorns are real.”

“The State Department is swiftly moving many organizations through a no-bid process for America First Global Health awards that will use a tricky, sometimes downright risky, funding approach called ‘fixed amount awards.’ Like so many things that State has gotten up to in its global health activities this year, the rationale is fairly solid; the process slippery as heck; and the likelihood of success incredibly country- and context-dependent….”

PS: “…. The State Department is way behind the schedule laid out in the January Implementation Planning Progress Guide for finalizing the implementation plans and budgeting tools that are a pre-requisite for AFGHS funds to start flowing. The Guide declared that all of these implementation plans were to be done and dusted by April 1, with money flowing in this fiscal year. Before the ink was even dry on my copy of the doc, though, the architects of the AFGHS were backpedaling. Brad Smith reportedly started telling country teams that the plans would take the time they needed to take; Jeremy Lewin said, in a public forum, that State was aiming for MoU-directed funds to flow by the end of this fiscal year—September 30, 2026.  Some implementation plans are finalized; many more are not. The process of securing US government legal review and approval for government-to-government contracts is still time-consuming and complex. And even a country like Uganda, which has an approved implementation plan and everything, only has 55 percent of its year one funding via G2G agreements….”

J Ratevosian – Two Countries, Two Very Different Futures for U.S. Global Health Cooperation

https://ratevosian.substack.com/p/two-countries-two-very-different?r=bhxkd&utm_medium=ios&triedRedirect=true

“Tanzania has signed a new five-year health agreement. Zimbabwe remains outside the MOU framework after negotiations stalled. Together, they show the uneven direction of the new U.S. global health approach.”

J Ratevosian – What Five Reports to Congress Reveal About the Future of Global Health

https://ratevosian.substack.com/p/what-five-reports-to-congress-reveal?utm_source=multiple-personal-recommendations-email&utm_medium=email&triedRedirect=true

(6 July) “Newly released reports offer the clearest public picture yet of how the administration is transitioning U.S. global health programs.”

“Last week, the State Department submitted and made public a series of reports to Congress on U.S. global health programs. These reports were required by appropriations law, including Section 7058(d) of the National Security, Department of State, and Related Programs Appropriations Act, 2026. Of the many reports published, I pulled out five related to global health and read them closely. Together, they answer some important questions: How does the administration define a successful global health transition? What happens in countries where no MOU is signed? What happens if national governments cannot meet their financial commitments? The answers are more revealing than I expected…..”

“…  The clearest clues are in the language the reports repeatedly use…”     “…Read together, these excerpts are overwhelmingly about the mechanics of transition: MOUs, implementation plans, co-investment, funding adjustments, corrective actions, benchmarks, workforce transfer, and reductions in U.S. assistance. There is much less discussion of incidence, viral suppression, advanced disease management, prevention gaps, community systems, or epidemic control. That doesn’t mean those things don’t matter. It suggests they are no longer the organizing principle….

He concludes: “…Every administration has its own priorities. But organizing principles matter because they determine what leaders measure, what they reward, and ultimately what they protect. When transition becomes the primary frame, there is a risk that epidemic control becomes something assumed rather than something actively managed.  ….… None of this is an argument against country ownership. Countries should lead their own health systems, and sustainability should remain a central goal of global health policy. The question is whether the United States is supporting a transition that protects epidemic control, or whether it is shifting costs and risks faster than health systems can absorb them.”

Devex – Can nominee to lead US CDC revive agency’s global role

https://www.devex.com/news/can-nominee-to-lead-us-cdc-revive-agency-s-global-role-112997

“Dr. Erica Schwartz looks to take over a CDC under fire domestically and shrinking globally, but Senate approval is not assured.”

FT – Trump to fund Maga-aligned projects in Europe as he reorders US aid

FT; 

“Objectives include countering ‘censorship’ from EU regulations and supporting ‘national sovereignty’.”

“ One of the core objectives of the grants is to bolster freedom of speech in the UK and Europe, which the administration claims is under attack. The proposed grants include $2mn to “counter censorship” stemming from EU regulations, including the Digital Services Act and the Digital Markets Act, according to a copy of a notice the state department sent to lawmakers, which was reviewed by the FT. The notification did not say whether the administration had identified a group to implement the project. The notice also details plans to provide $5mn to “develop a civilisational alliance” in Europe….”

“The notification also includes support for efforts to counter judicial over-reach and censorship in Brazil, where the US has accused officials of persecuting the country’s former President Jair Bolsonaro, a Trump ally. It also outlines plans to provide $1mn to document human rights abuses against ethnic minorities in South Africa. The document does not make explicit reference to white South Africans, but the Trump administration has repeatedly sought to portray them as victims of government-backed discrimination and genocide….”

Devex Pro – NCDs weren’t a US priority. Will the ‘America First’ reset change that?

https://www.devex.com/news/ncds-weren-t-a-us-priority-will-the-america-first-reset-change-that-112961

(gated)  “The “America First Global Health Strategy” talks about the importance of integration across disease programs. However, the document does not mention NCDs.”

“Noncommunicable diseases, or NCDs, are absent from the list of U.S. global health priorities under the “America First Global Health Strategy” — a notable omission at a time when experts warn that broader cuts to foreign assistance could undermine years of progress integrating NCD care into HIV and primary health programs….”

Polio

Nature (News Feature) –  Polio should have been eradicated by now. What’s plan B?

https://www.nature.com/articles/d41586-026-02229-6?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=62885761

(must-read analysis ) “Amid funding cuts and political barriers, researchers are asking whether the campaign can ever succeed, and what to do next.”

“The campaign to eradicate polio is, on the face of it, a huge success story: it has reduced cases of the disease by 99.98% since it began almost 40 years ago. But the virus is stubborn, and in the last decade, total-eradication targets have been repeatedly missed. Some researchers are doubtful that polio can be eradicated in Pakistan and Afghanistan — the disease’s two remaining strongholds — without a change in strategy, particularly amid unprecedented funding shortfalls. Some think that a focus on ending conflicts in these countries could allow vaccinators to reach currently inaccessible areas. Others suggest a move away from the goal of eradication, and toward one of global control of the disease.”

UN HL meeting on improving Global Road safety (New York)

WHO – Road deaths fall by 21% globally but stronger action is needed to save lives

https://www.who.int/news/item/20-07-2026-road-deaths-fall-by-21–globally-but-stronger-action-is-needed-to-save-lives

WHO press release.

“Despite the addition of more than one billion motor-vehicles to the world’s roads, road traffic deaths declined by 21% between 2011 and 2025, according to new data released by the World Health Organization (WHO).”

“The world has experienced profound changes in road traffic during this time with the emergence of new modes of transport and a sharp rise in motorcycle use. Despite this progress, however, road traffic crashes still claimed 1.16 million people’s lives in 2025. Road traffic injuries remain the leading cause of death among children and youth aged 5–29 years.”

“The new WHO data comes as global leaders today adopt a new United Nations (UN) General Assembly progress declaration on road safety. The declaration aims to boost global action to meet the Sustainable Development Goal (SDG) target of a 50% reduction in road deaths and serious injuries by 2030 compared with the levels in 2021….”

“… The new UN declaration includes a comprehensive set of commitments by UN Member States to implement national road safety strategies with clear targets, timelines and budgets. These commitments include establishing lead road safety agencies, improving data collection and analysis, developing and enforcing stronger legislation, and ensuring that roads, infrastructure and vehicles meet key safety standards…. … The declaration commits countries to implementing the proven ‘safe system’ approach, which recognizes that people will always make mistakes on the road. The approach promotes safer roads, infrastructure, vehicles, speed limits and regulations that account for human error and ensure that crash impacts remain within survivable levels. It also calls on governments to provide leadership and take additional action, and urges the private sector to prioritize road safety throughout their supply chains. The declaration also highlights the important roles of civil society, academia, youth, philanthropic organizations and the UN in driving progress….”

“… Across the world, 10 countries reduced road deaths by 50% in the decade to 2021 and more than half of all countries reported falling fatalities in that period. Yet progress is uneven, with 36% drop in deaths in the WHO European Region, a 15% drop in the Western Pacific Region, a 2% drop in the WHO South-East Asian Region, no change in rates in the Americas and a 17% rise in deaths in the WHO African Region.  …

Lancet Public Health – Global, regional, and national burden of road injuries 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00141-6/fulltext

The related (IHME) GBD study.

HPW – World Commits to Cut Traffic Deaths – But US Records Lone Vote Against UN Declaration

https://healthpolicy-watch.news/world-commits-to-cut-traffic-deaths-but-us-records-lone-vote-against-un-declaration/

“World leaders recommitted to reducing road traffic deaths and injuries by at least 50% by 2030 at the United Nations High-Level Meeting (HLM) on Road Safety this week – including by introducing measurable national targets, timelines and budgets. “

“However, the United States voted against the UN consensus progress declaration adopted on Monday afternoon, while all the other 162 countries present voted in favour.  The US delegate claimed that the declaration was “mandate creep”, complaining that it called for road safety measures to be integrated into climate, environmental and urban policies….”

PS: “More than 90% of all road deaths occur in low-income nations despite high-income countries having substantially more traffic crashes with injuries. The mortality rate in low-income countries was 43.8 deaths per 100,000 people, whereas that in high-income countries was 7.5 deaths per 100,000 – a clear indication of the standard of care available to those injured.  More than 200,000 lives could be saved each year through enhanced trauma care coverage in low- and middle-income countries, according to IHME….”

PS: “WHO Director-General Dr Tedros Adhanom Ghebreyesus commended UN member states for adopting a “strong political declaration” designed to “accelerate action to ensure more roads are designed for people first, not motor vehicles, with safety as priority”.   The declaration commits UN member states to progressively aligning speed limits, road and land-use design, traffic rules and signage, and vehicle design technologies to achieve the 2030 target, which they first committed to at an HLM in 2021…. Other commitments include “establishing lead road safety agencies, improving data collection and analysis, developing and enforcing stronger legislation, and ensuring that roads, infrastructure and vehicles meet key safety standards,” the WHO noted….”

Commercial & Digital Determinants of Health, & NCDs

BMJ – AI as a new commercial determinant of health

https://www.bmj.com/content/394/bmj-2026-100272

“Itai Bavli and colleagues argue that the growing use of AI by commercial industries is creating new opportunities to influence health, and an AI commercial determinants of health framework may help to identify and assess emerging mechanisms of influence.”

“We propose a new analytical framework, AI commercial determinants of health (AI-CDoH), to help examine how AI extends existing mechanisms of commercial influence with potentially substantial impacts for health….”

“… The tactics used by companies to maximise profit and influence health policy decision making and health systems can be grouped into three broad, interrelated mechanisms: knowledge capture, influence on decision makers, and shaping the public narrative. AI can transform these mechanisms by increasing their scale, speed, personalisation, and precision, with potentially greater negative consequences for health. AI may also increase the interaction between these mechanisms and their combined influence…..”

Key messages of this Analysis:

“Commercial organisations are increasingly using AI to influence health behaviours, public policy, and the health information ecosystem. The rapid development and adoption of these technologies have left the health implications of AI enabled commercial influence poorly understood.  An AI commercial determinants of health (AI-CDoH) framework can help to identify how AI is transforming existing mechanisms of commercial influence and enabling new tactics through which commercial actors may influence health. An AI-CDoH framework examines AI companies and platforms themselves as part of a wider commercial infrastructure, not only as providers of tools used by other commercial actors. An AI-CDoH framework helps researchers to assess the actors, data, algorithmic bias, and potential health effects associated with AI enabled commercial influence and to identify where transparency, monitoring, or audit requirements may be needed.”

Health Promotion International – Sharenting and the digital determinants of childhood 

Ilona Kickbusch  et al;  https://academic.oup.com/heapro/article/41/4/daag100/8738959?login=false

“In two earlier editorials, we argued that health promotion must lead the charge on the digital determinants of health (Kickbusch and Holly 2023) and took stock of how rapidly the concept has been taken up (Holly et al. 2025). Yet one of its earliest and most intimate expressions has gone almost unexamined within our field. Sharenting—the sharing by parents and carers of children’s images and information online—has been ceded largely to lawyers and the parenting press. UNICEF addresses it chiefly as advice to parents on privacy settings and consent (Steinberg n.d.), while WHO’s engagement with children’s digital lives has centred mainly on gaming, online violence and adolescent mental health (World Health Organization 2026). Health promotion, despite its determinants lens and life-course horizon, has been largely silent….”

Guardian – ‘If all else fails, sue’: how ultra-processed food firms are using the courts to obstruct health rules

https://www.theguardian.com/society/2026/jul/22/processed-food-firms-courts-obstruct-health-regulations

“Exclusive: Global investigation reveals 235 lawsuits have been brought against governments in five countries since 2010.”

“An investigation by the Guardian, in collaboration with academics, the non-profit newsroom Lighthouse Reports and a coalition of media partners across four continents, found many of these same companies are taking governments to court to overturn, weaken or delay the policies…. In total, 235 lawsuits were lodged over health policies targeting UPF in Mexico, Colombia, Brazil, the US and the UK from 2010 to 2025, the investigation found.”

“It is not clear who is behind every lawsuit. However, three-quarters were filed by UPF manufacturers or trade associations representing them, the investigation found. Some of the corporations involved in the legal cases, which can be revealed for the first time, requested courts withhold their names…. Of the cases filed by companies where the plaintiff was identifiable, 38% were brought by eight parent corporations: Coca-Cola, PepsiCo, Mondelēz, Kellogg’s, Danone, Ferrero, Xignux and Heartland Food Products Group….”

WHO Afro – Access to care for severe chronic diseases in Africa growing: new report

https://afro.who.int/countries/zambia/news/access-care-severe-chronic-diseases-africa-growing-new-report

“More than 170 000 people have been attending health facilities offering PEN-Plus services across 20 African countries during the three years of implementation of the PEN-Plus Regional Strategy, according to a new report by the World Health Organization (WHO) Regional Office for Africa….”

IHME – Global, regional, and national trends in the morbidity gap and contributing diseases, injuries, and risk factors, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

https://www.healthdata.org/research-analysis/library/global-regional-and-national-trends-morbidity-gap-and-contributing?s=09

Cfr a new study in the Lancet Public Health.

“People are living longer but spending more years in poor health (new IHME study published in  @TheLancetPH ). The global morbidity gap—the number of years people live in poor health—increased by nearly 2 years between 1990–2023, reaching an average of 10.7 years worldwide.”

Lancet Editorial – Who owns cardiometabolic disease?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01497-2/fulltext

This week’s Lancet Editorial, related to a Lancet series.

“A person with obesity, type 2 diabetes, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, and heart failure might receive five different diagnoses, attend five different clinics, and be managed according to five different guidelines. But these conditions are not independent, they often accumulate along connected pathways shaped by adiposity, insulin resistance, inflammation, and vascular dysfunction. This shared trajectory is increasingly difficult to ignore, as the Lancet Series on cardiometabolic multiple long-term conditions shows. Given the advances in biological understanding and cross-cutting treatments, isn’t it time for a cohesive cardiometabolic medicine?….”

The editorial concludes: “… Establishing a new discipline carries risks: duplication, complication, territorialism, and the creation of another referral boundary. And it would entail changes from training bodies, primary care and specialist colleges, guideline developers, and health systems that should not be undertaken lightly. Clinical redesign, moreover, cannot substitute for action on the upstream drivers of obesity and metabolic disease. But so much more is now known about cardiometabolic disease—its shared biology, risk factors, prevention, management, and rising burden. This knowledge needs to prompt a reconsideration of how cardiometabolic disease is thought about and how care is organised accordingly. Most patients do not need another appointment; they need fewer, better-owned decisions.”

SRHR

Johns Hopkins – Menopause Care is Falling Short Worldwide, Review Finds

https://publichealth.jhu.edu/center-for-global-womens-health-and-gender-equity/menopause-care-is-falling-short-worldwide-review-finds

“A major new scoping review published in The Lancet Obstetrics, Gynecology, & Women’s Health by Center faculty Anna Kalbarczyk and Rosemary Morgan highlights significant gaps in menopause care, despite menopause affecting millions of people globally. Drawing on evidence from 89 studies across multiple countries and diverse populations, the review found that many women experience fragmented care, limited access to evidence-based treatment, and a lack of support from healthcare providers.”

“Women frequently reported feeling dismissed, unsupported, and uninformed about menopause and available treatment options. The review also identified persistent inequalities, with barriers to care often shaped by race, socioeconomic status, cultural background, and geography.   Researchers found that healthcare professionals often receive insufficient training on menopause, national clinical guidelines are applied inconsistently, and culturally responsive care remains limited, particularly for marginalized groups, including LGBTQ+ people, Indigenous communities, migrant women, and those experiencing surgical menopause.  While telehealth has the potential to improve access to menopause care, the authors note that it is not a universal solution, as its acceptability and suitability vary across different populations and settings….

With a number of recommendations.

·         And a link: AP – Women are dying in Africa as US ramps up its global battle against abortion

Child Health

Lancet (Letter) – Newborn screening for birth defects in LMICs cannot wait

A de Costa; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01228-6/fulltext

“In low-income and middle-income countries (LMICs), gains in child survival reveal an important reality: birth defects account for a growing share of deaths among children younger than 5 years and cause substantial, often unmeasured, disability and long-term morbidity. More than 90% of infants with serious birth defects are born in LMICs, yet policy responses remain weak. Newborn screening for selected conditions should no longer be viewed as optional; it is a child survival and equity priority.”

“The Seventy-Seventh World Health Assembly resolution in 2024 reinforced this agenda by inviting member states to consider universal newborn screening, diagnosis, management, and long-term care for children with birth defects as part of efforts to accelerate progress towards Sustainable Development Goal targets 3.1 and 3.2. WHO has since convened global consultations with ministries of health in LMICs, academics, clinicians, and affected people, families, and non-governmental stakeholders to develop a framework, Strengthening Capacity for Newborn Screening, Diagnosis and Management of Birth Defects, to guide country planning and implementation within routine health services….”

Human Resources for Health

WHO Afro – Nine African countries develop roadmaps to transform health professions education

https://www.afro.who.int/news/nine-african-countries-develop-roadmaps-transform-health-professions-education

(17 July) “Nine African countries have developed costed national roadmaps to strengthen health professions education and ensure that future health workers acquire the competencies needed to respond to evolving health priorities. The roadmaps were developed during a five-day workshop convened by the World Health Organization (WHO) Regional Office for Africa in Dakar, Senegal.

The meeting brought together health workforce leaders, education regulators and technical experts from Benin, Chad, Lesotho, Nigeria, Senegal, South Africa, Uganda, Zambia and Zimbabwe. The nine countries are early adopters of the WHO Africa Prototype Competency-Based Curricula. Their roadmaps set out the policy, regulatory, governance and institutional actions required to adapt the regional curricula into nationally approved reference curricula and introduce competency-based education more widely….”

Planetary Health (and Climate/Health)

HPW – To Attract Funding for Air Pollution, Africa Needs to ‘Speak the Language of Finance’

https://healthpolicy-watch.news/to-attract-funding-for-air-pollution-africa-needs-to-speak-the-language-of-finance/

“ Multilateral agencies and funders urged African nations at last week’s Africa Clean Air Forum to speak the language of finance to attract investment in improving the continent’s air quality. “

“Air pollution is the second leading risk for death in Africa after malnutrition. Four African countries feature in the top 10 most polluted countries: Chad, the Democratic Republic of Congo (DRC), Uganda and Egypt.   Yet Africa only gets a sliver of international funding for air quality programmes – which itself only gets 1% of all international development funding, …”

“Sean Maguire, Clean Air Fund’s (CAF) executive director for strategic partnerships, warned that the state of international funding is “bleak” following the closure of USAID and aid cuts by France, Germany and the United Kingdom.   CAF is trying to persuade countries and cities to make a “much more attractive investment case” for different types of funding, said Maguire.  He recommends showing how air quality is a smart investment, and that gains can be higher than the costs. …”

PS: “The World Bank’s representative, Francis V Fragano, called for the creation of “bankable” projects. He cited Cairo as an example, where aid to reduce air pollution, particularly from landfill fires, led to a pilot e-bus project that is now creating jobs and cutting emissions.  “These co-benefits are important to bring out and help crowd-in some of the financing, because then we can work out with the private sector to help finance,” Fragano said. “The financing is out there… how can we de-risk them?”…”

ClimateHealth brief – Politics and science of measuring climate adaptation

Climate Health Brief;  

“UN negotiations over adaptation remain deadlocked, as researchers develop a practical framework to help governments track climate-health risks.”

“Climate negotiators’ meeting this June failed to agree on one question: how should the world measure whether countries are actually adapting to climate change? The 64th meeting of the UN climate convention’s Subsidiary Bodies (SB64) was meant to launch a two-year process to translate the recently adopted Global Goal on Adaptation (GGA) framework into a system for tracking and reporting countries’ progress. Instead, negotiations stalled over a familiar fault line: developing countries wanted to discuss financing for adaptation, while developed countries insisted on keeping the focus on technical implementation….”

“The deadlock means one of the first major opportunities to put the GGA into practice has now been deferred until COP31 in Turkey later this year. Yet while governments remain divided over how adaptation should be implemented and measured, technical work on indicators has continued outside the UN process, particularly for climate and health…..”

PS: on the latter: “… A statistical framework for climate and health: Over the past four years, the UK’s Office for National Statistics (ONS), supported by the Wellcome Trust, has been developing the Standards for Official Statistics on Climate-Health Interactions (SOSCHI) project: a framework designed to help governments produce official statistics on the health impacts of climate change using routinely collected national data…..”

Nature – This El Niño is set to be the largest on record by a ‘mind-blowing margin’

https://www.nature.com/articles/d41586-026-02293-y

“Forecasters predict that the monster climate pattern will combine with global warming to push global temperatures in 2027 to new heights.”

Guardian – ‘When I get home, my whole body aches’: extreme heat saps health and wages of India’s poorest workers

https://www.theguardian.com/environment/2026/jul/20/extreme-heat-india-outdoor-workers-poverty

Exclusive: “Outdoor workers losing up to 9% of income as weather becomes ‘poverty multiplier’, research says.”

“Extreme heat is pushing some of India’s poorest workers further into poverty, with income losses of up to 9% for outdoor workers, new research has found.  Analysis done by the International Institute for Environment and Development (IIED), and shared exclusively with the Guardian, found that extreme heat is acting as a “poverty multiplier” for hundreds of millions of workers in India’s informal sector….”

“… The IIED research estimated that each year, 21.1 working days were lost in India due to extreme heat, an unaffordable loss for many of the 550 million workers in the informal sector. … …. Ritu Bharadwaj, climate finance director at the IIED, said the research showed how extreme heat was deepening poverty and worsening existing structural inequalities in India, which is aiming to be a developed nation in the next two decades….”

·         Related:  Telegraph – ‘I feel like I’m in front of a fireball’: 45C heat becomes India’s new normal

“When bats fell from the sky, Ahmedabad became a pioneer in fighting extreme heat. Its strategy is both a blueprint – and a warning.”

“… A study from the University of Oxford this month ranked Ahmedabad as the world’s second most “heat-risk city”, after Basra in Iraq.   Yet the Indian city has also been a trailblazer in extreme heat policy. Its experiences in the last 15 years offer strategies to adapt – and a warning about just how difficult that is, especially to protect workers in a “survival economy”. …”

Global Climate & Health Alliance – New Report Finds Global Security Hinges on Climate Action, Health Investment and Peacebuilding

https://climateandhealthalliance.org/resources/report/report-climate-change-armed-conflict-and-global-public-health-a-reinforcing-cycle-of-harm/

“Following July’s NATO summit, and with hostilities resuming in the US-Iran war after a 60-day ceasefire, a new report from the Global Climate and Health Alliance highlights the deep interlinkages between climate change and armed conflict, and how the intersection of these issues become mutually reinforcing drivers of harm to human health.   The report, Climate Change, Armed Conflict, and Global Public Health: A Reinforcing Cycle of Harm presents current evidence on the relationship between climate change and armed conflict, and its implications for global public health. The report finds that each such crisis does not occur in isolation but rather they converge in a polycrisis, a condition in which multiple global crises such as climate change, armed conflict, economic instability, under-resourced health systems, and an evolving digital landscape interact and amplify one another, generating a significant threat to global public health. …”

“… GCHA is calling for integrated climate, health, and peacebuilding approaches, including sustainable investment in climate-resilient health systems, stronger multilateral cooperation, a just energy transition and universal clean energy access, adherence to international humanitarian law, ensuring the protection of healthcare personnel and infrastructure and critical infrastructure, and greater accountability for greenhouse gas emissions from military activities, to ensure a sustainable future for generations to come….”

More on Access to Medicines, vaccines & other health technologies

Reuters – Brazil readies ‘tough’ response to new Trump tariffs, sources say

https://www.reuters.com/world/americas/brazil-readies-tough-retaliation-new-trump-tariffs-sources-say-2026-07-16/?ref=newsletter.genevahealthfiles.com

(16 July) “Brazil is considering suspending patent protections for pharmaceutical products and agricultural seeds; Officials may curb dividend and royalty remittances by U.S. audiovisual companies, sources say; Brazil will also revive its WTO dispute, a source ​says.”

“Brazil’s government convened top ministers on Thursday to prepare retaliatory measures against Washington’s latest tariffs, with ‌options including curbs on U.S. audiovisual companies and suspension of pharmaceutical and agricultural patents, three sources told Reuters.  The measures under consideration are in line with Brazil’s reciprocity law, which President Luiz Inácio Lula da Silva pledged his government would invoke after the Trump administration announced a 25% tariff on many Brazilian products on Wednesday in response ​to what it said were unfair trade practices by Brazil….”

“… The planned response, targeting U.S. intellectual property rights and audiovisual sector interests rather ​than imports, would represent a new approach to trade retaliation designed to pressure Washington while shielding Brazilian consumers ⁠from higher prices….”

TGH – How Scientists Can Revive Global Health Drug Development

M Butani; https://www.thinkglobalhealth.org/article/how-scientists-can-revive-global-health-drug-development

“South African biomedical researchers are spearheading new approaches to catalyze drug discovery and manufacturing.”

“In producing technologies that bolster each step of the global health drug-development pipeline, South Africa shows how local innovation can reduce reliance on companies and research institutes in high-income countries. Local drug development could ultimately provide a more reliable and cost-effective option for global health….”

PS: “Although South Africa’s funding availability and capacity for research is unique on the continent, this model of innovation is replicable and spreading to countries with fewer resources. Through capacity-building efforts like the Grand Challenges Africa Drug Discovery Accelerator, South Africa’s expertise is catalyzing new drug-development projects in Cameroon, Ghana, and Zimbabwe. In Cameroon, artificial intelligence, new research tools, and a platform approach are being harnessed to glean new SARS-COV-2 antivirals from African medicinal plants. These treatments would act as proof-of-concept for the researchers’ new AI model, and they could prove far more accessible for local populations than past therapeutics like Paxlovid, which was denied to African researchers by Pfizer in 2022….”

Via AVAC:   “Vulnerability of HIV Supply Chains :  A new Unitaid report, The Oil Behind Every Pill, highlights the supply chain vulnerabilities of HIV products and other biomedical interventions associated with the shocks and disruptions in the global oil trade. Unitaid finds that rising oil prices could increase the manufacturing cost of first-line HIV treatment by as much as 44% because fossil fuels are embedded throughout pharmaceutical production processes, from raw materials to solvents. The report argues that strengthening and decarbonizing pharmaceutical manufacturing is not only a climate imperative, but also a strategy for protecting medicine affordability, improving supply chain resilience and safeguarding access to HIV treatment in an increasingly volatile geopolitical environment. …”

And a few links:

·         UNITAID – Unitaid invests an additional US$15 million to accelerate introduction, adoption and uptake of breakthrough HIV prevention products in diverse regions (23 July)

·         Lancet – Climate, war, and the global health-care supply chain  (in case you missed this from a few weeks ago)

Migration & health

Guardian – As Sudan’s war crosses borders and millions are made refugees, could Ethiopia’s plan solve ‘humanity’s migration issue’?

https://www.theguardian.com/global-development/2026/jul/21/ethiopian-plan-sudanese-refugees-migration-crisis-education-work

“Amid fears of fresh bloodshed, the country is hoping its offer of education and employment can provide a model for other nations to follow.”

“… UN officials are hyping Ahmed’s approach to an inevitable byproduct of any future fighting: refugees. Three days before the confirmation of his election triumph, the country’s government launched a pioneering project at a glitzy bash at the capital’s Adwa Victory Memorial Museum. The venture aims to transform Ethiopia’s more than 1.1 million refugees – one of the largest populations in Africa – into social and economic assets. … … Refugees will be given improved access to education, healthcare and work, allowing them to become integrated, taxpaying residents rather than having to rely on aid….”

“Dubbed Makatet – meaning “inclusion” in Amharic – its apparent progressiveness has quickly turned heads. It is not only a dramatically different approach from the hostile environment, anti-migrant agenda of Europe and the US, experts believe it could offer a solution to the global migration crisis….”  “Advocates include the new head of the UN refugee agency. Barham Salih describes Ethiopia’s approach as the most ambitious attempt yet to address the growing displacement of millions….”

Some more reports & papers

Guardian – Healthy diet too expensive for one in three people globally, UN report finds

https://www.theguardian.com/global-development/2026/jul/21/healthy-diet-too-expensive-for-one-in-three-people-globally-un-report-finds

“Global hunger declined for the third year in a row in 2025 but experts call for action to bring down costs of fruit, vegetables and dairy as report shows 2.69bn people can’t afford to eat well.”

“One in three people cannot afford to eat a healthy diet, a new report has found, prompting calls for urgent action on food affordability.  There are 2.69 billion people unable to afford a diverse diet that meets their energy and nutrient needs, and it will take “immense” amounts of work to achieve the global target of zero hunger by 2030, the annual report from five UN agencies warned.”

“… The State of Food Security and Nutrition in the World 2026 report calculated the cost of a healthy diet is 4.28 purchasing power parity (PPP) dollars a day. This means that in any given country, a healthy diet costs the amount of local currency with the same buying power that $4.28 has in the US….” ““The extreme poverty line is $3PPP per person,” Torero said. “So it’s significantly higher.”…”

PS: “Figures from the World Health Organization, another of the UN agencies behind the report, show adult obesity rose from 12.1% in 2012 to 16.2% in 2024.”

“… In Africa, 66.6% of the population was unable to afford a healthy diet in 2025, more than double the levels observed in Asia or Latin America and the Caribbean….” “Africa is now home to the highest number of hungry people for the first time, with about 309 million, surpassing Asia’s 292 million, the report showed. The rise is largely driven by higher population growth on the continent, Torero said, with the proportion of the population going hungry actually starting to decrease “for the first time in years”….”

PS: The report is authored by the FAO, WHO, Unicef, the UN World Food Programme and the International Fund for Agricultural Development.

·         Related (official press release): UN report: Global hunger levels ease for third consecutive year as regional disparities persist

“The 2026 edition of The State of Food Security and Nutrition in the World (SOFI) also examines the cost of healthy diets.”

“The report estimates that 7.8 percent of the global population faced hunger in 2025, down from 8.1 percent in 2024 and 8.6 percent in 2022, confirming a sustained, albeit slow, improvement. This means that around 645 million people were affected by hunger in 2025, representing a reduction of nearly 14 million compared to 2024 and 43 million compared to 2022….”

“Despite global progress, recovery remains uneven across regions. Asia, together with Latin America and the Caribbean, has recorded steady improvements in recent years. In contrast, Africa is now home to approximately 309 million hungry people, compared with 292 million in Asia. Although Africa’s previously rising trend is beginning to stabilize, with the share of its population facing hunger decreasing from 20.3 percent in 2024 to 20.0 percent in 2025, the continent now has the highest number of hungry people in absolute terms amid a rapidly growing population.”

“… Regional disparities remain stark. More than half of Africa’s population (56.6 percent) faced moderate or severe food insecurity in 2025, compared to 20.3 percent in Asia, 22.9 percent in Latin America and the Caribbean, and 8.7 percent in Northern America and Europe. …”

·         And via  Devex: Global hunger falls but 2.7B people can’t afford a healthy diet, UN says

“The 2026 State of Food Security and Nutrition in the World paints a mixed picture of global progress on ending hunger by 2030.”

New Political Economy – The myth of catch-up development: trends in core–periphery inequality from 1960 to 2023

J Hickel et al ; https://www.tandfonline.com/doi/full/10.1080/13563467.2026.2659076

“The conventional narrative in international development holds that poorer countries are “catching up” with richer countries through the process of capitalist growth. This paper assesses this claim using data on inequality in GDP per capita for 1960-2023, processed using three different methods for currency comparison. We find that convergence narratives are not supported by empirical evidence. In fact, the opposite is occurring: the absolute income gap between the core (‘advanced economies’) and the periphery (‘emerging and developing economies’) has increased since 1960, by 170–270% depending on the currency concept. The core has captured 4–10x more income than the periphery over this period. Even in relative terms, convergence is not occurring; for most regions and most countries in the periphery their relative position vis-à-vis the core has deteriorated. Core–periphery inequality worsened particularly during the period of market liberalisation in the 1980s and 1990s. China is the only peripheral region that has meaningfully improved its relative position, but its income remains just 22–38% of the core level. While some peripheral countries have been integrated into the core for geopolitical reasons, an increasing majority of the world population is peripheralised. These results support the insights of world-systems analysts who argue that convergence is unlikely to occur within the existing structure of the capitalist world economy. Real development in the South will require strategies of industrial policy and planning to increase economic sovereignty, develop South-South trade, and delink from the imperial core.”

Miscellaneous

WHO – WHO marks 25 years of Research4Life, advancing access to scientific knowledge in more than 120 countries

https://www.who.int/news/item/21-07-2026-who-marks-25-years-of-research4life–advancing-access-to-scientific-knowledge-in-more-than-120-countries

(21 July) “The World Health Organization (WHO) today marks the 25th anniversary of Research4Life, a public-private partnership that provides researchers, educators, health professionals and policy-makers in low- and middle-income countries with affordable or free access to scientific knowledge. The partnership has helped dramatically expand access to scientific knowledge for researchers, educators, health professionals and policy-makers in more than 120 countries….”

WHO launches seven strategies to prevent drowning

https://www.who.int/news/item/23-07-2026-who-launches-seven-strategies-to-prevent-drowning

“Ahead of World Drowning Prevention Day on 25 July, the World Health Organization (WHO) is launching a new technical package to help governments and communities implement seven proven measures to reduce drowning deaths.”

“Nearly 300 000 people die from drowning each year worldwide, and drowning remains among the ten leading causes of death among children aged 5–14 years. Many of these deaths occur in rivers, lakes, wells, domestic water storage containers and swimming pools. More than 90% of drowning deaths occur in low- and middle-income countries.”

“… The seven strategies, packaged under the acronym PROTECT, translate the vision of the first-ever Global Strategy for Drowning Prevention into practical, actionable policy guidance….”

Global health governance & Governance of Health

Devex Pro – Aid’s new mission

Devex

(gated)   “Europe’s aid budget is getting a makeover. The question is whether it’s still primarily about development.   As Brussels negotiates its next seven-year budget, the European Commission wants to roll development, humanitarian, and pre-accession funding into a single €200 billion Global Europe instrument. The proposal is being presented as a simplification effort. But critics see something much bigger: The formal completion of a shift from poverty reduction toward geopolitics, investment, and Europe’s own strategic interests.   “We’re moving from a development-first instrument with strategic dimensions to a strategic investment instrument with development dimensions,” Mikaela Gavas, the managing director of the Center for Global Development in Europe, tells Devex. She argues the shift has been building for years, driven by Russia’s invasion of Ukraine, competition with China, and Europe’s search for greater economic security….”

“…. The proposal also raises uncomfortable questions about whose interests aid is really serving. The commission wants to give preference to European companies in development procurement — a move critics say edges toward tied aid, making projects more expensive and less effective. “It basically signals to partner countries that EU development finance comes with strings attached that serve EU industrial interests,” Gavas says….”

Devex Pro Insider: Forget Germany — the world’s biggest donor might be the US public

https://www.devex.com/news/devex-pro-insider-forget-germany-the-world-s-biggest-donor-might-be-the-us-public-112971

(gated)  “The U.S. public and philanthropies combined have spent more money on international aid than the U.S. government in 2025.”

“According to the annual Giving USA report, published last month, which looks at all U.S. giving in 2025, “international affairs” received more than $33 billion in funding from the public, philanthropies and corporations — significantly more than the nearly $29 billion the U.S. spent on official development assistance, or ODA, in the same period….”

“That means that if nonstate donors in the U.S. were a single entity, that entity would arguably be the largest single source of funding for international development, anywhere in the world — albeit “international affairs” covers different things than ODA, and we don’t have a detailed breakdown of exactly what it involves, so the two figures might not be directly comparable…”

From Jamnagar to the World: How Ayurveda is transforming India’s global health diplomacy and soft power
Vivek Kumar;  https://organiser.org/2026/07/22/371195/bharat/from-jamnagar-to-the-world-how-ayurveda-is-transforming-indias-global-health-diplomacy-and-soft-power/

“Indian civilisational medicine is entering the world’s most powerful corridors. WHO centre at Jamnagar, ICD-11 recognition, Ayush chairs and embassy networks are transforming Ayurveda into New Delhi’s most persuasive instrument of health diplomacy.”

Analysis starting from NITI Aayog’s newly released report, ‘Strategic Roadmap for Making Ayurveda Global’.

CESP (blog) – Partners or Patrons? Indonesia, China, and the Terms of Health Cooperation

D Chaudry;  https://csep.org/blog/partners-or-patrons-indonesia-china-and-the-terms-of-health-cooperation/

“This blog draws on insights from a roundtable in Jakarta, convened by United Nations University-International Institute for Global Health (UNU-IIGH) and the Economic Research Institute for ASEAN and East Asia (ERIA) as part of a joint study with CSEP. It situates Indonesia’s evolving health partnership with China within broader discussions on the future of global and regional health governance and the reforms needed to better support national priorities and regional cooperation.”

“Indonesia’s deepening engagement with China has illuminated an emerging facet of Chinese health diplomacy in Southeast Asia— characterised as institution-to-institution engagement that runs through university faculties, medical schools, and increasingly, think tanks. While some of this activity reflects genuine bottom-up initiative by Chinese academic and medical institutions, it also operates alongside more deliberate, state-linked channels, with clear ties to Chinese industry interests….”

Kinaura Partners – The Present and Future of the Global Health Architecture: Navigating a System in Transition

https://kinaura.com/the-present-and-future-of-the-global-health-architecture-navigating-a-system-in-transition/

“In this original paper by Kinaura’s Global Health and Development Architecture team, we assess the system as it stands, trace the five trends reshaping it, and offer practical recommendations for the five groups of actors whose choices will define the next architecture, from member states and multilateral funders to country governments and the private sector….”

The 5 trends are worth a look.

PS: “Kinaura Partners (formerly Global Health Visions) is a woman-owned global consulting firm specializing in social impact, strategy, systems change, and evidence-based transformation.”

Global Policy – Symbolism and Substance: How Geopolitics, Organisational Design, and Continental Coherence Shape Africa’s Multilateral Reform Aspirations

Ueli Staeger; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70211

“ This article develops a theory of African agency in multilateral reform processes. Continental coherence of African actors, the (in)formal organisational design attributes of multilateral organisations, and the geopolitical permissibility of African reform demands shape the exercise of African agency. In particular, these three factors shape the interplay of symbolism and substance as co-constituted dimensions of African reform diplomacy…”

Global health financing

SS&M – Health impact bonds as an innovative payment model for health prevention programs: A scoping review

Yunfei Li  et al; https://www.sciencedirect.com/science/article/pii/S0277953626006349

« This scoping review identified 23 HIB programs implemented across 13 countries. Initial investments varied widely, from under US$100,000 to over US$29 million. Eleven programs fully met their targets, with investor returns ranging 5.0–27.4%. Modest returns, limited investor participation, and stakeholder misalignment are the major concerns. »

UHC & PHC

HSG (blog) – Balancing business and accountability: governing equitable primary healthcare partnerships with the private sector

S Zaidi, G Bloom et al;  https://healthsystemsglobal.org/news/balancing-business-and-accountability-governing-equitable-primary-healthcare-partnerships-with-the-private-sector/

Part 1 of a three part blog series.

 “Reflections from the Symposium on ‘How can the public–private mix advance public healthcare in a transforming world order?’ convened by the Health Systems & Policy Research Cluster at UCL’s Global Business School for Health in collaboration with the Health Systems Global’ s Private Sector & Commercial Determinants of Health Technical Working Group (TWG), May 2026.”

Health Systems & Reform – Challenges to Achieving Universal Health Coverage Through Public Financial Management Reforms: Insights from the Implementation of Single Nodal Agency Reform in India

Mita Choudhury et al; https://www.tandfonline.com/doi/full/10.1080/23288604.2026.2693357

“Public Financial Management (PFM) reforms are being increasingly recognized for their potential to enhance health financing systems and advance progress toward Universal Health Coverage (UHC). Although theoretical frameworks have outlined the pathways through which PFM reforms operate, empirical evidence on their effectiveness in specific low- and middle-income country (LMIC) contexts remains limited. This paper examines the reform of the Single Nodal Agency (SNA) system in India, aimed at improving budget execution in centrally funded schemes, including the flagship health sector scheme, the National Health Mission (NHM). The study analyzes the gains and challenges associated with the reform and highlights the institutional features that are critical to its effectiveness. The study draws on an assessment of SNA implementation in two Indian states, Bihar and Odisha…”

Health Economics, Policy & Law – Towards a new compact for health financing in Lao People’s Democratic Republic

P Gunaratnam et al ; Health Economics, Policy & Law;  

“Inadequate or ineffective health financing poses a significant challenge to the Government of Lao People’s Democratic Republic’s goal of achieving universal health coverage by 2030. Here we explore possible application in the Lao context of the Center for Global Development’s New Compact approach, including locally-led evidence-informed prioritisation, domestic financing and consolidated supplementary aid. Using WHO’s political economy analysis guide we identify opportunities and barriers and propose a road map towards implementation of the New Compact. “

Health Economics, Policy & Law – Private health insurance in universal health systems: a comparative analysis of Discovery Group’s operations in the United Kingdom and South Africa

Health Economics, Policy & Law;  

By P Pearcy et al.

Nature Medicine – Genomas Brasil program: building precision public health within Brazil’s Unified Health System

Giovanny Vinícius Araújo de França et al ; https://www.nature.com/articles/s41591-026-04523-2

“Brazil is embedding large-scale genomics into its universal public healthcare system, combining sequencing, infrastructure and clinical implementation at scale. The experience may provide a model for other countries in the global south that seek to deliver genomic equity and precision public health.”

Pandemic preparedness & response/ Global Health Security

Plos Med – Whose fears count? Legitimacy, trust and viral outbreak responses after COVID-19

Rebecca F. Grais;  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005184

“COVID-19 transformed viral outbreak response from a predominantly public health challenge into a political and security concern. Recent responses to Ebola, mpox, and other emerging infections suggest that preparedness is increasingly shaped by whose fears are prioritized in decision-making. The challenge is ensuring that competing perceptions of risk are managed in ways that are perceived as legitimate, fair, and inclusive.”

The author concludes: “… The central challenge facing outbreak preparedness after COVID-19 may therefore be different from the one that existed before the pandemic. The question is no longer simply whether institutions can persuade populations to trust them. Nor is it whether sufficient technical capacity exists to respond to emerging threats. Increasingly, the challenge is whether institutions can govern uncertainty and balance competing fears in ways that are perceived as legitimate and fair. Institutions must develop decision-making processes that visibly balance competing risks, explain trade-offs transparently, and demonstrate that those bearing the greatest burdens have genuine influence over how outbreak policies are designed. Preparedness assessments should therefore evaluate not only laboratories, surveillance systems, and countermeasures, but also whether institutions possess mechanisms for transparent decision-making, meaningful public participation, reciprocal support for populations bearing the greatest burdens, and the legitimacy to balance competing fears during future outbreaks.”

Molecular Medicine – Science tikkun: a bioscience pandemic framework in a Hebrew tradition of global repair

https://link.springer.com/article/10.1186/s10020-025-01244-z

by Peter Hotez. “… Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.”

Planetary health

Guardian – Space datacenters proposed by Musk and Bezos ‘catastrophic’ for planet, experts warn

https://www.theguardian.com/science/2026/jul/23/space-datacenters-bezos-blue-origin

“New US petition demands review of plans from tech companies amid fears of environmental destruction.”

“Space datacenters proposed by SpaceX, Jeff Bezos’s Blue Origin and others would release staggering levels of pollution that would probably alter the Earth’s atmosphere and be “catastrophic” for the planet, space industry experts and environmental groups warn in a new petition demanding a review of their impacts…”

Nature –  Air conditioning is not enough to keep people cool — can scientists find an alternative?

https://www.nature.com/articles/d41586-026-02273-2

“Advances in materials allow buildings to be cooled as temperatures rise.”

Re the passive cooling of buildings.

·         And a link: NPJ Climate action – Prioritizing the welfare of vulnerable nations promotes equitable achievement of Paris target

“The choice of justice framing in climate models fundamentally determines both the global ambition for decarbonization and who bears its burden.”

Covid

Cidrap News – New study offers clues about long COVID’s brain symptoms

https://www.cidrap.umn.edu/covid-19/new-study-offers-clues-about-long-covid-s-brain-symptoms

“For years, patients with long COVID have described neurologic symptoms like brain fog, memory problems, difficulty concentrating, and lack of motivation, but scientists have struggled to identify the biology behind these symptoms. Now, a new study suggests they may be tied to measurable changes in the brain’s dopamine system….”

Stat (Opinion) –  Science and the public are learning the wrong lessons from Covid

M Lipsitch et al ; https://www.statnews.com/2026/07/21/covid-non-pharmaceutical-interventions-masks-distancing-research/

“Research into early nonpharmaceutical interventions penalize states that acted quickly.”

“ …. Unfortunately, many seem to be taking the wrong lessons from Covid.

Two studies — one in a book by Princeton political scientists Stephen Macedo and Frances Lee, and one in a paper in the medical journal The Lancet by Tom Bollyky and colleagues at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington — found little or no evidence for an association between nonpharmaceutical interventions (NPIs) and reduced deaths from Covid during the first year of the pandemic, before vaccines were available. But both studies make critical errors that undermine their conclusions, biasing their findings against detecting any benefits of early intervention….”

Infectious diseases & NTDs

Nature Health – Global impact and cost-effectiveness of tuberculosis interventions

K C Horton et al; https://www.nature.com/articles/s44360-026-00171-5

“A modelling analysis at a global scale estimates that three interventions (vaccination, community-wide screening and prison screening programmes) could prevent more than 10% of tuberculosis cases between now and 2050, highlighting the need to shift policy focus towards prevention.”

Journal of Benefit-Cost analysis – A Smart Investment: The Health, Education and Economic Returns of Malaria Chemoprevention in School-Aged Children across Ten High-Burden Countries

Journal of Benefit-cost analysis; 

by K Snyman et al.  

Lancet Planetary Health (Review) – Climate change and malaria in west Africa: a review of strategies to handle one of the world’s most prominent anthroponoses

Prof Walter Leal Filho et al; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00057-4/fulltext

“We qualitatively analysed national malaria strategic plans and related policy documents from 11 west and central African countries, published between 2015 and 2025. We assessed incorporation of climate and weather information into malaria surveillance, early-warning systems, and vector-control planning. Although most countries recognise the influence of climate and seasonality on malaria transmission, explicit integration of climate data into planning and surveillance remains scarce. … This Review highlights policy and implementation gaps in integrating climate adaptation within malaria-control programmes. We recommend climate-resilient malaria strategies centred on enhanced surveillance, integrated meteorological forecasting, and strengthened institutional capacity to support adaptive, evidence-based interventions.”

Cidrap News – Climate change is driving dengue spread in low- and middle-income countries

https://www.cidrap.umn.edu/dengue/climate-change-driving-dengue-spread-low-and-middle-income-countries

“Climate change and rapid urbanization are reshaping how dengue spreads in low- and middle-income countries, according to a systematic review published this week in PLOS Neglected Tropical Diseases….”

NCDs

Plos GPH – The survival penalty: Age-based inequities in hypertension and diabetes management in African health systems (1990–2022) – a secondary quantitative analysis

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006306

By Lawrence Ejike Ugwu et al.

Social & commercial determinants of health

Annals of Global Health – From Rerum Novarum to Magnifica Humanitas: Catholic Social Doctrine and Decent Work

https://annalsofglobalhealth.org/articles/10.5334/aogh.5366

By Raimondo Leone et al.

Mental health & psycho-social wellbeing

Stat (Opinion) – MAHA is rewriting the vocabulary of American mental health care

https://www.statnews.com/2026/07/17/maha-mental-health-care-vocabulary-rhetoric-wellness/

“‘Wellness,’ ‘metabolic dysfunction,’ ‘dependency crisis’ — this language smuggles in an agenda.”

“The MAHA movement’s mental health agenda rests on linguistic substitutions. “Treatment” becomes “wellness.” Neurobiological complexity becomes “metabolic dysfunction.” Medication treatment becomes “dependency crisis.” Evidence-based care becomes “root cause resolution.” Social determinants of health become “environmental purity.” Each swap reads as a humane correction to a system that MAHA believes overprescribes, overdiagnoses, and underinvests in the conditions — sleep, nutrition, safety, connection — that shape how people feel….”

“…The danger is not in these ideas themselves. It is in the policy conclusion smuggled in alongside them: that metabolic and environmental interventions can serve as the primary pillars of a national mental health strategy, rather than as complements to treatments we already know work. That single rhetorical shift from and to instead of makes all the difference. …”

“When the problem is recast as overmedicalization and the solution as lifestyle, the locus of responsibility migrates. It moves from systems and infrastructure that government funds toward choices that individuals make. A “metabolic dysfunction” rooted in diet is, conveniently, yours to fix with better groceries and more sunlight. But doesn’t address the root challenges of food insecurity, which in fact, has been exacerbated by administration actions. …”

“… “deprescribing” elevated into a movement, and a cultural default, is a clinical hazard. Antipsychotic discontinuation in schizophrenia carries a steep relapse risk. Lithium remains one of the very few treatments in all of medicine shown to reduce suicide. These are not drugs to taper in the name of a slogan.  None of this requires defending a status quo that overprescribes, or dismissing legitimate science about metabolism and environment. It requires insisting on the conjunction. Food and mood. Metabolic care and pharmacology. Prevention and treatment. Wellness and health care. Otherwise the agenda goes from being a corrective to a withdrawal….”

Plos Med – Work-family conflict and mental health: A systematic review and meta-analysis

Dongyu Liu et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005162

“These findings provide evidence of the longitudinal association between work-family conflicts and mental health outcomes, underscoring the need for context-specific policies in promoting work-family balance and mental health.”

Lancet Public Health (Health Policy) – Evaluating the outcomes of national suicide prevention strategies: evidence and challenges

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00125-8/fulltext

By Camila S Altavini et al.

Sexual & Reproductive health rights

Plos GPH – Mapping the gendered dynamics of cesarean section: A scoping review

Noah M. Trudeau  et al ;  https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006634

« This scoping review examines how gender norms, roles, and power relations influence CS utilization across diverse global contexts….”

BMJ GH (Essay) – Abortion in Africa: diverging paths of DR Congo and Nigeria under the Maputo Protocol

By A M Makelele et al.  https://gh.bmj.com/content/11/7/e020673

 “This analysis presents a distinctive comparison between Nigeria and the Democratic Republic of Congo, showing how constitutional provisions, civil society mobilisation and political will shape domestication and the actual application of the Maputo Protocol….”

Neonatal and child health

Lancet – Oral step-down, optimal drug, and total duration of antibiotic treatment in African children hospitalised with severe community-acquired pneumonia (PediCAP): a factorial randomised controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00879-2/fulltext

And related Comment: How long must we treat? A question as old as penicillin

Access to medicines & health technology

Semafor – Cheaper Ozempic for sale

https://www.semafor.com/newsletter/07/20/2026/dr-congo-may-overhaul-its-mining-laws?utm_source=headernewsletterlink&utm_medium=africa

“Danish pharmaceutical giant Novo Nordisk has launched South Africa’s first low-cost version of its weight-loss drug, in a bid to squeeze out counterfeit products in Africa’s most obese nation. Demand for the drug, first developed for diabetes before becoming a global weight-loss phenomenon, has exploded. Some branded versions such as Ozempic can cost hundreds of dollars a month — prohibitively expensive for many — and that affordability gap opened the floodgates for unregulated weight-loss medications.  The new product will be “cheaper” than its main brand, said Sara Narcross, Nordisk’s South Africa head. The launch last week follows a court victory for Nordisk against local compounding pharmacies making unauthorized copies….”

Review of International Political Economy – Minimal norm compliance in global value chains: contesting local vaccine production in Africa

Peg Murray-Evans et al; https://www.tandfonline.com/doi/full/10.1080/09692290.2026.2700274

“This article examines why multinational biopharmaceutical firms supported local vaccine manufacturing in Africa during the COVID-19 pandemic despite having previously opposed agendas to promote geographical diversification of production. Focusing on BioNTech and Moderna’s planned investments in African mRNA vaccine manufacturing facilities, we argue that these initiatives amounted to ‘minimal norm compliance’: firms responded to mounting pressure to support equitable vaccine access while interpreting local production in narrow terms and retaining the option to scale back or exit their investment plans at a later date. …”

Nature Africa –  Africa’s vaccine ambitions must move beyond fill-and-finish

P Adepoju; https://www.nature.com/articles/d44148-026-00207-8

“The continent needs more than assembly lines to reduce its dependence on imported vaccines. It must also strengthen the science and systems that come before production.”

“… That shift in thinking was a key theme, Adepoju explains, at CEPI’s Global Vaccine Manufacturing Summit, which took place last month in London, UK….”

Euractiv – EU shrugs off Trump’s latest tariff threat on generics

https://www.euractiv.com/news/eu-shrugs-off-trumps-latest-tariff-threat-on-generics/

“Trump said that generics imported into the US could be subject to 100% tariffs.”

“US President Donald Trump announced steep tariffs on generic medicines from 2028, despite the products being exempt under the EU’s trade deal with Washington. Early Wednesday, Trump posted on his Truth Social account that generics imported into the US could be subject to 100% tariffs from 1 August 2028, rising to 200% a year later. “This is done in order to RESHORE Generic Pharmaceutical Production into America, with a penalty to those Companies that decide not to build Plant and Equipment within the stated period of time given to them,” he wrote.  The move comes despite the EU and US agreeing clear exemptions for cheaper, off-patent generic drugs under the trade deal struck in April, keeping them at the current 0% tariff rate. Innovative branded pharmaceuticals, meanwhile, are capped at 15%….”

“We expect the US will continue to uphold this commitment,” an EU spokesperson told Euractiv. … … Trump appears to be using the threat as leverage to bring more generic drug manufacturing to the US, which, like Europe, is heavily dependent on China and India for active pharmaceutical ingredients….

Decolonize Global Health

Lancet Regional Health Africa – Peer review in Africa: from invisible labour to shared infrastructure

Ibrahim F. Kamara et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00097-0/fulltext

« The peer review system that supports the publication process is failing African science in ways that require urgent, continent-specific attention to ensure equity in global health research….

… Whilst there are good examples of change in the right direction, reform is needed and possible, but it requires governance rather than exhortation. Nine priorities stand out specifically for the African context. … »

Papers & reports

Global Public Health – To adjust, reform, or transform? Criteria for distinguishing efforts to change knowledge practices in global health

A Bayingana, S Abimbola;  https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2707692#abstract

“…Based on interviews with researchers who have participated in change efforts within and around global health, we developed criteria for distinguishing change efforts between first-order change, which seeks to adjust the current system for efficiency and effectiveness while keeping things the same; second-order change, which seeks to reform the current system to meet the needs of stakeholders; and third-order change, which seeks the total transformation of the system. In addition to the schema, our findings illustrate how the desired order of change is not simply a choice but rather dynamically determined in the interaction between change seekers and the institutions and systems they seek to change…”

SS&M – Incarceration, inclusion, and health equity: A global challenge

Stuart A. Kinner  et al; https://www.sciencedirect.com/science/article/pii/S0277953626006805

Introduction to a special issue.

Nature Medicine –  Governing the social production of care: the hidden foundation of health systems

Jo-An Occhipinti, J. Jaime Miranda et al ;  https://www.nature.com/articles/s41591-026-04535-y#:~:text=Health%20systems%20rely%20on%20unpaid,%2C%20and%20labor%2Dforce%20exit.

“Health systems rely on unpaid care that is poorly measured and governed. We argue that unpaid care, and the wider social production system behind it, is a productive input whose breakdown drives avoidable admissions, delayed discharge, and labor-force exit. We propose a national accounting framework, a diagnostic lens, and five policy priorities.”

“… Treating unpaid care as an unmeasured residual is a governance failure with predictable costs. Treasuries, statistical offices, and health ministries should act now: measure currently invisible inputs, invest in the infrastructure that sustains distributed support, strengthen reciprocity-based models that convert cohesion into care, and embed safeguards that prevent cost shifting. In an era of demographic transition, workforce constraint and recurrent global and local disruptions, care capacity is a foundational element of health-system capacity. Across health systems and cultures, social production is the enabling social asset that determines whether such systems can be sustained. Governing it well requires engagement with actors beyond the health sector, turning what has been framed as a health-system deficit into a shared, cross-sectoral investment in societal resilience.”

Tweets  (via X & Bluesky)

M Kavanagh

“Continued alarming transmission. We have been here before. This is why pandemics and major outbreaks cannot be solved by the health sector alone. Whether AIDS or COVID or Ebola we keep learning this lesson….”

Rob Yates

“Why would anyone listen to the Americans on how to reach UHC? Like England advising countries on how to win World Cup semi-finals .”

The week started with “diplomatic smartass” Dr. Tedros (or his speechwriter) finding once again the right words after the World Cup Football,while studiously avoiding mentioning WHO’s collaboration with FIFA for  reasons now  clear to almost everybody:  “Congratulations to #Spain, 2026 FIFA World Cup champions! The magic of football isn’t only on the pitch in a final. It’s in every game played in a park, a street or a schoolyard. Physical activity, at any level, protects your heart, mind and body. Keep moving.”      Well, you know I don’t need much convincing on the magic of football : )

This week’s IHP issue won’t delve into the Belgian National Day (21 July), as unlike in MAGA-land the link with global health isn’t that obvious in my country. In the PABS Odyssey, we cover analysis of the latest (7^th) round in Geneva – with two models on offer now (‘federated’ & ‘hybrid’). In New York, a UN High-level meeting on improving global road safety (20-21 July) took place, and in Chandigarh, India,  the 16th BRICS health ministers’ meeting  (22-24 July)  (with, as always, a rather interesting set-up, featuring the likes of Brazil, Russia, India, China, South Africa, Egypt, Ethiopia, Iran, Saudi Arabia, the UAE and Indonesia – no doubt there were some ‘healthy exchanges’). 

On Wednesday (22 July), Tedros himself commemorated   that “…. 80 years ago, on 22 July 1946, countries emerging from WW II signed the constitution of the WHO, founded on a bold and radical idea: that health is key to peace and security, and that health is a human right.” 

Obviously, we also pay quite a lot of attention to theextraordinary African Union meeting on Health (21-22 July) in Accra, Ghana. Part of the backdrop:  the worrying Ebola outbreak in Congo which has now killed over 1000 people.  A new Africa-specific health security index was also launched earlier this week.

In the lead-up to the (26^th) AIDS conference in Rio de Janeiro,scheduled for next week (26-31 July),a number of HIV related reports were published – including the  first real world evidence of PEPFAR disruptions. The 2026 State of Food Security and Nutrition painted a mixed picture of “progress” (as still 2.7 billion people can’t afford the minimum cost of a healthy diet…).  And the Gates Foundation released the findings of the commissioned external review, just one week after Warren Buffett made it clear he would no longer contribute to the Foundation. Overall, findings of the Review were more or less in line with what was already known, though unfortunately, “Bill Gates’s Personal Emails Weren’t Part of the Review”.  Although  improving the governance and internal processes  of the Foundation is certainly to be applauded, the broader question remains: as discussions on global health architecture reform continue (also with a view on post-2030), do we really think billionaire philanthropy should remain part and parcel of the global health ‘ecosystem’? Of this gigantic size moreover (a few characters in The Odyssey  come to mind)? 

Realists will no doubt say ‘yes’. They’re probably the same ones claiming, in a related area – climate finance (eg at the Africa Clean Air forum), that  “Africa Needs to ‘Speak the Language of Finance”. As in: ‘attractive investment cases’, ‘bankable’ projects, ….   I tend to side though with the New Economics Foundation’s Lyam Burne,  G Zucman and ever more “likeminded” people:  “… The question is no longer whether we can tax extreme wealth more effectively. The question now is whether democracies can afford not to…..”

As sadly  “Dantesque scenarios”  are increasingly common, we leave you with a planetary health related quote from Stephen Barlow : “The single biggest delusion, false belief, in mainstream politics and economics, is that somehow the climate and ecological emergency, is just another issue, which can be set aside when considering other issues. Rather the ecological polycrisis will determine everything, economic and societal. There are no issues independent of it. It determines everything that is going to happen in our societies in the near future….“

I’m guessing that most global health reformers ( / Transformers?) are well aware of this. Maybe it’s time they act like it too.

Enjoy your reading.

Kristof Decoster

·         Ebola Emergency: WHO/Africa CDC messages & other updates

·         PABS negotiations in Geneva (round 7)

·         More on PPPR & GHS

·         Global Health Reform & future of development cooperation

·         HLPF in New York

·         Global Fund Board meeting (Geneva, 9-10 July)

·         More on Global Health Governance & Financing/Funding

·         Debt crisis

·         Trump 2.0 & US Global Health Strategy

·         More on impact aid cuts

·         World Cup Football

·         HIV

·         NCDs

·         Immunization & more on child health

·         Planetary Health

·         Access to Medicines, Vaccines & other health technologies

·         Conflict/War & Health

·         AI & health

·         Some more reports

·         Miscellaneous

Ebola Emergency: WHO/Africa CDC messages & other updates

We kick off this subsection with some WHO/Africa CDC messages from the past week, and then continue with other Ebola related reads, news snippets & analysis.

HPW – Ebola Cases Climb 25% as UN Warns Outbreak May Push One Million Into Poverty

https://healthpolicy-watch.news/ebola-cases-climb-25-as-un-warns-outbreak-may-push-one-million-into-poverty/

(10 July)  With coverage of last week’s Africa CDC media briefing. “The Democratic Republic of the Congo’s Ebola outbreak is the fastest-growing on record, Africa CDC told its weekly briefing on Wednesday, with confirmed cases up 25% over the past week to 1,759 and deaths reaching 600. The outbreak’s reproductive number is 1.4, meaning every 10 infections lead to roughly 14 more, while the case fatality rate is 34%, officials said….”

“…“The virus is still ahead of our response,” said Wessam Mankoula, who heads the continental Incident Management Support Team coordinating the response for Africa CDC and the World Health Organization (WHO). “However, the window of opportunity is still open.”… … “We need to go ahead of the virus,” Mankoula said. “And to go ahead of the virus, we need more resources.”

“… Just 32% of new cases come from known contact lists, against a 90% target, and each case is linked to only seven contacts. More than half of cases are flagged only after 72 hours of symptoms. “While progress has been made, key bottlenecks persist, including access to workforce, which currently challenges contact tracing and case investigation efforts,” Africa CDC said, adding that it is deploying 4,000 community health workers as part of a 20,000-strong target with WHO and UNICEF to shore up contact tracing….”

“… Mankoula said Africa CDC was in touch with the government to fast-track payments, while urging development partners who had pledged to financially assist the response to speed up disbursement. Around 21% of a pledged $1 billion has been disbursed, Mankoula said. The Ebola response needs $518 million, and the wider humanitarian bill exceeds $800 million….”

Reuters –Congo Ebola outbreak still spreading largely undetected, WHO official says

(10 July) – Reuters;

“Scale of outbreak could be two to four times larger than data shows; Cases remain concentrated in Ituri province; Deaths outside treatment centres remain a major concern.”

“Four out of every five new Ebola ​cases in parts of Democratic Republic of Congo have no known link to existing patients, a ‌senior World Health Organization official said, warning that the true scale of the outbreak could be two to four times larger than official data suggest….”

“… “Eighty percent of the… new patients confirmed are coming outside of known contact lists” ⁠in the heart of the outbreak in Bunia, Ituri province, WHO Emergencies Director Chikwe Ihekweazu told Reuters in ​an interview late on Thursday (last week).

Geneva Health Files –Resources to Fight Ebola Trickle In Slowly, Even as Funding is Earmarked: Authorities

https://newsletter.genevahealthfiles.com/resources-to-fight-ebola-trickle-in-slowly-even-as-funding-is-earmarked-authorities/?ref=geneva-health-files-newsletter

(10 July)  “quick update from the weekly presser of the Africa CDC on the Ebola outbreak. The WHO also had a briefing for countries this week on the emergency. We present information from these briefings below….”   (with all the detail on these two briefings)

PS: “… The challenges thrown by the emergency are relevant to the negotiations on the Pathogen Access Benefit Sharing system underway at WHO. It appears though, that Ebola has not had a decisive impact on the considerations weighed in by negotiators….”

Africa CDC Calls for Stronger Protection of Responders

https://africacdc.org/news-item/africa-cdc-calls-for-stronger-protection-of-responders/

(11 July) “As of 9 July 2026, 112 health workers had been infected with Bundibugyo virus across DRC since the outbreak began, including 35 who died. The confirmed infection of a U.S. humanitarian worker supporting the response in Bunia adds urgency to the protection of everyone working to contain the outbreak.”

·         See also  Cidrap News – Africa CDC calls for more protection for health workers as deadly Ebola outbreak shows no sign of slowing

“… The leader of the Africa Centre for Disease Prevention and Control (Africa CDC), is calling for stronger protections for first responders, including more gear and enhanced safety protocols in light of the Ebola outbreak in the Democratic Republic of the Congo (DRC), which is officially entering its second month and showing little signs of slowed transmission.  Africa CDC Director-General Jean Kaseya, MD, MPH, said that, as of July 9, 112 healthcare workers have been infected with Ebola since the outbreak began, including 35 who died…”

Reuters – WHO says it has less than half funding needed to fight Ebola

(14 July)    Reuters; 

“The World Health Organization has received less than half the funding it ​needs to fight the Ebola outbreak in eastern ‌Democratic Republic of Congo, a WHO official said on Tuesday, urging donors not to abandon the country at a critical ​stage of the epidemic.  The global health agency has ​received about 40% of its $115 million appeal to ⁠tackle the Bundibugyo outbreak, for which there is no ​proven treatment or vaccine. …

“ Chikwe Ihekweazu, head of the WHO’s ‌Health ⁠Emergencies Programme, told reporters in Geneva after a visit to the worst-hit province of Ituri. … … … He repeated estimates that the ⁠true ​number of Ebola cases in ​Congo is at least double, and possibly over four times, the official tally.”

UN News – ‘This is a fire’: DRC Ebola outbreak is fastest-growing ever, warns WHO

https://news.un.org/en/story/2026/07/1167933

(14 July) “Infections of the Bundibugyo species of Ebola in the Democratic Republic of the Congo (DRC) have reached record highs and a majority of new cases are coming from “unknown chains of transmission”, the UN World Health Organization (WHO) warned on Tuesday.”

“The WHO official (i.e. Chikwe) outlined a two-pronged strategy for the response: continue pushing at the heart of the outbreak in Ituri and at the same time, “understand the travel routes… and really map out where the risks are of new cases coming up”.  Urging the international community not to be “despondent” in the face of the disease’s rapid spread, the WHO official insisted that the work was bringing results. “Now is not the time to drop the ball,” he warned….”

HPW – With Over 2000 Cases in Two Months, DRC’s Ebola Outbreak Continues to Outpace Response

https://healthpolicy-watch.news/with-over-2000-cases-in-two-months-drcs-ebola-outbreak-continues-to-outpace-response/

(16 July) “Two months after the Democratic Republic of Congo (DRC) declared an outbreak of Ebola Bundibugyo, the outbreak is “continuing to outpace the response” – and with 2,073 people infected and 796 dead, this is the fastest outbreak ever, World Health Organization (WHO) Director General Dr Tedros Adhanon Ghebreyesus told a media briefing on Thursday….”

“Reporting that another treatment centre in Bunia had been attacked on Wednesday, Tedros once again appealed for international support to make up the $400 million-plus shortfall needed to mount a sufficient response.  “This is not charity. It’s an investment in national security,” Tedros stressed….”

“Dr Chikwe Ihekweazu, executive director of WHO’s Health Emergencies Programme, said that the primary focus across all the outbreak-affected areas “is getting cases into care”.   Over 60% of deaths are happening in communities, which means that people were likely to have been sick and infectious for weeks before their deaths – and were only diagnosed with Bundibugyo because health officials are taking swabs from dead people shortly before burials, Ihekweazu explained.  “Your chances of survival are three to four times higher when you come into care. We have, at the moment, a case fatality ratio of about 30 to 40%. If you look at those that come into care, it’s about 10 to 15%. If you look at those that die in the community, it’s about 60 to 70%,” he added.

To encourage people to seek care in health facilities, the DRC government is offering free healthcare for all diseases to everyone presenting to hospitals and clinics in the outbreak-affected areas, he added….”

·         On the funding gap, see also UN News:

“WHO’s joint continental preparedness and response plan with Africa CDC still faces a funding gap of more than $400 million. “We urge donors to fill this gap and to help us control this outbreak as quickly as possible,” Tedros said….

“The UN Children’s Fund, UNICEF, has also appealed for additional resources, warning this week that only 25 per cent of the funding required for its Ebola response is currently available. …”

·         See also Cidrap News – Africa CDC praises DRC’s new roadmap (16 July)

“The DRC has released a new roadmap to contain the outbreak, which is now the fastest-growing in history. The Africa Centres for Disease Control and Prevention (Africa CDC) applauded the guidelines.  The roadmap offers emergency and immediate deadlines for early detection, complete contact follow-up, rapid access to care, protection of healthcare workers, and advise for trustworthy community engagement. …”

Stat – More health workers strike as Ebola cases in Congo exceed 2,000, including 754 deaths

https://www.statnews.com/2026/07/15/ebola-outbreak-congo-2000-cases-health-workers-strike/

(16 July) « Workers at the region’s largest medical center are the latest group to claim payment issues.”

Reuters – Cut off from Kinshasa, Congo’s AFC/M23 rebels built their own Ebola response

Reuters;  

(13 July) “Outbreak is chance for rebels to show their ability to govern; Analysts say fragmented response could complicate containment; AFC/M23 staged lightning advance in east Congo last year; Backer Rwanda has helped rebels with medicine and supplies.”

“Congo’s AFC/M23 rebels have used a small Ebola outbreak in territory they control to showcase their ability to govern, mounting a response largely separate from authorities in Kinshasa and supported ​in part by neighbouring Rwanda, according to response teams and official documents. The response has highlighted how the rebels have extended parallel administrative structures into areas captured during a ‌lightning advance last year. Analysts, however, say the war-torn country’s fragmented response could complicate containment efforts should the outbreak spread further….”

Telegraph – The Ugandan city where the race for a new Ebola vaccine will be won or lost

https://www.telegraph.co.uk/global-health/science-and-disease/the-ugandan-city-at-the-centre-of-the-ebola-vaccine-race/

“The small Ugandan city of Masaka …. will soon be known for something very different: it is here where the UK’s bid to be first to produce a new Ebola vaccine will be won or lost.  In the coming weeks, 110 volunteers in Masaka are set to receive an experimental shot against the rare Bundibugyo species of Ebola, the deadly haemorrhagic fever currently spreading in Africa. The Phase I trial, designed primarily to establish whether the jab is safe, is a vital step towards creating a much-needed vaccine.”

“The vaccine is being developed by the Oxford Vaccine Group, the same team at Oxford University that helped to develop the AstraZeneca Covid-19 jab used during the pandemic.  There are two other vaccines also in the race, one from Moderna and another from the non-profit biotech firm IAVI.”

“… The study is a collaboration between the University of Oxford and a leading research unit in Uganda, a branch of the UK’s Medical Research Council (MRC) that is situated inside the Ugandan Virus Research Institute (UVRI).  …… If the results are positive, it is hoped that the Oxford jab can move into a larger clinical trial as soon as October, involving much larger numbers of people who are directly exposed to the virus. It would be run under an emergency use license, which allows an experimental vaccine to be used during an active epidemic.  … The Oxford vaccine itself is being made by the Serum Institute in India, who are understood to be making large batches of the shot already so that it can be available immediately for a phase III roll-out, if the trial is successful.”

“… The Oxford jab set to be tested in Uganda is one of three promising vaccine candidates that have received millions of dollars in funding from the not-for-profit organisation, the Coalition for Epidemic Preparedness Innovations (CEPI).  CEPI has also given funding to pharmaceutical giant Moderna and biotech organisation IAVI, both of which already had early-stage Bundibugyo vaccines in development. The IAVI candidate is currently at an earlier stage of development, and is expected to take between 7-9 months before it can reach clinical trials, according to the World Health Organization (WHO). Moderna is meanwhile developing an mRNA vaccine for Bundibugyo Ebola. Staff at the MRC in Uganda told The Telegraph Moderna had contacted them to discuss the possibility of running their own trials with the unit, but that the development is not yet as advanced as Oxford’s….”

“… It’s likely that within a year, at least one of the three jabs will have passed the trials, proving both safe and effective and will become available to bring the outbreak under control.”

·         See also  Reuters – Oxford begins first human trial of Bundibugyo Ebola vaccine

(13 July) “The University of Oxford has launched the first human trial of a vaccine against Bundibugyo ebolavirus, seeking to accelerate efforts to ​combat an outbreak spreading in the Democratic Republic of Congo ‌and Uganda.  The early-stage trial, known as BD-Ebov, will evaluate the safety and immune response of the ChAdOx1 BDBV vaccine in 50 healthy adults aged 18 to 55 ​in Oxford, the university said on Monday….”

Development Today (Opinion) –  Congolese humanitarians demand fair share of OCHA pooled funds

https://www.development-today.com/archive/2026/dt-5–2026/congolese-actors-demand-fair-share-of-ocha-pooled-funds

“In the last six months, the country pooled funds managed by OCHA have expanded, but support channelled to national humanitarian organisations in the Democratic Republic of Congo has collapsed. As OCHA plans for disbursement of another USD 1.8 billion in US funding, the Congolese gynaecologist De-Joseph Kakisingi calls for a minimum of 40 per cent of the DRC fund to be earmarked as direct grants to local actors.”

Politico – Americans in Congo barred from immediately returning home amidst Ebola outbreak

https://www.politico.com/news/2026/07/14/american-ebola-relief-workers-barred-from-returning-home-immediately-00997100

(14 July)  “U.S. citizens in the Democratic Republic of the Congo will have to spend 21 days in a third country before returning to the U.S., even if they show no signs of disease.”

“Larry Gostin, a global health law professor who directs Georgetown University’s O’Neill Institute, said a blanket ban on American citizens returning home is “unprecedented” and “blatantly unlawful.” Gostin said the U.S. has stopped people diagnosed with an infectious disease from boarding commercial flights many times before, but never people who have not been diagnosed or even assessed for disease exposure…..”

PS: “Two Americans have contracted Ebola in the outbreak so far and were sent to Germany for treatment….”

Guardian – Uganda calls for travel restrictions to be lifted after last Ebola patient discharged

https://www.theguardian.com/global-development/2026/jul/16/uganda-travel-restrictions-last-ebola-patient-discharged

(16 July) “Country begins 42-day countdown to outbreak being declared officially over, as numbers continue to rise in neighbouring Democratic Republic of the Congo.”

Nature (World View) – Africa’s response to this Ebola outbreak shows how to shape global health

S A Karim; https://www.nature.com/articles/d41586-026-02148-6

“Countries elsewhere must learn from the continent’s example and combat disease outbreaks by working together, not by closing borders.”

BOND – The Bundibugyo wake-up call: why the UK cannot afford to ignore the latest Ebola outbreak

https://www.bond.org.uk/news/2026/07/the-bundibugyo-wake-up-call-why-the-uk-cannot-afford-to-ignore-the-latest-ebola-outbreak/

“A policy brief analyzing the cost-efficiency of containing health emergencies at the source relative to reactive domestic border responses.”

Excerpt: “The economics of crisis: For UK policymakers managing tight budgets, global health spending must be understood as an insurance policy. Containment at the source is exponentially cheaper than a reactive global emergency response.   In a highly globalised economy, an unstable health system in central and eastern Africa creates a vacuum. Epidemics compound existing humanitarian crises, fuel displacement, and strain regional economies, which directly impacts the UK’s broader geopolitical and strategic interests…..”

Lancet (Comment) –  Bundibugyo ebolavirus from the 2026 Ebola outbreak in Uganda and DR Congo: a new variant

A Ayitewala et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01079-2/fulltext

“…. In conclusion, we show that the BDBV variant identified in Uganda from a travel-related case linked to the ongoing outbreak in Ituri represents a new clade of BDBV.”

And some links:

·         Cidrap News – Gilead launches Ebola antiviral trial in DR Congo as cases near 2,000    (14 July)

·         Reuters: MSF urges Ebola response scale-up as Congo outbreak nears 2,000 cases   

(15 July) “The Ebola epidemic in the Democratic Republic of Congo is spreading faster than efforts to contain it, global ​medical charity Médecins Sans Frontières (MSF) warned on Wednesday, calling for an ‌urgent expansion of containment and care measures.”

PABS negotiations in Geneva (round 7 – and counting…)

RANI’s Resilience Action Playbook newsletter: Deep in the messy middle

https://mailchi.mp/rani/future-financing-resilience-action-playbook-16-july?e=da8439b1d4

Very neat summary of the past 10 days:

“Deep in the messy middle. IGWG 7 (6–17 July) concludes on Friday after ten days of negotiations. Assessing the session’s progress is not straightforward. An updated text circulated on Wednesday evening shows little movement toward consensus, though it does contain new additions and proposals for consideration. Delegates have nonetheless covered considerable technical ground on some of the most complex elements of the PABS Annex and the WHO Secretariat has circulated working documents on specific issues among Member States. Here’s where things stand and what comes next.

• Ebola reminding what’s at stake. …
• A tense opening. During the opening session, some Member States expressed frustration that the outcomes of informal discussions have yet to translate into the negotiating text – making it harder to build momentum – while others cautioned against doing so before clarity emerges on the complex links between access and benefits. The session also revisited granting observer access to relevant stakeholders, which received push back from the EU, Switzerland, China, Namibia, and Algeria (on behalf of the Africa Group).
• Into the technical weeds. Building on IGWG7’s preparatory discussions, delegates have focused on the technical core of the PABS system. On access, debates centered on user traceability requirements and issues. Legal arrangements enforcing benefits were also discussed at length, with emphasis on formal WHO contracts with vaccines, therapeutics, and diagnostics manufacturers and on online (click-wrap) agreements. Notably, the Africa Group presented a proposal to tie access conditions to predictable, contract-based benefit commitments under a ’federated data platform.’ Spain explored how a ’hybrid’ access model would work. Delegates also addressed benefits and the WHO recognition of laboratories and databases authorised to upload and manage PABS data and samples.
• Financing gets a first look. Delegates also kicked off discussions on the Pandemic Agreement’s Coordinating Financial Mechanism (CFM), with WHO providing an overview of current funding gaps and what it would take to get the mechanism running. Discussions touched on whether and how the CFM would be governed under a single framework with its counterpart under the International Health Regulations.
• What’s next? IGWG 8 is scheduled for 14–19 Sept., with the PABS Annex again as the primary deliverable, plus a further session on the CFM. Informal discussions between sessions have not yet been confirmed. “

TWN –  WHO: User identification and Contracts indispensable for PABS says developing countries

N Ramakrishnan et al ; https://www.twn.my/title2/health.info/2026/hi260703.htm

“Recent negotiations show a growing recognition that users of pathogen materials and/or sequence information (PMSI) from a proposed multilateral pathogen access and benefit sharing system must be identifiable and subject to contractual obligations to ensure compliance with terms of use of PMSI and benefit-sharing.  This was the conclusion after the first week of the seventh meeting of the Intergovernmental Working Group (IGWG7) negotiating the Pathogen Access and Benefit-Sharing Annex to the WHO Pandemic Agreement that were held at the WHO Headquarters in Geneva from 6 to 17 July….”

PS: “Several delegates engaged in the negotiations from developed and developing countries speaking to Third World Network, were of the view that progress was being made even though divergences remain, as there is now a better understanding of the different positions, creating a stronger basis for finding agreement…”

Geneva Solutions – NGOs allege rights abuses by Western countries in deadlocked pandemic agreement talks

https://genevasolutions.news/global-health/frustrated-by-deadlocked-pandemic-treaty-talks-ngos-allege-rights-abuses-by-western-countries

“Civil society groups are calling on a UN human rights expert to investigate alleged foot-dragging by pharma-intensive countries at ongoing pandemic treaty talks, but will the motion have teeth?”

“…Frustrated by deadlocked negotiations, which were extended at May’s World Health Assembly (WHA) by another year, a group of NGOs appealed earlier this month to the outgoing United Nations special rapporteur on the right to health. They argued that the negotiating positions of the European Union, Norway, Switzerland, and Japan are at fault and run counter to their international obligations regarding the right to health….”

PS: “…. Some observers, meanwhile, were mystified by the timing of the statement, which came just weeks before the end of Mofokeng’s term as rapporteur. On Wednesday, the Human Rights Council appointed Mariângela Simão, former WHO assistant director general and former UNAIDS director, as her replacement, effective 1 August….  A spokesperson for the UN human rights office said that, due to the upcoming succession, the NGO’s request would be transferred to Simão’s inbox at that time, before the countries would have 60 days to respond to allegations, according to the rules…..”

More on PPPR & GHS

Stat – WHO: Uganda is silent on updates following disclosure of Marburg outbreak

https://www.statnews.com/2026/07/16/world-health-organization-wants-marburg-virus-update-from-uganda/?utm_campaign=twitter_organic&utm_source=twitter&utm_medium=social

“Repeated requests for information have been unsuccessful, agency says.”

“The government of Uganda has gone quiet on an outbreak of the deadly Marburg virus that it reported late last month, with the World Health Organization acknowledging Thursday it has made repeated requests for updated information on the status of the investigation into how it started and how far it may have spread.  “We’ve sent several additional requests for information, and we’re still waiting to hear from them specifically on the outcomes of the investigation that we know that they’re carrying out,” Chikwe Ihekweazu, executive director of the Geneva-based agency’s Health Emergencies Program, said during a new conference.  Ihekweazu said the WHO has formally filed a request for updates through the International Health Regulations, a treaty that requires countries to inform each other, through the WHO, of disease threats that could cross borders. “We’ve sent frequent and repeated requests to the government of Uganda, and we’re waiting on them to respond to the IHR request that we’ve sent to them,” he said….”

GAVI (Policy Brief) – Immunisation and global health security: financing the future of pandemic prevention, preparedness and response

https://www.gavi.org/sites/default/files/2026/Gavi-PPPR-Policy-Brief-2026.pdf

The policy brief sets out key lessons from COVID-19 and other major health emergencies and outlines five policy recommendations for building a cohesive approach to pandemic preparedness, prevention and response that enables governments and institutions to act decisively at the onset of a crisis, saving lives and reducing costs.

Including: 1. Invest in immunization.

SSM Health Systems – Playing the payer’s tune to govern health through security in Nigeria – a realist analysis

D Akhavein, S Abimbola et al; https://www.sciencedirect.com/science/article/pii/S294985622600108X

“The use and the application of health security, both as a frame and a set of practices, have increased and become central to global health governance. Nigeria navigates complex pressure in health priority setting, shaped by domestic political realities, economic constraints and a longstanding relationship with international donors. Yet how the framing of health as security interacts with these dynamics, and how the actors involved shape health system priorities and practices, remains under-examined…..”

Findings: “…. We identified four interrelated outcome patterns (1) centralisation of governance, where priorities were steered by global agendas and reinforced through federal structures; (2) shaping of resource allocation, often prioritising diseases of international concern over locally salient health needs; (3) reconfiguration of health services, including vertical programming and administrative reporting burdens; and (4) institutionalisation of security norms, normalising military and security actor involvement in health response. Our findings show that health security is more than a technical exercise; it is a dynamic phenomenon co-created across multiple dimensions, including global norms and domestic governance. To mitigate the negative consequences of this phenomenon, we recommend that policy, practice, and research actors – internationally, in Nigeria, and elsewhere – engage more critically with global framings of health and security.”

The Collective Blog –  Why financialisation matters for global health security

Ben Hunter; https://www.globe.uio.no/english/research/networks/the-collective-for-the-political-determinants-of-health/blog/ben-hunter/why-financialisation-matters-for-global-health-sec.html

“Finance and financialisation are increasingly central to sectors and institutions that impact global health security: they shape the conditions that generate health threats, influence the pathways through which they spread, and reconfigure the systems designed to detect and respond” says Collective Member Ben Hunter. “

“In June, Dina Kirpalani, Abhay Shukla and I spoke at the Global Health Security Conference, where we led a panel on global health security in the era of financialisation. At a conference oriented towards technical fixes, our panel made the case for understanding global health security in socio-political and economic context, specifically one that is remaking global health in the mould of finance. Here I outline three key domains in which financialisation is transforming global health security….”

Global Health Reform & the future of development cooperation

TWN –   WHO: Reforming Global Health Architecture on Whose Terms?

Dian Maria Blandina (UNU);  https://www.twn.my/title2/health.info/2026/hi260702.htm

Hardhitting must-read analysis: “The global health architecture with its systemic flaws is poised for reform but on whose terms?”

A few excerpts to provide you with a flavour:

“… the global health architecture (GHA) reform discourse focuses on architectural tweaks, i.e. reshuffling institutions and funding streams, as if the problem were technical rather than political, without acknowledging the decisions have led to the current situation.

…Despite widespread acknowledgment of its detrimental effects, fragmentation in GHG persists due to deeply entrenched, interconnected factors including the proliferation of actors, divergent interests, and power imbalances. An ongoing study is critically unpacking this fragmented architecture to identify structural opportunities for amplifying the voice and participation of the Global South….”   “While the WHO is formally tasked with restoring coherence to a fragmented GHG, the joint reform process instead embodies the contradictory interests of its actors; crucially, most entities within the Joint Task Force on GHA reform are themselves products of that very fragmentation strategy.

“… the reform agenda remains concentrated on coordination, transparency, and efficiency rather than on reallocation of power or resources. In other words, it aims to leave sustainable finance availability to these entities causing fragmentation and reinforce a donor-fragmented system to work better, not to remake it on more democratic terms. …”

“… While Member States and civil society were responding to WHO surveys and participating in official briefings, the normative parameters of “global health architecture reform” were being shaped in a parallel circuit of high‑influence convenings: the One Health Summit in Lyon under the French G7 presidency, the Wellcome Global Convening, and the World Bank-IMF Spring Meetings, among others. These were not WHO‑convened processes, and access to them was heavily skewed toward institutionally resourced Northern governments, think tanks and philanthropic intermediaries.  The Lyon Joint Political Declaration, adopted at the One Health Summit in April, is emblematic. Substantively, it endorses WHO‑hosted reform and echoes many Global South demands on sovereignty, equity and diversified financing. Politically, however, it derives its weight from being anchored in a G7 presidency, with heads of state, senior ministers and major funders in the room. That kind of declaration prejudges the WHO process: it sets expectations and defines the corridor of acceptable policy options. Formal multilateralism is thus placed in the position of legitimizing a narrative largely framed outside the WHO…”

“The WHO GHA reform process, therefore, cannot be understood as a purely technocratic exercise. It is an arena where competing visions of multilateralism confront one another: one that privileges flexible, donor-steered networks of funds, partnerships, and clubs, and another that insists on stronger public, universal, and Member State-centered institutions.  The interventions from Global South delegations at WHA79 were far from routine. They were explicit warnings against allowing GHA reform that manages, rather than rectify, a fragmented GHG order. The current GHA reform agenda carries the risk of formalizing the status quo by conferring legitimacy upon the very entities whose existence has fundamentally splintered global health governance, diverted resources, and privileged private and powerful interests.  Whether the process ultimately produces meaningful structural change will depend on which coalition succeeds in shaping its practical assumptions over the coming year. The GHA reform process would largely be confined to efficiency gains, financing alignment, and improved coordination among already powerful actors; it will consolidate rather than transform the current governance.  Hence, Member States (especially from the Global South) need to link the process to broader struggles over fiscal sovereignty, technology transfer, debt justice, and democratic multilateralism. The reform could become part of a larger effort to reclaim GHG from fragmented and donor-dominated control….”

TGH – Reforming WHO: Five Considerations for the Next Director General

A Nordström;  https://www.thinkglobalhealth.org/article/reforming-who-five-considerations-for-the-next-director-general

“The World Health Organization’s next chapter could become more focused, technically authoritative, and strategically disciplined through strategic reforms.”

“… present discussions about global health reform avoid the critical issue of reforms of WHO itself. To remain relevant in a changing landscape, WHO needs to be modernized and embark on institutional and structural reforms….

Nordström lists five reforms.

Andrew Harmer – Reforming WHO: some Considerations for an ex-Acting Director General

https://andrewharmer.org/2026/07/15/reforming-who-some-considerations-for-an-ex-acting-director-general/

Harmer focuses in his reply to Nordström on consideration #1 – WHO’s operational logistics. Listing a number of very good arguments in my view for a continued (and strong) operational WHO role.

Just a quote to provide you with a flavour: “… … There’s a scene in the film Gladiator where (Roman emperor) Commodus rides into battle too late. “Have I missed it? Have I missed the battle” he asks, feigning concern. “You have missed the war” replies his father. I could just leave it there – it’s an obvious point, after all. But to be clear, it’s crucial to WHO to be seen as legitimate in order for it to maintain authority, and a good way to do that is by ‘being present’ and capable in its operational support. Visibility is crucial, so WHO shouldn’t – to extend the gladiator metaphor further – become an armchair general. Nobody respects them….”

CGD (brief) – An IDA Health Window: The Future of Global Health Financing

P Baker;  https://www.cgdev.org/publication/ida-health-window-future-global-health-financing

“… Current (global health) reform processes have shied away from a precise prescription for a new financing mechanism. Without this, there can be no progress. An International Development Association (IDA) Health Window would resolve the challenges of the current architecture. This brief outlines its mission, policy objectives, and key design characteristics. It builds off a forthcoming working paper which reviews the World Bank’s role in health financing.”

“An IDA Health Window would be a ring-fenced fund at the World Bank for countries to seek support for financing their health systems. It would have a single, clear mission: to drive down mortality in low- and middle-income countries through the expansion of basic, cost-effective health services. It would significantly contribute to the World Bank’s target of delivering health services to 1.5 billion people. It has five main benefits that distinguish it from the current global health architecture. First, it can draw in G20 donors beyond the G7, pooling their funding and defragmenting health financing. Second, it can better target aid to the poorest countries. Third, it can blend grants and loans to stretch resources further and enable a more sustainable transition from aid. Fourth, it can provide on-budget funding without earmarks, thereby building impactful health systems. Lastly, it can deliver on widespread calls for health sovereignty.”

“It is an ambitious proposal, but realistic if it is adopted by the World Bank in a two-phase approach. Phase 1—comprising $1.75 billion—could be delivered rapidly with minimal downsides alongside IDA22, which comes into effect in mid-2028. Given global aid cuts, phase 1 would not seek additional money, but instead would redirect health system strengthening financing into IDA. Phase 2 would see a $4 billion window launched as part of IDA23 in 2031. The IDA Health Window would then become the primary multilateral route for health aid, consolidating 33 percent of development assistance for health, and would be accompanied by a set of complementary global health reforms. This two-phase approach would enable it to be established at minimal cost and with minimal harm to the current system; with the second phase resulting in a scalable and seamless pathway out of the current architecture….”

Rockefeller Foundation- New Commission Launches to Chart Next Chapter of Foreign Assistance

https://www.rockefellerfoundation.org/news/new-commission-launches-to-chart-next-chapter-of-foreign-assistance/

“Co-chaired by former Gov. David Beasley (R — South Carolina) and former Sen. Ben Cardin (D — Maryland), Rockefeller and Packard Foundations, along with other partners, launch initiative one year after USAID’s closure. Independent Commission gets underway as new polling shows 8 in 10 Americans want aid reformed, not eliminated. With Brookings Institution and AEI support, Commissioners (former senior U.S. politicians and executives from across the political spectrum) will spend the next year building a blueprint for a more effective and accountable system of U.S. foreign assistance.”

“The Rockefeller Foundation and the David and Lucile Packard Foundation, along with other partners, announced today the launch of the new Commission on the Future of Foreign Assistance to reimagine a more effective, accountable, and widely supported system for delivering U.S. assistance around the world….”   It’s “ … charged with developing a forward-looking blueprint for U.S. foreign assistance that will be released in 2027. “

Project Syndicate – The Purpose of Development Cooperation Is to Be Unnecessary

V Meja; https://www.project-syndicate.org/commentary/oecd-dac-reviews-miss-the-point-of-development-cooperation-by-vitalice-meja-2026-07

“The original promise of development cooperation was to help countries overcome poverty, build productive economies, and reduce their dependence on external resources. That has not happened, and ongoing reviews of (OECD’s DAC) development cooperation, which focus on donor countries’ needs and priorities, are unlikely to change this.”

Duncan Green (blog) – What Endures: Navigating AI and the End of Aid as We Knew It

https://blogs.lse.ac.uk/activism-influence-change/2026/07/13/what-endures-navigating-ai-and-the-end-of-aid-as-we-knew-it/

Including a few thoughts on the ‘end of Aid as we knew it’:

“…In the aid sector, the two sectors I think will survive the woodchipper are humanitarian (there will always be a need for international solidarity when states and communities are overwhelmed by disaster) and advocacy, both international campaigns on global issues such as climate change, inequality or tax, and national level influencing of government or private sector policy.”

“Otherwise, go and work for institutions and in spaces that have more impact – governments, private sector, grassroots organisations, and which do not depend primarily on aid and in any case, were always more important as drivers of change, in my book. Right now, my guess is that aid will not come back, becoming increasingly seen as a specific and timebound creation of the late 20th/early 21st Century. Remember the League of Nations? Thought not.”

HLPF on SDGs (New York) (High-level section)

This year with no special attention for SDG 3 (health).

UN News – Despite hurdles, don’t give up on Sustainable Development Goals, UN urges

https://news.un.org/en/story/2026/07/1167927

“In a world of “parallel realities” where stark inequalities seemingly divide people and challenge the promise of multilateralism, the vision of the Sustainable Development Goals (SDGs) is to bring people together and help them achieve a better reality.”

“President of key UN body ECOSOC, Lok Bahadur Thapa, reminded the international community on Monday that no country can achieve sustainable development on its own, and that political will and momentum is necessary to achieve the SDGs by 2030.”  “…The speech marked the beginning of the top ministerial level meeting of the High-Level Political Forum on Sustainable Development (HLPF), the UN’s annual forum to assess progress on the Sustainable Development Goals (SDGs) which is convened by ECOSOC – the UN Economic and Social Council.”

“The High-Level Segment will conclude on Thursday with a negotiated declaration between government ministers and heads of State on concrete actions Member States will take to advance progress on the 17 Goals….”  “ The latest draft of the 2026 ministerial declaration includes commitments to increase investment in the SDGs and develop international rules for transformative technologies such as artificial intelligence.”

Also with the view of Guterres (pointing  to the lack of SDG financing as a key factor)

Global Fund Board meeting (9-10 July, Geneva)

Global Fund – Global Fund Board Takes Strategic Decisions to Navigate a Changing Global Health Landscape

https://www.theglobalfund.org/en/news/2026/2026-07-14-global-fund-board-takes-strategic-decisions-navigate-changing-global-health-landscape/

Press release. “Framework to strengthen risk management and mechanism to enable more sustainable access to health products approved.”

Some excerpts:

“The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) concluded its 55th meeting from 9-10 July, approving two key measures to strengthen the partnership’s ability to deliver greater impact in a rapidly changing global health landscape. …

“…Already this year, lenacapavir, the new, game-changing innovation for preventing HIV, has been launched in nine countries. Twenty thousand people received this preventive medicine by the end of May, and by the end of June, this figure more than doubled to 49,000 people. Additional innovations to fight tuberculosis (TB) and malaria – new near-point-of-care tests and spatial repellents – are also moving forward in coordination with countries and technical partners.  “

“As countries prepare for implementation of Grant Cycle 8 (GC8) (2027-2029) in a truncated timeline, there is intense focus on the difficult trade-offs required from reduced grant allocations. Initial funding requests are incorporating the new strategic shifts, including integration of health services toward a stronger primary healthcare approach and preparations for explicit transition timelines: 61 disease components across 35 countries and three multi-countries will transition out of Global Fund support in GC8 and 21 disease components in 12 countries in Grant Cycle 9.  “

“…In 2025, the Global Fund managed approximately US$1.2 billion in procurement, including US$1.02 billion in grant-funded health products for more than 80 countries through its Pooled Procurement Mechanism. A key part of supporting countries in their transitions is ensuring they have continued access to lifesaving health products negotiated through the Global Fund’s market-shaping strategy.    To that end, the Board approved a new policy to expand access to quality-assured, affordable health products through the Global Fund’s procurement platform using financing outside of Global Fund grants, helping countries maintain reliable access to essential medicines and health products as they move toward greater self-reliance. To support this initiative, the Board also approved a separate, self-sustaining financing mechanism that introduces bridge financing for countries that cannot pay upfront. The mechanism will include a pre-financing modality to support countries and reduce access barriers. “

Do read on.

PS: “A pre-Board panel discussion on the evolving global health ecosystem brought together Dr. Jean Kaseya (the Africa Centres for Disease Control and Prevention), Dr. Joe Phaahla (on behalf of the Eastern Southern Africa & West and Central Africa Board Members), Dr. Edem Adzogenu (AfroChampions/Accra Reset), Katy Kydd Wright (HeAR-CSO Project /Global Fund Advocates Network), Dr. Peter Piot (London School of Hygiene & Tropical Medicine/Accra Reset High-Level Panel), Dr. Bruce Aylward (the World Health Organization) and Dr. Joy Phumaphi (African Leaders Malaria Alliance) to discuss how global health partnerships must adapt to fiscal constraints, shifting geopolitics and growing demands for country ownership. Speakers emphasized stronger country and regional leadership, clearer roles and accountability, and the continued relevance of the Global Fund’s multi-stakeholder partnership model, underscoring the need for more agile, coordinated and country-led approaches to sustain long-term health gains. “

“…The Board discussed the Global Fund’s role in an evolving global health ecosystem, emphasizing the importance of strengthening the organization’s operating model, deepening partnerships and contributing to broader global health reforms. The discussion underscored the importance of building on the Global Fund’s comparative strengths, including country ownership, community leadership, market shaping and pooled procurement – to reduce duplication, strengthen collaboration and maximize impact for the people and communities the partnership serves. é

“The Board also reviewed progress in strengthening collaboration with key partners, including Gavi, the Vaccine Alliance, to better align support for countries and simplify the way they access health financing and services. The two organizations have identified priority areas for collaboration, including reducing administrative burden, coordinating support for malaria and health systems, exploring joint approaches for TB and new TB vaccines, and improving operational efficiencies. These efforts aim to help countries deliver more integrated, effective and sustainable health programs while advancing broader reforms across the global health ecosystem. “

Devex Pro– Scoop: Global Fund proposal to scrap evaluation team draws board pushback

https://www.devex.com/news/scoop-global-fund-proposal-to-scrap-evaluation-team-draws-board-pushback-112937

(gated) “Some European donors raised questions on how the secretariat’s proposed new model would guarantee an independent evaluation of its programs.”

“The Global Fund to Fight AIDS, Tuberculosis and Malaria secretariat’s proposal to dissolve its independent evaluation function has sparked concerns from board members and insiders, who warn it could weaken independent oversight of the multibillion-dollar health financier…..”

·         See also Devex:  Self-policing

“…the secretariat’s proposal to nix its independent evaluation function has triggered concerns from board members and insiders, who warn it could weaken independent oversight of the multibillion-dollar health financier, Jenny writes.   A paper presented to the board last week proposes a “redesign” of the current evaluations model whereby the secretariat would synthesize evidence and data, and external evaluations would be commissioned “only when there are gaps in other available evidence, capacity constraints or unmitigable conflicts of interest.” The Office of the Inspector General, or OIG, would provide assurance over the quality of the process. That’s not enough for everyone.  Some European donors question how the secretariat’s new model would guarantee an independent evaluation of its programs. They say that while the OIG’s work is important, it is “not a substitute for evaluating whether programs actually work.”   Meanwhile, a source privy to the discussions says the proposal seems to treat independent evaluations as optional and that it’s “pretty ridiculous” for a global organization commanding billions of dollars not to have an independent evaluation function.   The source suggests the proposal may in part be driven by the Global Fund’s cost-cutting measures. The fund is facing a smaller operating budget in the next three years: $930 million, versus $1.02 billion for 2023–2025.  The current evaluation structure costs the Global Fund more than $3 million a year.”

·         And for more, see Devex Check-up – ‘Slash-and-burn’ — Global Fund proposes axing evaluation team

Devex – German lawmaker seeks more transparency in Global Fund leadership race

https://www.devex.com/news/german-lawmaker-seeks-more-transparency-in-global-fund-leadership-race-112953

“Sascha van Beek, a member of Germany’s national parliament (from CDU), said transparency in the process is important to maintain “public and parliamentary confidence in multilateral institutions.”

He wrote a letter to the Board. The Global Fund’s board chair and vice chair responded to his letter.

·         Related: HPW – Greater Responsibility Requires Greater Leadership From Germany in Global Health (by Sascha van Beek) 

“In this article, Sascha van Beek, a leading global health actor in Germany’s Bundestag (Parliament) and a nurse by training, explains why Germany, a major global health donor and host to world-class scientific research, also needs a seat at the table….”

PS: “… Germany remains firmly committed to the Global Fund. There should be no doubt about our continued support for this unique partnership.   But as a member of the German Bundestag who strongly advocates for these public expenditures, I am facing a difficult reality. It is becoming nearly impossible to justify sending billions of taxpayer Euros to an organisation that cannot transparently explain how its leadership is chosen.  At a time when many donor countries are debating whether to channel resources through bilateral programmes or multilateral institutions, the Global Fund should do everything possible to strengthen confidence in its governance. Opaque leadership selection processes do not strengthen multilateralism. They undermine the trust on which it depends.”

More on Global Health Governance & Financing/funding

WHO Tokyo Office opens to scale up health systems in developing countries

https://www3.nhk.or.jp/nhkworld/en/news/20260715_01/

“The World Health Organization has opened an office in Tokyo to deepen its cooperation with Japan. The aim of the new office is to strengthen health care systems in developing countries….”

“ … The Tokyo office says it wants to share its knowledge and know-how with developing countries and hold training sessions and meetings with health officials as part of efforts to deepen coordination with Japan….”

Also the UHC knowledge hub (see this week’s intro).

UN – General Assembly Decides Modalities for 2027 High-Level Meeting on Universal Health Coverage, Rejects Proposals to Alter Stakeholder Participation

https://press.un.org/en/2026/ga12770.doc.htm

(10 July) “The General Assembly decided today that the 2027 high-level meeting on universal health coverage will be convened under the theme, “Universal health coverage:  accessible and affordable health for all by 2030”, adopting a modalities resolution for the one-day New York gathering that surmounted two proposals by the Russian Federation to alter language around stakeholder participation….”

Check out the views of respective countries and entities -including the US and EU.

Devex – Ayoade Alakija, FIND’s controversial board chair, steps down

https://www.devex.com/news/ayoade-alakija-find-s-controversial-board-chair-steps-down-112929

“It’s unclear what happens to FIND after these leadership changes. The organization faces an uncertain future, based on its recently published financial statement.”

“In her place, Marcel Tanner, director emeritus of the Swiss Tropical and Public Health Institute, will serve as interim chair.”

“Alakija’s departure follows an announcement by Dr. Ifedayo Adetifa in May that he was stepping down from his position as CEO. It’s unclear what prompted the changes, though one former staffer suggests it was due to donor pressure.  Donor relations have indeed been a serious problem. The Swiss Agency for Development and Cooperation, one of FIND’s donors, launched an independent review of the nonprofit after former board members raised concerns about alleged mismanagement. This led to several donors terminating projects or suspending grants….”

FT – Buffett drops Gates charity from donation of $6bn Berkshire stake

https://www.ft.com/content/ebc72869-a233-4710-a9a4-e398f567a5b2?syn-25a6b1a6=1&s=09

“Billionaire chair of conglomerate says he plans to leave holdings in company to four family foundations.”

“Warren Buffett excluded the Gates Foundation from his annual donation of stocks on Tuesday, with the billionaire chair of Berkshire Hathaway directing nearly $6bn of stock to four family-linked charities.  Buffett, who will turn 96 this August, also confirmed that his remaining stake in the company would be directed to the four family-linked foundations within eight years….”

“The omission of the Gates Foundation on Tuesday follows a series of revelations about Gates’ ties to Jeffrey Epstein, which have emerged through disclosures of materials from the US Justice Department’s investigation into the deceased sex offender.  …”

Devex – Ebere Okereke believes global health is about power

https://www.devex.com/news/ebere-okereke-believes-global-health-is-about-power-112829

“Global health strategist Dr. Ebere Okereke joins Theory of Change for a wide-ranging conversation about building a new global health architecture — in the midst of upheaval.”

·         And via Devex check-up:   https://www.devex.com/news/devex-checkup-the-departures-keep-coming-at-find-112917

“The latest episode of Devex’s new podcast, Theory of Change, features Dr. Ebere Okereke, and one point she makes to my colleague Michael Igoe really stuck with me: The biggest force for improving health systems may not be donors or governments — but ordinary people.”

“She said that in the United Kingdom, a politician cannot win an election if they don’t have the National Health Service as part of their manifesto: “If you’re silent on the NHS, you’re not going anywhere.”  In much of Africa, though, she argued that’s not the case. A couple of years ago, her team reviewed the manifestos of African parties running for government. Very few, she said, devoted even a paragraph to health.  Her explanation? Populations “have been persuaded” to think that health is their own responsibility and not the government’s. In Nigeria, where she was raised, Okereke said more than 70% of health care delivery is provided by the private sector. And while the current government is now working toward a national health insurance scheme, coverage remains “infinitesimally small” and is limited to public sector hospitals….”

“Most people never go to a public sector hospital until they’re in dire straits. Their local pharmacies provision is private. Their local doctor is private … so they don’t see the government in their health system on an everyday [basis],” she said.  “Our responsibility as advocates [is] to actually start bringing that conversation back to people to say … that health is a right that your government has a duty to provide you access to. And whatever your problems are, you need to start asking your elected representatives or anybody who aspires to be your elected representative, ‘What are you going to do to ensure that my children can get vaccinated?’” she said.”

Habib Benzian –  The Diseases Global Health Can Hear

Habib Benzian;  

“The epidemic mind of global health, and what it struggles to hear.”

“Infectious disease gave global health five things it still relies on: an origin story, political permission, an administrative model, institutional architecture and a story people understand. Together, they made contagion the template through which the field learned to recognise urgency, legitimacy and success….”

Development Discourse – WHO Civil Society Commission Pushes for Stronger Voice in Global Health

https://www.devdiscourse.com/article/health/3948795-who-civil-society-commission-pushes-for-stronger-voice-in-global-health

“More than 300 participants took part in four events held during the assembly, focusing on sustainable health financing and stronger civil society participation in global health governance.  The WHO Civil Society Commission enhanced its influence in global health discussions at the Seventy-ninth World Health Assembly.”   “The Commission, representing over 540 organizations, aims to present coordinated recommendations to WHO and its Member States. Nearly 300 representatives from 270 organizations identified four key priorities to address the challenges of financing health systems….

“… The Commission presented four shared priorities during the assembly: increasing investment in primary health care, strengthening domestic health financing, ensuring civil society has a permanent role in health governance, and improving transparency in health financing data ahead of the 2027 United Nations High-Level Meeting on Universal Health Coverage.”

… The Health Assembly also marked progress on WHO’s upcoming Civil Society Engagement Strategy. During a dedicated side event, participants worked directly on ideas that will help shape the strategy’s first draft, expected in September 2026. Unlike a traditional consultation process, participants contributed to developing the strategy itself, with their recommendations expected to influence future collaboration between WHO and civil society organizations. The assembly also encouraged stronger collaboration across generations and regions through networking events that brought together members of the Civil Society Commission and the WHO Youth Council.  WHO said the Commission is now entering a new phase focused on delivering measurable results while expanding meaningful engagement between civil society, governments and international health institutions. “

·         See also  WHO – The WHO Civil Society Commission reshapes priorities at the World Health Assembly

Nature Medicine – Fertilizer scarcity as a failure of global health governance

A Nasari et al; https://www.nature.com/articles/s41591-026-04507-2

“The closure of the Strait of Hormuz in February 2026 has disrupted global fertilizer trade at a scale with few modern precedents. Public and policy attention has focused on energy markets, but this framing understates the health consequences. Synthetic nitrogen fertilizers, produced almost universally via the Haber–Bosch process, currently sustain the food supply of approximately half of the world’s population. Any major reduction in fertilizer availability therefore represents an upstream threat to population-level nutrition and mortality, one that existing health governance mechanisms are not designed to detect or respond to….”

Authors conclude: “…Fertilizer supply meets the criteria that global health governance has applied to justify structural intervention in other domains. It is an upstream, supply-chain-mediated determinant of child mortality, concentrated in a small number of geopolitically exposed producers, and invisible to existing health surveillance systems until its effects have already become irreversible. Reclassifying it accordingly and building monitoring and anticipatory response mechanisms to match is the minimum institutional response the current evidence supports.”

Debt crisis

Al Jazeera – How World Bank and IMF loans are reshaping policymaking in Africa

Al Jazeera;

“As debt pressures grow, African governments are reassessing the trade-offs of concessional financing.”   With focus on Kenya, Nigeria, Ghana …

“… For governments facing high debt levels and limited financing choices, cheaper loans remain attractive. Yet experiences across Africa suggest that the cost of concessional financing is measured not only by interest rates and repayment periods, but also by the reforms and consequences that accompany access to it. As Kenya and other countries continue to navigate the balance between financial support and national priorities, the debate over conditional lending is likely to continue. For many citizens, however, the debate is less about the technical terms of borrowing and more about what those choices mean in daily life.  “There’s a bitter irony here: Citizens are asked to pay more in taxes to fund health, education, water, social protection, then asked to pay out of pocket for those same services because the tax revenue never actually reaches targets,” Kebuchi said.”

Trump 2.0 & US Global Health strategy

BMJ Feature –African countries “under pressure” signed Trump’s America First health deal—and few rejected it

https://www.bmj.com/content/394/bmj-2026-100192

Thorough analysis of the current state of affairs, including in various countries. “Severe external funding cuts have left many African nations forced to sign new transactional health aid agreements with the US. Abduallahi Tsanni asks if these countries can get the benefits and still keep their health data and pathogens.”

A few excerpts:

“… while the US has framed the bilateral agreements as a new model for sustainable “global health cooperation,” experts tell The BMJ that the new agreements are increasingly “transactional,” “lopsided,” and “imbalanced,” with most insisting on pathogen samples, surveillance data, or other concessions in return for US funding.  …. …many countries entered the negotiations only after US aid programmes had already been suspended or cancelled by the Trump administration, leaving the countries with little time and limited leverage, says physician Githinji Gitahi, group chief executive of non-governmental organisation Amref Health Africa. Moreover, many countries are facing “debt pressures” and “shrinking fiscal space,” he adds.  “The governments are under pressure to sign,” Gitahi tells The BMJ. He worries that many African governments are going ahead to make commitments without sufficient public consultation: “They are committing because they want the money now, now, now and that’ll be problematic.”…”

“The US has a long history of providing health sector aid, often with requirements to share data and materials. For example, in 1999, PEPFAR funding helped provide medicines, money, and personnel to combat HIV and AIDS in affected African countries in exchange for blood samples from patients and the conducting of clinical trials. African countries have historically supplied biological samples and data that lead to vaccine development without receiving equitable access to resulting products, says Stuart Ssebibubbu, a research officer at Afya na Haki, a non-profit health research and training institute in Kampala, Uganda. “Instead of getting low priced medicines, we instead get more expensive medicines,” he says.  However, the new bilateral health deals make data sharing requirements more explicit and contractual than earlier forms of US health assistance, according to Ssebibubbu.”

“… Fifa Rahman, a global health lawyer who has consulted for Africa Group negotiators on the Pandemic Treaty negotiations in 2024, says governments must resist data and pathogen sharing without guarantee of benefits, even if they think they have to sign the health deals. Agreeing to share data through the US bilateral deals could weaken their negotiating position in ongoing global discussions about benefit sharing under the WHO pandemic agreement, she says….  ““Governments risk giving away access to valuable biological resources before international rules are agreed,” says Rahman.  She advises African governments to enact domestic access and benefit sharing laws to protect their genetic resources and ensure benefits such as technology transfer and involvement of local scientists in the development of final products and ensure affordable access.  “Scientists in the West are desperate for materials, pathogens, and data from Africa, and there must be conditions to their use,” she says…..”

PS: “HIV blow adding to workforce pressures for African doctors:  … For decades the US has funded African health programmes; it paid laboratory staff, clinicians, community health workers, researchers, programme managers, and epidemiologists. And it supported diagnostic services, laboratory networks and disease monitoring systems, and built surveillance infrastructure.  Gitahi estimates that more than half of the health workforce working within programmes supported by the US have already been laid off. But their governments, already constrained by debts, are struggling to absorb them. The result, he says, is severe shortages of health workers alongside large numbers of unemployed trained professionals.  And for those who remain employed, workloads are increasing. Clinicians who previously focused on non-communicable diseases now also have to manage HIV and tuberculosis services. Burnout from these excessive workloads is becoming a growing concern owing to the effect on clinicians’ morale, Gitahi says. He notes that governments are prioritising maintaining supplies of antiretroviral drugs and other essential commodities. But many have been unable to absorb large numbers of health workers or replace the workforce of donor funded programmes in full….”

Devex Pro – Experts warn that sidelining CDC threatens PEPFAR’s future

https://www.devex.com/news/experts-warn-that-sidelining-cdc-threatens-pepfar-s-future-112911

(gated)  “The U.S. Centers for Disease Control and Prevention helped build America’s global AIDS response. As the Trump administration overhauls the agency’s role both at home and abroad, CDC officials worry about the future of HIV programs.”

“Dozens of awards to CDC and its parent department, Health and Human Services, to operate PEPFAR programs that cover treatment costs for millions of people are about to expire with no explanation of how — or whether — those programs will continue.  Health experts K.J. Seung and Vincent Lin identified 120 awards to CDC that are set to end in September. In their analysis, Seung and Lin described ending the awards without establishing a replacement as “a second global health woodchipper.” “

“However, a State Department spokesperson tells us it’s possible to extend the contracts to ensure there are “no breaks in lifesaving services,” while also working to transition those services to recipient governments.  This transition is in line with the bilateral health financing deals the State Department has inked with 34 countries, but the specifics are still being hammered out. 
But experts question whether governments have the capabilities to take over CDC programs. It’s also important to note that CDC expertise on the ground positioned the agency to take a leading role in global health emergencies, such as the 2014 Ebola outbreak in West Africa. 
“The contributions in strengthening the systems in countries where we worked has been very considerable,” says Kevin de Cock, who served four separate stints as CDC director in Kenya.”

Emily Bass – Guess Who Owns “Country Ownership” and CDC turf?

Substack;  

“Department of State says: Why so serious?”        Excerpts:

“Since July 2, the US government website “simpler.grants.gov” has featured ten documents in which the aggressively taciturn State Department Bureau of Global Health Security and Diplomacy says the quiet part out loud, namely: the Trump Administration’s shift to government to government spending is a priority except when it’s not; and State appetite for capture of CDC’s global health program knows no bounds.”

“As a reminder, “simpler.grants.gov” is the info hub for the Annual Program Statement (APS) that State describes as a USD$ 4.5 billion “supplemental framework” for “projects that complement, extend, and/or fill identified gaps in the implementation of these bilateral MOUs.” The $4.5 billion is completely separate from the money going to countries via the MoUs. It’s under State control from end to end: the phrasing of the solicitations, the selection process, the award design, oversight of implementation, evaluation—the works.”

“… AFGHS has been critiqued, rightly, for its extractive approach; but the terms of the transaction haven’t been teased apart. Governments are trading data, specimens and perhaps other things like market access, military presence and mineral rights for money it controls for a health system it owns. But what if the trade isn’t so clean? What if America isn’t handing over the reigns in exchange for anything? Is that still ownership? Only in the mirror world. Under the Trump Administration’s America-First definition of “country ownership” and “government-to-government financing,” the State Department will make up to USD$4.5 billion in awards that will not go directly to governments, via a process that has no apparent co-signatory government input, even when the matter at hand is one where the government and other national stakeholders might just have a preference. The US could faithfully channel country priorities and hew closely to the MoUs; or, it could not. The consequences are the same. There are no accountability metrics or safety valves built in….”

Devex  – Democrats grill DFC chief over Trump family’s potential ties with agency

https://www.devex.com/news/democrats-grill-dfc-chief-over-trump-family-s-potential-ties-with-agency-112956

“U.S. International Development Finance Corporation CEO Ben Black testified at a House Foreign Committee meeting Wednesday where he was questioned about agency priorities and ethics.”

More on the impact of aid cuts

Guardian – UK aid cuts ‘reduce bilateral support to some African countries by 90%’

https://www.theguardian.com/politics/2026/jul/16/uk-aid-cuts-bilateral-support-african-countries

“Labour’s foreign aid cuts mean reductions of as much as 90% in the bilateral support the UK will give to some African countries, Foreign Office figures show.”

“The department’s annual report includes a long-awaited breakdown of how the reduction in the aid budget will affect individual countries for the next three years. Analysis by Bond, the umbrella group for development charities, shows cuts of 90% for Mozambique and Malawi by 2029, 80% for Rwanda and Sierra Leone and 49% for Somalia.”

PS: “The UK takes on the chair of the G20 next year – the coordinating body that includes China, India and Brazil alongside wealthy countries in the global north.”

·         See also Devex – UK aid cuts hit fragile states despite pledge to protect them

(gated) “The country-by-country allocations released by the U.K. government today alongside its Foreign, Commonwealth & Development Office’s annual report reveal which countries will see the sharpest decline in U.K. aid in the coming years.”

“The country-by-country allocations, released in FCDO’s annual report and accounts on the final working day before Parliament’s summer recess, show steep reductions for fragile and conflict-affected states including Afghanistan, the Democratic Republic of Congo, Myanmar, Somalia, Syria, and Uganda, despite a pledge from ministers to focus support on the world’s most vulnerable places.”

“They also show steep cuts to low-income countries such as Rwanda and Sierra Leone, while several long-standing African partner countries are left with only small residual country-specific allocations….”

UN News – Aid cuts leave at least one million women and girls without vital support

https://news.un.org/en/story/2026/07/1167908

“At least one million women and girls have lost access to critical humanitarian support since January 2025 as unprecedented aid cuts push women’s organizations in crisis zones to the brink of collapse, the UN’s gender equality agency, UN Women, said on Friday.  The warning comes in a new report, Beyond the Breaking Point, which finds that those providing essential services to women and girls are being forced to reduce or suspend programmes just as global humanitarian needs reach historic highs…..”

PS: “According to the latest figures, around 120 million women and girls worldwide now require humanitarian assistance and protection. Yet the local women’s organizations best placed to reach them are facing severe funding shortages, despite often operating in places where international agencies cannot…..”   “The report is ….  based on responses from 855 women-led organizations across 52 crisis- and conflict-affected countries.

Science Insider – An uncertain path 

https://www.science.org/content/article/rocked-aid-cuts-malawi-rethinks-how-it-funds-health

“After the shocks of 2025, Malawi is rethinking its relationship to foreign aid—and trying to protect dramatic gains in maternal health.”

“Economists estimated the country could lose more than $170 million that year, with U.S. support for sexual and reproductive health all but wiped out. Separate cuts by other foreign donors, as well as worsening fuel shortages and rampant inflation, are now further squeezing the country’s health system….”

Do read how Malawi is trying to transition.

HIV

Bill Gates – “AIDS-free” generation is no empty promise

https://www.linkedin.com/pulse/aids-free-generation-empty-promise-bill-gates-hbvue/

“Thanks to recent scientific breakthroughs, for the first time ever we can realistically hope to end AIDS as a global threat. To be clear, I’m not talking about eradicating HIV, the virus that causes AIDS. What I mean by “the end of AIDS” is that the vast majority of people with HIV will get medicine that keeps them from developing AIDS—and, eventually, will be able to get a cure for the disease—and that far fewer people will get the virus in the first place. By the late 2040s, we should be able to achieve a 90 percent drop in deaths and new infections compared with what they were in 2010.” “ The world won’t need to keep paying for treatment for tens of millions of people living with HIV. Low-income countries will be able to focus on fighting other diseases and investing in economic development. They will move faster toward self-sufficiency….

“Three things will make it possible to end AIDS: 1. Long-acting prevention drugs…. 2. A functional cure…. 3. The tools we already have…..

“But there’s a problem. Governments are cutting funding for global health. These cuts have already disrupted the delivery of services, and if they aren’t undone, we could see an additional 6.6 million infections and 4.2 million deaths by 2030. …”  

World Cup Football

ODI – The World Cup’s elitism problem

C Leon-Himmelstine; https://odi.org/en/insights/the-world-cups-elitism-problem/

“Every four years, the FIFA World Cup promises to unite the world. FIFA President Gianni Infantino predicted that this year’s tournament, hosted across Canada, Mexico and the United States (US), would be the ‘greatest and most inclusive World Cup ever’. Yet beneath this promise lies a more prosaic reality: the World Cup is not just a sporting event, it is a mirror of global inequality, revealing how privilege determines who gets to participate, who benefits and even who is seen.”

·         And a link: Guardian – Nearly one in five World Cup matches reached heat levels players’ union warns against

NCDs

WHO – New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

https://www.who.int/news/item/15-07-2026-new-who-guidelines–up-to-45–of-dementia-risk-could-be-prevented-or-delayed

“The World Health Organization (WHO) today released updated guidelines on reducing the risk of cognitive decline and dementia, providing countries with evidence-based recommendations to help prevent or delay the onset of dementia across the life course….” “While there is no cure for dementia, up to 45% of the risks can be attributed to modifiable risk factors such as tobacco, alcohol use, social isolation, physical inactivity, air pollution and noncommunicable diseases (NCDs), including high blood pressure and diabetes.”

Do read what the guidelines entail.

HPW – From Crisis to Capital: Why Cancer Care is Africa’s Next Great Economic Investment

R Walumbe et al;   https://healthpolicy-watch.news/from-crisis-to-capital-why-cancer-care-is-africas-next-great-economic-investment/

“Africa can no longer afford to manage cancer care as a perpetual crisis. Instead, policy leaders must recognize this crisis for what it truly is: the ultimate ‘stress test’ for national health systems.  The WHO Global Status Report on Cancer, published this week, highlights the persistent inequities in access to timely cancer diagnosis and treatment and disproportionately high levels of cancer mortality across the continent. When a system is overwhelmed, it reveals deep-seated fractures in how we finance health as a whole. But this is not just a fiscal failure; it is a human one.”

“…  individual suffering is the precursor to a looming regional emergency: by 2030, non-communicable diseases (NCDs), including cancer, are expected to become the leading cause of death in many African countries.  If our current fragmented and underfunded models cannot withstand the pressure today, they will certainly collapse under the weight of tomorrow’s demands. The debate now is not whether Africa can afford to invest in cancer care. It is whether the continent can afford not to….”

“…At the same time, treating advanced cancer can cost up to ten times more than investing in early screening and prevention. Continuing to finance cancer care primarily at the point of crisis is therefore not only inequitable but also economically unsustainable….”

“This urgency shaped discussions at the recent World Health Summit Regional Meeting in Nairobi, where policymakers, clinicians, patient advocates, and health financing experts converged around a common conclusion: Africa must move from crisis spending to long-term, strategic investment in cancer care…..”

Ps: “The shift toward prevention-first systems is not simply good public health policy. It is smart economics. Expanding HPV vaccination, integrating cervical cancer screening into primary healthcare, and strengthening community-based early detection can dramatically reduce long-term treatment costs while saving lives. Prevention remains one of the most underfinanced yet highest-return investments in Africa’s health systems.”

Devex Pro – Novo Nordisk Foundation increases global focus on cardiometabolic diseases

https://www.devex.com/news/novo-nordisk-foundation-increases-global-focus-on-cardiometabolic-diseases-112875

(gated) ““In cardiometabolic disease, I would argue we are the biggest foundation, philanthropy working in the field,” says Mads Krogsgaard Thomsen, the foundation’s CEO.”

“A decade ago, the Novo Nordisk Foundation purely focused on Denmark. But last year, more than 20% of its giving went beyond the country’s borders. This year, that figure will grow, the foundation’s chief executive officer, Mads Krogsgaard Thomsen, told Devex during their recent Global Science Summit.  “We are becoming more international,” he said….”

Immunization & more on child health

Global childhood immunization coverage inches forward despite conflict and hesitancy – UNICEF, WHO

https://www.who.int/news/item/15-07-2026-global-childhood-immunization-coverage-inches-forward-despite-conflict-and-hesitancy—unicef–who

“ Zero-dose children fell by nearly 750 000 in the past year, but drop-out numbers high and stagnant, increasing risk of disease outbreaks.”

“In 2025, 90% of infants globally – or nearly 116 million – received at least one dose of a diphtheria, tetanus and pertussis (DTP) vaccine, and 85% – or 110 million – completed the full three-dose series, according to the annual WHO-UNICEF Estimates of National Immunization Coverage (WUENIC) released today.  …” “While both indicators rose by one percentage point from the previous year, global coverage remains one point below 2019 levels – hovering within the same narrow range since 2009. “

“According to the data, an estimated 13.5 million “zero-dose” children did not receive a single vaccine in their first year during 2025. While these represent nearly 750 000 fewer children than the previous year, progress is offset by a rising number of children who start the schedule and do not complete it. Most of these children live in countries where national immunization programmes receive support from Gavi, the Vaccine Alliance. …”

“… Behind these global and regional averages are persistent threats that are driving variability and volatility in country-level vaccination coverage. More than half of all zero-dose children live in FCV settings, even though they account for only about a third of the world’s child population. In these settings, immunization programmes are often strained by political upheaval, insecurity, or chronic underfunding. …”

·         Coverage via HPW – Global Reduction in Unvaccinated Children, But Impact of Funding Shortage Is Yet to Hit

“… the 2025 data represent a snapshot of where global immunization stood before the funding cuts, driven largely by the US.  Around 85% of the drop in zero-dose children occurred in Gavi-supported countries, which also accounted for 95% of girls vaccinated against HPV. Last year, Gavi was only able to secure $9 billion out of its $11.9 billion goal – largely because the US refused to support it, with US Health Secretary Robert F Kennedy Jr. announcing that his country was halting support for the alliance until it could “re-earn” the public trust. Gavi said its ability to survey outbreaks has been impacted by its funding shortage, and it is already having to make some hard choices….”

“… Meanwhile, O’Brien warned that more backsliding could lie ahead: “We don’t think that the impact of those funding cuts is showing up yet fully in the 2025 data. Our concerns are very much for what’s happening in programs in 2026 and what is yet to come.”…”

·         Related:  GAVI – The state of global immunisation in eight charts

Plos GPH (Opinion) – International, but for whom? Pediatric sepsis guidelines and the limits of global applicability

Johanna Thomson et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006881

“Most children who die from sepsis live in low- and middle-income countries (LMICs), yet international pediatric sepsis guidelines are largely derived from evidence generated in high-income intensive care settings. This creates a fundamental tension between global standardization of care and unequal health system capacity. Interventions shown to be effective in well-resourced hospitals may not be feasible, safe, or beneficial in settings with limited monitoring, staffing, and critical care infrastructure…. …”

“Recent international pediatric sepsis guidelines, including the 2026 Surviving Sepsis Campaign guidelines, represent a major effort to synthesize evidence and standardize care. However, the generalizability of these recommendations to LMIC settings is uncertain, despite these settings accounting for more than 85% of global pediatric sepsis cases and deaths. Many recommendations assume access to intensive care services, including mechanical ventilation, invasive monitoring, vasoactive infusions, reliable laboratory testing, and timely escalation to pediatric intensive care. In many district and referral hospitals, these resources are unavailable or inconsistent. Guidance intended as a standard of care may therefore be difficult to implement safely and consistently in practice.”

“This reflects a broader imbalance in global pediatric evidence generation…”  “ …These concerns extend beyond sepsis. Similar criticisms have been made of Integrated Management of Childhood Illness protocols, growth standards, and nutritional guidance. Across global child health, recommendations often embed implicit assumptions about infrastructure, workforce, and access to care that remain unacknowledged…..”

“Addressing these limitations will require more than minor revision. Major global health funders, including the Bill & Melinda Gates Foundation, Wellcome, the National Institutes of Health, and national research agencies, should prioritize pragmatic trials and implementation research in district and referral hospitals in LMICs. Guideline organizations, including the Surviving Sepsis Campaign and the World Health Organization, should develop formal resource-stratified recommendations and ensure leadership from clinicians and researchers working in high-burden settings. Guidelines should explicitly acknowledge resource constraints and provide clear pathways for adaptation across different levels of health system capacity….” “ …More than a decade after FEAST and decades after similar concerns were raised across global child health programs, resource constraints remain inadequately incorporated into many international recommendations. “

Planetary Health (& climate/health)

Devex Pro – Multilateral giants explore new climate-health collaboration

https://www.devex.com/news/multilateral-giants-explore-new-climate-health-collaboration-112920

(gated) “The collaboration remains in early stages, but if approved, would mark the first time the Global Fund and Green Climate Fund have jointly financed programs.”

“The Global Fund to Fight AIDS, Tuberculosis and Malaria and the Green Climate Fund are exploring an unprecedented partnership to jointly finance climate and health programs in vulnerable countries — a move that could create a new model for funding climate adaptation where it has long struggled to attract investment. …”

“The Africa Centres for Disease Control and Prevention is leading the process of proposal development, on behalf of the partnership, and the Planetary Health Axis System, established at Peking University, has offered to provide data analysis through a series of artificial intelligence tools to help guide interventions….”

“The Green Climate Fund has approved an initial grant of nearly $1.6 million through its Project Preparation Facility to support the development of a funding proposal for Burundi, the Democratic Republic of Congo, and Guinea-Bissau, although both the proposal and funding remain subject to the fund’s approval. But if the proposed project is ultimately approved, it marks the beginning of a really innovative partnership with a lot of potential, Christoph Benn, executive director of the Center for Global Health Diplomacy, tells me.    “It’s a different approach,” he says….”

Interesting development.

Nature Comment – ‘Climate free fall’: why the biggest risk to our economies is yet to be recognized

A Levermann; https://www.nature.com/articles/d41586-026-02154-8

“Increasing instability of the ocean, ice and atmosphere threatens farming, finance and society. We all need to wake up to that fact.”

Excerpts:

“ Earth subsystems, including oceans, the cryosphere and biosphere, already seem to be destabilizing. The planet is heading for climate free fall.  … Research into early warning of tipping points has identified increased climate variability as a signal of reduced stability and used it to estimate the time remaining before widespread tipping begins. But variability caused by instability as a mechanism of climate impact has been widely neglected….”

“Modern economies are adapted to relatively stable climatic baselines. Agricultural productivity, infrastructure design, insurance pricing and financial risk management all rely not only on expected mean conditions but also on the predictability of variability…. …Farmers need to factor in lost harvests; architects and urban planners need to account for extremes of temperature, wind and rainfall; and financiers and insurers need to consider the cost and scale of damages. But once these factors are no longer predictable, all bets are off — life becomes uninsurable and the world becomes unsafe.”

“… Instead of analysing future climate as a sequence of quasi-equilibria — as a system that will settle when the world stops emitting carbon — researchers must treat it as an unstable system that is reorganizing while society tries to phase out carbon-based energy….”

NYT – Climate Change and Air Pollution Combo Is a ‘Double Whammy’ for Health

https://www.nytimes.com/article/heat-air-pollution-climate.html

“Days that are both extremely hot and polluted come with higher risks of respiratory ailments and other health hazards.”

“A 2023 analysis of more than 20 million deaths across the world found that hot days and days with bad air quality both resulted in higher-than-normal mortality rates. But periods in which heat and pollution are combined were even more deadly….”

PS: “…There are two main types of air pollution that experts track for their effects on human health: ground-level ozone and particulate matter….”

Vox Dev – Climate change politics in developing countries

G Grossman ; https://voxdev.org/topic/energy-environment/climate-change-politics-developing-countries

“Across developing countries, people are acutely aware of a changing climate through failing harvests and drying rivers, even when few connect this to global warming – yet that concern rarely becomes political demand. Why does the link between personal experience and government accountability so often break down?

“… Grossman, together with co-authors Audrey Sacks and Alice Xu, has written a new review examining how climate change becomes political in the developing world – and why the connection between lived experience and government accountability so often fails to form….”

Climate Change News – Loss and damage fund delays first project approvals as needs dwarf resources

https://www.climatechangenews.com/2026/07/10/loss-and-damage-fund-delays-first-project-approvals-as-needs-dwarf-resources/

“The new Fund for Responding to Loss and Damage faces an overwhelming number of initial requests for its limited pot of money and board members decided to take more time to choose which to back first.”  Cfr a recent Board meeting in Manila.

“The board of the UN’s fledgling Fund for Responding to Loss and Damage (FRLD) has decided to consider its first package of projects for support at its next meeting in December, confounding expectations that it might back an initial set of four proposals this week.  The fund faces a substantial dilemma about how to select projects to receive its limited resources after its first call for proposals saw nearly 180 submissions requiring around $2.8 billion. It currently has only $250 million available to allocate, although the board agreed on Friday to release $100 million more in the face of overwhelming demand….”

Common Wealth (Report) -Beyond The Climate Finance Gap: The Global Financial System, Decarbonization, and the Failure of the Wall Street Consensus

S Zylinski et al; https://www.common-wealth.org/publications/beyond-the-climate-finance-gap

“Global decarbonization is a development problem. The structure of the global financial system constrains green development through dollar hegemony, volatile capital flows, punishing borrowing costs, and predatory trade and IP regimes.”

“The dominant international climate finance policy response, the Wall Street Consensus (WSC), attempts to mobilize private capital through derisking and assetization of green infrastructure. This is a political choice; one that treats a question of public capacity and global wealth redistribution as a technical problem of producing “bankable” projects.  Despite a decade of WSC-framed initiatives — JETPs, GFANZ, country platforms, the World Bank Billions to Trillions agenda, the $100 billion pledge — private climate finance to the Global South remains a fraction of what is needed. Further, the WSC compounds the vulnerabilities it claims to address.”

Instead, “The Green Planning Commission (GPC)’s starting premise is that policy design should have the goal of building a global architecture of public coordination. US global green economic diplomacy should aim to build a multi-scalar system of public institutions capable of directing investment toward development needs rather than investor returns, disciplining private capital, and supporting Global South states in developing their own green industrial capacity on their own terms.”

Guardian – Surviving extreme heat increasingly boils down to this: access to air conditioning

M Wolfe; https://www.theguardian.com/commentisfree/2026/jul/15/air-conditioning-access-extreme-heat

“The next great climate divide will be between countries that have the resources to adapt and those that don’t.”

“The west should help countries in the global south invest in cheaper, more stable forms of clean and secure energy to build the infrastructure needed to live safely in a warmer climate. Low-income countries cannot build this infrastructure on their own.

Development banks, international climate funds, private investors and wealthier nations will all need to become partners in financing the next generation of climate adaptation. This should not be viewed as traditional foreign aid. It is an investment in global health, economic stability and human resilience….”

.”.. Climate policy has long been measured by how much carbon the world can avoid emitting. That will always matter. But over the coming decades, it may also be judged by whether the world’s wealthiest countries were willing to help billions of people in the global south adapt to a hotter planet.  In the United States and Europe, access to affordable cooling is increasingly a question of political priorities. In much of the global south, it is a question of resources and, increasingly, survival.  The next phase of the climate debate has to be about more than reducing emissions. It also has to be about helping people survive the climate we have already created by investing in reliable electricity, affordable cooling and heat resilience in the countries that can least afford them.”

HPW – Africa Clean Air Forum Banks On Continental Shift to Address Pollution

https://healthpolicy-watch.news/africa-clean-air-forum-banks-on-continental-shift-to-address-pollution/

“Participants from 47 African nations are meeting at the Africa Clean Air Forum this week as part of a continental drive to address the air pollution health crisis.   The forum, convened by the Africa Clean Air Network (AfriCAN), is in its fourth year, and this is the first time it is being held in southern Africa. “

“The theme of the four-day forum is “investment case for clean air and healthy cities”, and participants have been sharing evidence-driven clean air actions, discussing sustainable funding and promoting cross-border knowledge sharing.  It follows the first G20 resolution on clean air, which was proposed by South Africa last year. Advocates are now focusing on what the continent requires to improve air quality, especially as it faces development challenges and a growing population. …”

PS: “Although the focus is on Africa, South-South cooperation between all developing countries is one of the core themes….”

UNU – Beyond GDP Meets Economics of Health for All: A Compass for Global Cooperation

N Goldin; https://unu.edu/cpr/blog-post/beyond-gdp-meets-economics-health-all-compass-global-cooperation

“Two emerging frameworks are aligning how progress is measured, governed and financed beyond GDP.”

“…. Two recent multilateral frameworks seek to change that. And what they say together matters as much as what each says individually; signaling a potentially important shift in how economic progress is defined and governed. That shift was on display this month at the 2026 UN High-Level Political Forum on Sustainable Development, amplifying the idea that closing gaps in cooperation and delivery matters as much as closing the financing gap itself….”

“… What has shifted is an attempt to align three things at once – how we define progress, how we pursue it through policy, and how we resource it through national and global systems. The two frameworks approach this from complementary angles: Beyond GDP through dashboards and indicators, WHO through missions and policy levers. That pairing is rarer than it sounds in multilateral processes, where measurement reform and policy reform have tended to be pursued in separate institutional lanes…. … The meeting of these two agendas is long overdue, and an intergovernmental process is now underway to establish global norms for benchmarking progress beyond GDP, with a view to incorporating these metrics into global reporting and national policy frameworks. WHO’s strategy explicitly links its implementation to wider UN efforts on measurement – creating much-needed space for improved coherence across institutional silos….”

“… Ultimately, this is about the nature and future of international cooperation itself, and whether development and public health continue to operate as adjacent domains even as economies become more interconnected, challenges more systemic, and effectiveness more a premium. …”

Climate Change News (Comment) – Major emitting countries knew of climate risks decades earlier than claimed

L Fenlock et al;  https://www.climatechangenews.com/2026/07/15/major-emitting-countries-knew-of-climate-risks-decades-earlier-than-claimed/

“Governments have known since at least the 1960s that fossil fuel use was warming the planet. They kept quiet to avoid responsibility.”

Plos GPH – Addressing historical biases and the limits of biomedical commodities in vector-borne disease control in Africa

Jennifer S. Lord et al ; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006840

« In this essay, we describe efforts to curtail the spread of vector-borne infections and how these efforts are entangled in the causes and consequences of the destruction of life, and the ecosystems which support life, on our planet. Using examples from malaria and sleeping sickness, we show how current efforts to control vector-borne diseases reflect the Western logic of a highly compartmentalized, hierarchical approach, dominated by biomedicine and commoditized interventions. These have dramatically reduced morbidity and mortality yet perpetuate colonial legacies, global inequities, and environmental harm. For instance, billions of insecticide-treated nets, rapid diagnostic tests, and other single-use plastics used in health products generate waste and emissions, while reinforcing fossil-fuel dependence and Global North dominance. These approaches treat diseases as isolated problems detached from the broader socio-ecological system. They excel at suppressing symptoms but leave untouched the root causes such as poverty, ecosystem destruction, and entrenched power imbalances. Current disease research and control strategies are situated within a wider dominant culture that has led to multiple undesirable effects on our planet (including climate, ecological functions, and biosphere integrity) driven largely by wealthy minorities and a global extractive economic system. Our intention is not to promote the idea that communities should be denied commodities that protect against vector-borne disease, but to identify that a shift is urgently required to make space for alternatives. A change involving transdisciplinary, socially-just strategies, that center local leadership, and enforce full life-cycle responsibility for health commodities; all of which are essential to safeguard both human and planetary health. »

Access to Medicines, Vaccines & other health technologies

Stat – AIDS activists slam Biden R&D deal with Gilead over HIV prevention drug patents

https://www.statnews.com/pharmalot/2026/07/13/aids-activists-slam-biden-deal-with-gilead-over-hiv-prevention-patents/

(gated) “Advocacy group contends the company was rewarded for infringing on government-held patents.”

“After more than a year of squabbling, a group of AIDS activists obtained an R&D agreement that was at the heart of a settlement between the U.S. government and Gilead Sciences over patents for HIV prevention drugs. But in their view, the deal shows the Biden administration missed a “historic” opportunity to invest in — and expand access to — HIV prevention tools…..”

PS: “As noted previously, the settlement resolved a lawsuit that was filed six years ago by the previous Trump administration after the Centers for Disease Control and Prevention maintained that Gilead infringed on its patent rights. The agency had helped fund academic research that later formed the basis for two Gilead HIV pills, Truvada and Descovy.   … The administration had alleged that Gilead ignored the contributions by CDC scientists, exaggerated its own role in developing HIV prevention drugs, and refused to sign a licensing agreement despite “multiple attempts” at reaching a deal after unfairly reaping hundreds of millions of dollars from research funded by taxpayers….”

CHAI – African vaccine manufacturing is advancing, but the path to market has revealed challenges

https://www.clintonhealthaccess.org/report/african-vaccine-manufacturing-supply-landscape-2026/

(22 June) “Updated analysis from CHAI tracks the state of African vaccine manufacturing ambitions in 2026.”

PATH (brief) – The diagnostics deficit: Funding, access, and preparedness gaps in African health systems

https://www.path.org/our-impact/resources/the-diagnostics-deficit-funding-access-and-preparedness-gaps-in-african-health-systems/

“The latest report in the Blindspots series from PATH and Impact Global Health reveals a complex picture. Drawing on data on approved diagnostics, global R&D investment trends, manufacturing capacity, and regulatory systems, the report examines how well Africa’s diagnostic ecosystem is aligned with the diseases prioritized by the Africa Centres for Disease Control and Prevention (Africa CDC).”

“The findings reveal a persistent gap between progress and preparedness:   577 diagnostics have received regulatory approval, reflecting growing product availability. Diagnostic manufacturing capacity is expanding, creating new opportunities for regional production. R&D investment continues to decline, limiting innovation and the development of future-ready tools. Nearly half of approved diagnostics remain inaccessible at the primary care level, where most people first seek healthcare….”

Nature (photoblog) – Tuberculosis testing gets a massive boost

M Pai; https://communities.springernature.com/posts/tuberculosis-testing-gets-a-massive-boost

« At a recent Global Implementation Workshop on Near Point of Care (NPOC) TB Diagnostics in Bangkok, several country leaders presented impressive plans for implementing these new, affordable and decentralizable diagnostics, bringing new hope and energy to a field impacted by aid cuts.”

Lancet Editorial – The right medicines for the right reasons

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01419-4/fulltext

This week’s Lancet editorial, with focus on de-prescribing.  Starting from RFK jr.

The editorial concludes: “…The solution to overprescribing is not underprescribing or abruptly stopping treatment. The guiding aim should be that individual patients receive the right treatment for the right reasons, and understand the benefits and risks, and that health practitioners have the capacities and support to create a safe plan for starting, continuing, stopping, or restarting treatment as needed. Better care—not simply less or more—is the measure of success in medicine.”

And a link:

·         AP – The new malaria vaccine helps in Africa but faces a test: Completing all 4 doses

Conflict/War & health

MSF (report) – The destruction of healthcare in Ukraine is deliberate and calculated

https://www.msf.org/destruction-healthcare-ukraine-deliberate-and-calculated

“MSF’s latest report indicates that attacks on healthcare in Ukraine are too consistent to be a random consequence of war. Attacks on healthcare are impacting people’s ability to reach care, as well as medical staff’s ability to provide it. All parties must uphold their obligations under international humanitarian law, and states with influence over Russia must demand an end to attacks on healthcare. “

AI & health

HPW – AI Energy and Water Consumption Compounds Climate and Pollution Crises: Can It Also Be Part of The Solution?

https://healthpolicy-watch.news/ai-compounds-energy-water-crises/

“The explosive growth of artificial intelligence is siphoning off water and electricity supplies used by communities around the globe, and creating new sources of air pollution and climate emissions from additional power generation. Yet, experts and industry representatives claim that the technology holds the key to mitigating the very crises it compounds. Advanced algorithms are already driving profound environmental solutions, ranging from monitoring municipal water leakages to forecasting renewable energy generation. Efficiency and standardisation issues remain the biggest barriers.”

Re the AI for Good Summit in Geneva (from last week).   “From 7 to 10 July, more than 12,000 visitors, experts, regulators and diplomats crowded the hallways of Geneva’s Palexpo exhibition grounds to discuss the potential and limits of AI. The summit was organised by the International Telecommunications Union (ITU), alongside 50 UN partner agencies, other UN member states and the private sector….”

·         See also Devex  –  Race for AI governance ignores risks to nature, experts warn

“Nature and biodiversity have been sidelined in AI governance discussions — and time is running out to protect them, experts said during the United Nations dialogue on AI governance in Geneva.”

“… Most policy debates so far have focused on AI’s physical footprint — such as the energy, water, and land needed for data centers — and on “AI for good” use cases such as forest monitoring, weather forecasting, and land-use planning.  But unless AI governance frameworks explicitly embed biodiversity, land use, and Indigenous rights, the technology risks strengthening the very drivers of ecological collapse that many climate, food systems, and development advocates are trying to reverse…”

“AI is an economic force acting on nature through everything it speeds up,” O’Donnell said. “Its impact on nature is far larger than the footprint and will have a significantly bigger impact than whatever benefits AI can provide going forward.”  O’Donnell argued that limiting the conversation to footprint and “AI for good” applications misses an important part of the story: AI as a technology that simultaneously affects all industries and turbocharges extraction‑based economic models, including in agriculture, fisheries, and forestry….”

·         And via HPW – As Artificial Intelligence Drives Health Innovations, UN Agencies Launch Joint Strategic Guidelines

“As artificial intelligence drives rapid health innovations, global guardrails, equitable data, and local capacity are needed to ensure equitable progress. To address this, a landmark framework launched by three United Nations agencies lays out a strategic roadmap for innovators. Meanwhile, health leaders emphasise that lower-income regions must become co-creators of future innovations.”

Some more reports & publications

HPW – Half a Million Dead, One in Twelve Treated: UN Charts a Drug Trade Remade by Chemistry and Conflict

https://healthpolicy-watch.news/half-a-million-dead-one-in-twelve-treated-un-charts-a-drug-trade-remade-by-chemistry-and-conflict/

(see also last week’s IHP news): “Conflict is reshaping the global trade map, and the collapse of Afghanistan’s opium production could, paradoxically, be pushing the world even faster toward more dangerous synthetics. Meanwhile, governments continue to prioritise punishment over care for people caught up in the cycle of drug use.”

“Nearly half a million people died from drug use in 2023, driven by infectious disease, untreated addiction and the spread of synthetic drugs more potent than anything markets have seen before, according to the new report by the UN Office on Drugs and Crime (UNODC)….”

Plos Med (Perspective) – Re-emergence of vaccine-preventable diseases in the post-elimination era

C K Kumar et al ; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005175

“Measles and other vaccine-preventable diseases are re-emerging worldwide in locations where they were once eliminated. Targeted policy interventions in the locations at greatest risk may be an effective strategy to curb this public health threat.”

Miscellaneous

Guardian – Developing countries spend more repaying foreign debt than on education, UN reveals

https://www.theguardian.com/global-development/2026/jul/10/developing-countries-spend-more-foreign-debt-education-aid-cuts-unesco

“Unesco report shows children lost out to servicing debt in 113 countries, with 18 spending five times more on loans.”

“….  In sub-Saharan Africa, countries spent 3.6 times more on debt than education.  The situation is likely to be exacerbated by funding cuts, the agency warned. Low- and lower-middle-income countries have already lost 21% of the aid to education they were receiving in 2023 and could lose up to 30% by 2027…..”

·         Related:  Reuters – UNESCO urges wider use of debt-for-education swaps

“113 countries spend more on debt servicing than education, UNESCO says; UNESCO says debt-for-education swaps could redirect resources into schools, teacher training, student support; UNESCO projects global aid to education could decline by as much ​as 30% between 2023 and 2027.”

Guardian – Marco Rubio launches campaign to dismantle international criminal court

https://www.theguardian.com/us-news/2026/jul/13/marco-rubio-dismantle-international-criminal-court

“Trump’s secretary of state claims the global tribunal is interfering with US military and law enforcement operations.”

PS: “… The state department plan to “dismantle” the ICC will involve pressuring other nations to abandon the court, according to CNN. “Nations that refuse to reject the ICC’s false authority while relying on US assistance are likely to come under increased scrutiny,” an official told the outlet, adding that possible punishments could involve sanctions, travel bans and visa revocations….”

Telegraph – This Singapore bat colony could unlock the future of medicine

https://www.telegraph.co.uk/global-health/science-and-disease/singapore-bat-colony-could-unlock-the-future-of-medicine/

Very interesting article. “Scientists have designed anti-inflammatory drugs inspired by bats, with clinical trials launching in early 2027.”

Global health governance & Governance of Health

Reuters – UN sees no budget cuts in 2027 after US welcomes cash-saving steps

https://www.reuters.com/legal/government/un-sees-no-budget-cuts-2027-after-us-welcomes-cash-saving-steps-2026-07-07/

(7 July) “The UN Secretariat already cut its 2026 budget by 9.2%; The U.S. pays 22% of the UN’s budget and owes billions; Ryder said Washington has welcomed UN reforms.”

“A top U.N. official leading a reform process said ‌on Tuesday he did not expect further cuts in the organisation’s budget next year, after the U.S., the global body’s biggest financial contributor, welcomed money-saving measures already taken….”

Bretton Woods Observer – Summer 2026

https://www.brettonwoodsproject.org/publications/summer-2026/

·         Including among others: Global Partnerships Conference and World Bank Group’s London Financial Solutions Hub put spotlight on UK’s private finance push

“UK’s May Global Partnerships Conference reflects rich nations’ broader shift towards private finance as development solution over structural reform.  World Bank Group announces City of London will become new London Financial Solutions Hub.”

Bretton Woods Project – The Bretton Woods twins: How do the World Bank and IMF work together? 

https://www.brettonwoodsproject.org/2026/07/the-bretton-woods-twins-how-do-the-world-bank-and-imf-work-together/

“This Inside the Institutions looks at the evolving relationship between the IMF and World Bank: how they work together, leading to increasingly converging policy approaches, and how their coordination and lending practices continue to shape debates over conditionality, constrained policy space. It also highlights civil society critiques of their harmful impact on development and human rights outcomes.”

Devex Pro – ‘One country, one department’: Switzerland’s major development shake-up

https://www.devex.com/news/one-country-one-department-switzerland-s-major-development-shake-up-112918

“A Swiss government proposal would reorganize the country’s aid architecture by moving responsibility for middle-income countries to the economy ministry and increasing humanitarian spending.”

“…. The bigger changes are structural. Swiss development sits across the two ministries but shares a budget, my colleague Jesse Chase-Lubitz explains. Currently, around 70% of development activity happens in the Swiss Agency for Development Cooperation, which sits within the foreign affairs ministry. The other 30% is run by the State Secretariat for Economic Affairs.  Now, the proposal is to assign each country to one office, rather than having some split between the two depending on the project. And all middle-income countries — primarily those in the Western Balkans, parts of Asia and North Africa — would move entirely under the Swiss economy ministry.  The Ministry of Economy would therefore pull out of some countries it deems developed enough, such as Ghana, South Africa, and Peru, and treat them more as trade partners.”

“Here we get to a familiar pattern among wealthy donors: echoes of trade not aid, with the move meant to link cooperation with Swiss corporate interests, according to a government announcement….”

Lancet Regional Health – Western Pacific: Japan’s global health engagement in the Western Pacific: diagnosing structural inertia and a framework for human security diplomacy

H Sakamoto et al; https://www.sciencedirect.com/science/article/pii/S2666606526001252

“…As Asia’s sole G7 nation and a universal health coverage pioneer, Japan navigates tensions between domestic social protection and external change. Drawing on a two-round expert consultation and literature synthesis, this analysis diagnoses three interdependent structural barriers forming a cycle of strategic inertia: a crisis of solidarity, financing, and governance in the multilateral architecture; episodic leadership driven by institutional fragmentation and misaligned incentives; and unidirectional knowledge transfer that forecloses reverse learning needed to revitalise domestic capacity and regional partnerships. We propose a framework of human security diplomacy, positioning health as a pillar of regional architecture rather than discretionary expenditure. This framework advances three goals: harmonising global contribution with domestic growth; fostering solidarity and regional public goods through catalytic leadership; and mainstreaming health into social systems for planetary resilience. Central to this strategy is circular co-evolution, in which Japanese institutional expertise and partner-country innovations reinforce one another.”

Review of International Studies – Ad hoc coalitions across time: Shaping international cooperation amid political rivalry

S C Hofmann et al;   Review of International Studies;  

“Ad hoc coalitions (AHCs) have been a persistent feature of global governance. However, only recently have they become the focus in governance scholarship. Why are they created, and how do they vary in their composition and afterlife? We examine AHCs since 1919 across health and security governance challenges. Our analysis rests on archival material from international organizations (IOs) and national governments. We argue that, in bringing together political rivals, AHCs serve three primary purposes. Firstly, as agenda setters, they address new governance challenges. Secondly, as capacity generators, they reshuffle membership compositions. Finally, as decision accelerators, they enable their members to bypass existing IOs. Beyond these commonalities, notable differences exist that are rooted in relative issue salience. Less salient issues are often led by bureaucrats and experts, glossing over political agendas and mediating between rivals. This set-up often leads to permanent cooperative structures. Issues that decision-makers perceive as highly salient occupy the attention of politicians who want to keep the coalition small. As a result, rivalries can easily come to the fore, leading to short-lived coalitions. Overall, AHCs point to more or less exclusionary action that serves as a testing ground for international cooperation in times of uncertainty and (geo)political crises.”

PS: “…. In the health domain, we study the Epidemic Commission (1920–1924), the International Children’s Emergency Fund (ICEF, 1946–1953), and the African Leaders Malaria Alliance (ALMA, 2009–)….”

ECDPM – The future of development cooperation: reflections on a changing debate

A Jones; https://www.linkedin.com/pulse/future-development-cooperation-reflections-from-few-weeks-jones-z49pe/

“Over the past few weeks, I’ve had the opportunity to take part in a series of discussions on the future of development cooperation and the EU’s international partnerships. They took different forms and brought together different communities, but they all left me with a similar impression. Here are a few reflections on what I think is changing.  …    While all these discussions approached the issue from different angles, I noticed that something is changing in the way we are talking about development cooperation. The discussion is becoming less defensive and more willing to engage with the fact that development cooperation is increasingly seen as part of Europe’s broader strategic engagement with the world. Whether one agrees with every aspect of that framing is of course open to debate. But what matters is that development cooperation and external action are no longer being discussed as peripheral policies competing for resources, but as integral components of Europe’s wider political and strategic project….”

Chapter – Health Cooperation in South America: Making the Case of a Multilayered Regionalism

C Salgado et al;

https://link.springer.com/chapter/10.1007/978-3-032-17864-0_33

Chapter in ‘Handbook of South American Regionalism’.

“Health cooperation in South America has two main characteristics that reflect the integration processes in which the countries of this region participate. The first is diffuse cooperation, with initiatives in various organizations, including Mercosur, the Amazon Cooperation Treaty Organization (OTCA), and the Andean Community (CAN). Secondly, health cooperation benefits from the hemispheric architecture of governance, consolidated through the Pan-American Health Organization (PAHO) and the Organization of American States (OAS), with the presence of the Economic Commission for Latin America and the Caribbean (ECLAC). Thus, after presenting the main initiatives of each organization mentioned, the chapter discusses the extent to which the South-South Cooperation paradigm drives the health agenda in the scope of regional integration in South America. Given the coexistence of different mandates, priorities, and mechanisms of action among the regional organizations themselves, the central hypothesis this chapter investigates is that health represents an area in which political harmonization is indeed taking place despite those differences due to, to a large extent, the presence of a robust hemispheric governance fostering south-south cooperation in this area.”

Geopolitics –  The Politics of Repair in a Broken World

Tasniem Anwar et al; https://www.tandfonline.com/doi/full/10.1080/14650045.2026.2695034

“Much of the world is currently bearing witness to major transformations to the liberal-modern geopolitical order that has defined it for some time. Amid this crisis, an array of new political orientations have been adopted by the different actors now competing for the authority to establish the agendas that will shape our future. One such orientation is repair. Repair refers to a mode of political critique that reads our present malaise as the result of the myriad violences that accumulated over the course of liberal modernity. It also encapsulates a catalogue of practices, policies and legal mechanisms designed to make amends for such harms too. So while those invoking the need for repair stress the importance of environmental damage, capitalist exploitation, structural racism and imperial desire in shaping our contemporary moment, they also highlight pathways for engendering what they see as more equitable and just futures through loss and damage funds, land restoration policy or transitional justice. Drawing on their research into climate change, colonialism, humanitarian crises, revolution and counter-terrorism, this forum’s contributors come together to critically discuss the politics of repair as it appears across myriad scenes that contribute significantly to the current conjunctural crisis. Rather than seeking to make conclusive and definitive claims about repair, contributors reflect and account for its presence across these scenes and potential ramifications in the not-so-distant future. While significantly developing our understanding of why repair might figure as a source of hope, the forum also stresses the different reasons why repair should also be treated with caution in worlds to come.”

Global health financing

Plos GPH – Influence of public external debt on government health expenditure: A mixed-methods case study of Senegal

Frederik Federspiel , Josephine Borghi et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006698

“… Overall, our findings indicate that Senegal’s debt burden has constrained government health expenditure, serving as a possible co-determinant of the regression seen on the Abuja pledge since 2000. To mitigate the negative effect of debt repayment, official external creditors should consider more flexible debt repayment timelines and exploring options for debt relief including debt-to-health swaps. Supported by debt relief, increased government priority of the health sector working toward the Abuja pledge will be necessary to make progress on universal health coverage. …”

BMJ GH – The impact of investments in health systems: a rapid review of computational models

DN Guzman-Tordecilla et al ;  https://gh.bmj.com/content/11/7/e020960

“This rapid review highlights the diverse computational models used to simulate investments in health systems strengthening. Our analysis revealed a range of methodologies, from agent-based simulations and dynamic computable general equilibrium models to structural equation models and the OneHealth Tool. Each model offers unique insights and has its strengths and limitations that need to be carefully considered for every scenario…..”

UHC & PHC

Lancet Regional Health Western Pacific – Japan’s health system toward 2040: structural challenges and a renewed social contract

https://www.sciencedirect.com/science/article/pii/S2666606526001240

Review. And: “… We propose a Vision 2040 framework with three goals: transitioning to an open, community-based ecosystem prioritising daily functioning and wellbeing; establishing trust and scientific independence as foundations of governance; and ensuring equity through circular innovation, in which Japan contributes to and learns from regional health networks by integrating global learning with domestic value assessment.”

Pandemic preparedness & response/ Global Health Security

BMJ GH – The global SEARCH network: providing a framework for critical COVID-19 healthcare worker cohort studies transitioning from the pandemic to the interpandemic period

M A Katz et al;   https://gh.bmj.com/content/11/7/e017704

“… Investment in these HCW cohorts during the interpandemic period is essential to provide a framework to quickly evaluate the implementation of any new vaccines, antivirals, medications and other interventions that could be introduced in response to the next pandemic threat….”

Genetics & Molecular research – Biopolitics and public health governance: a sociological analysis of state response to emerging infectious diseases

Joydeb Patra et al; https://geneticsmr.com/index.php/gmr/article/view/2020

“Emerging infectious diseases have transformed public health governance into a critical arena of state intervention, surveillance, and population management. Drawing upon Michel Foucault’s concept of biopolitics, this paper examines how states govern populations during health emergencies through regulatory mechanisms, surveillance technologies, and risk-based interventions. Using a sociological framework, the study investigates state responses to emerging infectious diseases such as SARS, H1N1, Ebola, and COVID-19. The paper develops a Biopolitical Governance Index (BGI) integrating epidemiological and sociological variables to assess the intensity of state intervention during infectious disease outbreaks. Findings suggest that public health governance increasingly relies on biopolitical technologies including digital surveillance, population monitoring, vaccination campaigns, mobility restrictions, and behavioural regulation. While such interventions contribute to disease containment, they simultaneously generate concerns regarding social inequality, exclusion, civil liberties, and democratic accountability. The study argues that contemporary infectious disease governance represents a hybrid form of biopolitical management in which public health, security, and governance intersect.”

Globalization & Health – Institutional quality and pandemic resilience: cross-country evidence on health and economic outcomes during COVID-19

https://link.springer.com/article/10.1186/s12992-026-01230-y

By D A Diaz et al.

Planetary health

Guardian – ‘Super’ El Niño could cause global food price shock lasting into 2028, analysts say

https://www.theguardian.com/business/2026/jul/12/super-el-nino-severe-shock-global-food-prices-lasting-into-2028-economists-warn

“Weather cycle threatens harvests worldwide, adding to inflation already fuelled by the Iran war.”

Lancet Global Health – The 2025 small island developing states report of the Lancet Countdown on health and climate change: building resilience in the face of rising heat

Georgiana M Gordon-Strachan et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00106-3/fulltext

“Small island developing states (SIDS) are particularly vulnerable to climate change, and people living in SIDS continue to bear the brunt of its manifestations, including sea-level rise, droughts, floods, and extreme weather events. The vulnerability of SIDS stems from their size, remoteness, geographical locations, and small economies. Collectively, SIDS produce less than 1% of the global greenhouse gas emissions, yet climate change presents an existential threat to them. In this report, we shed light on the disproportionate impact of climate change on SIDS and progress towards achieving the goals of the Paris Agreement by presenting the findings of specific indicators at the climate change–health nexus in SIDS….”

PIK – Healthier, more sustainable diets would reshape global agriculture; a new study shows by how much

https://www.pik-potsdam.de/en/news/latest-news/healthier-more-sustainable-diets-would-reshape-global-agriculture-a-new-study-shows-by-how-much

“Transitioning to healthier, more sustainable global food systems by 2050 would substantially reshape agriculture by reducing livestock numbers and decreasing land use, according to a new study published in Nature. Led by Cornell University, with contributions from the Potsdam Institute for Climate Impact Research (PIK) and the Agricultural Model Intercomparison and Improvement Project (AgMIP), the research highlights both the possibilities and challenges of a global food system transformation. It also underscores the urgent need for proactive agriculture and food policies to drive this transformation and manage its socioeconomic impacts…”

“… To explore the potential impacts of a food system transformation, researchers used ten global food system models to compare a “business-as-usual“ scenario until 2050 with a “transformation scenario” characterised by healthy diets, improved agricultural productivity, and halved food waste…”

Carbon brief – Eight facts about air conditioning amid an overheated global debate

https://www.carbonbrief.org/eight-facts-about-air-conditioning-amid-an-overheated-global-debate/

“As successive heatwaves hit Europe, air-conditioning (AC) has emerged as a new front in the international “culture war” over climate action.”

“Here, Carbon Brief explains – via eight facts – why AC rates in some parts of Europe are relatively low, as well as clarifies and contextualises some of the misleading claims circulating about the technology.”

“Much of Europe has not needed AC in the past; AC is already widely used in hotter parts of Europe; Some European nations have ‘resisted’ AC – but its popularity is growing; AC emissions are growing, but its climate impact could be limited; Heat from AC can contribute to directly warming cities; More AC could help to reduce heat deaths in Europe; ‘Net-zero rules’ are not blocking AC installation in the UK; AC is not the only answer to overheating cities.”

HPW – Record-Breaking Dust Storms in 2025 Sent Pollution Soaring in China and US-Mexico Border

https://healthpolicy-watch.news/record-breaking-dust-storms-in-2025-sent-pollution-soaring-in-china-and-us-mexico-border/

“Record-breaking dust storms sent pollution levels soaring in China and the US-Mexico border region in 2025, disrupting transport, shutting schools and airports, and sending thousands to emergency rooms, according to a new World Meteorological Organization (WMO) report.”

BMC Global & Public Health – The role of embedded Non-Governmental Organisations and other stakeholders in building resilience to cyclone-related crises in Madagascar: a qualitative study

https://link.springer.com/article/10.1186/s44263-026-00300-y

by M K Sahani, S Mayhew et al.

AMR

Trends in Microbiology – Structural inequalities in global antimicrobial resistance governance

R Farzana  et al;  https://www.sciencedirect.com/science/article/pii/S0966842X26001617?via%3Dihub

“Despite substantial global investment, antimicrobial resistance (AMR) governance perpetuates structural inequalities, constraining low- and middle-income country (LMIC) capacity. Short-term funding, high-income country-centric research frameworks, and priorities undermine sustainable surveillance and scientific independence. Drawing on the BALANCE study, which enrolled approximately 67 000 patients across diverse economic settings, we argue that an equitable AMR response requires a transformation prioritizing LMIC institutional development and leadership…..”

NCDs

Lancet Comment –Dementia prevention in Latin America and the Global South

Juan Fortea et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01373-5/abstract

Linked to a new Lancet study.  “Dementia prevention is becoming a testable public health strategy. The 2024 Lancet Commission on dementia prevention, intervention, and care estimated that about 45% of dementia cases might be prevented or delayed by addressing 14 modifiable risk factors.  Because the distribution and impact of these factors vary across populations and might be higher in Latin America, interventions based on diet, exercise, social engagement, and vascular care cannot simply be transferred from high-income settings to Latin America without cultural and contextual adaptation. The LatAm-FINGERS trial reported in The Lancet rises to this challenge, showing that a rigorously adapted multidomain intervention can deliver cognitive benefits in precisely the populations with the greatest potential to benefit…. “

HPW – A Regional Approach to HPV Vaccine Design Can Advance Equity and Cervical Cancer Elimination

M Cavaleri; https://healthpolicy-watch.news/a-regional-approach-to-hpv-vaccine-design-can-advance-equity-and-cervical-cancer-elimination/

“HPV vaccines have transformed cervical cancer prevention, but the next generation of vaccines must better reflect regional disease patterns, including the HPV35 genotype prevalent in Africa.  “

Social & commercial determinants of health

Critical Public Health -Framing nico-colonialism and nico-genocide: a critical public health review of the tobacco industry’s role as a commercial determinant of health

Raglan Maddox et al;  https://www.tandfonline.com/doi/full/10.1080/09581596.2026.2697536

“This critical essay (re)frames the commercial tobacco and nicotine industry as a structural mechanism of settler colonial violence, contributing to the systemic elimination of Indigenous peoples. It introduces the concepts of nico-colonialism and nico-genocide to name these harms with greater conceptual precision….”

BMJ Analysis – Adolescent social media restrictions: are we missing the bigger picture?

https://www.bmj.com/content/394/bmj-2026-100084

“Amrit Kaur Purba and colleagues argue that the effects of adolescent social media restrictions are not simple and need to be considered within social, technological, commercial, and political contexts.”

Among the key messages: “Adolescent social media restrictions should be understood as complex systems interventions rather than isolated behavioural policies. As well as the intended benefits, restrictions may generate unintended consequences, adaptive responses, and unequal effects across populations. Lessons from other commercial determinants of health such as the tobacco and alcohol industries can help predict how social media companies may adapt politically, scientifically, technologically, and economically after regulation….”

Mental health & psycho-social wellbeing

Lancet Regional Health Africa – Suicide mortality across Africa, 1990–2023: temporal, demographic, subregional, and national patterns from the Global Burden of Disease

Giloume Van Der Walt; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00084-2/fulltext

Findings: “Africa’s suicide burden is large, geographically patterned, and concentrated among men, with a persistent sex gap across all ages. Wide UIs across most estimates (particularly for temporal change) limit conclusions about trends and reflect gaps in underlying mortality data.”

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00084-2/fulltext

Nature Health -Mental health hospitalizations associated with sustained extreme heat in multiple countries

Yanming Liu et al; https://www.nature.com/articles/s44360-026-00166-2

“In an analysis of more than 2 million hospitalizations during warm seasons in four countries, extreme and prolonged heatwaves were associated with increased risk of hospitalization for mental and behavioural disorders.”  The countries: Brazil, Canada, Chile and New Zealand.

Sexual & Reproductive health rights

IHP – Pads without pipes: India’s menstrual health crisis is above all an infrastructure failure

K Babbar & A Kakkat; https://www.internationalhealthpolicies.org/featured-article/pads-without-pipes-indias-menstrual-health-crisis-is-above-all-an-infrastructure-failure/

“Walk into almost any government school in India and you will likely find a toilet block for girls. On paper, the progress is real: the government’s own school-records system, the Unified District Information System for Education, (UDISE+) 2024–25 data, which tracks every recognized school in the country, reports that 97.3% of schools have girls’ toilets, 99.3% have drinking water, and 95.9% report handwashing facilities. These figures are showcased as markers of how far school sanitation has come, most of that gain arriving over the past decade, after the 2014 Swachh Bharat: Swachh Vidyalaya drive to build toilets in every government school. But ask an adolescent girl what happens when she gets her period at school, and a different story emerges. Behind the signage lie broken or missing disposal bins and dry taps; incinerators installed during high-profile drives often sit unused for want of maintenance. Left with no dignified option, a girl changes her pad, wraps it in newspaper, carries it out in her bag, and hopes no one notices. This is the norm, not the exception, and it points to a misdiagnosis at the heart of our menstrual health agenda. We have treated menstruation as a product-distribution problem, when it is, above all, an infrastructure failure….”

TGH – Making AI Tools Work for Low-Resource Maternity Wards

S Kanayan; https://www.thinkglobalhealth.org/article/making-ai-tools-work-for-low-resource-maternity-wards

“A Cambodian physician argues that artificial intelligence can help improve maternal health outcomes, but only if accompanied by structural reforms.”

“… In my experience, real-world implementation depends on three things that no algorithm can substitute for: reliable infrastructure, including connectivity and functioning devices; clinical staff with the training and protected time to interpret and act on AI outputs; and institutional governance structures that give the tool a functioning system to work within. Without all three, the tool runs but does not function….”

Access to medicines & health technology

Economist – Eli Lilly is reinventing the pharma business

https://www.economist.com/business/2026/07/15/eli-lilly-is-reinventing-the-pharma-business

“The world’s largest drugmaker is betting big on preventive medicines—and learning from big tech.”

“In an interview with The Economist, Mr Ricks laid out a grander plan. He wants to turn his company into a different kind of drugmaker: one focused on keeping people healthy rather than simply treating disease, while borrowing ideas about business from Silicon Valley….” “ Lilly’s rapid rise in obesity drugs helps explain its confidence….”

“… For Lilly, however, there is a bigger prize than slimming waistlines. GLP-1s are proving useful beyond their original purpose, reducing the risk of cardiovascular disease, sleep apnoea and chronic kidney disease. Early evidence suggests they may also help with addiction and psychiatric illness. Now the big question for Lilly is: can its medicines prevent maladies from developing in the first place?…” “The pursuit of prevention is shaping Lilly’s pipeline. …”

“… The model comes with plenty of challenges, Mr Ricks admits. Today’s health-care systems, he says, are designed to treat illness, not prevent it. Then there is the thorny question of who pays. The costs of preventive medicines are immediate, but the savings may not emerge for years, making them difficult for insurers to value and reimburse. Prevention also risks over-diagnosis and over-treatment, raising difficult questions about who should receive medicines, and when. A business built on prevention has to stay much closer to patients than pharma traditionally has. It must persuade people to start treatment earlier, make medicines easy to obtain and keep them on therapy for years. That is why Mr Ricks increasingly talks about Lilly less like a drugmaker and more like a technology company, emphasising a frictionless customer experience and the creation of platforms….”

“…Mr Ricks describes GLP-1s not as a product but as a platform—a common foundation on which multiple medicines can be built by adding other hormones…”

Human resources for health

International Health – Nurses’ social responsibility and health system strengthening for equity in low- and middle-income countries 

https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihag070/8733709?searchresult=1

By Muhammad Asad Ullah et al.

AI & health

·         Via  Devex@AIforGlobalGood Summit:  

(10 July)  “Alongside the AI for Good Global Summit this year were the World Summit on the Information Society, or WSIS, Forum and the inaugural United Nations Global Dialogue on AI Governance. The confluence of events — not accidental, in case you hadn’t guessed — transformed Geneva into the center of the global AI conversation….”

“From AI policy to development policy: Guterres called for a $3 billion global fund for AI to help LMICs build computing capacity, data infrastructure, and digital skills. The proposal reflects a growing recognition that without deliberate investment, the AI divide could become the next great development divide.”

“Several conversations in Geneva suggested the challenge goes well beyond expanding access to AI.  At a roundtable conversation, Ryan McMaster, deputy director of international relations and policy planning at the Gates Foundation, argued that AI policy and development policy are still treated as separate conversations, at least in Washington, D.C., where he is based. That distinction, he said, won’t hold for long.  Countries may gain access to AI tools that improve agriculture, weather forecasting, or public services. But much of the wealth created by AI — from breakthroughs in pharmaceuticals, advanced manufacturing, robotics, and new materials — is likely to accrue where frontier AI, or the most cutting-edge AI models and systems, is developed and controlled.      In other words, the biggest development question may not be who gets to use AI, but who owns the technologies that generate the next generation of innovation, productivity, and economic growth. “The frontier AI policy conversation will become development economic policy at some point,” McMaster said….”

Nature Health – Global analysis of country-level factors associated with chatbot usage for health

P Schoenegger et al; https://www.nature.com/articles/s44360-026-00174-2

“An analysis of 1.7 million health-related conversations with Microsoft Copilot in 109 countries reveals heterogeneous patterns in usage and type of query, varying with respect to income levels, age structure and trust in healthcare and governmental systems.”

Miscellaneous

Nature (Editorial) – Why there needs to be a global debate on inequality

https://www.nature.com/articles/d41586-026-02147-7

“Researchers have a responsibility to search for consensus on this crucial issue, both for future generations and the future of our planet.”

Coming back on the ‘Global Justice report’ (by Piketty et al)

PS: “… the Global Justice Report comes at a time when many countries are becoming concerned about inequality and looking to researchers for answers. Between 2000 and 2024, the richest 1% of people captured 41% of all new wealth created in the world, according to a report on the state of knowledge on inequality that was published last year under South Africa’s presidency of the G20 group of the world’s 20 largest economies (see go.nature.com/4wrehdz).  Mindful of the disagreements among researchers, the G20 report’s authors, led by economist and Nobel laureate Joseph Stiglitz, recommended the creation of an international panel on inequality similar to the Intergovernmental Panel on Climate Change (IPCC). … “

“The inequality panel is expected to get the green light from the UN in September. Imraan Valodia, an economist at the University of the Witwatersrand in Johannesburg, South Africa, who is on the panel’s founding committee, says members will work on the causes and consequences of inequality, among other things. The founders want researchers representing diverse backgrounds to participate in the panel’s activities. Disagreement in research is healthy and often necessary. But with so much at stake, and with little time to lose, policymakers are asking the research community for the best available shared understanding.  The authors of the Global Justice Report could readily plead guilty to utopianism (or idealism), safe in the knowledge that they have made a significant contribution to an important debate. All those who have relevant knowledge need to engage with the work of the inequality panel and help to guide its conclusions. The alternative — sitting still amid mounting social, economic and environmental problems — is not an option, not least because it will be an injustice to future generations.”

Papers & reports

Scientific Reports – Profound health inequalities between Sub-Saharan Africa and other world regions: a comparative analysis

Ping-Ying Wei et al; https://www.nature.com/articles/s41598-026-62287-8

“ This analysis provides an up-to-date comparison of health inequalities in Sub-Saharan Africa to inform evidence-based global health policy, resource distribution, and collaborative international action… … The findings reveal striking and statistically significant disparities across nearly all indicators examined. Sub-Saharan Africa exhibited substantially higher incidence of tuberculosis and malaria, markedly elevated maternal and neonatal mortality, greater mortality attributable to unsafe water, sanitation and hygiene (WASH), air pollution, and violence, alongside profound shortages in health workforce density and service coverage. …”

Nature Health – Associations between male child marriage and intimate partner violence across low- and middle-income countries

S Chen et al ; https://www.nature.com/articles/s44360-026-00169-z

“Using Demographic and Health Survey data from 154,051 men across 41 low- and middle-income countries, this study reports that marriage before age 18 years among young men is associated with higher odds of physical intimate partner violence perpetration and victimization in adulthood, varying by national gender inequality and income.”

Tweets  (via X, LinkedIn & Bluesky)

Pete Baker  (CGD)

“The Global Fund’s 55th Board Meeting finished on Friday. The documents are not yet fully out. But the key decision document has been released (prematurely?).  Of note you can see the global fund working to scale up its capacity and increase its flexibility for “Non-Global Fund-Financed Procurement”.

Presumably this is to:
1) to allow for countries that receive financing under the US MOUs to procure through the Global Fund, as the US seems to wish.
2) position itself as a key procurement agency for other financing flows during this year of debate on global health architecture reform.     “

Catherine Kyobutungi

“A message that’s staying with me from the #AccraReset in Dakar: “Sovereignty is not a slogan. It is a discipline of delivery.” Simple words, but they cut right to the heart of what’s often missing in development conversations — the follow-through.”

“Too often, sovereignty is invoked as a talking point rather than practiced as a discipline. This gathering is a reminder that real sovereignty is earned through consistent delivery, institutional capacity, and the courage to execute — not just the language we use to describe our ambitions.”

Ian Mitchell

“The FCDO has just published its 3-year spending plans by country. And no wonder they held it back to the last day before Parliament’s summer recess because it lays bare the brutality of the reductions.

One stand-out is that in 10 of the UK’s 17 African partners the budget is being cut to a de minimis level. Those countries are home to over 130m people in extreme poverty and this is a decision to significantly reduce the UK’s role on the continent.  The UK is set to spend barely above 0.2 percent of GNI on international assistance. That’s an all-time low and insufficient for a country that says it’s serious about an international role.”

Earlier this week, at the High-level section of the High-Level Political Forum on SDGs in New York, General Assembly president Baerbock ended her speech with a comparison between the SDGs and this year’s football World Cup competition: “It has told us very clearly one thing: to never give up at minute 80.” “One goal at the right moment can change everything. And 17 goals at the same moment can change the world. It is up to us to play the last four years together.”   Well, maybe, and at minute 85 great things can still happen too, but 17 goals is still a bit much to pull off. At the very least, you probably need a thorough change of strategy, given that ‘accelerating’ the SDG agenda isn’t exactly working out. Indeed, the only things ‘accelerating’ for the time being, seem to be (1) AI,  “…. as a technology that simultaneously affects all industries and turbocharges extraction based economic models, including in agriculture, fisheries, and forestry….” (cfr an apt quote at the recent United Nations dialogue on AI governance in Geneva); (2) wars & conflicts and (3) the climate emergency ( in a recent Nature Comment, I learnt about  ”‘Climate free fall’, “the biggest risk to our economies yet to be recognized”). Nevertheless, I do agree with the UN’s “Don’t Give up”  mantra – and as mentioned before, Peter Gabriel & Kate Bush’s ‘Don’t Give Up’  would make a neat soundtrack in the final years before 2030 (and many years after).

In other news vaguely related to the World Cup, the so called ‘wisdom of the crowds’ (via the dodgy prediction market ‘Polymarket’)  on the question ‘Who’s going to win the World Cup’ ?, went in just a few hours from ‘France: 37.8 %’ to ‘Spain: ‘58 %’.  Tells you all you need to know about the ‘wisdom of the crowds’ : )  (and count me in, even if I didn’t place a bet obviously). 

The summer edition of the Solidarity Levies taskforce  newsletter features a number of interesting suggestions for Gianna Infantino and policy makers worldwide (certainly including ‘global health reformers’). They point to Denmark as a role model lately ( the country is  moving towards a levy on private jets and cruise ships), but also argue, “The FIFA World Cup highlights the case for premium flyer levies”. Among others, dare I say.

But there was much more global health news this week. 

14 July marked the official opening of the World Health Organization Office in Tokyo, an important milestone in strengthening collaboration between WHO and the Government of Japan. “The WHO Office in Tokyo will also host the UHC Knowledge Hub—an innovative, country-led initiative designed to strengthen health financing systems in LMICs in support of UHC.  Established jointly with the World Bank and with the support of the Government of Japan, the Hub serves as a global platform for knowledge exchange, technical cooperation, capacity building, and supporting countries on their path toward achieving UHC.”

The Ebola emergency  still outpaces the response and sounds  really worrying (as well as underfunded). It’s now the  fastest-growing Ebola outbreak in history. We also come back on a rather important Global Fund Board meeting from last week (9-10 July). In the category ‘cringy global health communications’ (or at the very least not connecting many dots), some brilliant EU staffer came up with a ‘Team Gaza Initiative’ , while UNAIDS ‘mourns the passing of Senator Lindsey Graham’. The latest PABS round ends today in Geneva (17 July) (with some progress being made it seems). And oh yes, Warren Buffett dropped the Gates Foundation from his annual donations, a bit earlier perhaps than anticipated as the  results from the external review on the Epstein links, commissioned by the Gates Foundation, aren’t in yet. Apparently Buffett “extensively reviewed information about Gates’ relationship with Epstein before deciding to overhaul his charitable giving” (cfr interview with CNBC).

Speaking of Bill, we’d like to flag an informative post by him on LinkedIn, “ “AIDS-free” generation is no empty promise”, listing three good reasons why this is the case. Unfortunately, towards the end of his post, Gates still ‘misunderstands’ the problem as  “Governments are cutting funding for global health”. Any global tax justice (& democracy/social contract) expert will tell you that’s putting the cart before the horse. It’s not because Bill claims otherwise 200 billion times, that it becomes any more true.

Last but not least, we flag a few must-read blogs related to the global health reform discussions (eg at last week’s pre-Board Global Fund panel discussion on the evolving global health ecosystem; whereas this week an Accra Reset High-Level Panel retreat  is ongoing in Dakar).

Habib Benzian published a lovely and as always slightly poetic post on the  ‘epidemic mind of global health’, “The Diseases Global Health Can Hear “. Partly inspired by his (not so big) “surprise” that even in the year 2026, NCDs aren’t exactly top of mind in the ongoing global health architecture reforms.

In a slightly different style, and reacting to a TGH article, Andrew Harmer came up with a neat ‘Gladiator’ comparison in his latest blog, ‘Reforming WHO: some Considerations for an ex-Acting Director General’, in which he zooms in on WHO’s operational role. He’s not mincing words.

PS: we already want to draw your attention to an Extraordinary African Union Summit on Health which will be held in Accra (from July 21 to 22).

Enjoy your reading.

Kristof Decoster

·         PABS negotiations – a new round

·         Ebola emergency: WHO/Africa CDC messages

·         Ebola emergency: more analysis, news snippets…

·         HLPF in New York & SDGs

·         Global Health Reform, future of international cooperation & post-2030 brainstorm

·         More on Global Health Governance & Funding/Financing

·         Journey towards Health Sovereignty

·         Trump 2.0, US Global Health Strategy & bilateral health agreements

·         World Cup Football

·         NCDs & Commercial determinants of Health

·         SRHR

·         Child Health

·         NTDs

·         Planetary Health

·         Access to Medicines, Vaccines & other health technologies

·         Digital Health & AI and health

·         Miscellaneous

PABS negotiations – a new round  (6-17 July)

Seventh meeting of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement  (hybrid, Geneva)

We start with some primers by Geneva Health Files as the new round was about to kick off on Monday.

And then continue with great coverage/analysis (drawing upon colleagues from HPW, Devex, Geneva Health Files, …). And at the end, more academic analysis (peer reviewed articles).

Geneva Health Files – PABS Primer: The State of Play for the July Negotiations at The WHO

https://newsletter.genevahealthfiles.com/pabs-primer-the-state-of-play-for-the-july-negotiations-at-the-who/?ref=geneva-health-files-newsletter

(July 3) “a quick primer ahead of the forthcoming negotiations on the Pathogen Access Benefits Sharing system at the WHO in Geneva next week. …”             A few excerpts & quotes on what to expect in July:

“Countries have had bilateral consultations, and also had a round of informal discussions in late June 2026 ahead of these formal negotiations. … According to our intersessional reporting during this period, many delegations appear to be of the view that no real concessions will be given during the July meeting. There is now a tendency to buy more time, sources said.”

“Many expect a discussion also on process in order to streamline discussions in a bid to bring positions closer…. Diplomatic sources told us that developed countries, among others, continue to be keen to use a hybrid approach to share information, where countries can opt whether to provide the access to information without conditions, or alternatively to make it conditional but follow a different track. This has variously been referred as a blended or an integrated model, sources said. Because such an approach has not been formally tabled at the IGWG, many delegations are unable to comment on whether they see this as a potential landing zone, sources told us. But many agree that having “a breakthrough” on access matters in July will be key to the eventual success of these negotiations, diplomatic sources across different delegations share this view.”

“… The Ebola emergency provides for an unfortunate, but a live case for negotiators to test their positions and assumptions on how information, both data and biological samples, must be shared. The emergency has ripped apart, and thrown open the lack of adequate capacity, preparedness, lack of rules on information sharing, and access to benefits – matters that speak to the heart of the PABS mechanism.  And yet, it seems countries are drawing different lessons from the same emergency – some pushing for seamless access to information, and others pointing to the need for assured benefits during an emergency. “

PS: “More than a dozen civil society organizations are building pressure on developed countries for their positions in these negotiations. A  complaint letter was sent this week, to the United Nations (UN) Special Rapporteur on the Right to Health Concerns Over the Role of the European Union, Norway, Japan and Switzerland in the PABS negotiations….”

Geneva Health Files  – How a Live Debate on the Sharing & the Access to Pathogen Information Could Affect Negotiations Over a Rules-Based System at the WHO

V Venmetsa & P Patnaik;   Geneva Health Files;  

(6 July) (open access) “There are three parts to this edition.  Indications on information sharing from current outbreaks; Questions it raises for PABS negotiations; Views from experts.”

A few excerpts to provide you with a flavour from this must-read analysis, freely available.

Re the latest Ebola emergency: “… This piece traces how that information moved – through formal databases and bilateral channels – and what that movement reveals about the unresolved questions in the negotiations on WHO’s Pathogen Access Benefits Sharing (PABS) System. The access to information is a key area that needs an urgent breakthrough in these negotiations….”

Among others, zooming in on the role played by Pathoplexus: “Pathoplexus is Switzerland-based non-profit association hosting more than 200,000 sequences. It offers submitters a choice: immediate open sharing, with automatic transfer to INSDC (the open International Nucleotide Sequence Database Collaboration); or open access with a time-limited use restriction of up to one year – after which the data auto-transfers to INSDC. The Kinshasa’s INRB and Kampala’s CPHL teams chose the latter…..”

“… For PABS and broader policy discussions, we believe this is a central insight: access to pathogen sequence data for legitimate public health and research purposes should be preserved, even when other use terms (like commercial applications or publication rights) may require specific benefit sharing. Sequences shared under Restricted Use on Pathoplexus demonstrate that this is possible and encourages the rapid sharing of pathogen data….

“… A benefit-sharing system designed around the physical transfer of samples, the architecture of the older Pandemic Influenza Preparedness Framework – maps poorly onto a world in which the scientifically actionable information is the sequence, and the sequence is everywhere….”

PS: “… In addition, national public-health laboratories operate under domestic legal, ethical and administrative requirements. Scientists may not have independent authority to release clinical or outbreak data internationally…” ….

“Experts and stakeholders (also) draw attention to the GISAID model of operation. …”

GHF then discusses how American Actors Got Access (via two mechanisms).

And lists some of the issues that negotiators must address.

The article ends by giving an overview of the gist of the discussion recently organized by the Global health Centre, The Geneva Graduate Institute (June 30)  (on  Sharing Pathogen Data in Ebola and Hantavirus Outbreaks: Implications for Pathogen Access and Benefit Sharing).

HPW – Africa Asserts Itself as Pandemic Agreement Talks Resume

https://healthpolicy-watch.news/africa-asserts-itself-as-pandemic-agreement-talks-resume/?feed_id=938&_unique_id=6a4b6d1c98544

(6 July)  Must-read on the opening day.

“The Pandemic Agreement talks resume at the World Health Organization’s (WHO) headquarters on Monday (7 July), kicking off immediately with a closed session on how to share specimens of pathogens with pandemic potential. While those close to the talks say that slow progress is being made, the 10-day negotiations (which ends 17 July) are unlikely to result in an agreed pathogen access and benefit-sharing (PABS) system just yet.”

“Africa is asserting itself in several global platforms, insisting on measures to level the playing field to ensure that the citizens of its 54 countries have better access to medicines, vaccines and diagnostics.  However, the continent’s demands are being met by the same obstacles that it faces in the PABS talks: an insistence, particularly by countries with powerful pharmaceutical interests, that intellectual property rights need to be respected….”

(with some recent examples of Africa’s stance as a ‘block’, eg in the political declaration on HIV/AIDS, and opposition from the likes of Switzerland and others).

The article then provides some of the key inputs from the opening day (re the ‘hybrid model’ and far beyond), among others by a Pathoplexus representative, South Centre, IFPMA, KEI.   Very insightful.

Geneva Health Files – Binding Benefits, Open Data and Innovation: PABS Fault Lines Return, Positions Fierce as Negotiations Resume

A Rosario & P Patnaik; https://newsletter.genevahealthfiles.com/binding-benefits-open-data-and-innovation-pabs-fault-lines-return-positions-fierce-as-negotiations-resume/?ref=geneva-health-files-newsletter

(8 July) Quick update on the negotiations (as of Wednesday morning).  (Do subscribe to GHF!)

Excerpts: “Opening statements made at the meeting, revealed broad support for the need for a PABS system, but showed considerably less agreement on how the access to pathogen materials and sequence information should be legally connected to benefit-sharing. Formal statements indicate that positions continue to be entrenched, and have become more fierce.  African and Caribbean countries called for standardized and legally binding obligations, including mandatory monetary contributions, traceability and technology transfer. The European Union placed greater emphasis on preserving incentives for private-sector research and innovation. Relevant stakeholders were similarly divided over how much legal and technical friction could be introduced without slowing scientific collaboration during an outbreak….”

“The opening statements made by countries (see below) identify five issues likely to determine whether the additional negotiating period produces an agreement.  The first is conditionality: whether access to pathogen materials and sequence information can occur before a user assumes binding benefit-sharing obligations. The second is differentiation: whether manufacturers, academic researchers, public laboratories, commercial databases and other users should face different obligations.  The third is traceability: whether unique identifiers and database terms can provide meaningful accountability without creating barriers to rapid and open research. The fourth is equity in manufacturing: whether the annex merely allocates finished products during emergencies or also changes where, by whom and under what licensing conditions those products can be developed and manufactured.  The fifth is political procedure: whether the additional negotiating time will produce convergence or reinforce calls to consider voting if consensus remains unreachable….”

“The annex will ultimately have to reconcile two forms of urgency. One is the scientific need to share pathogen materials and information immediately. The other is the political demand that countries sharing those resources should not again be asked to wait for vaccines, technology, financing and other benefits after a crisis has already begun.”

Lancet Regional Health Africa (Comment) – Equitable access to pathogens and countermeasures: is the pandemic agreement’s pathogen access and benefit-sharing system the answer to Africa’s future health security?

Adebisi Adenipekun et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00092-1/fulltext

“Beyond the outcome of PABS negotiations, Africa’s long-term health security will depend on strengthening four interrelated priorities: a robust R&D ecosystem; sustained investment in human capital; effective and equitable technology transfer; and stronger continental collaboration and coordination. These priorities are essential for building resilient systems capable of preventing, detecting, and responding to outbreaks, including those that may not immediately attract global attention. While the PABS system seeks to address inequities in access to pathogens and resulting benefits, broader structural investments will ultimately determine Africa’s preparedness for future health emergencies….”

“…. These priorities were highlighted during discussions at the Africa Pandemic Sciences Collaborative Annual Policy Forum, convened on the margins of the World Health Summit Regional Meeting in Nairobi, Kenya, in April 2026. The forum brought together academics, policymakers, funders, and other stakeholders to strengthen collaboration to translate scientific evidence into practice in Africa and agreed on a call to action ….”

London Review of International Law – Coercive containment of the Africa Group’s Equity Agenda in the WHO Pandemic Treaty negotiations

S J Lake et al; https://academic.oup.com/lril/advance-articles

“Calls to make global health more equitable are laudable but limited by philosophical idealism that obscures how the legal form of health relations between states forecloses equity. Analysing the Africa Group’s equity agenda in the WHO Pandemic Treaty negotiations, we illustrate how the group’s demands for equity were first absorbed into the dominant development rationality, which diluted their transformative potential, and then coercively contained through force. The result is a treaty that affirms equity rhetorically while hollowing it out juridically. Building on and extending Sundhya Pahuja’s account of international law’s ‘critical instability’, we theorise coercive containment as a structural feature of global health law. When Global South claims cannot be ideologically contained, coercion restores stability while preserving inequality. We, therefore, offer a critical account of global health law’s limits in redressing injustice and warn against idealising multilateralism as a path to global health equity.”

Graduate Institute (Global Health Centre) – Spotlight on process: lessons for PABS from other multilateral negotiations: workshop report

https://repository.graduateinstitute.ch/record/322048?v=pdf

“On 22 June, we convened the workshop “Spotlight on Process: Lessons for PABS from Other Multilateral Negotiations.”  Read the resulting report, highlighting lessons from past negotiations that may help inform the ongoing PABS process…”

HPW – An Equitable Pandemic Agreement is a Global Public Good

M Masisi & M Weinstein ; https://healthpolicy-watch.news/an-equitable-pandemic-agreement-is-a-global-public-good/

High-level advocacy. “As the WHO Intergovernmental Working Group reconvenes in Geneva in the quest to nail down an accord on Pathogen Access and Benefit-Sharing (PABS), the former President of Botswana and the President of AIDS Healthcare Foundation argue that this critical annex to the 2025 Pandemic Agreement needs to ensure benefit-sharing commitments are just as mandatory and enforceable as commitments around rapid and transparent pathogen sharing.”

Ebola emergency: WHO/Africa CDC messages

Africa CDC – In Kinshasa, President Tshisekedi Leads Ebola Response Push as President Ramaphosa Brings African Solidarity

https://africacdc.org/news-item/in-kinshasa-president-tshisekedi-leads-ebola-response-push-as-president-ramaphosa-brings-african-solidarity/

(2 July)   “The President of the Democratic Republic of the Congo, H.E. Mr Félix Antoine Tshisekedi Tshilombo, today welcomed the President of the Republic of South Africa, H.E. Mr Cyril Ramaphosa, to the Institut National de Recherche Biomédicale in Kinshasa for a high-level meeting focused on accelerating the Ebola response in the DRC and mobilising African support around the country.  The meeting, convened by Africa CDC in support of the DRC authorities, brought together the two Heads of State, Africa CDC Director General Dr Jean Kaseya, and senior representatives of the World Health Organization, the World Bank, the European Union, the United Kingdom and other partners engaged in the response….

PS: “The meeting also confirmed that significant resources have been committed. The Government of the DRC has committed US$50 million to the response. South Africa has committed US$13.5 million. The World Bank announced an additional US$10 million, building on its existing US$63 million commitment. The European Union, the United Kingdom and other partners also reaffirmed their support to the response.  The joint Africa CDC–WHO continental preparedness and response plan estimates Ebola and health response needs at US$518 million. Commitments announced exceed this amount, but only 21% of funds had been released according to data presented. The priority now is to turn commitments into rapid operational support for teams on the ground, affected communities, clinical trials, surveillance, laboratories, points of entry and regional preparedness….”

Cidrap News – Ebola deaths top 500 as DR Congo health workers threaten to strike

https://www.cidrap.umn.edu/ebola/ebola-deaths-top-500-dr-congo-health-workers-threaten-strike

(July 6) “The Ebola outbreak in the Democratic Republic of the Congo (DRC) has reached another grim milestone, as 506 people have now died from the Bundibugyo strain of the virus, which has no targeted treatments or vaccines. “

“… Yesterday healthcare workers in Ituri issued a 24-hour notice of an impending strike, saying working conditions were too poor to continue. They reported unpaid benefits, low wages, and inadequate supplies since the outbreak officially began in May.   The strike could hinder the execution of two experimental therapies that were launched this past week in the DRC. Enrollees will be given the antiviral drug remdesivir, the experimental antibody treatment MBP134, or a combination of both, with survival rates calculated during a 28-day follow-up period. …”

PS: “… In related news, the World Health Organization (WHO) also added the first diagnostic test for the Ebola Bundibugyo virus to its emergency use listing. The test can quickly confirm infection in blood samples. “

·         See also Bloomberg – Ebola Health Workers Strike in Hardest-Hit Congo Towns as Outbreak Intensifies (8 July) 

Reuters – Ebola outbreak in Congo still spreading, WHO says

https://www.reuters.com/world/africa/ebola-outbreak-congo-still-expansion-phase-who-says-2026-07-07/

(7 July)  “Some Ebola treatment centres are nearly saturated; Virus spreading through miners who return home sick, WHO says; Over 500 people killed since outbreak declared in mid-May.”

“The Ebola ‌outbreak in Congo has not yet stabilised and is still expanding as population movement fuels transmission, a World Health Organization official said on Tuesday. The Democratic Republic of Congo has confirmed 1,561 cases, including ​506 deaths, in the worst-ever outbreak of the rare Bundibugyo species ​of Ebola, for which there is no proven treatment or ⁠cure. … … “It is still in the expansion phase, unfortunately. We would like to ​say it is stabilising but, frankly, we cannot say it yet,” Anne Ancia, ​WHO representative in Congo, told reporters by video link from Bunia, at the epicentre of the epidemic….”

UN News – World must move faster on Ebola response for DR Congo: UN relief chief

https://news.un.org/en/story/2026/07/1167910

(9 July) “The world must move faster to contain the spread of Ebola in the Democratic Republic of the Congo (DRC), UN relief chief Tom Fletcher said on Thursday.  Mr. Fletcher warned that while Ituri province remains the centre of the outbreak, the virus is spreading to other provinces due to conflict and displacement….”

Ebola emergency: more analysis, news snippets, …

Telegraph – Witchcraft and WhatsApp: The fight to contain Ebola misinformation

Telegraph;  

“Huge groups on messaging apps, where many share voice notes because many cannot read, are a major conduit for information about the outbreak.”

NEJM (Perspective) – Ebola at 50 — Lessons for Outbreak Response and Preparedness

A Zumla, P Piot, J-J Muyembe et al ; https://www.nejm.org/doi/full/10.1056/NEJMp2607819?query=featured_home

“…The current outbreak highlights enduring lessons from Ebola’s history, which has been shaped as much by scientific recognition, community trust, research governance, sample ownership, and equity as by virology and outbreak control. The history of Ebola is still often narrated through the lens of laboratory discovery in Europe and North America, but this narrative is incomplete. A more accurate account begins with partnerships among clinicians, nurses, public health workers, affected communities, national investigators, and international laboratories, and ultimately between responders and the populations they serve….”

Listing 8 lessons.

Stat Opinion – What if this Ebola outbreak can’t be stopped?

I B Gayton et al ; https://www.statnews.com/2026/07/07/ebola-outbreak-drc-uganda-endemic-control/

“The greatest risk is not that this outbreak spreads. It is that it never ends.”  (authors were involved in previous Ebola outbreaks)

“… The risk of all this is that Ebola becomes endemic, continually threatening millions in Central Africa while periodically casting sparks into the rest of the world. Once that future arrives, the authors argue, containment will become a recurring expense and control will be impossible….”

Guardian – What will define Elon Musk’s legacy? Doge cuts to USAID Ebola programs

Melody Schreiber;  https://www.theguardian.com/technology/2026/jul/07/elon-musk-doge-cuts-usaid-ebola

“Experts say cuts have hindered the response to DRC’s Ebola outbreak and resulted in ‘significant numbers’ of deaths.”

“Elon Musk has an Ebola problem. SpaceX stock dropped precipitously after its initial public offering, and Tesla faces a wave of lawsuits. But instead of focusing on his companies, Musk has posted frequently on X about the US Agency for International Development (USAID), which he helped dismantle – or, in his words, feed into the woodchipper – last year.  “Elon’s USAID crash-out over the past week has been a thing to behold,” said Jeremy Konyndyk, a former top USAID official who oversaw the agency’s Ebola response in 2014-2015 and the president of Refugees International. “In a way, it’s helpful that Elon is doing this, because it’s putting attention back on the issue of what he did last year.”…”

“… Musk’s cuts, through the short-lived US “department of government efficiency” (Doge), have come under renewed scrutiny during the Ebola outbreak in the Democratic Republic of the Congo (DRC). Last year, Musk admitted to “accidentally” cutting Ebola detection and response programs….”

Plos GPH (Opinion) – The Bundibugyo Ebola Virus Emergency and the erosion of global health security

Boghuma K. Titanji; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006648

Quotes: “…. reforming a system is not the same as dismantling it in the middle of an emergency, and partnership is not a contract signed under duress that trades a population’s health data for access to its minerals. Self-reliance built by withdrawing support before any alternative exists is not sovereignty; it simply transfers the risk onto those least able to absorb it….”

“As we watch the events unfold in the DRC, it is increasingly evident that a global community of 8 billion people cannot keep itself safe without solidarity and international collaboration. The recurring cycle of neglect followed by reactive, after-the-fact response continues to reveal itself as a model that will never succeed…”

PS: “… The US holds a patent covering the virus isolated during the 2007 outbreak, tied to research and development of vaccines and therapeutics, yet no vaccine for this virus exists today, nor was its development ever prioritized. The existence of a patent is not the same as a development pathway – it is evidence that scientific capacity existed, while the political and commercial incentives to move a product forward did not. The parallels with the Ebola epidemic in West Africa are glaring. ….”

Euractiv – Commission nudges EU countries to launch Ebola drug trials

https://www.euractiv.com/news/commission-nudges-eu-countries-to-launch-ebola-drug-trials/

(gated) “No EU-based manufacturers are currently being considered by the WHO.”

Devex –   Can the Ebola response avoid another sexual abuse disaster?

https://www.devex.com/news/can-the-ebola-response-avoid-another-sexual-abuse-disaster-112821

“The last major Ebola outbreak was marred by widespread sexual abuse and exploitation by many aid workers against the people they were purportedly there to help. Is the humanitarian sector doing enough to ensure it doesn’t happen again?”

PS:  “… WHO says this time is different. In 2021, it began “an intensive period of reforms and action,” including adopting a new strategic framework, said Tarik Jašarević, a WHO spokesperson. He noted the agency has “zero tolerance” for inaction and retaliation against those reporting or bearing witness.  He said efforts to prevent and respond to SEA (sexual exploitation & abuse) are “embedded” in the current Ebola outbreak.  WHO has deployed three experts in preventing and responding to SEA to the field to ensure compliance with agency safeguarding standards, as well as to brief responders, community leaders, and volunteers — in coordination with U.N. partners…..”

“… Additionally, within WHO and Africa CDC’s continental response plan for this Ebola outbreak, preventing SEA is one of the 15 pillars — but this pillar is considered cross-cutting across the response as opposed to a “standalone function.” This wasn’t the case for WHO’s emergency response framework during the 2018-2020 outbreak.  ….”

High-Level Political Forum in New York (7-15 July) & SDGs

UN News – ‘Shared blueprint for peace’: Development goals deliver for billions, but challenges remain

https://news.un.org/en/story/2026/07/1167888

“With fewer than five years left to achieve the Sustainable Development Goals (SDGs), a new UN report says sustained investment and international cooperation have improved billions of lives, but warns that governments must urgently accelerate action if the goals are to be met by their 2030 deadline.”   “The findings come from the 2026 SDG Progress Report, released on Tuesday, which calls the goals “a shared blueprint for peace” while acknowledging the significant political and financial challenges associated with meeting the 17 ambitious targets. …”

Coinciding with the annual report is the High-Level Political Forum on Sustainable Development (HLPF), which kicked off in New York on Tuesday and will run until 15 July. The forum serves as the main UN platform tracking progress on the SDGs.

“… Since 2015, hard-won gains have been made, including:

• Nearly one billion people gaining access to safe drinking water
• 1.2 billion people gaining access to safely managed sanitation
• New HIV infections falling by 30 per cent between 2015 and 2024
• Electricity now reaching 92 per cent of the global population
• Internet access surging from 40 to 74 per cent
• Social protection now covering more than half the global population

Despite those achievements, the report concludes that overall progress remains far too slow:

• One in 10 people still live in extreme poverty
• Food insecurity affects 2.3 billion people
• Maternal mortality remains nearly three times the global target
• In 2025, global temperatures reached 1.43°Celsius above pre-industrial levels
• 273 million children and young people remain out of school
• The global refugee population has more than doubled in the past decade

“Of the 139 SDG targets with trend data, only 36 per cent are on track or making moderate progress. Meanwhile, 49 per cent of them are advancing too slowly and 15 per cent have regressed below 2015 baselines.” 

“ Escalating conflicts, climate change, slowing economic growth, rising debt and a record decline in official development assistance have slowed progress toward the SDGs and disproportionately affected the world’s most vulnerable people, according to the report…..”

Reuters – World must close $4 trillion annual funding gap to reach development goals, UN says

Reuters;

“ Countries around the world must take decisive action to close a $4 trillion annual financing gap to ensure that sustainable development targets set just over a ​decade ago can be reached by 2030, a new United Nations report ‌found….”

PS: “The external debt of low- and middle-income countries reached a record $8.9 trillion in 2024….”

Global Health Reform, Future of International cooperation & post-2030 brainstorm

Partnership for International Politics and Diplomacy for Health – The Promise of Accra Reset

https://globalhealthdiplomacy.se/the-promise-of-accra-reset

Two-pager. (see also A Nordström’s LinkedIn comment from last week)

“July may prove pivotal for the trajectory of reforms of the international system for health. Important developments are underway for the two major reform initiatives:
1. The Accra Reset High-Level Panel will convene in Senegal to draft its report and recommendations;  2. At the same time, WHO Member States are expected to nominate representatives for the joint process on reforming the global health architecture.

“The Partnership for International Politics and Diplomacy for Health have continuously analysed and reflected on trends and perspectives in an ongoing series of Insights papers. Read our reflections on the Promise of the Accra reset here….”

(starting to hum Cock Robin’s ‘The Promise you made’    now : ) )

Plos GPH – Same actors, same processes, same outcomes: Global health architecture reform or restoration?

I D Kantiana, Rahman-Shepherd et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006781

“On 22 May 2026, the 79th World Health Assembly (WHA) adopted the proposal for a joint, inclusive, transparent and time-bound process, hosted by WHO, to support reforms of the global health architecture (GHA). The proposal outlines a process to develop options and recommendations for aligning mandates and capacities of GHA actors with essential GHA functions, and enhancing coordination to strengthen collaboration, accountability and coherence. A 25-member Taskforce, comprising 14 Member State representatives and 11 non-Member State representatives, will develop two reports (interim and final) containing a roadmap for implementation for consideration at the 80th WHA in 2027. We question whether this process is designed to genuinely reform the GHA beyond the status quo by unpacking the composition of the Taskforce, as well as the accountability and scope of the joint process….”

“… While we recognise that the proposal has already been adopted, limiting the extent to which it can be substantively changed, we urge the Taskforce to make four critical adjustments….”

Geneva Solutions – UN reform chief admits structural changes ‘difficult’, rules out further budget cuts

https://genevasolutions.news/sustainable-business-finance/un-reform-chief-admits-structural-changes-difficult-rules-out-further-budget-cuts

“Guy Ryder, who is leading UN chief António Guterres’s reform push, says controversial merger proposals were to assess the merits of fusing organisations, not to force decisions on member states.”

“With just two months left to come up with the United Nations’ biggest structural shakeup, Guy Ryder, chairman of the UN80 reform task force, announced that no further budget cuts will be made while difficult discussions on agency mergers proceed.  “It has been a reform effort to respond to the entirety of the circumstances operating on the UN system, be they financial, be they political,” Ryder said at a press briefing, referring to the major cuts in aid funding, particularly by the UN’s biggest contributor, the United States. The former head of the International Labour Organization said that after the secretariat’s 9.2 per cent budget cut this year – coming on top of a seven per cent reduction in 2025 – no further cuts are foreseen.  “

“Ryder was in Geneva on Tuesday to update member states on the process that had been launched in 2025 by UN secretary general António Guterres.  … … Ryder maintained that Guterres had not pushed for mergers but rather to “make an assessment of whether these would bring benefits or not” and would not force any decisions on member states. The secretary general, however, was determined to “front load” as much of the UN80 plan as possible before the high-level opening of the UN General Assembly in September…..”

Lancet Comment – WHO’s operational role in emergencies: mandate and evolution

R Brennan, R Peeperkorn et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01330-9/abstract

“In the context of worsening geopolitical turmoil, attacks on multilateralism, expanding emergency demands, declining financial resources for global health, and a reforming international system, it is timely for WHO to reassess its mandate, priorities, and comparative advantage in emergencies such as outbreaks, natural disasters, conflicts, and technological emergencies. The Accra Reset, UN80, Humanitarian Reset, the growth of regional public health institutions, and review of the global health architecture provide precisely these opportunities….”

“…The proposal that WHO should withdraw from humanitarian operations when public health stakes are so high, especially for the world’s populations most affected by the impacts of climate, conflict, and disease outbreaks… …. raises serious questions….”

“…WHO’s role in emergency operations has arguably never been more important, given its extensive country presence, trust of governments, wide partner networks, and strong linkages between technical and operational functions.  Rather than debating whether WHO should maintain an operational role, attention should focus on which emergency functions WHO should retain as resources contract and the international system realigns. We propose five priorities. First, WHO’s core functions of coordination, surveillance, outbreak control, and health logistics must be maintained. Second, retaining sufficient operational capacity to act as the provider of last resort in the most severe emergencies is essential. Third, WHO should expand collaboration to build the operational readiness of member states and local partners. Fourth, WHO should convene member states, partners, and donors to identify the gaps likely to emerge as WHO adjusts to a constrained resource environment and explore options to address them. Finally, WHO must engage in sustained, evidence-based advocacy for collective action to ensure that priority health gaps are consistently met in the most severe crises….”

Lancet GH – Lived experience and global health architecture reform: from afterthought to cornerstone

Johanna Ralston et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X%2826%2900161-0/fulltext

“Global health architecture reform is underway, and we are worried. In March 2026, WHO called for comments on its plan to reimagine global health as part of the UN80 process. The first draft of the framework did little to suggest seizing this moment to address root causes and longstanding issues that hamper the impact of WHO. Our greater concern was the absence of any reference to lived experience as either a principle or a constituent group. Despite indications of the WHO commitment to engagement,  the framework made no mention of those whom the new architecture is meant to serve….”

“We are a group of health professionals and advocates from the Global North and South, all living with non-communicable diseases and other chronic conditions. All of us have worked in leadership and expert roles in global health. We share a common sense of exasperation, bordering on outrage, that the insights of the lived experience community are so often an afterthought, even in light of growing evidence to suggest that outcomes are improved when those using the systems aid in their design. There was no meaningful mention of us in the initial proposal or subsequent draft; following our protests, a cursory reference was added to the document that was prepared for the World Health Assembly. At best, we anticipate tokenistic inclusion in later phases.”

“The exclusion in the WHO process of lived experience expertise raises three questions….”

And they conclude: “… To realise a genuinely inclusive and equitable global health architecture, we call for: (1) shared governance (institutionalise lived experience power rather than mere representation in decision-making bodies with equal voting power); (2) accessible participation mechanisms (provide financial and logistical support and simplified processes for lived experience experts to co-work with dignity and agency); (3) redefining evidence frameworks and expertise (lead by example to normalise co-working with lived experience experts, including in monitoring, evaluation, and policy design); (4) accountability systems (commit to meaningful measurement, indicators, and independent review mechanisms to track inclusion and equity commitments toward lived experience expertise); (5) ethical standards for engagement (develop and enforce global norms to prevent tokenism and extractive practices); and (6) localisation of global commitments (ensure that global frameworks translate into tangible, community-level impact, particularly in low-income and middle-income countries)….”

Devex Check-up – Calling Jack

https://www.devex.com/news/devex-checkup-waiver-or-not-us-places-no-gag-rule-conditions-on-global-fund-funding-112867

With an update on UNAIDS reform. “…. Last week, I reported on the latest thinking about the future of UNAIDS. Though far from final, an interim report raised several possibilities: a smaller UNAIDS secretariat; a new setup in which it is hosted by another entity in the U.N. system; or a merger with another global health partnership…..” 

“There weren’t any strong reactions from the board to the ideas presented, although there does seem to be some divergence over the options being explored, I was told. The Nordic countries, along with Austria and the Netherlands, asked that the final recommendations and timeline be “grounded in realism,” noting years of declining funding for the global HIV response and UNAIDS. They also called for a “realistic funding model and well-thought-out timeline” to guide donors.  All this to say, the narrative seems to have moved away from sunsetting UNAIDS in 2026 and toward a more phased transition. UNAIDS Executive Director Winnie Byanyima even pointed to the U.N. secretary-general’s May progress report on the UN80 Initiative, saying the terminology is no longer about sunsetting UNAIDS…..”

“But Paul Janssen, who was the lead author of a 2023 MOPAN assessment of UNAIDS that called for a rethink of the joint U.N. response and the value of the UNAIDS secretariat, tells me the recommendations feel like “rearranging deckchairs on the Titanic.”  Why?  “It seems oblivious of the fact that UNAIDS is actually running out of funds,” he says. He fears the agency is losing so many competent staff that “there will not be much left to transition by 2027.””

PS: “UNAIDS slashed its core operating budget by more than half, from $150 million in 2025 to $63 million in 2026, triggering a massive restructuring and cuts of more than 50% to secretariat staffing. It also had to tap its operating reserves to cover obligations to departing staff. So far, it has raised just $40.8 million for 2026.…”

UNAIDS – Planning for the future at UNAIDS’ 58th Board meeting

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2026/july/20260702_PCB58_future

Press release after the UNAIDS board meeting.

“Just one week after Member States adopted a new Political Declaration on HIV/AIDS at the United Nations General Assembly in New York, the 58th Programme Coordinating Board (PCB) took the next step in shaping how the Joint United Nations Programme on HIV/AIDS (UNAIDS) will evolve to help deliver those commitments.  Building on the renewed global political commitment to end AIDS as a public health threat by 2030, Board members reaffirmed the need for a strong, coordinated global HIV response while advancing discussions on how the Joint Programme should accompany the global response in a changing financial and global health landscape. …”

“Across three days of discussions, Member States, communities and partners broadly agreed that while the current operating model must evolve, the world continues to need strong political leadership, multisectoral coordination, accountability and meaningful community participation. The discussions marked an important milestone in the work of the independent PCB Working Group, which will present final recommendations on the future structure and governance of the Joint Programme in October. …”

PS: “The Report to the Board by the UNAIDS Executive Director, and the reports for each agenda item and the PCB’s decisions can be found here. There will be a Special session in October followed by a regular PCB in December.  …”

ODI (Briefing paper) – North Stars for Northern Donors in a Post-Aid World: moving from dialogue to decisions

N Gulrajani; https://odi.org/en/publications/north-stars-for-northern-donors-in-a-post-aid-world/

“Over 18 months, ODI Global convened the Donors in a Post-Aid World dialogue series: five frank, future-facing conversations with bilateral DAC members, thinkers, activists and government officials from the Global North and South.  Launched before US aid cuts sent the sector into a tailspin, the series anticipated many of the questions now confronting donor governments about their purpose, legitimacy and future.  This publication is the final product of those dialogues.  Drawing on events held between October 2024 and May 2026, the brief presents the more ambitious takeaways from the series as a set of “North Stars” to orient Northern donors towards their next phase.”

With 8 North Stars. Many of them great ideas.  (Number 7 – ‘stop looking for public support, build it’ is the weakest in my opinion – certainly re the ‘how’, which is a pity given the focus on fixing ‘the broken social contract’…).

Devex (Opinion) – The DAC review is a test of OECD’s future relevance

Dan Peters (Gates Foundation); https://www.devex.com/news/the-dac-review-is-a-test-of-oecd-s-future-relevance-112881

“As development finance becomes more diverse and aid budgets come under pressure, DAC has an opportunity to redefine its role for a new era of development cooperation.”

“… The (DAC) review is often portrayed as a discussion about aid rules, reporting systems, and eligibility criteria. But at its core, it is also a conversation about the future role of DAC and aid itself…..”

“Moving from ODA quantity to quality: For much of the DAC’s history, the central challenge was mobilizing more ODA. That challenge remains important. But today the question is increasingly about how different forms of finance can be deployed most effectively to achieve different development objectives.  Not every challenge requires the same financing instrument.”

“… In our submission to the DAC review’s recent call for inputs, we proposed thinking about the increasingly limited concessional finance through three distinct but complementary purposes that should not be compromised.  We believe increasingly scarce concessional finance should be understood through these three distinct but complementary purposes.”

“The first is core development investment: poverty-focused development investments in countries and sectors where concessional finance remains irreplaceable. These investments help expand economic opportunity, strengthen human capital, and build the foundations for long-term development where alternative sources of finance remain limited. The second is humanitarian assistance: financing designed to save lives and alleviate suffering during crises caused by conflict, displacement, disease outbreaks, natural disasters, and food insecurity. The third is financing for global public goods: investments that support collective action on transnational challenges such as climate mitigation, pandemic preparedness, antimicrobial resistance, and scientific research…..”

“… One of the most important questions facing the DAC review is whether a single set of graduation rules remains appropriate for fundamentally different uses of concessional finance.  Countries may transition away from poverty-focused concessional support while continuing to contribute to global public goods or requiring humanitarian assistance in times of crisis. Yet, the current framework largely applies a single logic across these different purposes.  A more differentiated approach to eligibility/graduation would better reflect today’s development finance landscape. In our submission, we propose tighter graduation rules for core development investment, ensuring this type of concessional financing is not further diluted, while maintaining broader eligibility for humanitarian assistance and global public goods where justified by the nature of the challenge being addressed….”

IISD – UN Report Explores Synergistic Solutions to Triple Planetary Crisis, SDGs

https://sdg.iisd.org/news/un-report-explores-synergistic-solutions-to-triple-planetary-crisis-sdgs/

Moving now to post-2030 brainstorming.

“The report argues that synergies do not emerge in isolation and therefore need an enabling environment backed by aligned finance, robust data and analytical tools, and effective governance models.  It emphasizes the critical role of regional cooperation in developing, implementing, and scaling synergistic approaches and solutions from pilots to policy.”

“The UN Economic and Social Commission for Asia and the Pacific (ESCAP), the UN Environment Programme (UNEP), and the Asian Development Bank (ADB) issued the first synthesis of “experiences from the Asia-Pacific region on translating synergies into practical, policy-relevant lessons for decision makers at multiple levels.” The report calls for synergies to be used “as a core organizing principle in policies and actions toward 2030 and beyond.”

“Themed, ‘Advancing Synergistic Solutions to the Triple Planetary Crisis and the SDGs,’ the Asia-Pacific Synthesis Report highlights the region’s wide range of synergistic solutions to climate change, biodiversity loss, pollution, and other developmental challenges. It draws on 36 featured case studies and more than 140 case studies overall to show how synergistic approaches can tackle the triple planetary crisis while enhancing resilience, equity, and resource efficiency and accelerating progress towards the SDGs.”

“The report identifies four entry points for advancing synergies:  Health-centered climate action; Nature-positive nexus approaches; Circular economy approaches; and Cities as delivery platforms for synergies…..”

More on Global Health Governance & Financing/Funding

Devex Pro –  Scoop: Global Fund, US agree on path around expanded gag rule

https://www.devex.com/news/scoop-global-fund-us-agree-on-path-around-expanded-gag-rule-112873

(gated)  “”We have aligned on a path forward that places no related conditions on funds coming to the Global Fund,” the multilateral funder tells Devex.”

“The U.S. government is not placing any conditions on its funding to The Global Fund to Fight AIDS, Tuberculosis and Malaria.  The multilateral funder told Devex it has “worked closely” with the U.S. government on the implementation of the Promoting Human Flourishing in Foreign Assistance policy, more commonly known as the expanded global gag rule, and that the two sides “have aligned on a path forward that places no related conditions on funds coming to the Global Fund, enabling the Global Fund partnership’s continued effectiveness in sustaining progress in the fight against HIV, tuberculosis and malaria.”  …. The arrangement appears similar to the more laissez-faire approach certain United Nations entities are also seeing, namely the U.N. Office for the Coordination of Humanitarian Affairs, which told Devex in May that no conditions had been placed on its U.S. funding….”