IHP - Recent newsletters, articles and topics

Weekly topics: IHP news 893: Highlights of the week (IHP News #893)

International Health Policies — Fri, 14 Aug 2026 04:41:55 +0000

Structure of Highlights

· Global Tax Justice

· Global Health Reform

· More on Global Health Governance & Financing/Funding

· Ebola emergency DRC

· More on PPPR & GHS

· Impact aid cuts & journey towards health sovereignty

· Decolonize Global Health

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

· Mental health

· More on NCDs

· Commercial & Social Determinants of Health

· Digital Health & AI/health

· Planetary Health

· Access to medicines, vaccines & other health technologies

· Conflict/War & health

· Miscellaneous

Global Tax Justice

The latest round in the UN Tax convention negotiations in New York ended on 13 August. Stay tuned for some overall analysis in the coming days.

Devex – UN tax talks reach critical stage as global south pushes for fairer rules

https://www.devex.com/news/un-tax-talks-reach-critical-stage-as-global-south-pushes-for-fairer-rules-113063

(7 August) Analysis from last week. “Delegates from more than 100 countries are negotiating the draft U.N. tax convention in a pivotal round that could reshape how multinational companies and the ultra-wealthy are taxed — and who gets the revenue. … With countries in their fifth round of negotiations, experts told Devex that this is the most critical turning point in the process so far. The negotiating committee meets three times a year. The target is to submit the final texts to the General Assembly by mid-2027.”

“… Between Aug. 3–13, delegates will debate three texts: the zero draft of the core convention, which would become the legal, institutional, and voting structures on how global tax decisions will be made; the cross-border services protocol, which will determine exactly how countries can levy withholding taxes on digital services, automated platforms, and insurance premiums; and the tax disputes protocol, which explains the mechanisms used to resolve cross-border disputes in a way that would avoid forcing lower-income countries into expensive international legal battles.”

“One of the core fights is whether there will be an “exit door” in the text, which would allow countries to sign the main framework convention but skip or opt out of specific protocols. Experts are watching more carefully for text on source-based taxation, a rule where a country taxes income made inside its borders, no matter where the worker or business lives. They are also looking for an article on the equitable taxation of multinational corporations, and mandatory country-by-country reporting….”

· CESR – Updates from the fifth session (with daily updates (Aug 3 till Aug 12), & key messages per day)

Global Health Reform

Lancet Letter – The next global health architecture cannot exclude women

S Dube, M R Moeti, M Pate et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01413-3/fulltext

“As we navigate the redesign of global health at a moment of acute constraint, one troubling reality stands out: the women who already effectively run our health systems are chronically underfunded as leaders. Women provide nearly 70% of health care globally but hold fewer than 25% of senior leadership roles. Women are under-represented in decision-making discussions where health policy and budgets are decided. This is not an equity problem; it is a matter of whether the next system has the shared leadership it needs to perform. Furthermore, the window to fix this issue, during this architectural redesign, is closing….”

Including some findings from a WomenLift conducted evaluation across 5 regions.

Authors conclude: “At this crucial moment, we call on fellow African health leaders to do three things: fund women’s leadership from institutional budgets and pooled financing, not one-off grants; set targets for women’s seats on the bodies now redesigning health financing and governance; and write leadership development into the founding mandates and budgets of the institutions replacing the old architecture, so that these changes survive in leadership and funding.”

The Swedish Association for Sexuality Education – Safeguarding Rights in Transition – Sexual and reproductive health and rights in the transformation of the Global Health Architecture

https://www.rfsu.se/globalassets/rfsu/dokument/rapporter/safeguarding-rights-in-transition-rfsu.pdf

Important read from June. In case you missed this.

Global Public Health (Comment) – Beyond restoration: Tipping points, leverage points and the reimagination of global health architecture

Lutchmie Narine; https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2715200#abstract

« The United States’ withdrawal from the World Health Organisation and the defunding of multilateral health programs represent more than a political disruption. Complexity science identifies them as a phase transition in a system that had been losing resilience for decades. This article applies complexity science to global health governance, arguing that the old equilibrium is gone and cannot be restored. Drawing on complexity science’s concept of leverage points (places where targeted interventions have disproportionate systemic effects), it identifies four interventions that act on the structure of the system rather than its surface. These are building redundant regional hubs to replace a fragile center; embedding polycentricity so that failure of any single node does not cascade; redesigning the rules and incentives that currently reward dependency over capacity; and restoring civil society as the accountability mechanism that keeps distributed power from becoming unaccountable power. The analysis reframes the governance challenge from crisis management to navigating a phase transition, with implications for multilateral institutions, regional bodies, civil society organisations and donor governments.

Global Health & Medicine – Late release of World Health Organization governing body documents: Trends in documentation timing at the World Health Assembly and Executive Board and considerations for Member State engagement

K Komada et al ; https://www.jstage.jst.go.jp/article/ghm/advpub/0/advpub_2026.01075/_pdf

“Timely access to documentation is essential for meaningful participation in global health governance. At the World Health Organization (WHO), governing body documents for the World Health Assembly (WHA) and the Executive Board (EB) provide the basis on which Member States assess agenda items, consult domestically, and prepare their negotiating positions. In this sense, the timing of document release directly affects transparency, accountability, and quality of decision-making. This study examines trends in documentation timing between 2016 and 2026 using data from the WHO governing body documentation portal. The findings show a clear and sustained shortening of the interval between document release and opening of WHA sessions since 2021, reaching the lowest level observed during the study period. By contrast, timelines for the EB, which were affected during the COVID-19 period, have largely recovered, suggesting that earlier circulation remains feasible in practice. Although this analysis does not directly measure downstream effects, shorter preparation periods may constrain Member States’ ability to review materials carefully, coordinate across institutions, and develop negotiation strategies. These constraints may be felt most strongly by countries with limited participation capacities, potentially widening existing disparities in participation. A recent case further illustrates how late document release can affect not only meeting procedures but also depth and coherence of discussions. Despite ongoing WHO governance reforms, the timeliness of documentation has received limited attention.”

More on Global Health Governance & Financing/funding

IHME – With landmark 10-year investment, the Institute for Health Metrics and Evaluation will deliver more local, timely health evidence worldwide

https://www.healthdata.org/news-events/newsroom/news-releases/gpg-news-release

“The Institute for Health Metrics and Evaluation (IHME), an independent research organization at the University of Washington, has received a landmark 10-year grant from the Gates Foundation to strengthen freely available, scientifically rigorous health evidence used by governments, researchers, and leaders to improve the health and well-being of people in Washington, the United States, and around the world. IHME is part of the UW School of Medicine, and the $540.2 million investment will provide long-term support for expanding the Global Burden of Disease study to provide health data for thousands of new areas. GBD is the most comprehensive assessment of health trends and conditions across countries. Under the grant, GBD will expand from roughly 925 locations today to nearly 5,000 — a major expansion in the geographic detail available to the people making decisions. The grant will also support IHME’s health forecasting and future-scenarios work, and its tracking of health spending worldwide….”

CGD (blog) – Is the World Bank Ready for a Bigger Role in Global Health Financing?

R Eldridge, P Baker et al; https://www.cgdev.org/publication/thematic-review-potential-future-role-world-bank-financing-health-systems

· Blog linked to a new CGD policy paper – A Thematic Review of the Potential Future Role of the World Bank in Financing Health Systems

“…. This paper pairs a descriptive analysis of the World Bank’s health portfolio with a thematic analysis of how the bank engages in the health sector. The aim is to describe the World Bank’s current role in health financing, identify its strengths and weaknesses, and inform discussions on its potential future role—as well as the broader role of MDBs—in health financing. “

“We find that the World Bank is a major financier of health, with an estimated $7.0 billion in 2025 health commitments: $3.5 billion from the International Development Association (IDA), $2.8 billion from the International Bank for Reconstruction and Development (IBRD), and $713 million from trust funds. (An additional ~$540 million in parallel co-financing from other multilateral development banks—primarily AIIB, IsDB, and ADB, concentrated in the Indonesia Health Systems Strengthening Project—flows alongside World Bank health operations but is excluded from these figures as it originates outside World Bank financing sources.) World Bank financing is equivalent to 16 percent of government health expenditure in IDA countries and just 0.4 percent in IBRD countries. However, health comprises a relatively small share of the World Bank’s overall active portfolio, at 7 percent. The World Bank has substantial advantages that could be built on: a country-led approach, coverage of nearly all low-income countries, on-budget financing, the ability to use both loans and grants, and a multisectoral approach to health. The World Bank also has significant downsides. It has many competing priorities and limited tools to earmark resources for health; given its demand-driven nature, governments choose which sectors to prioritize with bank financing, and health is often not at the top of the list. The World Bank also faces external pressures, internal incentive structures, and operational challenges that risk undermining the effectiveness of an expanded health portfolio. If these challenges can be mitigated, the World Bank has a prominent role to play in the future of health financing.”

· And do check out also the blog (also a must-read). With among others: (1) The size and scope of the World Bank’s current health portfolio: Key takeaways; (2) How the World Bank engages in health: Key takeaways

Quote: “…We find that the World Bank is a major financier of health, with an estimated $7 billion in 2025 health commitments—approximately 18 percent of the $39.1 billion in total development assistance for health—and comparable in size to Gavi and the Global Fund combined…..”

Or via P Baker (LinkedIn):

“Five headline findings:

1. It’s big. The Bank committed $7bn to health in 2025 — 18% of all health aid, comparable to Gavi and the Global Fund combined.

2. It intentionally has no mechanism to focus on health. Countries choose to allocate 7% of Bank support to heath. Raising that share requires an innovation like an IDA Health Window.

3. Bank financing for health really matters in the poorest countries: a median 16% of government health spending in IDA countries, only 0.4% for IBRD.

4. The Bank’s model has real strengths: G20 donors (not just G7), on-budget, through ministries of finance, blending grants and loans to stretch aid and support countries as they grow.

5. Operational improvements that would enable a greater role include faster project preparation, staff incentives aligned to health impact, and stronger results measurement.”

Who got hit hardest by the 2025 UN staff cuts?

K Hemmerich; https://www.reformworks.org/post/who-got-hit-hardest-by-the-2025-un-staff-cuts

“The UN Chief Executives Board (CEB) has started to release some of its personnel data about the number of staff in the UN system in 2025, in preparation for the next High Level Committee on Management (HLCM) meeting in late September. The data finally allows for a preliminary analysis of which staff were hit the hardest by last year’s budget cuts.”

“… IOM and UNHCR were by far the hardest hit, both in terms of absolute numbers of staff cuts and the proportional decline of their workforce. The number of staff in IOM fell by 4,471 people from 2024 to 2025, reflecting a 29.5% decline. UNHCR is the only other UN entity to have decreased its staff by more than 20%, losing 2,932 staff, equivalent to a 22% decline, according to CEB data. UNAIDs and UNICEF were the other two UN entities that cut more than 10% of their workforce. The significantly smaller size of UNAIDS means its 19% decline translated into 118 staff, whereas UNICEF’s 10.5% decline comprised 1,614 staff. …”

“With all the often contentious negotiations about cutting budgets and posts in the UN Secretariat and WHO last year, it is perhaps surprising that they only saw a 6% and 5% reduction in their staffing respectively. …. … both the Secretariat and WHO are funded through a combination of assessed and voluntary funding. The 2025 staffing reductions are likely a reflection of a loss of some voluntarily funded positions and the anticipation of further cuts of assessed budget posts that became vacant and were part of the agreed cuts in their respective 2026 budgets. That also means both WHO and the Secretariat will clearly see more staff reductions by the end of 2026….”

Devex Check-up – re US & GAVI Board

https://www.devex.com/news/devex-checkup-bad-luck-comes-in-threes-113023

“…as for the Trump administration’s expectations that the funding (i.e. the release of the 600 million) would allow it to regain its place on the Gavi board, the spokesperson acknowledged that the U.S. is now eligible to rejoin the board, but it’s still “subject to further discussion within Gavi’s donor Board constituency.” …”

Devex – Mark Dybul says this was never the plan for PEPFAR

https://www.devex.com/news/mark-dybul-says-this-was-never-the-plan-for-pepfar-113080

“An architect of the flagship U.S. global AIDS initiative joins Theory of Change to explain why the next 12 to 18 months are critical for the future of global health.”

“Mark Dybul, who led PEPFAR from 2006 to 2009, joined the Theory of Change podcast to deliver a blunt assessment of the legacy and current trajectory of foreign assistance. Reflecting on the evolution of former President George W. Bush’s signature global health initiative, Dybul addressed the sharp criticisms now driving a broader push for reform. While acknowledging the lifesaving impact of past initiatives, Dybul pointed to a fundamental failure in long-term strategy: The shift toward true local ownership never fully materialized. In Dybul’s view, Musk’s Department of Government Efficiency surfaced uneasy truths about how the U.S. government has worked with countries to end the AIDS epidemic — and the opportunities that were missed along the way.”

“… He also pushed back on projections that PEPFAR funding cuts could cause thousands of deaths, arguing that these underestimate governments’ ability to protect health programs — as well as opportunities for greater efficiency. As global health systems undergo a rapid overhaul, Dybul argues that the next 12 to 18 months represent a critical window. They must either adapt to a model centered on country sovereignty, local innovation, and mutual economic partnership, or risk watching the entire architecture collapse….”

MJGH – Network fragmenting and the 2025 funding shock: Network Fragmentation and the 2025 Funding Shock: Early Warning Signs of a Systemic Risk in Global Health Governance

A B Santos Dominguez et al ;https://mjgh.library.mcgill.ca/article/view/1926/3649

« Global health governance (GHG) has shifted from polycentric coordination to topological fragmentation. COVID-19 expanded World Health Organization (WHO) financing participation but eroded cohesion, producing dispersed connectivity. The 2025 contraction, driven by major donor withdrawal, intersected with existing fragilities. “

Objective: “… To assess whether changes in WHO’s financing architecture (2016–2025) exhibit early-warning patterns of declining resilience and critical transition dynamics. …”

Some findings: “… The WHO financing network exhibits patterns compatible with lower-resilience configurations approaching critical thresholds. For WHO leadership, topology-based metrics may offer diagnostics of systemic vulnerability. For donor states, findings suggest that concentrated bilateral funding can affect multilateral resilience through network cohesion. ….”

Journal of Public Administration and Social Change – Global Governance for Health: Role of India in Global Health Diplomacy

Wajiha, Poodari Rohith Goud et al https://www.jopaasc.com/JOPAASC_Jan-Jun_2026.pdf#page=96

“This article highlights how India’s COVID diplomacy during one of the most unfavourable global crises in recent decades has enabled it to emerge as a responsible and credible international player, even as many established global powers have floundered.”

Excerpt from the conclusion: “India’s approach to global health governance accordingly signals a shift from “a state that was historically a recipient of foreign aid in health to one which is becoming a key global provider of public goods and is an emerging agenda setter within the evolving architecture of global health governance.” Through its experiment with pharmaceutical diplomacy, Vaccine Maitri, digital public infrastructure, medical assistance, South-South cooperation and AYUSH diplomacy, India has demonstrated its ability to project power and influence by transforming domestic expertise into global advantages. Most notably, the instrumentality of India’s Digital Public Infrastructure in deepening and broadening global health cooperation is a recent innovation along this trajectory, reflecting the expansion of health diplomacy beyond the provision of medicines and vaccines to include areas such as digital governance models and technological expertise…..”

Bhekisisa – Aids is no longer exceptional. What happens now?

M Malan; https://bhekisisa.org/opinion/2026-08-11-aids-is-no-longer-exceptional-what-happens-now/

“For decades, HIV attracted extraordinary political attention, billions in international funding and an activist movement that changed global health. Now, donor funding is shrinking just as science has delivered powerful new medication that could dramatically cut new HIV infections. Does the HIV movement need to change too — from how it funds programmes to how many Aids conferences it holds and how it reaches a new generation?”

Plos GPH – The future of global health partnerships: Co-investment, reciprocal learning and mutual benefit

Ben Simms, Jim Campbell et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007017

After discussing the UK Global Health Summit, compare with the inaugural African-Nordic Health Summit, and the Global Partnerships Conference with South Africa, they conclude: “We are therefore optimistic for the future of global health partnerships. A contemporary model for international cooperation is evolving. Three partnership events reaching similar conclusions without coordination is both a signal of a new momentum and fortuitous timing as the future of global health debate unfolds and the UK Government prepares to chair the G20 in 2027 and the G7 in 2028. Having helped shape the UK Global Health Summit, and organised the Global Partnerships Conference that followed, and having already funded the kind of reciprocal partnerships its own Compact describes, the UK Government now has the evidence, the credibility and, in its G20 and G7 presidencies, the platforms to coalesce international cooperation around a new generation of global health partnerships: an era premised on honesty and humility and with intentional priority on reciprocal learning and mutual benefit.”

Lancet Letter – Beyond the metaphor: what One Health must become

R Laxminarayn; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01303-6/fulltext

“France’s decision to anchor its 2026 G7 presidency around One Health signals a high point for this approach. Although the political energy is real, so is the risk of squandering it. Despite years of discussion, One Health is better at describing a vision than specifying what must change and for whom. The 2022 One Health High-Level Expert Panel definition speaks of balancing the health of people, animals, and ecosystems as parallel goods. The Berlin Principles affirm the intrinsic value of wildlife and ecosystem health independent of human utility. These definitions share an internal inconsistency that it is impossible to optimise three variables simultaneously without acknowledging trade-offs. If the Lyon moment is to be durable, the concept must acknowledge its internal tension and derive a sharper agenda.”

“… Similar to universal health coverage, which began with the logic of ensuring people obtain needed services without financial hardship but has expanded to include everything desirable in health, One Health too, from its origins in zoonoses, now encompasses antimicrobial resistance, non-communicable diseases, climate change, biodiversity, and governance reform. A concept that justifies almost any investment justifies nothing.”

“It is important to specify what One Health predicts, what it would cost, and how its effects would be measured. For any proposed One Health intervention—integrated zoonotic surveillance, cross-sectoral antimicrobial-resistance stewardship, or deforestation reduction linked to spillover prevention—the relevant question is: what reduction in human disease burden, at what cost, and compared with what alternative? This also requires a recognition of trade-offs that have equity consequences. For example, environmental protection constrains agricultural expansion but increases the price of and access to food. Animal welfare standards raise food production costs that are regressive in their distributional effects. One Health’s basic insight that human health cannot be secured through technological tools applied to human bodies without attending to the ecology those bodies inhabit is correct and urgent. The Lyon moment should clarify what One Health actually requires: whose health, at what cost, at whose expense, measured how, and accountable to whom.”

Bloomberg – Dangote’s Heirs Back Plan to Give Third of His Wealth to Charity

https://www.bloomberg.com/news/articles/2026-07-28/dangote-s-heirs-back-plan-to-give-third-of-his-wealth-to-charity

“Aliko Dangote plans to leave a third of his wealth to charity, according to his daughter Halima Dangote. The pledge is rare among Africa’s wealthy and follows Islamic inheritance rules, with Dangote’s current wealth valued at $35.1 billion. The Dangote Foundation, which was endowed with $1.25 billion, spends 70% of its funding in Nigeria and has partnered with organizations such as the Bill and Melinda Gates Foundation.”

“The pledge by Dangote is rare among Africa’s wealthy — a continent with nearly half of the 50 most unequal countries in the world, according to Oxfam. Based on Dangote’s current wealth, valued at $35.1 billion by the Bloomberg Billionaires Index, he will leave $11.6 billion….”

PS: “While useful, the Giving Pledge, which was created in a US context, “is not the best measure of philanthropy in Africa,” said Katja Schiller Nwator, founder of Philanthropy Circuit, a Lagos-based media and research institution focused on Africa. “Across Africa, philanthropy is often expressed through families, communities, faith-based institutions, and increasingly through foundations.”….”

Devex Pro – Who are the top non-DAC donors in development?

https://www.devex.com/news/who-are-the-top-non-dac-donors-in-development-113050?utm_term=Autofeed&utm_medium=Social&utm_source=Bluesky#Echobox=1786354209

(gated) “Official development assistance hit $177.7 billion in 2025. DAC members still lead with $165.5 billion, but non-DAC nations added $12.3 billion — and their influence is growing. Discover who these emerging donors are.”

“…. with countries such as Turkey and the United Arab Emirates channeling the most.”

“Not all non-DAC nations have yet reported their spending last year. Those that did report gave more than last year, with their collective aid totaling $12.3 billion. Eight non-DAC donors cut their funding last year, while four — the UAE, Qatar, Taiwan, and Monaco — increased it. Another four recognized non-DAC donors are still to report, including a nation that’s consistently given the most among non-DAC donors: Saudi Arabia.”

“But here’s what we do know: Turkey, the most generous non-DAC donor of the bunch, gave $6.7 billion in official development assistance in 2025, meaning that its aid rivals that of several major DAC donors such as Canada, Italy, the Netherlands, and Sweden. Despite that, Turkey’s aid has declined, with data from the Organisation for Economic Co-operation and Development showing the nation’s aid has nearly halved since its peak in 2020.”

“The biggest riser, on the other hand, was the UAE, which picked up aid spending significantly last year after a long period of decline. Last year, the UAE’s official development assistance grant equivalent slotted in at $3.24 billion, over $1 billion more than its giving in 2024. Qatar’s spending on aid rose too, rising nearly 23% from 2024 to 2025….”

Rob Reich – Democracy and a Third Wave of American Philanthropy?

https://aigovlab.substack.com/p/democracy-and-a-third-wave-of-american

“AI generated philanthropic wealth, and some unsolicited advice for soon-to-be-millionaires at Anthropic and OpenAI.”

“I want to offer some thoughts from the vantage point I know best: the political theory of philanthropy. The argument of my 2018 book Just Giving was that philanthropy — and big philanthropy above all — is not merely private generosity that should expect to be met with civic gratitude…..”

Reich discusses 4 core questions in this post.

CGD (blog)- AI Philanthropy Should Buy the Breakthroughs Markets Won’t

L R Rosenzweig; https://www.cgdev.org/blog/ai-philanthropy-should-buy-breakthroughs-markets-wont

“This sixth and final blog in the (AI philanthropy)) series makes the case for investing in innovations that markets wont supply on their own. “

“This blog proposes that the new AI philanthropy should do two things: (i) fund innovation through pay-for-success “pull” mechanisms and (ii) help build a permanent institution that can administer a series of these….”

Among others, on ‘building a home for AMCs’.

Why Does Global Health Keep Financing Institutional Problems with Projects?

Emilie S Koum Besson ; https://www.linkedin.com/pulse/why-does-global-health-keep-financing-institutional-koum-besson-8ys0c/

Excerpts:

“We often ask whether countries have enough money to sustain health systems. We ask much less often whether countries have the policy and institutional conditions needed to spend that money well. …And yet global health still frequently tries to solve institutional problems through projects.”

“… Pandemic preparedness makes this mismatch particularly visible. A country can invest substantially in laboratories, surveillance systems, emergency operations, supply chains and workforce capacity. But when an outbreak occurs, someone still needs the authority to act. Money needs to be released and moved quickly. Emergency procurement arrangements need to function. Responsibilities across institutions and levels of government need to be clear. Workers may need to be mobilised. Data must move between institutions. Much of this cannot be invented during an emergency. Preparedness is therefore not only about having money available when a crisis arrives. It is about having built the domestic policy architecture that allows that money to become a response. Without that architecture, even the largest emergency financing account may struggle to produce impact at the moment it is most needed.”

“Technical assistance can help. Training can help. Investment can help. But if the institutional constraint remains unchanged, a project may meet its input- or output-based objectives while leaving the underlying problem intact. Which raises a question: Why are we trying to solve institutional problems using project financing without systematically linking that financing to the policy changes required to solve the institutional problem?…”

“This is where policy-based lending becomes interesting for global health….”

However, she admits: “… Policy lending is not politically neutral — and history matters. None of this is historically neutral. Policy-based lending has an important lineage in structural adjustment and programme lending, where access to financing was tied to packages of macroeconomic and structural reforms. That history matters enormously, particularly in health and particularly in Africa….” “…. It would therefore be both historically inaccurate and politically unwise to rediscover policy-based financing for global health without confronting that legacy. But the lesson should not necessarily be that financing and policy reform must remain separate. Perhaps the more important lesson is that who defines the problem and who determines the reform matters as much as the financing instrument itself….”

“From country ownership to epistemic sovereignty: … Instead of beginning with the amount of money available and deciding what it can finance, we begin with the function that needs to work, identify the constraint preventing it from working sustainably, and then consider the combination of financing and reform capable of addressing that constraint. Sometimes the answer will still be a project. Sometimes it will be additional domestic financing. Sometimes it will be investment combined with technical assistance. And sometimes it may be financing linked explicitly to policy and institutional reform…. Global health should remain concerned about financing gaps. But the next era of health financing requires paying equal attention to policy gaps.”

· And via Devex Check-up:

“Tedros announced last week that Dr. Sylvie Briand will serve as acting ADG on health systems, access, and data “until further notice,” on top of her chief scientist duties….”

Ebola emergency DRC

First with some key messages from WHO, WHO Afro & Africa CDC of the past week (only to some extent chronologically).

Then a few more reads & analyses.

UN News – Ebola tracing improves in DR Congo – but the virus is still winning the race

https://news.un.org/en/story/2026/08/1168137

(13 August) Latest update from yesterday. “Health authorities in the Democratic Republic of the Congo (DRC) are tracking a growing share of people exposed to Ebola, but the epidemic in the country’s restive east continues to outpace their ability to find and isolate the sick, the World Health Organization (WHO) has warned.”

“In its latest update, published Thursday, WHO said hidden chains of transmission are being fuelled by patients who reach advanced stages of the disease without ever receiving care. Deaths are still occurring outside health facilities and known transmission chains, while several treatment centres are now overwhelmed. “Transmission is occurring faster than case detection and isolation, while contact tracing capacities are increasingly strained,” WHO said….”

“One indicator is improving: the contact-tracing rate has passed 85 per cent nationally for the first time. But the average masks sharp regional gaps – in Haut-Uélé, the rate is only around 58 per cent, which WHO attributed partly to incomplete reporting….”

“The challenge is now twofold: finding the transmission chains still evading surveillance, while urgently expanding capacity to treat those who are found. Until case detection and isolation outpace transmission, better tracing alone will not be enough to turn the epidemic around.”

UN News – Ebola deaths top 2,000 as scientists race to develop vaccine

https://news.un.org/en/story/2026/08/1168117

(11 August) “Local officials in the DR Congo (DRC) reported on Tuesday that deaths from the Ebola virus disease have surpassed 2,000, with half of that number in the last 20 days.

“With more than 4,000 confirmed cases, it is both the second-largest and the fastest-growing on record. …”

HPW – With Over 2000 Dead, Priority is to ‘Break the Chains’ of Ebola Transmission

https://healthpolicy-watch.news/with-over-2000-dead-priority-is-to-break-the-chains-of-ebola-transmission/

(12 August) Some WHO messages from a media briefing on Wednesday.

“Over 2000 people have died so far in the Ebola Bundibugyo outbreak in the Democratic Republic of Congo (DRC), and the only way to break the chains of transmission is via scaled-up local surveillance, according to the World Health Organization (WHO). “Most concerningly, we see a high proportion of deaths in communities instead of treatment units, outside of known contact lists,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told a media briefing on Wednesday.” “That tells us there are chains of transmission we don’t know about, and until we know about and break every chain of transmission, we will not stop the outbreak,” he said.”

““Surveillance is our priority operational challenge. With partners, we’re mapping and pooling resources to strengthen community-based surveillance to bring every suspected case into care and reach the 95% contact tracing target needed to interrupt transmission.”…”

“… Yet the response is only around 50% funded, with $264 million of the $518 million pledged having been disbursed…” “ WHO DRC representative Dr Anne Ancia said that the DRC Government’s latest estimate to address the outbreak was $940 million. She added that most of the money raised so far had gone to partners rather than the DRC government. The DRC government, which has invested $50 million, aims to cover health workers’ salaries with domestic funds eventually, but it was not yet possible given the massive need for additional posts….”

“… Meanwhile, the speed of the outbreak was more likely the result of the difficult conditions, including armed conflict, rather than viral mutation, WHO Chief Scientist Dr Sylvie Briand told the briefing….. “Currently, we have not seen any mutation in this virus, and probably the course of the outbreak is currently much more explained by the context in which the virus is circulating, which is an area of conflict with a lot of population mobility,” said Briand.”

Bloomberg – Ebola Case Count Set to Increase as Congo Officials Expand Hunt for Hidden Infections

Bloomberg;

(10 August) “The Ebola outbreak in Democratic Republic of Congo may appear to worsen in the coming weeks as health officials dramatically expand their search for infections that have gone undetected.”

“ Africa Centres for Disease Control and Prevention and its partners are shifting from conventional contact tracing toward door-to-door case finding in the hardest-hit areas, where widespread community transmission means almost anyone could have been exposed. The intensified search is expected to increase the number of suspected cases reported each day as thousands of community health workers uncover illnesses the existing surveillance system has missed, Wessam Mankoula, Africa CDC’s head of emergency preparedness and response, told reporters last week.

“With this level of community transmission in some of the zones, everyone is becoming a potential contact,” Mankoula said. “The time for incremental action is over.”…”

“… An outbreak this large might be expected to generate 160,000 to 200,000 contacts based on previous responses, compared with roughly 17,000 currently listed, Africa CDC Director General Jean Kaseya said. “This contact list is not accurate,” Kaseya said. “It’s not giving the real figure of this outbreak in DRC.” “

“Africa CDC and its partners ultimately aim to mobilize 25,000 to 30,000 community health workers for case finding, contact tracing and community engagement. About 2,000 are being trained and deployed, with another 4,000 planned in coming weeks, Mankoula said….”

Africa CDC supports the immediate implementation of the DRC Government’s decisions to control the 2026 Bundibugyo Ebola emergency

https://africacdc.org/news-item/africa-cdc-supports-the-immediate-implementation-of-the-drc-governments-decisions-to-control-the-2026-bundibugyo-ebola-emergency/

(10 August) “From presidential direction to operational delivery. At the meeting on 5 August 2026, the Government of the DRC, under the leadership of President Tshisekedi, took courageous political decisions to control the outbreak. These are summarized in the concept “One Response, six mutually reinforcing interventions”:….

“A village-centered response led by trusted community health workers (CHWs) and Digitally Transformed…..

Protocol-governed expanded use of licensed Ervebo vaccine. ….

Free access to essential health services and a reliably paid workforce. …

Providing Treatment and post-exposure prophylaxis under approved protocols …

Management of humanitarian issues, including the safe reopening of schools. ….

Strong coordination and end-to-end financial accountability. ….“

Re the final aspect: “President Tshisekedi called for stronger coordination, greater financial transparency, and more effective use of available resources to accelerate control of the outbreak. Each partner must disclose amount received and allocation made. At the DRC Government’s request, Africa CDC is working with WHO to establish a unified financial tracking to ensure that resources are aligned with national priorities and reach frontline operations rapidly. Solidarity of African member states and partners has been unprecedented, with more than US$450 million already mobilized for the Ebola response (in addition to funds for the humanitarian response). …”

UN News – DR Congo: Ebola is killing people before they ever reach a doctor

https://news.un.org/en/story/2026/08/1168105

(10 August) View from WHO Afro. “More than 1,900 people have died in the Democratic Republic of the Congo’s Ebola outbreak – and most of them never made it to a treatment centre. Between 60 and 70 per cent of deaths are happening in communities far from care, a gap that is now central to the World Health Organization’s response. “The Bundibugyo virus continues to outpace us,” said Dr. Mohamed Janabi, WHO Regional Director for Africa, speaking from Bunia, the epicentre of the outbreak in eastern DRC – referring to a particularly lethal Ebola strain for which there is still no approved vaccine. “

“Three months into the outbreak, the UN health agency intends – along with Congolese authorities and their partners – to “urgently intensify” the response because behind the heavy human toll lies a problem that has become central: too many patients are receiving treatment too late. “

“Discussions with representatives of the local transport association highlighted shortcomings in the patient transport system. According to WHO, half of the deaths observed among transported individuals are linked to the conditions of their care. “We asked ourselves why people are dying in Bunia? But talking to these leaders, we understood two things,” said Dr. Janabi.

“Village centres outside of Bunia, they don’t have these services. As a result, everyone comes to Bunia. Unfortunately, they come late.” The concentration of healthcare capacity in the city thus transforms distance into a factor in mortality. As patients lack suitable facilities near their homes, they must travel long distances before receiving care, and sometimes when their health is already severely compromised. The journey itself can also fuel the epidemic. Patients taken to Bunia are not always sent directly to an Ebola treatment centre. Some are first taken home. When they die, their bodies may be taken back to their villages, thus multiplying contacts and the risk of further infections. “

“WHO wants to break this chain by bringing healthcare facilities closer to communities, better informing the public and transport providers, and promptly referring suspected cases to appropriate centres. …The objective is twofold: to treat patients earlier and to prevent the provincial capital from becoming a hub for both patients and increased risk of transmission. “

“… After three months of the epidemic, WHO is therefore counting on a change of scale but above all, of method: less concentration of the response in Bunia and earlier intervention closer to transmission hotspots. Dr. Janabi believes that this approach could produce results in the next two or three months. ….”

“Today the World Health Organization (WHO) regional director for Africa told the press that genomic sequencing of the Bundibugyo strain of Ebola virus currently causing an outbreak in the Democratic Republic of the Congo (DRC) shows the virus has been circulating since mid-February, and not mid-May, which was when officials began to suspect an Ebola outbreak in Bunia, DRC. “So we are chasing the virus, the virus is ahead of us,” Mohamed Yakub Janabi, MD, PhD, said, explaining that initial testing did not pick up the Bundibugyo strain, and many cases were likely misdiagnosed as malaria or typhoid fever. ….”

Science Insider – ‘Mismatched’ vaccine being rolled out against Ebola outbreak

https://www.science.org/content/article/mismatched-vaccine-being-rolled-out-against-ebola-outbreak

(must-read) “Amid ethical questions, DRC proceeds with shot that may offer some protection against the Bundibugyo virus.” Excerpts:

“… the evidence has changed dramatically. Studies in test tubes and animals have convinced scientists Ervebo is worth testing in a large study in the DRC, and WHO “is working with partners to start this trial as soon as possible,” the agency’s director-general, Tedros Adhanom Ghebreyesus, wrote on Bluesky on 7 August. Three days later, the Africa Centres for Disease Control and Prevention (Africa CDC) and the DRC government went much further, announcing their support for the “immediate launch” of a much broader rollout of Ervebo—a move that could undercut WHO’s trial. Complicating matters is the fact that two Bundibugyo-specific vaccine candidates have just started phase 1 safety trials in Canada and the United Kingdom. If those studies are successful, researchers plan to rush the vaccines to the DRC for efficacy trials as well, perhaps as early as next month…..”

“One reason for the change of heart about Ervebo is the sheer scale and speed of the outbreak, which has already caused more than 4200 cases and almost 2000 deaths. Many scientists feel an option has to be tried to slow or stop the spread of the virus. But more important, several lines of evidence, presented to the WHO expert panel on 31 July, bolster the case that Ervebo will offer at least some protection against Bundibugyo….”

“… In its 10 August announcement, (Africa CDC) said the vaccine would be given to many groups at risk, including contacts of Ebola patients and their contacts, health care workers, staff at labs and treatment centers, ambulance and taxi drivers, and members of burial teams. Such broad distribution might discourage people from joining the WHO trial and running the risk of getting a placebo. …”

Stat – Talks on launch of clinical trial of Ebola vaccine in DRC advance, WHO says

https://www.statnews.com/2026/08/12/ebola-who-drc-ebola-vaccine-trial/

(12 August) “The first candidate for study would be Merck’s Ervebo.”

“Talks are underway between authorities in the Democratic Republic of the Congo and the World Health Organization to expedite the start of a multi-armed Phase 3 clinical trial of vaccines geared toward helping to contain the spread of the Bundibugyo virus in the northeast of the country, which the director-general of the global health agency warned Wednesday is on track to become the largest Ebola outbreak on record.”

“The first vaccine to be pushed into the field for study will be Merck’s Ervebo, a vaccine that targets a different species of the virus, Ebola Zaire. An expert panel that advises the WHO was initially reluctant to recommend its use, but an increasing number of studies in animals and in people have persuaded it that the vaccine could offer some cross-protection against Bundibugyo, and should be tested to see if it could help. ….”

“… The trial is not using the ring vaccination approach employed in the Ebola Ça Suffit trial — French for “Ebola, that’s enough” — that proved Ervebo’s effectiveness and was conducted in Guinea during the West African outbreak. In that trial, rings of contacts of cases, as well as contacts of the contacts, were randomized to either get the vaccine immediately or on a delayed basis. Field studies have later estimated Ervebo’s effectiveness against Ebola Zaire at about 84%. Moorthy said the results of multiple Ebola trials conducted in the intervening years led officials to conclude that randomizing contacts individually, rather than as part of a ring of contacts of an infected person, would be a better approach. “It is more efficient to individually randomize,” he said….”

PS: “The WHO officials did not address — nor were they asked to address — a report this week in which DRC authorities announced they want to roll out Ervebo for general use outside of a clinical trial. The approach has received the support of the Africa Centres for Disease Control and Prevention. It is unclear whether the DRC could access the number of vaccine doses that would be needed to put such a plan into action. There is a roughly 500,000-dose stockpile of Ervebo, but it is controlled by the International Coordinating Group on Vaccine Provision, which is run by the International Federation of Red Cross and Red Crescent Societies, Doctors Without Borders (MSF), the United Nations Children’s Fund (UNICEF), and the WHO. ….”

“Several Bundibugyo-specific vaccines could join the trial in the early autumn, Moorthy suggested.”

· Related: Cidrap News – DR Congo Ebola outbreak on track to be largest in history

(12 August) “ Today during general remarks, Director-General Tedros Adhanom Ghebreyesus, PhD, of the World Health Organization (WHO) said the ongoing Ebola outbreak in the Democratic Republic of Congo is on track to become the world’s largest, outpacing the West African outbreak of 2014 to 2016, which saw more than 11,000 people die. … “The outbreak had a big head start, it is still way ahead of us, and we are playing catch-up,” Tedros said. “

“…. “With partners, we are mapping and pooling resources to strengthen community-based surveillance, to bring every suspected case into care and reach the 95% contact-tracing target needed to interrupt transmission—today we are at around 80%,” Tedros said. He also said the WHO was working to train and place more healthcare workers in the area, as Ebola patients need providers at a 3:1 ratio. “

UN News – Ebola in DR Congo: Childhood deaths rise; hopes raised over new vaccine

https://news.un.org/en/story/2026/08/1168100

(7 August) From late last week. “More than 300 children have died in the Ebola outbreak in the eastern Democratic Republic of the Congo (DRC), the UN said on Friday, as health experts urged trials of the only vaccine against the disease to halt further spread of the rare Bundibugyo species.”

“Children and women continue to bear a disproportionate share of the outbreak in Ituri, the most affected province, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). The outbreak emerged in mid-May and since then, more than 300 children have succumbed to the virus, the UN Children’s Fund (UNICEF) said. Moreover, children make up nearly a quarter of confirmed cases, but almost a third of all deaths, the agency added. Earlier this week, the UN reported that the outbreak is also severely disrupting essential healthcare….”

Third meeting of the WHO Technical Advisory Group on candidate vaccine prioritization (TAG-CVP) for Bundibugyo virus disease outbreak response: meeting report, 31 July 2026

https://www.who.int/publications/i/item/B09865

Also from late last week. “On 7 August 2026, the WHO Technical Advisory Group on candidate vaccine prioritization (TAG-CVP) for Bundibugyo virus disease (BDBV) outbreak response released a new report regarding possible candidate vaccines for Bundibugyo virus disease. The members recommended Ervebo, the only vaccine licensed Ebola vaccine, be prioritized for inclusion in a randomized clinical trial in the context of the ongoing outbreak….”

Stat Opinion – We prepared for Ebola — but not this Ebola

K Kuppali & P Mbala; Stat;

“Preparation for the next Ebola outbreak focused on the wrong species, showing a global health blind spot.”

“…for much of the past decade, global preparedness efforts have largely focused on a single species: Zaire ebolavirus (EBOV). Bundibugyo ebolavirus, first identified in Uganda in 2007, is genetically distinct. Although it belongs to the same virus family, we cannot assume that diagnostics, vaccines, or therapeutics developed for one Ebola virus species will perform equally well against another. The current outbreak has demonstrated exactly why that assumption is dangerous.”

“The first warning came from diagnostics. …”

… Vaccines provide perhaps the clearest illustration of both the strengths and the limitations of current Ebola preparedness. The licensed rVSV-ZEBOV vaccine (Ervebo) transformed the response to outbreaks caused by EBOV and remains one of the greatest achievements in infectious disease research. Because it was designed to target the glycoprotein of EBOV, however, its effectiveness against Bundibugyo virus has long been uncertain. Recognizing this uncertainty, the World Health Organization appropriately recommended in May that the Ervebo vaccine not be used routinely during the Bundibugyo outbreak outside of research settings, citing insufficient evidence to support its effectiveness against this Ebola virus species. Since then, however, the scientific landscape has evolved. Emerging laboratory studies, immunologic data, and ancillary analyses from the current outbreak suggest that Ervebo may induce immune responses capable of providing at least partial cross-protection against Bundibugyo virus. Although these findings remain preliminary and are not yet sufficient to establish meaningful clinical effectiveness, they raise important scientific questions about whether the role of the Ervebo vaccine should be reconsidered as additional evidence accumulates….” “… The broader lesson is that these questions should have been asked and answered before a crisis — not in the midst of one of the largest Ebola outbreaks ever recorded. Preparedness cannot depend on assumptions about cross-protection between related viruses. It requires generating the evidence needed to guide vaccine policy before the next outbreak begins and not while lives hang in the balance.

“… Therapeutics tell a similar story. Rather than relying solely on treatments developed for EBOV, investigators are now generating evidence specifically for Bundibugyo virus disease….”

The authors conclude: …” Preparedness cannot mean optimizing every investment for yesterday’s epidemic. It must anticipate viral diversity, biological uncertainty, and the reality that the next outbreak will almost certainly differ from the last. That means investing in pan-filovirus diagnostics capable of detecting every pathogenic Ebola virus species. It means developing broadly protective and multivalent vaccines before outbreaks occur rather than during them. It means evaluating therapeutics with activity across multiple filoviruses, strengthening adaptable clinical trial networks that can rapidly evaluate countermeasures against emerging pathogens, and building manufacturing systems flexible enough to pivot when a different virus emerges.”

Nature Medicine – Emergence of a Bundibugyo virus variant in the 2026 outbreak in the Democratic Republic of the Congo and Uganda

A Amuri-Aziza et al https://www.nature.com/articles/s41591-026-04628-8

“A phylogenetic analysis of 22 genomes from the recent Bundibugyo virus outbreak in the Democratic Republic of the Congo and Uganda suggests the outbreak was caused by a new zoonotic spillover event.”

Geneva Solutions – The race to develop a vaccine for world’s fastest spreading Ebola

https://genevasolutions.news/global-health/the-race-to-develop-a-vaccine-for-world-s-fastest-spreading-ebola

“Efforts to develop a vaccine to help stem the Ebola outbreak in DR Congo are intensifying as it becomes the world’s second-largest on record and the fastest-spreading. Aurélia Nguyen, deputy CEO of Cepi, one of the non-profits leading the push, appears nonetheless optimistic.”

Some excerpts from this interview with CEPI’s Nguyen:

“The Ebola outbreak has quickly become a live test case of the 100 days mission, a Cepi-led initiative endorsed by the WHO and the G7 that aims to rapidly deliver vaccines, diagnostics and therapeutics when a new pathogen emerges. Hitting that ambitious target this time appears unlikely, but Nguyen argues there is progress. “Every time we have an outbreak, we get better and faster. Even looking at how quickly Oxford and Serum were able to produce a vaccine and get into the clinical trials, we have surpassed the Covid-19 timelines.”…”

“Cepi’s new strategy focuses on understanding critical scientific and logistical bottlenecks to speed up vaccine delivery but also building a response that can adapt to any threat – whether from an accidental leak from a lab or a deliberate manipulation of pathogens with the help of AI….”

Re the PABS negotiations: “… Cepi’s own funding agreements require manufacturers to guarantee vaccine access for low-income countries, typically through capped prices – an experience she hopes will help negotiators reach a minimum framework that sets standards and “helps all boats rise with the tide”….”

“Global health has also been struggling from aid cuts. Cepi’s own funding, largely from western donors like Germany, the United Kingdom and Norway but also philanthropic powerhouses like the Gates Foundation, has held steady. Even the US Congress has fought back against the Trump administration’s budget cuts for the organisation. Still, Nguyen worries about the wider sector. “The chances of another pandemic in our lifetimes are more than not. So at some point, money will need to be spent in response to an epidemic or pandemic – whether you spend it now in preparedness or multiple times later in the response,” she says, citing a study from the International Monetary Fund’s economic review journal that put the annual cost of pandemic risk at over $700 billion going forward. “That’s annualised, but when an epidemic or pandemic happens, it’s all in one go. The Covid pandemic was $14 trillion just in direct costs…”

Lancet Regional Health Africa – Bundibugyo ebolavirus re-emergence in Africa: an opportunity to catalyse the transition from reactive outbreak response to genomic epidemic intelligence

Jean de Dieu Harelimana, C Happi et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00114-8/fulltext

“The re-emergence of Bundibugyo ebolavirus (BDBV) in eastern Democratic Republic of the Congo (DRC), with subsequent cross-border transmission into Uganda, should be a catalyst for rethinking epidemic intelligence in Africa. Despite substantial investment in epidemic preparedness following previous Ebola epidemics in West Africa, the current BDBV outbreak highlights the need to strengthen pathogen surveillance systems to enable timely outbreak detection and characterisation of transmission dynamics.”

“The ongoing BDBV outbreak illustrates that epidemic surveillance remains predominantly reactive in Africa, often detecting epidemics only after sustained community transmission has occurred. Modelling studies suggest that the outbreak in Ituri Province, DRC, was detected approximately six weeks after the probable index case, underscoring the limitations of existing epidemic intelligence. Although clinical and epidemiological surveillance remain essential, they are increasingly insufficient in the context of intensified population mobility, ecological disruption, and expanding human-wildlife interfaces that facilitate repeated zoonotic spillover. Preventing future filovirus epidemics will require moving beyond conventional surveillance by integrating genomic and epidemiological data into predictive, actionable intelligence systems….”

“…Africa has made considerable progress in strengthening genomic surveillance through initiatives led by the Africa Centres for Disease Control and Prevention and the World Health Organization. Nevertheless, genomic capacity remains unevenly distributed, with many countries relying on external sequencing facilities that delay analysis and limit public health interventions. During the current BDBV outbreak, samples from Ituri were transported to the Institut National de Recherche Biomédicale in Kinshasa for sequencing, highlighting the need to invest in decentralised genomic capacity development, particularly in epidemiologically high-risk regions. In Africa, capacity building in genomics is still frequently equated with investment in diagnostic sequencing infrastructure alone. However, sustainable genomic epidemic intelligence requires investment in the entire ecosystem, including specimen referral networks, bioinformatics capacity, workforce development, quality assurance, interoperable data governance systems, and mechanisms for translating genomic data into public health decisions.”

Authors conclude: “The re-emergence of BDBV in DRC should represent a pivotal inflection point for epidemic preparedness in Africa. Future investment should prioritise resilient, context-specific genomic ecosystems, and institutionalise genomic epidemic intelligence within national and regional public health systems. This will strengthen anticipatory surveillance, enable timely evidence-based responses, and enhance Africa’s capacity to mitigate emerging infectious disease threats.”

More on PPPR & GHS

Health Economics, Policy and law – An investment too good to be true?: Reassessing the World Health Organization and World Bank return-on-investment estimates for pandemic preparedness

G W Brown et al ; Health Economics, Policy and Law;

“The World Health Organization, World Bank, G20 and related health agencies have requested annual investments of US$31.1 billion in pandemic prevention, preparedness and response. To justify these unprecedented costs, they rely on a return-on-investment case developed by WHO and World Bank. Any investment in one area of public health will have knock-on effects on others, through diversion of funds and human resources. Intended outcomes must outweigh alternate investments and be likely to achieve the results on which such comparisons are predicated. This perspective examines the assumptions underlying the WHO and World Bank return-on-investment estimates and outlines implications for equitable and evidence-based global health financing. The examination reveals several problematic assumptions and crude baselines used for comparison – inflating return-on-investment estimates and undermining its use for policymaking. The case is based on improbable assumptions of 100% mitigation of pandemic economic impacts, including rapid vaccine development completely blocking transmission. WHO/World Bank do not disaggregate direct and indirect costs, while the economic impact of comparator diseases appears significantly undervalued. Thus, the return-on-investment case underpinning the current pandemic agenda appears under-evidenced and unreliable, and the apparent over-valuation of pandemic interventions over existing investment in high-burden infectious diseases raises equity concerns, suggesting a reassessment is needed.”

WHO’s Alliance for HPSR –No one-size-fits-all: webinar shares new evidence on the governance and structure of national public health agencies

https://ahpsr.who.int/newsroom/news/item/11-08-2026-no-one-size-fits-all-webinar-shares-new-evidence-on-the-governance-and-structure-of-national-public-health-agencies

“What makes a national public health agency able to act quickly and credibly when an outbreak strikes? In mid-July, more than 1000 participants – joining from Argentina to Armenia to the Philippines – attended a WHO Health Emergencies (EPI-WIN) webinar presenting the results of a three-year learning initiative on the governance of national public health agencies (NPHAs), convened by the Alliance for Health Policy and Systems Research and the WHO Health Emergencies Programme with research teams in countries across all regions and income levels.”

“The initiative grew out of a WHO meeting in March 2023 with representatives from NPHAs from 14 Member States on their experiences during the COVID-19 pandemic. As after previous pandemics, many countries have since reformed existing institutions or created new ones. Yet, as Dr Kumanan Rasanathan, Executive Director of the Alliance, noted in his framing remarks, “there is no one-size-fits-all model” for how countries structure these functions – and there was a deficit of knowledge on how best to govern them. Three years on, he said, “countries in our learning network have together built an evidence base to support other countries rethinking the governance of their public health functions.”…”

Re What the study found; and some views from countries & partners.

Impact aid cuts & journey towards more health sovereignty

Devex – Aid cuts compel Malawi lawmakers to ‘think outside the box’

https://www.devex.com/news/aid-cuts-compel-malawi-lawmakers-to-think-outside-the-box-113066

“Members of Malawi’s parliament told Devex they’re looking at tax reforms and cutting costs, but also pushing for fiscal prudence and in rooting out corruption.”

From the recent UNITE Global Summit in Manila that brought together parliamentarians from different parts of the world.

Decolonize Global Health

Abir’s Substack – Africa Is Not Developing. It Is Recovering.

https://abiribrahim.substack.com/p/africa-is-not-developing-it-is-recovering?utm_source=multiple-personal-recommendations-email&utm_medium=email&triedRedirect=true

“The word we use to describe the continent’s trajectory is not a matter of semantics. It is priced into the cost of capital.”

JGPOH – Broadening the decolonisation of global health beyond identity-based approaches toward structural transformation

Jens Holst; https://jgpoh.com/wp-content/uploads/2026/07/Jens-Holst-JGPOH-2026-1.pdf

Review.

“The examination of the socio-political and economic dimensions of the colonial legacy points to several critical gaps in the current decolonisation discourse, particularly with regard to the relative marginalisation of perspectives from Latin America. Beyond rather technical challenges, three gaps emerge as essential for decolonising global health. Firstly, contemporary decolonisation efforts frequently reflect a Eurocentric perspective predominantly shaped by scholars from the Anglophone Global North, often neglecting the dynamics and implications of internal colonialism. While aiming to dismantle historical injustices and power imbalances, these approaches insufficiently address the role of domestic elites in sustaining neocolonial dependencies. Secondly, the decolonisation discourse in global health remains heavily Anglo-Saxon in orientation, marginalising diverse geographic regions, epistemologies, and ethnic perspectives. Thirdly, an examination of the intersection of race, capitalism and colonialism reveals insufficient attention being paid in the decolonisation debate and practice to the framework conditions. These are increasingly set by the neoliberal, increasingly feudalist global economic order and its role in reproducing and perpetuating health inequalities.”

“This review calls for a critical reassessment of dominant paradigms in global health decolonisation, emphasising the need for systemic transformation that takes account of the historical, geographic, ethnic and socio-political complexities. Greater attention to internal colonialism is imperative for decolonising global health, alongside the inclusion of marginalised voices and perspectives. Promoting a more equitable and comprehensive landscape requires a transformative approach that addresses the structural drivers of global health, including the economic and commercial determination of health, and challenges the broader conditions that sustain inherited inequality.”

BMJ GH – Where are the non-sovereign islands in health policy and systems research?

R Borst; https://gh.bmj.com/content/11/8/e025304

“Global health policy and systems research largely ignores small non-sovereign islands, despite these islands facing significant and unique challenges. Existing frameworks generally exclude islands or compress them into a single narrative with metropolitan political economies.”

“Health system challenges on non-sovereign islands stem from political relationships with metropolitan states, not smallness alone. Decolonising global health requires research that treats islandness as an analytic category by itself. A decolonial research agenda for non-sovereign islands must be rooted in island priorities.”

Trump 2.0, US Global Health strategy & bilateral health agreements

Devex Pro – US announces nearly $2B in ‘historic’ faith-based partnerships

https://www.devex.com/news/us-announces-nearly-2b-in-historic-faith-based-partnerships-113074

(gated) “It’s the largest allocation of global health aid to faith-based organizations in over two decades.” (see also last week’s IHP news)

“The department said the funding will be provided to an “extensive network” of international and local faith-based partners — including World Vision, Compassion International, and Samaritan’s Purse, which are all American-based, internationally operating Christian humanitarian organizations. “

“The funding is broken into three major baskets: providing health services through faith and community-based hospitals and clinics; health funding included in government-to-government bilateral deals; and humanitarian aid awards….”

Check out the case studies.

Devex – Local African Christian groups await clarity on role in US funding

https://www.devex.com/news/local-african-christian-groups-await-clarity-on-role-in-us-funding-113102

“How will funding trickle down to locally based faith-based organizations under the “America First” Global Health Strategy?”

Emily Bass – US State Dept Causes Closure of CDC Zimbabwe

On Substack;

“And we’re all a little less safe because of it.”

“The US Centers for Disease Control and Prevention program in Zimbabwe will completely close down by the end of the year as a result of actions taken by the Department of State. ….… CDC Zimbabwe is the first CDC global health program to be fully closed as a result of the Trump Administration’s approach to transferring funds from State to CDC….”

CGD blog – Designing Direct Assistance: Exploring Options for the State Department’s New Approach to Global Health

J Estes; https://www.cgdev.org/blog/designing-direct-assistance-exploring-options-state-departments-new-approach-global-health

« In recent decades, the United States has allocated only a modest share of its aid directly to governments for health and development outcomes, but there’s an important opportunity to learn from past experience—including that of other donors— providing direct assistance to governments to advance health outcomes. New case studies from Phillip Palmer and Deborah Cook Kaliel—formerly of USAID, each with years of experience in G2G programming—spotlight important lessons for the Department of State as it works to operationalize its new global health agreements. Each of the three case studies examines an arrangement involving direct, performance-based assistance for health, across nine areas: goals and objectives; design; risk management; indicators and disbursement; flow of funds; data monitoring, reporting, and verification; sustainability and co-financing; staffing, management, and technical assistance; results.

Using its Program-for-Results instrument, the World Bank provided a financing package to Ethiopia, supporting maternal and child health services under the Ethiopian government’s national plan. This model operated through a pooled donor fund, linked disbursements to a narrow set of indicators, and used many of the government’s existing systems instead of creating parallel structures.
The Global Fund shifted its portfolio in Rwanda toward a performance-based approach that disbursed funds linked to performance indicators on a sliding scale, aimed at facilitating accountability and flexibility. Given Rwanda’s strong governance and data systems, the program has relied on Rwanda’s Auditor General and national health information management system, allowing for a small donor staffing footprint.
USAID provided direct assistance to the government of Jordan in support to the Jordan Health Fund for Refugees, a pooled donor fund, and incentivized policy reform while strengthening systems and facilitating country contributions to refugee health programming.”…”

Mike’s Substack – Why Is Implementation Science So Damn Slow?

Mike Reid; On Substack

“HIV programs need evidence now. Academic incentives are optimized for publishing papers long after they are relevant.”

“… In a world of real time analytics and shrinking budgets, a lot of HIV implementation science (at least US-funded, I cant speak to elsewhere) is in danger of rendering itself obsolete if it continues to move so slowly. With PEPFAR programs rapidly transitioning to partner governments, HIV programs need evidence now now, not on 3 years time….”

Stat – Trump returns to controversial vaccine policy with order questioning childhood schedule

https://www.statnews.com/2026/08/10/trump-return-to-vaccine-policy-executive-order/

“‘Gloves are off’ once again, top adviser says.”

“The Trump administration, which in recent months had avoided public discussions of vaccine policy because of concern around the political repercussions, is changing course. Speaking from the Oval Office, President Trump on Monday unveiled a new executive order as he and his top health officials presented a new, skeptical government approach to vaccines, making extraordinary claims without evidence to support the remade federal agenda….”

“…The executive order lists vaccines to be recommended for all children, those at high risk of infection, or just in consultation with a clinician — a stark change from the usually public, scientist-led process of determining the federal government’s approach to immunization issues. The new “Gold Standard Childhood Vaccine Recommendations” were instead made in consultation with the president’s advisers and relied on comparing the U.S. system to those in other countries. …. The order recommends all children get 11 vaccines instead of the 18 previously recommended by the federal government — and would spread out the doses over a longer time, the president said. The administration did not provide immunological evidence for the changed schedule….”

“…The order also calls for the MMR vaccine, which protects against measles, mumps, and rubella, to be broken up into three vaccines. That wouldn’t be possible, experts say, without years of work and investment to make a change not supported by evidence. Still, the president said without evidence that the vaccine could be “quite lethal” in its combined form, despite the shot being repeatedly proven safe through large-scale studies…”

“President and RFK Jr, the health secretary, repeatedly referred to autism during signing, though studies show no link between it and vaccines.”

“Breaking up combined vaccines would leave children vulnerable, say Tedros and other leaders.”

“Senior officials of the World Health Organization, including Director-General Tedros Adhanom Ghebreyesus, criticized the Trump administration’s newest attempt to trigger an overhaul of U.S. vaccination policy on Wednesday, calling it politically motivated and contradictory to the best available science…..”

“ The US administration’s vaccine scepticism is weakening vaccine confidence, write Tiago Correia, Martin McKee, and Gregg Gonsalves.”

Mental Health

Lancet Comment – Towards a joint classification of neurological and psychiatric disorders

P White et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01498-4/fulltext

“Psychiatry has been called the other half of medicine, reflecting the separation of mental health services from the rest of health care. Patients with a mental illness are treated in different clinics and hospitals to those with physical illnesses. Advances in neuroscience and medicine have gradually eroded the justification for this divide, but the compelling evidence for the interdependence of brain and mind is easily neglected within our siloed specialties and services. We believe this separation causes harm to patients with disorders on either side of the line and propose that a joint classification of neurological and psychiatric disorders is theoretically justified, practically feasible, and would benefit psychiatry, neurology, and medicine more broadly.”

“…A potential solution to the problems created by the nosological separation of neurological and psychiatric conditions is to merge the ICD’s neurological and psychiatric chapters into one chapter about the nervous system (or of nerve, brain, and mind). We suggest that the evidence in favour of such a merger is now so overwhelming that it should occur in the next (12th) version of the ICD, for which a date is not yet set….”

The conclude: “… We call for detailed discussion of such a merger, not only between and within the disciplines of psychiatry and neurology, but also among key clinical disciplines, from psychology to neurosurgery and, crucially, among patients with these conditions. We encourage WHO to address this proposal and to draft a merged chapter of the nervous system as the 12th version of the ICD is developed. A joint classification of psychiatric and neurological disorders would improve the understanding of these disorders by health-care professionals and the wider public, encouraging integrated holistic care for conditions that make up a large proportion of the global burden of disease.”

Nature Comment – Why environmental treaties must also address mental health

M Kumar et al ; https://www.nature.com/articles/d41586-026-02450-3

“Global conventions have mainly overlooked the psychological and social impacts of climate change, biodiversity loss and pollution. Here’s how to change that.”

“Here, we argue that environmental treaties such as the United Nations Framework Convention on Climate Change should be recognized as upstream policy instruments that shape mental health and psychosocial well-being before clinical intervention is needed. The UN high-level political declaration recognizing the widespread burden of non-communicable diseases, including mental-health conditions, can become a basis for further action. To show the interconnected pathways, we propose, as a first step, a tiered policy framework that differentiates between environmental conventions according to their relevance for mental health and their readiness for indicator-based evaluation…”

More on NCDs

Lancet Editorial – Skin diseases: beyond the visible

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01644-2/fulltext

This week’s Lancet Editorial on vitiligo & new trends in dermatology.

“… A deeper understanding of vitiligo’s pathophysiology—the immune-mediated loss of pigment-producing melanocytes—has enabled the development of new targeted therapeutics. In this week’s issue of The Lancet, Thierry Passeron and colleagues report the first phase 3 trials (Viti-Up) of an oral systemic therapy—the JAK inhibitor upadacitinib—for non-segmental vitiligo in adults and adolescents. Similar developments have been occurring across dermatology. The boom in trials of targeted therapies, including for chronic hand eczema and plaque psoriasis, is reshaping the treatment of skin conditions long dealt with only superficially with topical therapies. The field deserves to be taken much more seriously. Skin diseases affect billions of people worldwide and rank among the leading causes of years lived with disability; vitiligo alone affects tens of millions. In 2025, WHO recognised skin disease as a global public health priority. Advances in research are just the first step. Viti-Up highlights key clinical questions that need to be addressed if this new phase in dermatology is to have meaningful global impact….

The editorial concludes: “Skin diseases have for too long been judged only by what is visible. But their health effects, and the value of any treatment, often lie beyond what the eye can see, in whether the patients can live unashamed, unshunned, and accepted. To translate scientific progress into clinical benefit, dermatology must do more—to enrol the patients who reflect the full range of those affected and to measure what has often gone unmeasured: stigma, comorbidity, and quality of life, alongside the long-term risks and financial toll for patients across their lifetime.”

Commercial & social determinants of health

International Journal for Equity in Health – From knowledge accumulation to transformative action: research to catalyze progress on social determinants of health equity

J Berenson, R Marten, Kumanan Rasanathan et al ; https://link.springer.com/article/10.1186/s12939-026-02900-4

“Despite three decades of expanding scholarship on social determinants of health (SDH), progress in reducing health inequities has remained limited. While the SDH framework has reshaped global health discourse and informed policy rhetoric, the translation of knowledge into transformative action has been insufficient. The gap between evidence and impact is not explained by political constraints alone but is also contributed to by the orientation, methods, and practices of SDH research itself. We identify key limitations in what is studied, how research is conducted, and who leads knowledge production….”

“We propose a reorientation of SDH research toward agency and action with greater focus on solutions and implementation pathways, methodological pluralism, multisectoral and participatory knowledge production, improved communication and policy engagement, and reforms to research incentives, funding and governance. By repositioning SDH research as an active contributor to political and institutional change, researchers can more effectively support equitable and sustainable health outcomes in a global context increasingly inhospitable for attention to health equity….”

Habib Benzian – Let’s Take a Walk

On Substack;

“On streets, systems, and the quiet normalisation of inequality.”

Excerpt: “… This logic has a name. For decades, it has been described as putting health into all policies. On paper, the concept of Health in All Policies is hard to disagree with. In practice, it often stops at awareness rather than authority. Health is acknowledged, consulted, assessed, and then traded off….”

“… The street then becomes more than a diagnostic. It is also a test of what we are willing to treat as non-negotiable….”

“What it suggests is something more demanding than another framework, and something different from importing middle-class consumption into poorer neighbourhoods. It points instead to a rethink of what we treat as a boundary condition. As long as health remains something to be balanced rather than something that sets limits, inequality will continue to assemble itself quietly, storefront by storefront….”

Digital health & AI/health

Nature Medicine – Reinventing health communication for the digital era

https://www.nature.com/articles/s41591-026-04556-7

“The commissioners behind the Nature Medicine Quality Health Information for All Commission explain why improving access to accurate, timely and evidence-based information is now essential to global health.”

Global Public Health – The case for near-term artificial intelligence risks to be considered a public health problem

Richard C. Armitage; https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2716984

“AI is being rapidly integrated across nearly all sectors, including within healthcare and health systems. The prevailing dominant narrative frames AI’s impact on health as overwhelmingly positive and destined to improve further. However, this benefit-focused discourse overlooks a growing set of serious risks to human health arising from AI systems already in use or clearly on a path to deployment—termed as near-term AI risks to health. The most prominent near-term AI risks to health are outlined, including algorithmic bias, erroneous clinical diagnoses and recommendations, AI-enabled health disinformation, harms to mental health, AI-driven mass unemployment, lethal autonomous weapons systems, AI-enabled chemical and biological weapons and AI as both a vulnerability and an enabler of cyberattacks on health systems. Each risk is already causing harm, or could plausibly do so soon, to the health of substantial proportions of populations, thereby collectively satisfying the criteria for a public health problem. Recognising near-term AI risks to health as a public health problem rebalances the benefit-centric narrative. The article addresses counterarguments and briefly outlines potential risk management responses: mandatory AI health impact assessments for high-risk systems, public health-oriented surveillance of AI-related harms and systematic embedding of public health expertise within AI governance structures.”

Lancet – AI for science: decoding complexity for planetary health

E Chen, I Kickbusch et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01368-1/fulltext

“The planetary health system is extraordinarily complex, encompassing human communities, wildlife species, natural ecosystems, and diverse societal factors. Planetary health is constrained by boundaries and finite resources shared across generations.Without artificial intelligence (AI), fully tracking and simulating humanity’s collective environmental footprint against planetary limits was an insurmountable challenge.”

“Peking University, China, is leading an international collaborative effort to build the Planetary Health Axis System (PHAS)—an AI-driven dynamic model. PHAS maps the intricate, non-linear connections of a vast array of interconnected elements and runs century-scale projections across tens of thousands of variables, capturing interactive loops and networks that integrate social and ecological systems. Designed to support decision making, PHAS assesses the systemic impacts of individual or combined policies across four interconnected axes: human health, species health, environmental health, and societal health. PHAS also reveals synergies, trade-offs, and crucial leverage points that conventional fragmented indicators fail to identify…..”

PS: “Preliminary PHAS results from a preprint paper have reproduced well documented associations between extreme temperature, air pollution, and mortality. Comprehensive out-of-sample validation and a public data dashboard will be launched in late 2026….”

Planetary Health

Devex Pro – Could COP31 be the end of negotiations?

https://www.devex.com/news/could-cop31-be-the-end-of-negotiations-112866

(gated) “No blockbuster deal is on the table at COP31. Instead, negotiators are grappling with climate finance, implementation, and an uncomfortable question: What is COP for now?”

Devex – Turkey bets on south-south cooperation ahead of COP31

https://www.devex.com/news/turkey-bets-on-south-south-cooperation-ahead-of-cop31-113068

“Turkey is pitching a new global south-south climate cooperation initiative ahead of COP31 as a practical way to connect developing countries with finance, technology, and implementation support.”

“In July, the Turkish Cooperation and Coordination Agency, or TİKA, alongside the COP31 High-Level Climate Champion and the U.N. in Turkey convened a policy dialogue in Ankara as an initial step toward establishing a Turkey-anchored South-South and Triangular Cooperation Climate Initiative. The initiative is meant to connect developing countries with practical solutions, expertise, technologies and financing while supporting climate resilience and the implementation of nationally determined contributions, with a particular focus on least developed countries and small island developing states. The dialogue was framed by organizers as a way to get ahead of the implementation gap that’s expected to dominate COP31 in Antalya…”

PS: it’s just a proposal for the time being.

Nature (News) – A ‘super’ El Niño could transform the Amazon. Is the world’s biggest rainforest doomed?

https://www.nature.com/articles/d41586-026-02449-w

“The Amazon rainforest might be closer to a tipping point than scientists thought. Some fear that droughts and fire could nudge it into irreversible decline.”

Nature – Ocean temperatures set to break all-time record: what’s next?

https://www.nature.com/articles/d41586-026-02496-3?utm_source=x&utm_medium=social&utm_campaign=nature&linkId=63218791

“High sea surface temperatures are expected to weaken ocean carbon sinks and damage coral reefs.”

“The world’s oceans are on the brink of setting an all-time heat record, reaching temperatures that could roil marine ecosystems and sap the ocean’s ability to take up carbon dioxide from the air. “It just spells trouble for the planet,” says Kristina Dahl, a climate scientist at Climate Central, a non-profit organization in Princeton, New Jersey.”

One Earth- Toward actionable planetary boundary intelligence

K R Shahi, J Rockström et al ; https://www.cell.com/one-earth/abstract/S2590-3322(26)00181-8

“The Planetary Boundaries framework underpins sustainability governance, yet seven of nine boundaries are transgressed and assessments remain too coarse and infrequent to guide action. A planetary boundary intelligence system leveraging Earth observation and geospatial AI could deliver validated, uncertainty-aware indicators of Earth system dynamics if built on defined needs and sustained infrastructure.”

The Conversation – As the climate breaks down, costs go up: Welcome to ‘climateflation’

R M Katz-Rosene et al ; https://theconversation.com/as-the-climate-breaks-down-costs-go-up-welcome-to-climateflation-289352?utm_source=bluesky&utm_medium=bylineblueskybutton

“… Our new research proposes a new way of thinking about rising costs in our contemporary era, through the lens of what we call “climateflation.”…” As a concept, climateflation proposes that the causes, effects and even attempts to mitigate and adapt to climate change are conspiring to make everyday life more expensive. As ecological political economists, we are concerned not just with how rising costs impact people’s wallets, but also with how it might have spin-off effects in areas such as social inequality, political radicalization, geopolitical instability and environmental degradation.”

“…the three main areas we outline above — fossilflation, carbonflation and greenflation — are the main constituent parts of climateflation…..

Guardian – AI’s potential climate benefits outweighed by role in boosting fossil fuels, study finds

https://www.theguardian.com/technology/2026/aug/11/ai-will-do-more-to-boost-fossil-fuel-production-than-green-energy

“Modelling finds AI-driven productivity gains in coal, oil and gas enable more emissions than applications in renewables avoid.”

“AI-driven productivity gains enable more planet-heating pollution from fossil fuels than they avoid from renewables, a study has found….”

Nature (News explainer) – Heatwaves have killed millions. Here’s how scientists tally lives lost

https://www.nature.com/articles/d41586-026-02430-7?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=63131448

“Two very different methods are used to estimate the human toll of heatwaves such as those now hitting parts of Asia and Europe.”

Climate Change News – “We’ve gone backwards” – new plastics treaty text dims hopes for production curbs

https://www.climatechangenews.com/2026/08/12/weve-gone-backwards-new-plastics-treaty-text-dims-hopes-for-production-curbs/

“During troubled talks, fossil fuel-producing nations have pushed for a global pact to tackle only plastic waste rather than reducing the size of the problem.”

“A new draft text to revive deadlocked UN plastics treaty talks does not include specific measures on managing runaway plastic production, a growing source of greenhouse gas emissions, drawing criticism from some countries and campaigners that ambition for the global pact is shrinking.”

BMJ GH – It’s time to put plastics on the health security agenda: a call to action for Indonesia and Australia

S A Saisabilla et al ; https://gh.bmj.com/content/11/8/e023316

« Indonesia has become the primary recipient of Australia’s exported plastic waste, adding to more than 7 million tonnes of domestic plastic waste generated each year. A significant proportion of this waste is openly burned or poorly managed, releasing toxic pollutants linked to respiratory disease, cardiovascular stress, adverse pregnancy outcomes and elevated cancer risk—firmly placing plastic waste as an emerging public health threat and not just an environmental issue.”

« ….Recognising plastics as a regional issue and integrating plastic waste management into Comprehensive Strategic Partnerships (CSP), such as the recently signed Australia–Indonesia CSP, could enhance regional environmental security, reduce health risks and support pan-national achievement of sustainable development objectives and health protection goals….”

BMJ (Opinion) – India’s heatwaves expose the gendered harms of the climate crisis

https://www.bmj.com/content/394/bmj-2026-100556

“Men can adapt to hot weather, whereas women are expected to cope while conforming to social expectations around modesty and housework, write Indu Subramanian and Christianez Ratna Kiruba.”

Access to Medicines, Vaccines & other health technologies

Nature Medicine – Global access to different classes of diabetes medicines: a framework for targeted policy actions

F Teufel et al ; https://www.nature.com/articles/s41591-026-04579-0

“Around 530 million individuals globally have type 2 diabetes, leading to substantial health burdens, as well as economic losses estimated at US $10.2 trillion between 2020 and 2050. Yet, only one in five individuals with diabetes attain glycemic control. The largest diabetes care gaps are in low- and middle-income countries (LMICs), where limited access to medicines is a major barrier in averting diabetes complications. Policy lessons from the HIV response offer a general toolkit for increasing the availability, accessibility and affordability of chronic disease medicines, but these approaches must be adapted to the far larger scale of the diabetes epidemic. Here, we propose a framework that categorizes diabetes medicines based on key access-related characteristics and outline corresponding health policies that could help achieve and sustain access, particularly in LMICs….”

Lancet Regional Health Africa – Trends and inequities in childhood immunisation coverage across West Africa, 1992–2024: a pooled analysis of 81 Demographic and Health Surveys from 14 countries

G E Azumah et al ; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00105-7/fulltext

Findings: “Pooled full immunisation coverage was 48.0%, ranging from 24.1% (Guinea) to 85.6% (Gambia) in recent rounds. Zero-dose prevalence declined but remained 17.2% pooled. Pro-rich inequality was confirmed in 11 of 14 countries, most severely in Nigeria (Wagstaff CI = 0.168) and Guinea (0.156). Equity reversals were detected in Ghana, Mali, and Senegal around 2012–2013, while the regional wealth gradient narrowed over time (interaction OR = 0.962 per decade, 95% CI 0.937–0.986). Skilled birth attendance (OR = 1.84) and four or more antenatal visits (OR = 1.53) were the strongest modifiable predictors.”

Interpretation of the findings: “Immunisation inequities persist across West Africa even as average coverage improves. The equity reversals in Ghana, Mali, and Senegal occurred independently of coverage gains, confirming that monitoring average coverage alone is insufficient and that equity metrics should be embedded in routine surveillance. The strongest modifiable predictors, skilled birth attendance and adequate antenatal care, identify health system contact as the primary leverage point.”

Conflict/War & Health

Lancet Global Health (Comment) – Disability, conflict, and emergencies: 17 years on

A Hamid et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00225-1/fulltext

« Armed conflicts and humanitarian crises are escalating worldwide, displacing record numbers of people and placing unprecedented strain on fragile health systems. People with disabilities are disproportionately affected by conflict, which acts as both a driver and amplifier of disability globally through injury and health system disruption. In Gaza, at least 43 000 people have sustained life-changing injuries from explosive weapons and the destruction of health facilities, likely resulting in long-term disability. The Eastern Mediterranean region is disproportionately affected, yet evidence on access to services for people with disabilities in conflict remains scarce. As the international community convened in June, 2026, for the 19th Conference of States Parties to mark 20 years of the Convention on the Rights of Persons with Disabilities and review its implementation, this scarcity of evidence highlights the persistent gap between policy and practice. Despite escalating needs, disability inclusion remains an afterthought, rarely integrated into frontline responses. »

« Nearly two decades after Kett and van Ommeren warned in The Lancet that disability remained a neglected dimension of conflict and humanitarian emergencies, a substantial gap persists between international disability policy and field-level implementation. Across these two decades, several institutional shifts have reshaped disability inclusion in humanitarian action…”. But implementation is lacking.

Miscellaneous

Nature Editorial – The forgotten 20 million: why is the world neglecting Afghanistan’s girls and women?

https://www.nature.com/articles/d41586-026-02454-z

“It is shameful that half the country’s population continues to be overlooked by the international community.”

“Aid workers say vulnerable Afghans are paying the price for declining Western assistance and limited engagement with the Islamic Emirate.”

· And a Lancet World Report – Afghan health under pressure 5 years after Taliban takeover

“Restrictions on women and girls, deep cuts to international aid, health-facility closures, and mass returns are mounting pressure on Afghanistan’s fragile health system. Sophie Cousins reports.”

BMJ (Analysis) – Pitfalls of announcing regulatory policy in medical journals

https://www.bmj.com/content/394/bmj-2026-100438

“Sean Tu and Aaron Kesselheim argue that sidestepping established administrative processes to announce major regulatory policies undermines transparency, public participation and trust, and regulatory legitimacy.”

Lancet World Report – The global resurgence of syphilis

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01646-6/fulltext

“WHO’s efforts to eliminate the disease are way off target. Sophie Cousins reports.”

““Total global health failure.” That is the view of Michael Marks, Professor of Medicine at the London School of Hygiene & Tropical Medicine, on the inability to tackle syphilis and congenital syphilis. The latest data from WHO show that between 2016 and 2022, new cases of syphilis in adults aged 15–49 years increased globally from 6 million to 8 million. The Americas and Africa together account for more than 70% of the global burden of the disease….”

UN News – Cholera spreads across borders in West and Central Africa

https://news.un.org/en/story/2026/08/1168125

“Cholera is spreading rapidly across West and Central Africa, with active outbreaks now in six countries and millions of children at growing risk, UN children’s agency UNICEF has said.”

Global health events

Africa CDC (press statement) – Africa is Ready to Lead: CPHIA 2026 Opens the Next Chapter of African Public Health

https://africacdc.org/news-item/africa-is-ready-to-lead-cphia-2026-opens-the-next-chapter-of-african-public-health/

“Africa CDC invites scientists and public health experts to submit their work and help shape the scientific programme as the continent moves from health dependency to ownership, resilience and sovereignty.”

“Africa’s public health story is entering a new chapter, shaped by stronger African institutions, African science, local capability and a growing determination to set the continent’s own health agenda. That ambition will be at the centre of the 5th International Conference on Public Health in Africa (CPHIA 2026), convened by Africa Centres for Disease Control and Prevention (Africa CDC) from 23 to 27 November 2026.”

“… Under the theme “Africa’s Health Security and Sovereignty: Transformation from Health Dependency and Vulnerability to Ownership and Resilience,” CPHIA 2026 comes at a consequential moment for the continent….”

2027: A decisive year to consolidate Spain’s commitment to global health

J M Rubio et al ; https://www.global-health-edctp3.europa.eu/news-and-events/news/2027-decisive-year-consolidate-spains-commitment-global-health-2026-07-09_en

“Madrid, Zaragoza and Barcelona will bring together international experts to discuss strategies for addressing health challenges in a globalised world.”

“In 2027, Madrid, Zaragoza and Barcelona will host three of the leading international forums on research, prevention and the fight against infectious diseases. The 13th EDCTP Forum on infectious diseases (April, Madrid)…; the 8th Global Forum on TB vaccines (April, Zaragoza); and the 15th European Congress on Tropical Medicine and International Health (ECTMIH 2027) (October, Barcelona).

Global health governance & Governance of Health

Guardian – Costa Rican diplomat emerges as strong contender to be first female head of UN

https://www.theguardian.com/world/2026/aug/09/costa-rican-diplomat-rebeca-grynspan-contender-first-female-head-of-un

“Rebeca Grynspan seen as continuity candidate with tacit support from current secretary general, António Guterres.”

· WPR Briefing – How the Next U.N. Secretary-General Will Shape the World Order to Come (M Wählish)

“…. While much of the media coverage has focused on the contenders’ ideological leanings and their palatability to the veto-wielding permanent members of the Security Council, the choice of the next secretary-general will reveal less about the candidates themselves than about the major powers charged with selecting them. Their decision will show what kind of U.N. they are still prepared to tolerate, and how much room they are willing to leave for independent multilateral diplomacy.”

Wählish concludes: “In an era of growing confrontation, an effective secretary-general is not a luxury for the international system, but a strategic asset. The next secretary-general will not determine the future of world order. But the choice will reveal something important about the order we already inhabit: whether the major powers still see value in an independent diplomatic voice that can mediate between them, warn them and, when necessary, tell them things they would rather not hear. In an age of renewed confrontation, preserving that space is no small responsibility.”

Global Governance: A review of Multilateralism and International Organizations – Global South Redux: The Making of a Geopolitical Concept

R Kaur; https://brill.com/view/journals/gg/32/2/article-p207_4.xml

“The idea of the Global South has been re-surging since the onset of the Ukraine War. Yet its renewed form is not a re-run of its twentieth century original. It draws from multiple bloodlines of anti-imperialist struggles, bureaucratic regimes of development, and the promise of capitalist markets. Once a name for the global ‘other’, the concept has been reconfigured as self-identification of an emerging geopolitical force by a coalition of postcolonial nations. It simultaneously captures the dreams of multipolarity as well as contradictions of great political and economic shifts rearranging the postcolony. What makes the Global South a durable sign that can be repurposed time and again, is its flexibility: the capacity to not only encompass multiple lineages sometimes at odds with each other but also continuously absorb contradictions and new meanings. This introductory essay to the special forum traces the historical conditions within which the Global South redux emerged, and its manifold futures that lay ahead….”

· Check out the other papers in this Special Forum Global South Redux

Foreign Aid and What Comes Next

B M Hunter et al ; https://scga.scot/2026/08/11/foreign-aid-and-what-comes-next/

A review paper from Scotland. Includes a review of the prospects for three aspects of the proposed post-aid settlement: private & blended finance; domestic resource mobilization; reparations.

Carnegie – How Populist Middle Powers Are—and Are Not—Reshaping Global Politics

C S Chivvis et al ; https://carnegieendowment.org/research/2026/08/how-populist-middle-powers-areand-are-notreshaping-global-politics

“There is a transnational far-right populist movement that links middle powers in a global movement that extends well beyond Trump.” “ Focusing on middle powers, the series explores how populist leaders reshape foreign policy, build transnational networks, and advance shared agendas across borders…. “

ODI – Is the Shanghai Cooperation Organisation the future of multilateralism? India may be the test

V Cable; https://odi.org/en/insights/india-sco-and-the-future-of-multilateralism/

“India’s continued engagement with the Shanghai Cooperation Organisation reveals how major powers are learning to cooperate without alignment.”

“The Shanghai Cooperation Organisation (SCO) Heads of Government meeting at the end of August involves countries which account for 42% of the world’s population and 36% of world GDP, measured at purchasing power parity. Comparable metrics for the G7 are 10% and 28%. Yet the G7 meeting in France in June attracted global attention while the SCO meeting will likely attract very little. That may be a mistake. In an increasingly fragmented world, the SCO raises an important question: can countries with very different interests and political systems still build meaningful forms of multilateral cooperation? India’s membership brings that question into particularly sharp focus….”

“India frames its membership of the SCO as being part of its overall diplomatic strategy of ‘multi-alignment’. Multi-alignment is not the same as non-alignment…”

UHC & PHC

Lancet Primary Care – July issue

https://www.thelancet.com/issue/S3050-5143(26)X2007-6

Including the Editorial: One year of The Lancet Primary Care

“July, 2026, marks 1 year of The Lancet Primary Care. The addition of this title to the growing portfolio of The Lancet Group signalled a clear commitment to advocate for primary health care globally, with public health services, primary care, and community engagement as the foundation for comprehensive care for complex health needs. Our mission to provide an independent voice for the community and champion the value of primary health care worldwide, with the ultimate goal of strengthening health systems as essential institutions, has been our guiding principle during this first year…..”

Pandemic preparedness & response/ Global Health Security

WHO and Tsinghua University launch collaboration to strengthen global health emergency preparedness

https://www.who.int/news/item/06-08-2026-who-and-tsinghua-university-launch-collaboration-to-strengthen-global-health-emergency-preparedness

“The World Health Organization (WHO) and the Vanke School of Public Health (VSPH) at Tsinghua University, People’s Republic of China, have launched a two-year collaboration to strengthen global health emergency preparedness through research, capacity-building and the application of frontier technologies, including artificial intelligence (AI)….”

Planetary health

Guardian – World’s seas have hit hottest temperature on record for July, say scientists

https://www.theguardian.com/environment/2026/aug/10/global-seas-hottest-temperature-july-scientists?utm_source=dlvr.it&utm_medium=bluesky&CMP=bsky_gu

“Average sea surface temperature outside polar regions was highest on record for July, beating previous high in 2023.”

Siberian methane emissions have doubled in a decade, study co-led by UK scientists finds

https://www.eurekalert.org/news-releases/1139031

“Methane emissions from Siberia have more than doubled over the past decade, according to new research co-led by scientists at the University of Edinburgh’s National Centre for Earth Observation (NCEO)…”

Nature News – Ancient rise in CO2 was catastrophic for forests: what that means for today’s plants

https://www.nature.com/articles/d41586-026-02544-y

“A widespread dieback of forests due to climate change 56 million years ago has parallels with today.”

Re a new Science study. “…This sudden warming event, called the Paleocene–Eocene Thermal Maximum (PETM), was one of the most notable climatic upheavals in Earth’s history. The volume of CO2 released during that period is thought to be roughly equivalent to total human emissions that would be released by the end of the twenty-first century under a pessimistic scenario. The ancient surge of CO2 raised global average temperatures by between 5 and 9 °C, changing the climate for more than 150,000 years….”

Guardian – India fuels worldwide jump in planned coal production

https://www.theguardian.com/environment/2026/aug/13/india-planned-coal-production-new-mine

“Rise in new mine proposals, mainly in states of Odisha and Jharkhand, comes despite plateau in global demand.”

“Enough new coalmining projects were proposed last year to increase global supplies by 2.5bn tonnes a year, an increase of 11% from the year before, even as demand for coal plateaus, according to a new report.

“Global Energy Monitor, an NGO, found that India ignited a rise in new coalmine proposals in 2025 despite a global slowdown in the number of mine openings because of falling demand for the fossil fuel. The increase was driven almost entirely by the states of Jharkhand and Odisha, which doubled their proposals for new coalmines in line with an ambitious plan from India’s ministry of coal to increase the country’s output. India plans to increase its coal production by nearly 100m tonnes to 1.15bn tonnes in the 2025-26 fiscal year to help meet the country’s rising demand for electricity to support economic growth and contend with heatwaves, which have become more severe and more frequent because of the climate crisis. The planned increases come despite signs that the world is beginning to turn its back on coal in favour of renewable electricity, Global Energy Monitor said…..”

Inside Climate News – Wildfire Smoke Is Now a Bigger Prenatal Threat Than Human Sources of Air Pollution

https://insideclimatenews.org/news/07082026/wildfire-smoke-pollution-prenatal-threat/

“As regulations have reduced prenatal exposure to harmful emissions from vehicles and industry in recent years, smoke from climate-fueled wildfires is erasing air quality gains.”

Nature Sustainability- On the relevance of post-growth in China

M Li, J Hickel et al ; https://www.nature.com/articles/s41893-026-01889-6

« This Perspective discusses China’s position in a possible global post-growth transition and explores convergence and difference between post-growth principles and development priorities in China. We consider how China’s concepts of ‘high-quality development’ and ‘ecological civilization’ could integrate post-growth principles, and vice versa. Understanding China’s context is crucial for a collaborative, effective approach to sustainability and global equity. »

Infectious diseases & NTDs

Lancet Comment – Once-weekly oral antiretroviral therapy for HIV

https://www.thelancet.com/journals/lancet/onlinefirst

From the study: “Once-weekly islatravir–lenacapavir showed non-inferior efficacy to the standard of care and was generally well tolerated. Longer-term safety data will provide further valuable insights beyond the week 48 data presented here. Islatravir–lenacapavir has potential to be the first once-weekly complete oral single-tablet regimen for HIV-1 treatment.”

Science – A boost for chemical vaccination against malaria

https://www.science.org/doi/10.1126/science.aek0196

“Chemical inhibition of Plasmodium plasmepsin proteins offers a new path for drug-based malaria vaccination.”

PS: “In chemovaccination, exposure to live parasites is accompanied by the administration of antimalarial drugs that arrest the parasite life cycle, preventing illness and allowing the immune system to respond to the attenuated parasite…..”

Plos GPH – Resilience of health systems in Africa to infectious disease shocks: A qualitative evidence synthesis

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006938

By Denis Okethwangu et al.

NCDs

NEJM – Evidence-Based Tobacco-Cessation Strategies for Low- and Middle-Income Countries

D Shelley et al; https://www.nejm.org/doi/full/10.1056/NEJMra2507061?query=featured_secondary_home

« This review summarizes tobacco-cessation strategies in low- and middle-income countries, with emphasis on population-level interventions, subsidized pharmacotherapy, and systemwide integration to expand access to treatment. »

Nature Medicine – Sleep as therapy

https://www.nature.com/articles/s41591-026-04582-5

“Once seen as a symptom, disrupted sleep is emerging as a modifiable driver of chronic illness. Drugmakers are targeting sleep pathways to reshape chronic disease biology, from pain to depression.”

Nature Medicine – Type 2 diabetes prevention across the life course

Y Wang et al; https://www.nature.com/articles/s41591-026-04550-z

“Rather than intervening when dysglycemia is established, prevention efforts should focus on prediabetes remission and restoration of normoglycemia. Here the authors call for a new agenda informed by mechanistic heterogeneity, a life-course risk architecture and scalable precision tools.”

Plos GPH – A content analysis of global and national policies, plans, and guidelines to integrate NCDs with HIV care in LMICs

Reet Kapur et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007072

“ Global organizations have called for integrating NCD management into existing HIV care systems, but it is unclear what actions countries are taking to accomplish this goal. To bridge this knowledge gap, we conducted a quantitative content analysis of HIV policy documents from the World Health Organization (WHO), the US President’s Emergency Plan for AIDS Relief (PEPFAR) and 22 PEPFAR-sponsored LMICs to analyze mentions of: 1) screening and treatment of selected NCDs (hypertension, diabetes, cervical cancer, and depression) and/or two NCD risk factors (alcohol and tobacco use), and 2) health system-strengthening strategies when mentioned in relation to the selected NCDs and risk factors. We used the WHO’s Building Blocks framework to identify these strategies…”

Social & commercial determinants of health

Unseen Women, Invisible Struggle: Zika and the Gendered Burden of Care in Brazil

C Batista et al; https://academic.oup.com/edited-volume/62988/chapter-abstract/570427671?login=false&redirectedFrom=fulltext

« The Zika epidemic in Brazil can be understood not only as an arboviral outbreak with severe congenital consequences but also as a socially patterned public health crisis that exposed how infection, reproductive risk, and the long-term consequences of care were unequally distributed across gender, race, class, and territory. First identified in Brazil in 2015, the infection in pregnant women was later associated with a steep increase in microcephaly and other severe congenital abnormalities, later described as congenital Zika syndrome. The epidemic unfolded through pre-existing structural inequalities and disproportionately affected poor Black and brown women in the Northeast, in some of the country’s least developed territories. This article examines the Zika epidemic in Brazil through four lenses: intersectionality, structural inequality and the social determinants of health, reproductive politics, and the gendered burden of care. It shows how precarious housing, inadequate access to sanitation and piped water, food insecurity, low education levels, weak reproductive protection, and unequal access to health care and social support shaped exposure to infection, limited women’s ability to avoid contact with mosquitos, constrained women’s reproductive autonomy, and transferred the long-term work of care to mothers and families. A decade after the crisis gained global visibility, the burden of Zika persists in certain impoverished regions of Latin America and the Caribbean, posing potential threats for future reemergence. As the virus followed the contours of race, vulnerability, and deprivation, an unfinished agenda remains with regard to integrating the social determinants of health, long-term caregiving, and reproductive justice as part of global health preparedness. »

Sexual & Reproductive health rights

Lancet GH – Drivers of adolescent pregnancy decline in five adolescent sexual and reproductive health and rights exemplar countries: a quantitative decomposition analysis

C B Aerenson et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00196-8/fulltext

“In 2023, there were 9·9 million births among adolescents aged 15–19 years in low-income and middle-income countries, with an estimated half of those births unintended. Cameroon, Ghana, Malawi, Nepal, and Rwanda stand out as exemplar countries experiencing some of the largest declines in adolescent fertility (ie, the demographic concept of livebirths per woman) globally between 2000 and 2023 relative to countries with similar socioeconomic change during this period. We aimed to examine how these five countries reduced adolescent pregnancy by decomposing declines into key determinants….”

Lancet Regional Health Africa – Breastfeeding in Africa: mothers need enabling environments beyond education

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00101-X/fulltext

Editorial of the new August issue .

Related to World Breastfeeding week.

Neonatal and child health

Lancet Global Health (Comment) – Beyond survival: malaria-associated acute kidney injury

M A Alao et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00169-5/fulltext

“In this issue of The Lancet Global Health, Kagan A Mellencamp and colleagues report that children who survive severe malaria complicated by acute kidney injury (AKI) have three times the risk of major adverse kidney events, four times the risk for mortality 2 years after discharge, and an elevated likelihood of subsequent chronic kidney disease (CKD). Their findings shift attention from the immediate question of survival to the longer term question of kidney health after survival. This reframing is timely. Malaria caused an estimated 263 million cases and 597 000 deaths globally in 2023, with the WHO African region accounting for 94% of malaria-related deaths; children younger than 5 years accounted for more than three-fourths of these deaths….”

“For decades, the paediatric severe-malaria agenda has appropriately prioritised a single urgent outcome: survival through acute illness. That priority remains unquestionable. However, the new findings presented by Mellencamp and colleagues challenge the assumption that malaria-associated AKI is typically transient after fever resolves and serum creatinine levels improve. This distinction is important because AKI in severe malaria is common, frequently community acquired, and often under-recognised, particularly when non-standard definitions, isolated creatinine measurements, or inadequate urine-output monitoring are used…”

· The new study in the Lancet GH: Long-term mortality and risk of chronic kidney disease in children following severe malaria complicated by acute kidney injury: a prospective observational study

Access to medicines & health technology

· Via People’s Health Dispatch: “An India–US trade deal could come with a hidden price tag: more expensive medicines. At the heart of the discussion lies the contentious issue of Data Exclusivity (DE) – a provision that could delay generic competition, extend monopolies, and ultimately put life-saving drugs out of reach for millions….”

Lancet Regional Health – Invisible fungal disease, visible consequences: diagnostic capacity and antimicrobial resistance in Africa

Samar R. Abdullahi et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00108-2/fulltext

« Severe invasive fungal diseases (IFD) cause about 6.5 million infections and 3.8 million deaths every year, a burden similar to tuberculosis and malaria. However, IFD are largely missing from national health records and global disease estimates. The problem is especially clear in Africa, where high rates of HIV and tuberculosis drive cryptococcal disease, invasive aspergillosis, and histoplasmosis. Yet, these are often the same places where fungal testing and disease tracking are hardest to access….”

“…Poor access to fungal testing also affects antimicrobial resistance. When IFD cannot be confirmed, patients often receive long courses of antibacterial treatment while the real IFD goes untreated. Patients with chronic lung aspergillosis may receive repeated antibiotics or extra tuberculosis treatment, while patients with bloodstream yeast infections or cryptococcal meningitis may be treated as bacterial infections simply because the right tests are not available. Resistance in fungi is equally invisible: without culture and susceptibility testing, resistant isolates are never identified and never counted. Antimicrobial resistance strategies have rightly focused on antibiotic stewardship and surveillance, but diagnostic stewardship, making sure the right test happens before treatment, has received far less attention. Expanding access to essential fungal tests should be seen as a core part of antimicrobial stewardship, not a separate goal….”

Nature Africa – Nanophotonics offers new hope for early malaria diagnosis

https://www.nature.com/articles/d44148-026-00226-5

“Tanzanian physicist Amos Kiyumbi is developing affordable malaria diagnostics for low-resource settings by harnessing the power of light and nanotechnology.”

Lancet Infectious Diseases (Newsdesk) – Merck’s alimatravir licensing deal receives mixed response

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00439-1/abstract

“In July 2026, Merck announced licensing agreements with seven manufacturers for generic production of its HIV drug alimatravir, though access and equity concerns remain. Ed Holt reports.”

Human resources for health

Human Resources for Health -Critical unemployment or shortage of the health workforce in West Africa? Unravelling the health labour market puzzle in Guinea, 2024

Delphin Kollié et al; https://link.springer.com/article/10.1186/s12960-026-01087-7

“The 2016 global strategy on health human resources highlights the health workforce as a cornerstone of sustainable and resilient health systems. Over the last decade, Guinea has launched great reforms to tackle critical health workforce challenges, including shortages and geographical imbalances. We undertook this study to understand the implications of these reforms on the availability, distribution, gender composition, and employment of the workforce in rural areas….”

SSM Health Systems – To leave or stay towards Universal Health Coverage: qualitative analysis of factors influencing poor retention of primary healthcare workers in deprived districts of Ghana

https://www.sciencedirect.com/science/article/pii/S2949856226001303

By S Amon et al.

HP&P – The political economy of novel food taxes and subsidies in India: insights from stakeholder interviews and a scoping review

https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag093/8739469?login=false

by A Summan et al.

Decolonize Global Health

Plos GPH – The precarious state of community engagement in African clinical trials: A systematic review of funding, workforce gaps, and the path to institutionalization

L Engelbert Bain et al. https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006484

“…. Analysis revealed a dependency trap with approximately 90% of clinical trials in sub-Saharan Africa estimated to be funded by external international donors, creating a sustainability gap where essential trial components, such as community engagement and laboratory infrastructure, often dissolve upon the conclusion of a specific grant. We identified three primary typologies: instrumental (recruitment-focused), ethical (compliance-focused), and collaborative (partnership-focused). Findings show that while robust CE correlates with improved recruitment and social value, the reliance on uncompensated community labor and indirect funding models threatens the long-term viability of the African trial ecosystem. Transitioning from extractive CE to institutionalized CE is critical for Africa’s vaccine sovereignty, requiring funding models to shift toward direct, ring-fenced budgets to ensure pandemic preparedness and ethical integrity.”

Migration & Health

UN News – Migrant deaths climb sharply in 2026, new UN data shows

https://news.un.org/en/story/2026/08/1168127

“Severe weather, war, economic pressure and shifting policies reshaped migration journeys across multiple regions in the first four months of 2026, driving a surge in deaths, according to new data released on Wednesday by the International Organization for Migration (IOM).”

Think Global Health – Japan’s Immigration Push Calls for Health System Reform

H M Abeywickrama; https://www.thinkglobalhealth.org/article/japans-immigration-push-calls-for-health-system-reform

“As Japan seeks to attract foreign workers, the government should address its health system’s language barriers, cultural misunderstandings, and structural challenges.”

Papers & reports

HP&P – Examining evidence use in vaccine policymaking in Kenya: A qualitative case study

D Waithaka, et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag100/8758085?searchresult=1

“Although evidence-informed health policymaking is widely promoted, evidence use in vaccine policymaking and the institutional and actor dynamics shaping it remain poorly understood. This study investigates what types of evidence were used and how they were used in vaccine policymaking in Kenya. Using a qualitative case study design, we focused on the introduction and roll-out of HPV and malaria vaccines. “

“… Framework analysis was used to analyse the data, guided by two analytical frameworks: (1) a spectrum approach for categorizing evidence along two dimensions – scientific to tacit and global to local – and (2) Weiss’s models of research use, which interpret patterns of evidence utilization in policymaking. The findings show that international actors, through their financial and technical authority, substantially influenced national policymakers’ adoption of global guidance and scientific evidence. Local programmatic expertise played a crucial role in validation and contextualization of global guidance and scientific evidence to fit local contexts. The dominance of medical and public health professionals in decision-making spaces led to the prioritisation of evidence on vaccines’ public health benefits over socio-political considerations. Local civil society’s influence in vaccine policymaking was limited, with their community-based experiential knowledge primarily informing advocacy, communication, and social mobilization, rather than vaccine prioritisation and policy decisions. We conclude that strengthening evidence-informed policymaking requires more inclusive approaches that value diverse evidence types.”

Editorial: Taking a few weeks off (IHP News #893)

Kristof Decoster — Fri, 14 Aug 2026 04:41:54 +0000

Dear Colleagues,

First a short “message from the house”: IHP is about to go on holidays for a few weeks. Stay tuned for the next issue somewhere early September (probably a big catch-up issue).

In this week’s issue, you find among others some of the usual updates on global health governance and financing, including important new work from CGD on the World Bank and Global Health Financing. Sadly, the Gates Foundation ignored our gentle hint from last week, and decided to splash out again on IHME “with a landmark 10-year investment” (over half a billion, pocket money for Bill) : ) Although the fine print is no doubt an improvement over the Gates/IHME collaboration in the MDG era, I wonder how this rhymes with the ‘new paradigm towards more health sovereignty’ and other “Accra Resets”, but hey, that’s just me. Speaking of the Accra Reset, many of us are already looking forward to the High-Level panel recommendations, set to be released in the coming weeks, ahead of UNGA. Members of the Joint Task force in the WHO-convened process are also known now (scroll down to ‘Joint task force’).

On Wednesday, Tedros warned “the ongoing Ebola outbreak in the Democratic Republic of Congo is on track to become the world’s largest in history”. Deaths from the Ebola virus disease have now surpassed 2,000, with half of that number in the last 20 days, according to local officials. We hope the new momentum and approach, agreed upon after last week’s High-level visits to the country, will manage to turn the tide in the coming months. In the meantime, “a ‘mismatched vaccine’ is also already being rolled out”, Science insider reported.

Speaking of vaccines, still on Wednesday, Tedros and other WHO officials probably didn’t make themselves any more popular in the White House, strongly condemning Trump’s intended vaccination changes – for good reason. Long ago, this White House has moved beyond just ‘misguided policies’; for many observers Trump 2.0 has turned the presidency into a cruel farce. Some day, American historians will try to figure out what exactly happened there. They’ll need more than a few tomes, I reckon.

Over here in Europe, after this summer most people (and a fair amount of leaders I suspect) now understand that ‘climate change’ is not just “another issue/challenge to be dealt with in the coming decades”. I might be naïve, but I would hope that something of that realization also trickles down a bit more prominently in the two main global health reform efforts mentioned above. While keeping in mind a suggested updated definition of global health (2025), global health reformers could perhaps take some inspiration from G Monbiot’s latest op-ed in the Guardian, “Don’t despair about what’s happening to our planet. That’s what they want you to feel”. In the viewpoint, he argues “there are social tipping points when the seemingly impossible suddenly becomes inevitable” (as history has shown many times). Monbiot concludes on this note, however: “…The greatest question we confront, possibly the greatest question humanity has ever confronted, is whether we can hit the social tipping points before we hit the environmental tipping points.”

The related question for me is: will global health reformers largely remain “by-standers” in this urgent need for social tipping points, or will they do their part? With the risk of environmental tipping points increasing fast, and even ‘societal collapse’ less of a prepper conversation topic than before, time is running out. I’m probably not the only one reading articles from “Centres of Existential Risk” with a bit more interest these days. Can we really wait for the ‘post-2030’ global health related conversations? We all know the answer.

And all this, while in our polycrisis era so many other urgent priorities should get much higher on the political agenda. For example this one, emphasized in a Nature editorial: The forgotten 20 million: why is the world neglecting Afghanistan’s girls and women? Five years after the Taliban took back control in the country, it’s a grim question indeed.

Enjoy your reading.

Kristof Decoster

Editorial: IHP news 892: A new tax era of development ? (IHP News #892)

Kristof Decoster — Fri, 07 Aug 2026 07:45:33 +0000

Dear Colleagues,

In case you missed our Monday morning ‘catch-up issue on the past 10 days’ (with focus on the AIDS2026 conference in Rio), see the IHP newsletter page (where you can find the ‘archive’). Today we continue with this week’s global health news. Still on the Rio conference, Mukesh Kapila’s HPW analysis is a must-read. After just three episodes, we’ve already become quite fond of his incisive take on the global health week ( in his weekly ‘Vital Signs’ column).

As already flagged on Monday, this week is World Breastfeeding week (1-7 August) (with also an updated Global Investment case). Ahead of the UN High-Level Meeting on PPPR end of September, HPW presented the ‘Final Text’ of the UN Political Declaration on Pandemics (while admitting its adoption is far from guaranteed).

There are also a few updates in the WHO DG race, which is heating up (nominations close on 24 Sept) against the backdrop of a very worrying Ebola emergency in the DRC, currently spreading faster than all previous Ebola epidemics. Earlier this week, Africa CDC’s Jean Kaseya visited Bunia for the second time “in a joint Africa CDC–World Health Organization mission to assess the Ebola response, support teams on the ground and identify what more is needed to stop the outbreak and protect communities.” Tedros followed suit a few days later. They have their work cut out, with plenty of external factors also playing a role in what is now the second-deadliest Ebola outbreak in history. Let’s hope the high-level visit leads to new momentum in the response.

As you might have noticed, FIFA boss Infantino has also been ‘in the news’ lately, but so far WHO and other UN organisations with collaborations with FIFA stay fairly numb on the issue. Maybe under the motto “you never know where the guy might still end up.”

In this week’s issue, we also pay some attention to the start of the 5th round of negotiations on the UN Framework Convention on International Tax Cooperation (3-13 August, New York). In a Project Syndicate op-ed, “The Case for a Pay-Where-You-Play Tax System”, in which J Ghosh also refers to a new Global Tax Justice report, she doesn’t mince words on the stakes: “… it is worth remembering that democracy itself emerged from the struggle for fair taxation, reflected in the principle of “no taxation without representation.” For decades, multinational corporations have been shifting profits out of the countries where they are generated into accounting “nowhere” zones. This has led to widespread economic insecurity, creating fertile ground for billionaire-backed authoritarianism. The UN Tax Convention offers a different path, asserting that the shops, offices, factories, and workers that generate global profits matter. By restoring the link between where profits are made and where they are taxed, the Convention advances a modern form of taxation with representation and carries forward one of democracy’s oldest principles.”

That’s right. And so I’m not a big fan of CGD’s new blog series ‘Putting the AI Windfall to Work’. Rationale for the series: “ The AI boom could result in anywhere from $50 billion to $100 billion in annual philanthropic spending over the next few years. The question is, how can this money be spent effectively?”. Together with many others, I doubt that’s “the (key) question” in this age, even if some CGD suggestions certainly make sense.

Over to global health (architecture) reform then, which among others featured this week a smart read from Arush Lal et al in Nature Health, ‘Reforming global health for an age of mistrust, fragmentation and overlapping crises’ and an eye-opening (as well as worrying) HPW analysis by K Rifat Hossain. This week, both CGD and Think Global Health also published updates on the US bilateral health agreements. Yesterday, there was also a high-profile announcement by the Trump administration on a “Historic $2 Billion in Health and Humanitarian Assistance to Faith-Based Organizations”.

Zooming out a bit, it’s clear many Africans (and certainly young Africans) are ‘done with aid’, even if they acknowledge the current hardship of a way too abrupt transition. Maybe it’s time the “Global Health community” (including the ‘regulars’ at high-profile conferences and summits) shows equal courage, and joins the new ‘tax era of development’ unequivocally, with all that entails? I’m personally ‘done with philantropy’, at least of the indecent billion-dollar kind : ) While I agree Gates and other Bloombergs certainly aren’t part of “The Nerd Reich” (very much to their credit), the overall power (/ danger) of the billionaire class is now huge, and not just in the US (see also the quote from J Ghosh earlier). It’s time to ‘go beyond billionaires’, including in global health. There are many other good reasons for a gradual transition in the coming years away from billion-dollar philanthropy (as I sure admit many of their global health teams do valuable and great work), such as: philantropists’ outsized impact on global health’s Overton Window (clear during the pandemic eg, but which in my opinion also partly explains this relative reluctance to join the global tax justice movement more enthusiastically), their strong links with the relentless financialization of the global economy, the fact that many of them, together with other neoliberal Davos men & women, have helped to pave the way for the current billionaire-backed authoritarianism etc … But this is a personal view, as a concerned ‘global (health) citizen’ : )

I admit a lot of the ‘New Paradigm for Global Health Financing’ (by Kaberuka, Pate et al, Project Syndicate op-ed) goes in the right direction. Yet, global health big shots like them still leave making the case for the ‘new tax era’, and what it would really imply, too much to Tax Justice Network, Oxfam and other Zucmans. For example, in order to get to what they call ‘financing for GPGs, ” – their third focus in the op-ed. The fact that they label this ‘a long-term agenda’ doesn’t sound very promising either. I personally doubt we still have the luxury of a ‘long term agenda’ (see below – paragraph re planetary health)…

But let’s indeed assume that getting to global tax justice, broadly defined, at all levels will take some time (not wrong, if ever), and so, for the fun of it (still as a ‘concerned global health citizen’), while awaiting that tax nirvana, just brainstorm a bit on how the 200 billion dollar the Gates Foundation intends to spend in the coming decades already could be spent more in line with such a new ‘fit for purpose model’ in terms of inclusive governance, for example via a new Global Public Investment entity (with far more inclusive governance than currently Bill, Mark Suzman and whoever happens to be on the GF Board), plus a number of regional health entities (also with inclusive governance). My guess is that would help to tackle the current “mistrust” in the global health architecture considerably. Heck, it could be a ‘game-changer’ : ) Far greater minds can help work out the specifics of ‘how to spend 200 billion dollar by 2045 with more inclusive and transparent governance than just Bill, Mark & a few others’. And as you know I’m a generous man (on days with enough sleep, that is), in that set-up, Bill and Mark would still be allowed a few hundred million a year to play with themselves, as entrepreneurs trying to ensure ‘catalytic innovation’, ‘address market failures’ etc. : )

Meanwhile, coming back on the abovementioned ‘long-term horizon’, the planetary health havoc wreaked by our global and increasingly billionaire-driven economic system, is rapidly increasing. Clearly, “the climate emergency is upon us” now. Or in the words of (a slightly subdued) UN SG Guterres last week: the “Climate Crisis (is now) in ‘Overdrive’. Perhaps Rebecca Solnit put it most poignantly, at least for people who live in the world’s temperate zones like myself: “Summer is not what it once was. We have been robbed of one of life’s great joys….”

Let’s end on a more combative note, however: the world might have entered the ‘era of farce’ on more days in the week than we’d like, but we wholeheartedly agree with Tedros (in a Nature viewpoint), that “as WHO enters its ninth decade, it’s more needed than ever”. In times like these, somebody will have to stay cool-headed.

Enjoy your reading.

Kristof Decoster

Weekly topics: IHP news 891: Highlights of the week (IHP News #891)

International Health Policies — Mon, 03 Aug 2026 06:54:21 +0000

Structure of Highlights

· IAS26 in Rio: key news, themes & reports

· IAS26 in Rio: some more analysis & snippets

· Global Health Reform

· WHO DG race

· More on Global Health Governance & Finance/Funding

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

· Ebola emergency in the DRC

· More on PPPR (incl PABS)

· AMR

· UHC & PHC

· Commercial determinants of health

· Maternal and child health

· Planetary Health

· AI & health

· Access to medicines, vaccines & other health technologies

· Miscellaneous

26^th Aids conference in Rio: key news, themes & reports

This subsection will be mainly based on the valued work of colleagues of Devex & Health Policy Watch, present in Rio. But don’t expect an exhaustive overview, and it will only be to some extent chronological. After all, last week was a holiday for me : )

UNAIDS report – Global HIV response falters as reemergence looms

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2026/july/20260727_PR_UNAIDS_special_report_AIDS2026

This report set the scene for IAS26. “In 2025, 1.2 million more people became infected with HIV and 570 000 more people died of AIDS-related illnesses as the world fell short of global targets. Without urgent action to meet the 2030 goals, more than 3 million could become infected with HIV by 2030. “

“A special report released by UNAIDS for the 26th International AIDS Conference taking place in Rio de Janeiro, Brazil from 27 to 31 July, shows that reductions to international funding and cuts to HIV prevention and community services are likely to lead to a resurgence of the epidemic. “

“Why experts are worried about an HIV resurgence: International funding to combat HIV suffered a “profound shock” last year, according to a new report from UNAIDS, a United Nations effort around the virus. The report found that disbursements from donor governments to low- and middle-income countries decreased 25% from 2024 to 2025. Overall funding to combat HIV fell 18%, to $6.2 billion….”

“Why it matters:

1.2 million people acquired HIV and 570,000 died from AIDS-related illnesses in 2025
22 per cent of people living with HIV are still not receiving treatment
International HIV funding fell 18 per cent, the steepest decline in nearly 20 years
Such new medicines as lenacapavir are nearly 100 per cent effective at preventing HIV infection
20 million people need access to antiretroviral-based prevention to make a meaningful impact on the epidemic
Generic versions of lenacapavir could cost as little as $40 per person per year, but they will remain unavailable in many countries”

Excerpts:

“The conference, taking place in Rio from 27 to 31 July, is defined by a paradox. By the end of this decade, more than three million people could become infected with HIV, yet the tools to stop this crisis already exist, from groundbreaking prevention medicines to community-led interventions with a proven track record. What is missing is sustained financing. This growing funding gap is already forcing countries to cut essential services and close community organizations, according to the new report from UNAIDS, the agency working to end the epidemic by 2030. Unless urgent action is taken, the agency warns, the world is on course for a resurgence of the epidemic. That contradiction defines the 26th International AIDS Conference. On the one side stands a revolution in HIV prevention, with a new generation of medicines now offering protection against HIV comparable to that of a vaccine. On the other is a growing concern that these breakthroughs will remain out of reach for millions because they are priced too high and controlled by pharmaceutical patent holders.”

PS: “Equitable and universal access remains a distant reality for millions of people because of high prices and the exclusion of many countries from voluntary licensing agreements,” said Variano Terto Jr., vice president of the Brazilian Interdisciplinary AIDS Association (ABIA). He was speaking at a conference side event organized by the Community of Portuguese Language Countries (CPLP).

He added that patents on essential drugs have been “reinforcing monopolies and privatization of public knowledge”. One of the conference co-organizers, ABIA recently published a study showing that Brazil could manufacture lenacapavir domestically for approximately $75 per patient per year. By contrast, the patented version costs more than $20,000, a price considered unsustainable for Brazil’s public health system….”

PS: “Calls for new funding model: The current moment should be understood as “the end of the era of dependence on international aid”, the UNAIDS chief (Winnie Byanyima) said, calling for a new financing model, including measures such as sovereign debt restructuring, to enable governments to invest in “the future of their people”.”

KFF/UNAIDS – Donor Government Funding for HIV in Low- and Middle-Income Countries in 2025

KFF/UNAIDS

(27 July) Accompanying report. “Donor Government Funding for HIV Drops by $2.1 Billion in 2025 Due to Declines in Funding from the United States, Marking Largest Annual Decrease Since Scale-up for the HIV Response Began.”

“Donor government funding to combat HIV in low- and middle-income countries fell by $2.1 billion in 2025, a 25% decrease from the previous year, according to a new report by KFF and the Joint United Nations Programme on HIV/AIDS (UNAIDS). … Total disbursements dropped to $6.2 billion in 2025, down from $8.3 billion in 2024, marking the largest single-year decline since donor funding scale-up began and the lowest funding level since 2007, the report finds….”

“The 2025 decrease was driven by a decline in U.S. disbursements following the U.S. administration’s substantial reductions in global health funding, programs, and personnel. Despite this decline, the U.S. remains the largest donor to HIV in the world.”

“Excluding the U.S., HIV funding from all other donor governments, while steady in 2025, has declined by half since 2011 — from $3.2 billion in 2011 to $1.6 billion in 2025 — primarily due to reduced bilateral support. As a result, the U.S. share of total donor government funding for HIV has risen — from 59% in 2011 to 74% in 2025 — making available resources increasingly vulnerable to changes by the U.S., as was seen in 2025….”

PS: “… The donor government findings are part of a broader UNAIDS analysis of HIV financing from all sources, including domestic, multilateral, and philanthropic funding, which found that overall international assistance for HIV declined by 18% between 2024 and 2025.”

· More coverage & analysis via HPW: US Drives 25% Plunge in HIV Funding in 2025

Devex CheckUp: US State Dept’s unexpected opening act at world’s largest HIV conference

(28 July) https://www.devex.com/news/devex-checkup-us-state-dept-s-unexpected-opening-act-at-world-s-largest-hiv-conference-112938

“Jeffrey Graham, head of the State Department’s Bureau of Global Health Security and Diplomacy, says the public misunderstands the new U.S. bilateral health deals. …””

Full excerpt: “Here’s what Graham said:

• Not all countries that sign memorandums of understanding will receive direct government-to-government financing, and those that do will undergo “difficult procedures to qualify.” But some examples of those slated to get direct financing include Kenya, Rwanda, and Uganda.

• Other countries that sign MoUs but won’t — at least initially — receive direct financing will have funding funneled through implementing partners. But this will only sometimes include the usual suspects: international NGOs. The State Department is looking to lean heavily on locally headquartered faith-based organizations, the private sector, and other organizations.

• Given the State Departmen t must report to Congress on how tax dollars are used, the U.S. has a final say on which implementing partners countries use with American financing.

• Not all U.S. partnerships take the form of MoUs. Some are just multiyear bilateral arrangements — the key difference being that MoUs require countries to coinvest alongside U.S. funding.

• Implementation has yet to begin, but there are 71 countries developing implementation plans with the U.S., including over 50 with PEPFAR programming.

• Thirty-four countries have signed nonbinding MoUs with the U.S. That number could still grow.

• There are other “buckets” of funding the State Department will manage centrally. One to finance innovation, another for incentives for countries that exceed defined health targets, and to support countries hit by unexpected roadblocks beyond their control.

• New awards will be issued for work in Nigeria, Mozambique, Uganda, Malawi, Côte d’Ivoire, and Cameroon under the State Department’s annual program statement — an opportunity for organizations to receive U.S. funding outside of the bilateral deals.

Graham also pushed back on several criticisms surrounding the new agreements, disputing claims the MoUs include critical minerals provisi ons, saying the U.S. isn’t forcing countries into rapid transitions of country ownership, and arguing that the data-sharing requirements are in line with previous arrangements…..”

“At AIDS 2026, U.S. officials offered their clearest account yet of how the new bilateral health agreements will work.”

Devex@the 26^th IAC – Left out

Andrew Green; Devex;

(29 July) “…. At the start of this year’s IAC, U.S. government officials offered some long-awaited insights into their plans for ongoing funding of the HIV response …. At the center of those efforts are the bilateral health deals that partner countries have struck with governments to maintain some support for HIV programs and other health services. We’ve only had patchy insight into those deals through memoranda of understanding that have leaked or been released. …” “ But this week, I’ve spoken to officials from partner governments who told me that implementation of those agreements is set to begin on Oct. 1 in many places. And they say efforts are being guided by implementation plans that were drafted — or are still being drafted — in a collaborative process between U.S. and domestic officials. Not in the room? Representatives from civil society or community groups.”

HPW – Amid Row Over Exclusion, US Concedes that HIV Approach Needs to Include ‘All People at Risk’

https://healthpolicy-watch.news/us-concedes-that-hiv-approach-needs-to-include-all-people-at-risk/

(26 July) “The United States has conceded that the HIV epidemic cannot be stopped “unless we have services for all people at risk” at a major event on the eve of the International AIDS Conference. Dr Rebecca Bunnell, deputy head of implementing the US President’s Emergency Plan for AIDS Relief (PEPFAR), made the remark at a US government event to explain the new “America First Global Health Strategy”….”

“…the US government session had been interrupted by HIV activists blowing whistles and chanting: “You lie, people die. Restore PEPFAR now.””

HPW – New HIV Frontier: The Fight to Access Long-Acting Prevention Drugs

https://healthpolicy-watch.news/brazil-pushes-for-inclusion-in-pharma-deals/

(29 July) “News that an antiretroviral drug injected twice a year had prevented almost all HIV infection in trials electrified the HIV sector two years ago – but access to Gilead’s lenacapavir has been slow, particularly for countries in Latin America.”

“Brazil, which faces significant HIV transmission in certain groups, has been routinely excluded from HIV voluntary licensing deals offered by pharmaceutical companies – particularly for long-acting pre-exposure prophylaxis (PrEP) – as it is deemed an upper-middle-income country. Brazilian Health Minister Dr Alexandre Padilha told the International AIDS Conference (AIDS 2026) being hosted in his country that negotiations with Gilead had run aground as the company wanted a price 10 times higher than that being paid by Indonesia and Thailand. Brazil offers PrEP as part of its free universal health coverage, and Padilha said he was not prepared to bankrupt the health system by paying a high price for lenacapavir. “Innovation without access is injustice,” said Padilha at the conference opening on Monday night.”

PS: “Instead of pursuing lenacapavir, his country has opted to use ViiV’s cabotegravir, injected every second month, to bolster its PrEP programme as the company has offered Brazil “an acceptable price”, Padilha added. ViiV and the Medicines Patent Pool (MPP) signed a voluntary licensing agreement to enable generic manufacturers to make generic versions of long-acting cabotegravir for PrEP for 90 countries – but this excludes most Latin American countries….”

Science – Activists and leaders at global HIV meeting decry price of prevention drug

K Kupferschmidt; Science;

(28 July) “Gilead is criticized for lack of affordable access to lenacapavir in Latin America.”

“ “Activists briefly interrupted the opening ceremony of the 26th annual International AIDS Conference here last night to protest the lack of access in Latin America to lenacapavir, a new long-lasting drug that prevents HIV infection. Brazilian officials, too, criticized the drug’s manufacturer, Gilead Sciences, for not making the drug available at an affordable price in the region, as did World Health Organization Director-General Tedros Adhanom Ghebreyesus and Winnie Byanyima, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).”…”

“… The drug costs $14,000 per dose in the United States, but Gilead is offering lenacapavir for an HIV-prevention strategy known as pre-exposure prophylaxis (LEN PrEP) at no profit to 120 low- and middle-income countries. (It has not revealed the exact price, but reportedly charges $60 per dose.) But Gilead says Latin American countries can pay more than that and has been negotiating with governments in the region. Byanyima said Brazil has negotiated with Gilead for more than a year and failed to reach a deal. The country “should not now be forced to stand in the back of the queue,” she said…..”

“… Even in countries that get LEN PrEP at a discount, there aren’t enough doses to meet the demand. As Science reported last week, fewer than 250,000 people in developing countries had begun to use it by the start of this month. Byanyima said she would like to see 20 million people get the injections in the next 3 years, noting that the world vaccinated 4.5 billion people against COVID-19 in 1 year. “This is not beyond the world’s capacity,” she said. “So I ask my friends at Gilead again, help us to change this.”…”

NYT – With Hopes High for New H.I.V. Prevention Pill, Merck Takes Steps to Ensure Access

https://www.nytimes.com/2026/07/24/us/politics/merck-hiv-pill.html?unlocked_article_code=1.0FA.0N8d.ldOClV4GjaOd&smid=url-share

(24 July) Some good news as the conference was about to kick off. “Companies in Africa and India will make generic versions of the pill that could cost as little as $5 per person per year. But access to the drug and other new products in much of Latin America remains uncertain.”

“The pharmaceutical company Merck said on Friday that it would license seven generic drugmakers to produce a low-cost version of a new monthly H.I.V. prevention pill that has generated significant optimism about the role it could play in ending the H.I.V. epidemic. The decision is intended to make stockpiles of the drug immediately available in developing countries if clinical trial results next year live up to expectations for the pill.”

“The company’s announcement on Friday comes as a major international AIDS conference begins in Rio de Janeiro, against a backdrop of disappointment with limited progress on cutting H.I.V. infection rates. …. The new drug, alimatravir, is a pill taken once a month for what is called pre-exposure prophylaxis, or PrEP. It is being tested in a late-stage trial involving young women in three sub-Saharan African countries, and in a separate trial in countries across Latin America, Asia, Europe and Africa that involves transgender people and men who have sex with men….”

“ … Merck’s deal will allow generics to be produced for 129 low- and middle-income countries. The company said it would also manufacture a bridge supply to be sold to those countries at a no-profit price, before the generic product comes to market and gets regulatory approval. The company would not disclose the price…. … Merck will give a royalty-free license to four generic companies in India, and to three in sub-Saharan Africa — drugmakers in Uganda, Kenya and South Africa — in a boost for regional manufacturing efforts. That has been an African Union priority since the continent was largely shut out of access to Covid vaccines until a year after the rest of the world…..”

“Because production of alimatravir uses a small quantity of its active pharmaceutical ingredient, and because it is a standard oral formulation, companies could produce it profitably at scale and sell it to national health systems for as little as $5 per person per year….”

PS: “The timing of Merck’s announcement, coming well ahead of final clinical trial results, is unusual, and appears to be an effort to avoid problems that have dogged the introduction of other PrEP products. … … Alimatravir, at just 12 pills a year, would be much easier to deliver than an injectable, and could be distributed outside clinics, and in venues such as hair salons and high schools, Mr. Mwehonge said….”

· Related: Africa CDC – Africa Advances a New Model for Global Health Innovation

“The Africa Centres for Disease Control and Prevention (Africa CDC) welcomes MSD’s voluntary licensing agreements with three African pharmaceutical manufacturers for an investigational once-monthly oral HIV pre-exposure prophylaxis candidate known as MK-8527. The announcement resonates with Africa CDC’s Health Security and Sovereignty Agenda by advancing innovation along Africa’s pharmaceutical manufacturing value chain. The public-private collaboration links Africa’s robust clinical research ecosystem with regionalized manufacturing to secure equitable access of high quality, novel health innovations for Africa. “

“The agreements are established with three African pharmaceutical manufacturers: Aspen Pharmacare in South Africa, Quality Chemicals Industries Limited in Uganda and Universal Corporation Limited in Kenya. …”

AVAC: (update as of July 30)

https://mailchi.mp/avac/ias2025-2108470?e=f66302bb8e

“As the AIDS 2026 conference enters its second half, one message has emerged above all others: the barriers to ending HIV are no longer primarily scientific; they are political. In one of the “most spectacular plenaries”, Raphy Landovitz argued that the field now faces “a challenge of political will” and “moral decision-making,” asking whether the world will choose to deliver lifesaving innovations with “speed, scale and equity” or allow them to remain out of reach. …”

UNAIDS – Failing to tackle inequality puts countries in pandemic danger, new research shows

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2026/july/20260730_PR_NEJM

On a vital new report. “Analysis in the New England Journal of Medicine – co-authored by experts including Nobel laureate Joseph Stiglitz, leading epidemiologist Professor Sir Michael Marmot, and Chairperson of the One Economy Foundation and former First Lady of Namibia Monica Geingos – finds economic inequality, not conventional preparedness, has been the clearest predictor of how countries fared against pandemics, upending traditional assumptions about what actions governments need to take for health security. The new research from the Global Council on Inequality, AIDS and Pandemics finds that while technical capacity remains necessary, it is not sufficient. To respond to and prepare for pandemics effectively, governments need to include efforts to address inequality. …”

They call for “Inequality-Informed Pandemic Preparedness and Response”.

And list “four ways governments can break the cycle”:

“The research sets out proven, practical and affordable policies to address the inequalities driving pandemic risk, so that countries can respond more effectively to HIV, tuberculosis, Ebola and other pandemics. The actions governments need to take include:

· Protecting people during outbreaks: surge social protection such as paid sick leave, cash transfers and unemployment support, so no one has to choose between following health advice and feeding their family – alongside long-term investment in housing, education and secure work to build resilience before the next crisis.

· Governing across society, not health alone: multi-sectoral planning that brings in finance, labour and education ministries, and embeds community-led organisations in the response, drawing on hard-won lessons from the AIDS pandemic.

· Fixing the global financial rules: a debt-standstill mechanism for countries facing emergencies, the automatic release of emergency international financing when a pandemic is declared, and expanded pandemic lending so that every country has the means to respond.

· Sharing life-saving science: open licensing of publicly funded research, a global prize fund that rewards innovators while allowing medicines and vaccines to be produced anywhere, and expanded regional manufacturing of the treatments and vaccines needed to stop today’s and tomorrow’s pandemics.”

For more, see the article in NEJM: The Inequality–Pandemic Cycle — Rethinking Preparedness (by M M Kavanagh et al) “Increasing pandemic frequency and increasing economic inequality are creating a self-reinforcing cycle. What’s needed is therefore a new, inequality-informed approach to pandemic preparedness.”

WHO – Integration, innovation and community leadership key to ending HIV, hepatitis and STIs

https://www.who.int/news/item/27-07-2026-who–integration–innovation-and-community-leadership-key-to-ending-hiv–hepatitis-and-stis

(27 July) “The World Health Organization (WHO) today launched a new report assessing progress in implementing the Global Health Sector Strategies (GHSS) on HIV, viral hepatitis and sexually transmitted infections (STIs) for 2022–2030. Released during the 26th International AIDS Conference (AIDS 2026) and ahead of World Hepatitis Day (28 July), the report highlights significant achievements and persistent challenges in the global response to these epidemics….”

“…. This report tells two stories. It demonstrates what is possible when countries invest in health, communities and science. But it also shows how quickly progress can be undone with funding disruptions, humanitarian emergencies and persistent inequalities,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Over the next five years, we must build integrated, resilient health systems that reach those furthest behind.”

PS: “The report identifies integration as one of the greatest opportunities to accelerate progress. Countries reporting the strongest results are increasingly delivering services for HIV, viral hepatitis and STIs through primary health care, together with services for tuberculosis, sexual and reproductive health, maternal and child health and noncommunicable diseases….”

“… To support countries in strengthening responses, WHO has released its first consolidated HIV service delivery guidelines bringing together the latest evidence-based recommendations to help countries organize HIV prevention, testing, treatment and long-term care. WHO has also published HIV surveillance guidance, designed to improve routine HIV surveillance systems and enhance the use of national health data for public health action….”

Johns Hopkins – Lancet Report Recommends Paradigm Shift in Care for Older Adults with HIV

https://publichealth.jhu.edu/2026/lancet-report-recommends-paradigm-shift-in-care-for-older-adults-with-hiv

“Expanding care beyond essential antiviral therapy will help support growing older population with HIV expected to reach 20.2 million worldwide by 2040.”

“A new report by a group of HIV researchers in the journal Lancet HIV recommends that health systems caring for older individuals with HIV should move beyond the standard antiretroviral therapy to a more comprehensive, healthy-aging approach. The report was led by researchers at the Johns Hopkins Bloomberg School of Public Health and Yale School of Medicine, with colleagues at more than 40 institutions and nine persons living with HIV. “

“While most new HIV cases are among young people, the number of individuals living with HIV worldwide is increasing and getting older: nearly a third of people with HIV were over 50 in 2025, and half will be over 50 by the year 2040. In their report, commissioned by the editors of the journal Lancet HIV, the authors recommend a broad set of health-system changes to manage the distinct challenges involved in HIV prevention and screening, treatment, and long-term care in this older population. Recommendations include monitoring physiological age and functional declines, minimizing the multi-pharmaceutical use common among older adults, and promoting mental health and a healthy lifestyle—all while maintaining adherence to antiretroviral therapy…”

· For more, see The Lancet HIV Commission on ageing and HIV

“As the number of people living with HIV aged 50 years and older continues to increase, prevention, treatment, and health systems must adapt to support lifelong health and wellbeing. Supporting healthy ageing requires more than sustained viral suppression; it requires care that is informed by what matters most to the individual, with attention to maintaining physical and mental function, minimising healthcare complexity, and addressing multimorbidity, polypharmacy, stigma, and social determinants of health. Bringing together clinical evidence, modelling, policy perspectives, and community voices, this Commission outlines the changes needed to ensure that the millions of people living with HIV can age well.”

AIDS conference Rio: some more analysis & snippets

Guardian – A quarter of young Africans believe USAID cuts could be positive, survey finds

https://www.theguardian.com/global-development/2026/jul/30/a-quarter-of-young-africans-believe-usaid-cuts-could-be-positive-survey-finds

“Losing funds should force leaders to confront their own challenges, they said, while many voiced concerns over increasing foreign influence.” Based on the African Youth Survey, which interviewed almost 5,000 people across 16 of the continent’s 54 recognised countries.

Emily Bass – The US State Department Redraws the Map of Africa at the AIDS2026 Conference

Emily Bass;

I doubt you missed this (even if on holidays), but just in case. “And rewrites history, too. All before the official opening.”

“A senior US State Department official displayed a map of Africa that was completely wrong before high-level officials from African nations, including some whose countries had been mislabelled. The map mishap occurred during a presentation at “Transforming health assistance: Implementing U.S. government MOUs for sustainable HIV programs,” a pre-conference event at the largest AIDS conference in the world, held this year in Rio de Janeiro. The map mis-identified the locations of Cote d’Ivoire, Mozambique, Nigeria by enormous margins—making Nigeria landlocked, Mozambique an east African nation and Cote d’Ivoire a southern African state. The map put Uganda and Malawi in the right vicinity, but with the wrong borders. And it nope’d out altogether for Cameroon, which doesn’t have a line connecting the name to a country at all. (There is also a country without a name Alas, they are not a match.)….”

J Ratevosian: Beyond the State Department’s Bad Map: What Mattered at Global AIDS Conference

On Substack

(Recommended analysis) “Now let’s focus on the map that matters: the one on which HIV finally disappears.”

“…. I was also disappointed that this (map) mistake became one of the conference’s biggest media stories. Because AIDS 2026 produced important science, serious policy analysis and real progress on issues ranging from PrEP delivery to global aid transitions. Rather than add to the gotcha coverage, I will highlight the six stories I think that matter more….”:

1. The HIV prevention revolution is here; 2. We need to make PrEP much, much easier to get; 3. Communities built the HIV response. They came with receipts. 4. AI is already part of the HIV response. Now we must make it work at scale. 5. The tension we cannot ignore: Countries are finding solutions, but funding cuts are causing real harm. 6. We need to be more honest about “resilience”

The Insider – The unwelcome spectres at this year’s International AIDS Conference

The Insider;

Via ONE Data. “Elephant meets room.”

“Two spectres plagued this year’s International AIDS Conference, which took place in Brazil this week. 1. The major decline in global funding to combat HIV/AIDS; 2. The uneven access to new, transformative drugs…”

“International HIV financing dropped by 18%—more than $1.5 billion—between 2024 and 2025. That’s the lowest level in nearly two decades. At the same time, multiple drugs that are highly effective at preventing the transmission of HIV have already—or are expected to soon—come onto the market. One of those is lenacapavir, a twice-yearly injectable drug that is nearly 100% effective at preventing HIV transmission. While licensing deals have brought down the high cost of lenacapavir for many low- and middle-income countries, some countries have been excluded from low-cost deals. Without a deal, they (and their citizens) will pay full price—which for many countries is several times their per capita GDP, as we highlight below. So at the very moment in which game-changing drugs offer the possibility to win the decades-long fight against HIV/AIDS, money—the lack of it and the lust for it—could slow progress….”

Listing three things to know: “1. For the first time, the fight against HIV/AIDS appears winnable. 2. Getting the drugs to those who need them is critical. 3. More than two dozen middle-income countries have been excluded from low cost deals.”

Science – A rocky rollout

Jon Cohen; https://www.science.org/content/article/drug-could-help-end-hiv-epidemic-its-rollout-has-hit-speed-bumps

(24 July) Science analysis as IAS26 was about to start. “A powerful new prevention drug could help end the HIV epidemic—but supply is falling far short.”

Excerpt to provide you with a flavour: “… Adding LEN PrEP to the arsenal presents a new opportunity to slow, or even stop, the spread of HIV. The stakes are enormous. In an “optimistic” introduction scenario—in which about half of South Africa’s adolescent girls and young women, men who have sex with men (MSM), and sex workers would be on LEN PrEP by 2030—the country could effectively end its epidemic by 2039, according to a model by biostatistician Lise Jamieson and health economist Gesine Meyer-Rath of the University of the Witwatersrand. The model, posted on medXriv on 7 January, suggests the effort would increase the county’s HIV/AIDS expenditures by only 9% …”

“A similar scenario could play out in other parts of Africa, though it would require a massive rollout of the drug. A model constructed by epidemiologist Nora Rosenberg from the University of North Carolina at Chapel Hill and colleagues found that if 25 million women in 15 countries in sub-Saharan Africa received some form of PrEP and adhered to it, new infections in that population would drop by two-thirds….”

“But as Science saw during visits in June to South Africa and Zambia, a poorer country where the rollout started on 1 December 2025, there are major obstacles. One is that far too little LEN PrEP is available—a problem sure to take center stage at the international AIDS conference taking place next week in Rio de Janeiro….”

“… The rollout of lenacapavir (LEN) PrEP in Africa, which started in December 2025, initially targeted nine countries where HIV prevalence—the percentage of the population living with the virus—is among the highest in the world. But as of July, Africa’s main supplier, the Global Fund to Fight AIDS, Tuberculosis and Malaria, had delivered only 225,000 doses to those countries, and most had few initiations—people who started on the drug…. … The reasons for the slow delivery remain murky, says Mulenga, who until recently headed the HIV response for Zambia’s Health Ministry. “When you speak to either Gilead or to the Global Fund, or even to the U.S. government, we get different answers,” Mulenga says. “It’s very frustrating, and the community, they blame government.”…”

“Gilead won’t reveal production figures but tells Science it has not hit its manufacturing capacity. Representatives from the Global Fund say other than a “hiccup” or two—including the Iran war, which halted flights—orders have arrived on schedule. “Yeah, there is more demand than we’re able to supply,” says Martin Auton, who heads planning and procurement for the Global Fund. “But somebody would have to pay [to meet] that additional demand, and at the moment we don’t have money for more.”… …. The shortages could ease if the six generic companies begin to sell LEN PrEP next year…”

HHR (Viewpoint) – Key Populations Under Threat: A Central Theme at AIDS 2026

J J Amon; https://www.hhrjournal.org/2026/08/03/key-populations-under-threat-a-central-theme-at-aids-2026/

“Woven throughout the presentations and poster sessions at AIDS 2026 was an inescapable theme of continuing, and escalating, threats facing key populations, including criminalization, anti-LGBTQ+ legislation, and funding disruptions. The result: decades of HIV progress undermined and imperiled….”

Global Health Reform

BMJ – Reforming global health architecture requires confronting its political economy

https://www.bmj.com/content/394/bmj-2026-100315

“Daniel Bernal-Serrano and colleagues argue that the preventable deaths caused by global health inequity are structural outcomes of a capitalist world economy, which organisational reform alone cannot reverse.”

“…We argue that architectural redesign alone cannot resolve a problem with foundations in political economy: the dynamics of a capitalist world economy. We draw on Engels’s concept of “social murder,” the knowingly caused, avoidable death of those deprived of the material conditions for life and on Wallerstein’s world systems theory, which describes how a capitalist world economy concentrates wealth, technology, and productive capacity in “core” states, while “peripheral” states supply labour, raw materials, and markets on terms that reinforce their disadvantage. These frameworks resonate with traditions familiar to health audiences—Paul Farmer’s theory of structural violence and WHO’s Commission on Social Determinants of Health—but go further: where structural violence and social determinants of health describe structural conditions, Wallerstein explains their reproduction in the world economy, and the social murder concept assigns responsibility for sustaining them.”

Key messages:

· “… The preventable deaths caused by the global health order are not mere governance failures but structural outcomes of monopoly intellectual property, sovereign debt, and the commodification of health under a capitalist world economy

· Reform processes such as the Lusaka Agenda, the Accra Reset, and the WHO Pandemic Agreement represent genuine diplomatic progress on governance architecture, but leave these structural foundations in place

· Transformation requires three simultaneous changes—making publicly funded innovation a public good, restructuring the debt architecture around reparative finance, and delinking essential health functions from profit—each with identifiable actors accountable for enacting it

· Such change will come not from political will alone but from organised pressure that makes the cost of inaction greater than the cost of change.”

Global Policy – The Accra Reset: Reimagining Global Health Governance in an Era of Fragmentation

https://www.globalpolicyjournal.com/blog/03/08/2026/accra-reset-reimagining-global-health-governance-era-fragmentation

“The Accra Reset has been widely understood as a call for African health sovereignty and greater strategic autonomy. Nelson Aghogho Evaborhene contends that its broader significance lies in reframing how global health governance should be organised, placing regional institutions at the centre of a more coherent and resilient governance architecture.”

Lancet (Letter) – An eleventh lesson: escaping the scarcity equilibrium

Keith Cloete & Mickey Chopra; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01364-4/fulltext

“Richard Horton’s Offline on the ten lessons for reproductive, maternal, newborn, child, and adolescent health is well judged, but misses the political economy trap that chronic resource scarcity itself creates and sustains….”

“Scarcity does not simply constrain what health systems can do; it actively reshapes who benefits from the status quo and who is responsible for the cost of change. Under conditions of persistent fiscal stress, the political economy of health systems aligns closely with short-termism, fragmentation, and centralised control, not by accident, but because these configurations serve identifiable interests. Earmarked and fragmented financing streams—whether donor-driven or domestically generated—create constituencies with a direct material stake in preserving programmatic boundaries. Together, these arrangements become self-reinforcing: fragmented financing narrows the coalition for reform; centralisation forecloses the spaces where reallocation might be negotiated; and short budget cycles make the political cost of any visible loss prohibitive. The result is a scarcity equilibrium—constraint produces the institutional arrangements that entrench the constraint.”

“…Hence, the lessons prove difficult in practice. Mutually supporting partnerships are structurally undermined when vertical funding streams make integration a material threat to programme budgets and organisational survival. Independent accountability is resisted as the actors being held accountable have strong institutional incentives to defend existing arrangements. The post-2030 agenda will remain gestural unless it is designed explicitly to disrupt the financing architectures and decision-rights structures in which scarcity equilibria reproduce themselves.”

“…The eleventh lesson is clear: without confronting the political economy of the scarcity equilibrium—who benefits from fragmentation, who controls allocation of funding, and whose interests centralisation protects—the ten lessons Horton offers will remain a testament to what was understood but not yet structurally enabled.”

WHO DG race

HPW – EXCLUSIVE: WHO Regional Directors Running for Director-General Must Take Leave for Campaign

https://healthpolicy-watch.news/who-regional-director-loophole/

“In a first, WHO Regional Directors must take a leave of absence to run for the top job, the World Health Organization (WHO) confirmed to Health Policy Watch on Monday. This sweeping election reform closes a crucial loophole in the ongoing Director-General election process, aiming to curb shadow campaigns just as the first candidates officially enter the race. Meanwhile, Dr Jarbas Barbosa, WHO Regional Director for the Americas / Pan American Health Organization, who had been reported as a possible contender, told Health Policy Watch he is not running.”

PS: “WHO Regional Director Dr Hanan Balkhy reportedly entered the race. The reform arrives as the formal succession race begins, with Saudi Arabia and Qatar reportedly circulating the first diplomatic notes to nominate Dr Hanan Balkhy, the current Regional Director for the Eastern Mediterranean, and former public health minister Dr Hanan Mohammed Al Kuwari, respectively….

“… One rumoured contender who will not be impacted by the new mandatory leave directive is the Director of the Pan American Health Organization (PAHO), Dr Jarbas Barbosa. “I am not running for WHO DG,” said Barbosa, responding to a query by Health Policy Watch….”

More on Global Health Governance & Financing/Funding

HPW – African Union Pushes for Greater Domestic Spending on Health Amid Reports of Huge Disruptions to HIV and TB Services

https://healthpolicy-watch.news/african-union-pushes-for-greater-domestic-spending-on-health/

(24 July) Coming back on the extraordinary AU summit on health from last week. “The African Union held a special health summit this week, primarily aimed at mobilising high-level political support for more domestic health spending – particularly on HIV, tuberculosis and maternal health.”

“The summit coincided with the release of two new studies reporting on the huge disruptions to HIV and tuberculosis treatment throughout the world following the Trump administration’s changes to the US President’s Emergency Plan for AIDS Relief (PEPFAR)….”

“… leaders who addressed the AU summit urged African states to implement the Abuja Declaration decision, adopted 25 years ago, to allocate at least 15% of national budgets to health.”

“Deliberations focused on HIV, tuberculosis, malaria, maternal and newborn health, viral hepatitis, neglected tropical diseases (NTDs), and non-communicable diseases (NCDs).” “The summit also discussed how to advance the AU Roadmap to 2030 and Beyond, which envisions ending HIV as a public health threat and sets out how to control TB, malaria, NTDs and NCDs….”

“AU Commission Chairperson Mahmoud Ali Youssouf called on countries to make a “decisive shift from commitments to implementation”. “Future generations will remember this Summit not for our speeches, but for whether we changed the trajectory of health in Africa,” said Youssouf.”

“Speaking at the close of the two-day summit, AU Health Commissioner Amma A. Twum-Amoah urged countries to “translate the AU Roadmap and the Accra Declaration into concrete national action. “This means strengthening primary health care, integrating services, increasing domestic investment, advancing the local production of medicines, vaccines and diagnostics, investing in the health workforce and reinforcing surveillance, laboratory and digital health systems,” she said….”

HPW – Markets Offer Costly Cures while Courts Ensnare Prevention; meanwhile Ebola Response Stumbles

Mukesh Kapila; https://healthpolicy-watch.news/markets-offer-costly-cures-while-courts-ensnare-prevention-meanwhile-ebola-response-stumbles/

Kapila’s take on the week in global health governance. “A trillion-dollar food industry sues to keep prevention at bay while governments spend billions subsidising the drugs that treat what bad diets do. Meanwhile, Ebola outruns a hollowed-out WHO, and its Director-General’s legacy hangs on whether he can get a grip.”

On the former issues: “…Set that against the direction health policy is travelling – with 2026 crowned as “the year of obesity pills.” WHO issued its first global guideline on GLP-1 medicines for obesity. The US launched a Medicare GLP-1 Bridge, offering beneficiaries a month of weight-loss drugs for $50, and European health systems have opened conditional access. The real story is around ‘money’. The global processed-food industry is valued at an annual $2.2 trillion, rising toward $3.4 trillion by 2035. The GLP-1 market stood at $79 billion in 2025 and is forecast to reach $190 billion by then. The antidote, in other words, is around one-twenty-eighth the size of the products creating the problem – a downstream market spun off from an upstream one. Both are dwarfed by the costs of the diseases caused by unhealthy diets. Overweight and obesity will cost the world more than $4 trillion a year by 2035, over 3 percent of global GDP, comparable to the Covid-19 shock in 2020. So, the public purse is asked to subsidise the cure at the very moment efforts to mitigate the cause are litigated into paralysis. “

Mukesh concludes: “… A world that finds billions to medicate while it will not spend political capital to prevent disease in the first place is making a choice. It is not a neutral one, let alone sensible, from the socio-economic perspective.”

But do check out also why he reckons Tedros’ legacy hangs on at least partly on whether WHO gets a grip on the ongoing Ebola emergency.

HPW – New Unitaid Head Gets High Marks – but Can He Save the Organization?

https://healthpolicy-watch.news/new-unitaid-head-gets-high-marks-but-can-he-save-the-organization/

(Analysis) “Luis Pizarro, Unitaid’s newly-appointed Executive Director comes to the organization with sizeable depth and breadth of experience – as the leader of Geneva’s Drugs for Neglected Diseases Initiative (DNDi) and before that, leadership of ventures in Africa, Asia and the Americas. However, his main challenge at Unitaid will be steadying the financially troubled organization, which has raised less than half of the funds needed to sustain its annual investment budget of $300 million for 2026. And it faces a shortfall of more than $800 million in the current five-year $1.5 billion budget cycle (2023-2027). …”

“The crisis follows the loss of support for Unitaid’s innovative financing model, built upon the world’s first solidarity fund taxing airline tickets and certain financial transactions. The model was pioneered two decades ago by France, Unitaid’s leading donor, in the birthing of the organization in 2006. But the Solidarity Fund for Development was abolished last year in the wake of French legislation redirecting the airline tax revenues and fees to the general budget. That leaves Unitaid heavily exposed to the vagaries of donor whims in annual fund-raising cycles. Meanwhile, Unitaid’s longtime director, Philippe Duneton, who was instrumental in the foundation of the agency in 2006, is stepping down. …”

PS: “…. In a sense this is the first piece of the puzzle in terms of finding new leadership for Geneva institutions,” added Thiru Balasubramanian, Geneva representative of Knowledge Ecology International (KEI), a US-based NGO focused on equitable access to medicines and vaccines. “The Global Fund and WHO are still in the hunt of course, and now, DNDi. “And perhaps Gavi will be as well,” he said, referring to as-yet-unconfirmed reports that Gavi’s Executive Director, Sania Nishtar, might leave her current post to compete in the race for Director General of WHO….”

“After four years, Dr Luis Pizarro will be stepping down from his role as DNDi’s Executive Director to take on a new position as Executive Director at Unitaid at the end of 2026. Since 2022, Dr Pizarro has guided DNDi through a period of scientific accomplishment and institutional maturation. Most recently, DNDi delivered acoziborole – the first single-dose oral treatment for sleeping sickness – a milestone that puts elimination of the disease within reach for the first time. DNDi’s global network now counts more than 230 staff and over 200 partner institutions across five continents, and the organization is a leading voice for needs-driven, collaborative, and equitable medical research and development. … ‘Luis has been a defining force in DNDi’s evolution into a globally recognized institution,’ said Dr Marie-Paule Kieny, Chair of Ndi’s Board of Directors. …”

HPW – Africa’s New Medicines Regulator Wants to be More than Another Approval Channel

Paul Adepoju; https://healthpolicy-watch.news/african-medicines-agency-regulator-chief-mimi-darko-interview/

“When the African Medicines Agency became operational in Kigali in October 2025, it inherited one of the continent’s most difficult health-policy problems: how to make medicines regulation faster, more trusted and less fragmented across 55 African Union member states. For years, African countries have relied on a patchwork of national regulators, regional harmonisation initiatives, WHO prequalification, collaborative registration procedures and external pathways such as Swissmedic’s Marketing Authorisation for Global Health Products. Those systems have helped accelerate access to some products, but they have not removed the deeper problem of fragmentation.”

“For Dr Delese Mimi Darko, the inaugural Director General of the African Medicines Agency (AMA), the issue is not that Africa lacks regulatory expertise. It is that the expertise is unevenly distributed and poorly coordinated. “AMA is not there to replace any national agency,” Darko explains. “It is there to coordinate them to ensure that their impact or their strengths are magnified as a body.”…”

“In an interview with Health Policy Watch in London on the sidelines of the Global Vaccine Manufacturing Summit, Darko discussed whether the agency is already operating, what it can offer beyond existing reliance pathways, how it is being built institutionally, whether it can function as a single continental regulatory channel, why ratification still matters, and how it is being drawn into the response to the Bundibugyo Ebola outbreak….”

WHO – Health financing under pressure as civil society calls for urgent action

https://www.who.int/news/item/28-07-2026-health-financing-under-pressure-as-civil-society-calls-for-urgent-action

With global health financing under increasing strain, driven by declining donor funding and tightening national budgets, civil society organizations are warning that urgent action is needed to sustain essential health services and protect progress toward universal health coverage.”

“On 10 December 2025, the WHO Civil Society Commission, in partnership with Save the Children, convened the first in a series of global dialogues on health financing, bringing together a diverse group of stakeholders from across regions to help shape priorities ahead of the Seventy-ninth World Health Assembly (WHA79)….”

· On the second global dialogue, see WHO – Civil society pushes for action on health financing

As global health financing pressures intensify, the focus is shifting from commitments to delivery. There is growing concern that existing pledges are not translating into tangible improvements in health systems. Civil society organizations are calling for concrete action to ensure financing results in stronger systems and better access to care. On 15 April 2026, more than 130 participants joined the second global dialogue convened by the WHO Civil Society Commission and Save the Children to advance priorities in the lead-up to the Seventy-ninth World Health Assembly.”

“Ravi Ram, Co-Chair of the WHO Civil Society Commission, emphasized that the dialogue series focuses on ensuring that civil society perspectives translate into implementation, with a clear objective of influencing decisions at the Health Assembly. …” Do read on.

Devex: Promises vs. progress
Devex

Reporting on a new Global Policy Forum Europe assessment of the Sevilla Commitment from a year ago.

“… A year after governments signed the Sevilla Commitment at the Fourth International Conference on Financing for Development, or FfD4, the verdict is in: plenty of promises, far less delivery.”

“A new assessment from Global Policy Forum Europe finds that of the 43 commitments it examined, only nine have been fully implemented. Another 17 have made some progress, while progress has stalled completely on nine and gone into reverse on four — including commitments on official development assistance, climate finance, aid for trade, and support for domestic resource mobilization. Two more need clarification, and the final two were deemed unable to be assessed.”

“The bright spots have largely come from the U.N. system, including the launch of negotiations for a U.N. tax convention, a new Borrowers’ Platform, a debt support service for small island states, recurring ECOSOC meetings on credit ratings, and work on a “beyond GDP” framework….”
Elsewhere, the picture is far less encouraging, my colleague Jesse Chase-Lubitz tells me. The report finds no progress on IMF governance reform, rechanneling Special Drawing Rights, the African Financing Stability Mechanism, or a U.N.-led effort to overhaul the global debt architecture.

“The authors argue that many of Sevilla’s commitments were so loosely drafted that they lacked clear owners, deadlines, or ways to measure success — making accountability difficult from the outset. As they put it: “Our monitoring shows very different levels of compliance among different groups of actors.” The U.N., they conclude, has “mostly done their homework.” The IMF and other international financial institutions? Not so much.”

· See GPF – Tracking the Sevilla financing for development commitments: Where do we stand one year on? (by Bodo Ellmers)

ICTD (report) – Taxing smarter: Advancing Reform Through Research and Partnership

ICTD;

“The road to revenue is not in taxing harder, but smarter.”

“In this newly launched report, we reflect on lessons from 15 years of research collaboration with partners. It argues that the road to revenue lies not in taxing harder, but smarter, highlighting how politics, institutions, trust, and administrative capacity shape the success of tax reform.

These lessons come at a critical moment. A new phase in global development has begun: aid is retreating, debt servicing costs are rising, and governments face growing demands to invest in everything from climate adaptation and infrastructure to health, education, and social protection. In this context, taxation will play an increasingly central role in financing development. Looking ahead, the report identifies some of the questions that will define the next decade of tax and development, from inclusive growth and rising debt pressures to the opportunities and risks presented by digitalisation and AI….”

Habib Benzian – Why Dentistry Thinks It Is Different

Habib Benzian; on Substack;

“And why health systems were happy to agree.”

Excerpt: “…. This is the unresolved tension at the heart of modern dentistry. Dentistry wants the authority of healthcare and the autonomy of a trade. It speaks the language of prevention, but still earns heavily through intervention. It presents itself as essential while tolerating systems that price essential care out of reach. It wants to be part of health while defending arrangements that keep it apart. The result is a profession that can move between identities depending on the room. When seeking recognition, it is healthcare. When resisting integration, it is different. When arguing for public support, oral disease is serious. When defending private payment, dental care becomes personal responsibility. When claiming status, dentistry is medicine. When protecting autonomy, it becomes something else entirely. This flexibility has served the profession well politically. Ethically, the bargain is harder to defend…..”

Trump 2.0, bilateral health agreements & US Global Health Strategy

Some important updates on the bilateral health agreements & US Global Health Strategy you already found in the IAS26 subsection.

Here some more news, including other Trump 2.0 & “global health’ updates.

NYT – With a Series of Big Donations, State Department Restores Some Global Health Aid

https://www.nytimes.com/2026/08/02/health/trump-health-aid-state-department.html

“The amount is still far below what the U.S. spent previously on humanitarian and health aid, but resumes the flow of money for key efforts to fight malnutrition and disease.”

“Over the past two months, the United States has made financial commitments that hint at a limited return to global health and humanitarian assistance partnerships, after the abrupt severing of many of those relationships a year and a half ago. Last week, the State Department notified Congress that it would send $600 million to Gavi, the organization that helps low-income countries buy essential childhood immunizations, a year after Health Secretary Robert F. Kennedy Jr. withdrew American support. It was the latest in a series of financial commitments from the U.S. government to international organizations, working on issues such as hunger and tuberculosis, totaling nearly $2 billion.”

“In most cases, these payments move money that had been appropriated by Congress but which had been stuck since the Trump administration took office in January 2025 and instituted a freeze on foreign aid. It was not yet clear whether the disbursements represented a lasting shift, or how close any further commitments would bring the total to what the United States used to spend on aid and global health. “

“People who have been part of talks with the State Department about this funding said that there were at least two motivations behind the money flowing to resumed partnerships. First, recent health threats including, most notably, the ballooning Ebola outbreak in the Democratic Republic of Congo, reinforced the need for funding multilateral agencies that work on global health security. Second, with the Trump administration’s dismantling of the United States Agency for International Development and absorption of a skeleton crew of its staff into the State Department, there was no longer the infrastructure or staff for the United States to move humanitarian assistance on this scale by itself, making these large international agencies necessary partners….”

“… In addition to the money for Gavi, recent major funding announcements from the State Department include:

$800 million for the World Food Program to fight malnutrition in countries including Ethiopia, Myanmar and Ukraine

$218 million for Unicef to work improving child health through nutrition, water and sanitation projects

… $50 million to the Coalition for Epidemic Preparedness Innovations for the development of new Ebola vaccines

$203 million to the International Committee of the Red Cross and the International Federation of Red Cross and Red Crescent Societies for disaster response and humanitarian assistance

$220 million for the Ebola response in the Democratic Republic of Congo and $350 million in new humanitarian funding to the affected region, as of June 12

$661 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria, a payment against what was owed from prior year appropriations…”

Politico – State Department will dispense $600M for vaccines RFK Jr. held up, Collins says

https://www.politico.com/news/2026/07/28/vaccines-rfk-collins-gavi-rubio-01013690

“The State Department will dispense the $600 million Congress appropriated to an international partnership helping developing countries buy and distribute vaccines (i.e. GAVI), Susan Collins (R-Maine), the chair of the Senate Appropriations Committee said Tuesday. Health Secretary Robert F. Kennedy Jr., a longtime vaccine safety skeptic, has held up the funding for months because he believes the partnership, Gavi, uses outdated and dangerous shots….”

PS: “… Collins’s announcement comes after months of delay in disbursing the funding, appropriated for the 2025 and 2026 fiscal years, to Gavi, which the U.S. co-founded a quarter century ago. The $600 million expires on Sept 30….”

“The United States has announced the release of $600m for Gavi, as it cut off the World Health Organization (WHO) from the global vaccine alliance, in a major financial blow to the United Nations group. In a joint statement, the US Department of State and the Department of Health and Human Services said: “The United States also reaffirms that it will not provide US Government funding to the World Health Organization through Gavi.””

· And for more analysis, see HPW – Gavi Welcomes Restoration of US Funding – But No Clarity on How Agency will Phase out Thimerosal

“The United States has unlocked frozen Gavi funding, resolving a bitter political impasse in Washington while doubling down against the WHO. But can the alliance eliminate thimerosal, a mercury-containing preservative, from its stockpiles without leaving millions of vulnerable children unprotected?”

“The United States will immediately release $600 million for fiscal years 2025–2026 in frozen Gavi funding, ending a tense congressional stand-off that threatened global immunisation plans, the US announced in a joint media note by the State Department and Department of Health and Human Services (HHS). The decision follows a bipartisan campaign led by Senate Appropriations Committee Chair Susan Collins and Vice Chair Patty Murray, who urged Secretary of State Marco Rubio to restore the funds. However, the US money comes with a strict caveat, demanding Gavi work towards transitioning away from vaccines that use thimerosal as a preservative…”

“… In a press release on Thursday, Gavi welcomed the US decision. “This investment will help us to strengthen global defences against outbreaks and pandemics and protect more children from preventable diseases,” Gavi Chief Executive Officer Sania Nishtar said. The breakthrough strengthens Gavi’s recalibrated $10.2 billion strategic budget, keeping the alliance on track to meet its 2026–2030 mobilisation goals. According to recent Gavi board projections, the partnership has already secured $9.3 billion in qualifying resources, including $2.7 billion formally signed in donor agreements…..”

“Gavi insists science guides portfolio decisions: The State Department said Gavi committed to work towards transitioning away from using thimerosal as a vaccine preservative to unlock the funding. Responding to a query by Health Policy Watch, Gavi noted that transitions were already underway but had previously stalled due to financial constraints. The alliance “began supporting adoption of the hexavalent and multivalent meningococcal conjugate vaccines (MMCV) in 2023,” highlighting these newer vaccine options. However, Gavi explained that “progress has been held back due to funding challenges”. The alliance also insisted that its medical portfolio remains anchored strictly in global science. “Gavi always has and always will be guided by the global scientific consensus…”

NYT – Former Officials Protest U.S. Plan to Defund Pan American Health Organization

https://www.nytimes.com/2026/07/30/health/paho-us-pan-american-health-organization-withdrawal.html

“The group of former health and national security officials warned that Americans will be more vulnerable to infectious disease threats.”

“The Trump administration’s plan to stop funding the Pan American Health Organization, which coordinates public health efforts across dozens of countries including the United States, will leave Americans more vulnerable to infectious disease threats, more than 100 U.S. leaders in health and national security warned in an open letter [to be] released on Thursday. …”

“… Founded in 1902, the organization is supported by contributions from its 35 member countries. The United States, a founding member, owes nearly $135 million in overdue fees since late 2024. On his first day in office, President Trump withdrew the United States from the World Health Organization and ended all U.S. funding for the agency. The administration’s proposed budget for next year now eliminates funding for P.A.H.O., which serves as a regional offshoot of the W.H.O. That decision makes little sense given the rising threat of infectious diseases like dengue, bird flu and screwworm, the letter’s signatories argued….”

PS: “… Officials from some other countries worry the Trump administration’s abandonment of P.A.H.O. will endanger more than just Americans….” “The administration’s “denialist stance” will threaten people in the entire region, said Dr. Alexandre Padilha, Brazil’s health minister. “Leaving W.H.O., leaving P.A.H.O., weakening these multilateral institutions is a mistake for global health, and also it will impact the U.S.,” he said. “

“The United States’ contribution to P.A.H.O. represents just 0.001 percent of total federal spending, the letter noted, but it makes up roughly 20 percent of the organization’s budget. P.A.H.O. has received some additional money from Spain, an observing member of the organization, and other countries, but those contributions do not make up for the loss of support from the United States, Dr. Barbosa said….”

HPW – Adjusting to a Post-PEPFAR World

https://healthpolicy-watch.news/adjusting-to-a-post-pepfar-world/

(30 July) “Zambia is hopeful that it can reach an agreement with the United States to salvage funds for its HIV programme, but South Africa remains frozen out of any new US funding for its HIV programme, government officials told journalists at a media briefing at the International AIDS Conference on Wednesday….”

Emily Bass – Three mistakes that matter more than the State Department’s messed-up Africa map.

On Substack

“1) Rubbishing a report of “near universal” disruption of HIV services—instead of taking responsibility and action

2) Ignoring evidence that children with HIV are dying painful preventable deaths because of US government funding transitions.

3) Concealing the details of future America First Global Health Strategy plans and investments from the people in the countries with the clearest picture of what’s going on….”

Think Global Health – Making Aid Transition Work: Seven Lessons From the Private Sector

Chris Collins et al Think Global Health;

“As global health financing shifts toward country self-reliance, emphasis on principles like measurement and accountability can guide implementation.”

“Chris Collins, president and CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria; Jirair Ratevosian, former chief of staff for the President’s Emergency Plan for AIDS Relief; and Jeffrey L. Sturchio, former chairman and CEO of Rabin Martin, describe how the AFGHS can maintain progress against those diseases by applying certain private-sector principles—such as accountability and metrics—to the aid transition. …”

Nature (Spotlight) – How does Make America Healthy Again hold up against scientific scrutiny?

Nature ;

“MAHA health claims under the microscope: US health secretary Robert F. Kennedy Jr’s Make America Healthy Again (MAHA) programme contains some solid recommendations, mixed with a big dose of others that are based on weak or insufficient evidence, say health researchers. At worst, the MAHA platform includes policies that are harmful — for example, by reducing the slate of routine vaccines for children.”

Stat – Key Senate panel backs Trump’s picks for CDC, pandemic preparedness

Stat

“Nominees now move to a full Senate vote, and they are likely to be confirmed.”

“The Senate health committee approved two nominees for key health roles Thursday, including the director of the Centers for Disease Control and Prevention and a pandemic preparedness leader, after Chair Bill Cassidy (R-La.) once again set aside his reservations to support Trump administration leadership picks. The vote on Erica Schwartz for CDC director was approved by all Republicans and by Tim Kaine (D-Va.), with other Democrats opposed. Sean Kaufman won support from all Republicans to be assistant secretary for preparedness and response (ASPR), and all Democrats were opposed….”

Ebola emergency in the DRC

HPW – Fear and Fatigue Grip Congo’s Health Workers as Ebola Response Crumbles

https://healthpolicy-watch.news/fear-and-fatigue-grip-congos-health-workers-as-ebola-response-crumbles/

(31 July) Update, also on Africa CDC’s media briefing of last Thursday. Some excerpts:

“In mid-July, the severely underfunded frontline response was thrown deeper into chaos. Dozens of medical workers at Rwampara General Hospital in Ituri, a northeastern province on the border with Uganda where the first case was detected, on strike to protest unpaid wages. … Health workers from epidemiologists to health investigators and gravediggers leading the strike said they had not received pay since the epidemic began. The strike included everyone from epidemiologists and health investigators to gravediggers. … It has been a stop-cycle of strikes since protests began. Health staff walk out, receive new promises of payment, return to work, then resume strikes when the promised money doesn’t materialise….” “ Visits from top country officials have done little to quell the frustration. ….”

“…. The DRC’s current outbreak – its 17th Ebola epidemic since 1976 – is spreading faster than any on record globally… and is on pace to become the largest in the history of the continent….” “Africa Centre for Disease Control (Africa CDC) director Dr Jean Kaseya said at a press briefing on Thursday that the current outbreak has recorded seven times more cases than at the same stage of the 2014-2016 West Africa Ebola outbreak… The critical threshold of 1,000 cases, which signals that an epidemic is spiralling out of control, was crossed in just 40 days, a pace the Africa CDC described as the “fastest-growing” epidemic ever recorded. The 2,000-day threshold was crossed in only 20 days. it took 235 days to reach 1000 cases during the 2018 North Kivu epidemic, which until recently, was at the time was the DRC’s worst outbreak on record….”

“The country has recorded 3,442 confirmed cases and 1,521 deaths – a case fatality rate of 44% – as of July 28, according to the DRC Ministry of Communications and Media. Nearly 800 patients remain in isolation or hospitals. The toll includes 112 infected health workers – 35 of whom have died – across five provinces in eastern DRC: Haut-Uele, Ituri, North Kivu, South Kivu, and Tshopo.”

“… Over 80% of new cases in Ituri, the epicentre of the outbreak, are not linked to known cases, according to Africa CDC. Over 60% of deaths are linked to communities instead of treatment centres, showing authorities still have major ground to cover to catch up with the speed of the outbreak. Struggles in contact tracing are compounded by the lack of medical countermeasures….”

“… The early weeks of the Ebola response were difficult and unbalanced, delaying the construction of Ebola treatment centres and proper patient care. Since then, funding has poured in, though not always fast enough to keep pace with the outbreak. … In June, Africa CDC and the WHO launched a joint response plan costing $518 million for the period June-November 2026. Since then, the DRC government has already injected more than $50 million into the response. Paid in two instalments ($20 million then $30 million) by the public treasury, the funding pales in comparison to the overall national response plan budgeted at $319 million, and the continental Africa CDC/WHO plan of $518 million for June-November 2026…. …. In total, nations and international organisations have pledged around $1 billion to the response. Some 472$ million of that total has been distributed so far, according to Africa CDC. The agency estimates $1.4 billion will be required to fully quell the outbreak. Among the main donors: the United States ($270 million), the United Kingdom (£20 million), the EU (€15 million), and the World Bank ($243 million). The WHO Foundation is running a campaign to raise $115 million, but so far has received less than half of that amount. While international mobilisation remains visible, execution on the ground has struggled. … … Some donor countries are channelling funds directly through NGOs, which are involved in awareness campaigns and the construction of treatment centres. But in some cases, including funds allocated by the United States, questions have also arisen around the opacity of fund recipients and how they have been used. … Criticisms have also arisen that the WHO-Africa CDC coordination effort may have diffused, rather than sharpened accountability over the management of the crisis…..”

Reuters – Merck, Wellcome partner with global health group to make Ebola vaccine for clinical trials

Reuters;

“Hilleman Laboratories, a Singapore-based joint venture between Merck and the global charity Wellcome, is gearing up to manufacture doses of a ‌promising experimental vaccine against the rare Bundibugyo strain of Ebola responsible for a fast-spreading outbreak in the Democratic Republic of Congo. The effort is backed by up to $8.5 million in funding from the global partnership Coalition for Epidemic Preparedness Innovations, or CEPI, those involved in the effort said on Thursday….”

“Hilleman aims to make finished doses for early-stage trials using IAVI starting material

Partners would transfer technology to a large-scale manufacturer if early trials succeed;

Other vaccine candidates also being funded.”

Via Stat: “The vaccine will use the same platform employed for Merck’s Ebola Zaire vaccine. It’s expected that it will take roughly 6½ months to make the doses, though doses needed to start clinical trials should be available sooner. “

Nature Q&A – First volunteer gets Ebola vaccine — three months after the outbreak began

Nature ;

“The University of Oxford has already vaccinated its first clinical-trial participant. The study’s lead scientist, Teresa Lambe, tells Nature how the team was able to move so fast.”

“The first trial to test an experimental vaccine for the Bundibugyo species of Ebola is underway, two months after the current outbreak in the Democratic Republic of the Congo and Uganda was declared an international public-health emergency. The trial aims to assess the safety of the vaccine and the immune response it generates before larger trials are rolled out in Uganda later this year. “We actually had in the freezer the right type of genetic sequence to let us make the Bundibugyo virus-specific vaccine really quickly,” immunologist Teresa Lambe, who’s leading the trial, tells Nature. “It looks like we’re going to need as many different tools as we have to combat this outbreak.””

KFF – Analysis Compares the U.S. Response to the Current Ebola Outbreak to Past Ones

KFF;

“A new KFF analysis compares the Trump administration’s response to the ongoing Ebola outbreak in the Democratic Republic of Congo – the most significant international infectious disease outbreak of its second term – to earlier outbreaks during the Obama administration and first Trump administration.”

Some of the findings: “… While the current administration significantly altered the structure of the U.S. global health response, the analysis shows that the speed of the response is on par with the prior two outbreaks. In addition, the U.S. pledge of $375 million during the first two months of the current outbreak already exceeds funding levels during the prior outbreaks. At the same time, there are still many unknowns about the U.S. response and there are distinctions from the past, including lack of formal coordination with the World Health Organization, significant changes in U.S. global health efforts, including funding reductions, and a more restrictive domestic border protection approach….”

Nature Africa – Why the fight against Bundibugyo Ebola depends on trust

Godfrey Musuka, J Kaseya et al; Nature Africa;

“With no vaccine or cure for Bundibugyo Ebola, containment depends as much on trust as on epidemiology. Yet the work that builds that trust remains chronically underfunded.”

“Without an available vaccine or treatments for the Bundibugyo species of Ebola spreading in the Democratic Republic of the Congo (DRC), controlling the outbreak relies on identifying and isolating cases. These measures can’t succeed without public trust, but efforts to build it aren’t considered a core public health intervention, argue a group of public-health researchers. The DRC, and other countries affected by Ebola, must plan and finance social and behavioural change programs “as a core pillar of outbreak preparedness and response, not as a communications add-on”, the group writes.”

Science – Congo’s Ebola epidemic started at least 4 months before it was detected

https://www.science.org/content/article/exclusive-congo-s-ebola-epidemic-started-least-4-months-it-was-detected

“A remote mining town gripped by fear saw hundreds of suspected cases before the government declared an outbreak, report says.”

“… Mysterious deaths that extinguished entire families. A cemetery unable to cope with the flood of dead bodies. Taxi drivers who refused to go to certain parts of town. Months before the Democratic Republic of the Congo (DRC) officially declared its latest Ebola outbreak on 15 May, the disease was already sowing fear and death in Mongbwalu, a gold mining town in Ituri province, an unpublished analysis by three researchers suggests. After interviewing almost 100 people in and around Mongbwalu—including nurses and doctors, community leaders, survivors, grieving family members, coffinmakers, and cemetery caretakers—the team concluded the epidemic ignited in January, and perhaps even earlier, in Mongbwalu’s outskirts. A patient seeking care may have brought it to the city from a rural area. By the time health authorities in the distant capital, Kinshasa, recognized the disease as Ebola, a “widespread, sprawling epidemic” was already underway, the team says in a PowerPoint presentation that is circulating in a WhatsApp group in the DRC and that Science obtained. One of the researchers, anthropologist Jules Villa of the Pasteur Institute in Paris, also presented the findings to a group of researchers on a Zoom call today, and Villa said the team is also submitting a correspondence piece to The Lancet….”

Lancet Infectious Diseases – A review of Bundibugyo virus and the 2026 outbreak: lessons for epidemic preparedness

Krutika Kuppalli et al; https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00414-7/fulltext

“….In this Review, we synthesise evidence on BDBV from its discovery to the current 2026 outbreak, highlighting advances in epidemiology, clinical management, diagnostics, vaccines, therapeutics, and preparedness. More broadly, the outbreak shows that scientific innovation alone is insufficient; its public health impact depends on integrated, species-inclusive systems capable of rapidly detecting, evaluating, and responding to outbreaks caused by any human-pathogenic Orthoebolavirus spp.”

More on PPPR (incl PABS)

As Ebola Deaths Rise, the UN Pandemic Declaration Must Deliver Measurable Commitments

https://theindependentpanel.org/news/as-ebola-deaths-rise-the-un-pandemic-declaration-must-deliver-measurable-commitments/

(30 July) A Statement from the Co-convenors of the Friends of the High-Level Meeting on Pandemic Prevention, Preparedness and Response.

“Without targets, timelines or accountability, political commitment cannot become concrete action.”

“…. As currently drafted, very few of the political commitments are linked to concrete, measurable, and time-bound actions that will make the world safer from pandemic threats. …. The Political Declaration requires an infusion of urgency and ambition. Examples of areas that must be strengthened include the following, including those stressed in the Friends’ key asks:…” (do check them out).

Trump Pathogen Agreements and Global Equity Proposals

Public Citizen: Trump Pathogen Agreements and Global Equity Proposals

https://www.citizen.org/article/trump-pathogen-agreements-and-global-equity-proposals/

(30 July) “Public Citizen reviewed the six US bilateral specimen sharing agreements (SSAs) shared publicly by the US State Department, and an additional agreement accessed independently. These are agreements signed in conjunction with health funding agreements (memoranda of understanding, or MoUs) negotiated between the US government and partner country governments as part of the Trump administration’s America First Global Health Strategy. The US is entering these specimen agreements separate from ongoing negotiations among World Health Organization (WHO) member states for the creation of a multilateral pathogen access and benefit sharing (PABS) system, which is the linchpin of the recently-adopted WHO Pandemic Agreement, aiming to remedy COVID-19 inequity by establishing a mechanism to ensure equitable access to health tools in future pandemics. The Africa Group plus Egypt, Somalia and Sudan (Africa+ Group), which includes all of the countries for whom SSAs are available, and many others that have also signed MoUs, is working to negotiate a stronger PABS system. We also reviewed the Africa+ Group’s PABS proposal, comparing it with the United States’ template bilateral specimen sharing agreement. …”

“… Our analysis of seven US bilateral specimen sharing agreements finds that there are inequities within countries that signed the agreements including in terms of recognition of authorship and contribution to publications, the right, on the part of the co-signatory government, to be informed when specimen data have been shared with non-US government entities, such as private sector companies, and the number of such entities with whom specimen data can be shared. All of the agreements retain the majority of language from the previously-published template text, whose provisions differ from virtually every substantive aspect of the “federated model” proposed by the Africa+ Group for the PABS annex to the Pandemic Agreement. Negotiations on the PABS annex have occurred over the past year, and the final text has yet to be reached. The bilateral agreements signed by several countries that are also involved in the Africa+ Group underscore the need to finalize a PABS annex that establishes standardized, fair, and reciprocal terms related to access and benefit sharing for pathogens with pandemic potential. “

AMR

Telegraph – New drug for super-gonorrhoea points to better antibiotic development

Peter Beyer (GARDP); https://www.telegraph.co.uk/global-health/science-and-disease/new-drug-for-super-gonorrhoea-points-to-better-antibiotics/

“It is possible to break the cycle that has left much of the world waiting years for new antibiotics.”

“For decades, the global pipeline for developing new antibiotics has worked in reverse – prioritising the countries least affected by bacterial infections, while leaving those with the greatest need waiting. That is why the licencing in Thailand of zoliflodacin – a new antibiotic for gonorrhoea – matters so much. Coming just six months after its initial authorisation in the US, it marks a significant break from a long-entrenched tradition and is a big step forward for global health….

Thanks to GARDP, Beyer argues: “… That model is a public-private partnership, driven by the Global Antibiotic Research & Development Partnership (GARDP), which was created to do two things: ensure that the right antibiotics are developed – those with the greatest public health need – and that countries can access them affordably and quickly. Funded by governments, philanthropic foundations and other public-interest donors, GARDP can invest in antibiotic development based on public health priorities rather than commercial returns….”

UHC & PHC

Global Public Health – Reconceptualising Universal Health Coverage (UHC) for global distributive justice: The case of the Drugs for Neglected Diseases initiative

Markus Fraundorfer & Harriet Green; https://www.tandfonline.com/doi/pdf/10.1080/17441692.2026.2707689

“Since its inclusion in the Sustainable Development Goals in 2015, the global health target of achieving Universal Health Coverage (UHC) has largely stalled. This article contends that one of the reasons for this lacking progress refers to the fact that the current definition of UHC does not sufficiently account for the transnational realities of global health. This article seeks to develop a more conceptually robust understanding of what UHC is, and what is normatively required to achieve it. In this context, the article proposes a novel definition of UHC that is adapted to the transnational realities of global health and advances an understanding of UHC as a global distributive justice norm. This normative theorising draws on literature in global distributive justice, which has largely been neglected in research and policy-led efforts to understand UHC. In this reconceptualisation, the article accentuates three required discursive shifts: from ‘good health’ to ‘fair health’; from ‘assistance’ to ‘duty’; and from ‘cost’ to ‘investment’. To illustrate the conceptual and empirical validity of this reconceptualisation of UHC, it is then empirically applied to the activities of the Drugs for Neglected Diseases initiative (DNDi) in its health system strengthening efforts on Chagas disease in Latin America.”

Commercial Determinants of health

Guardian – Ultra-processed food companies hindering health drives by suing countries, says WHO

https://www.theguardian.com/society/2026/aug/01/ultra-processed-food-companies-hindering-health-drives-by-suing-countries-says-who

“Exclusive: Director general accuses corporations of obstructing efforts to tackle obesity crisis after investigation by Guardian and others.”

“The world’s biggest ultra-processed food corporations are hindering global efforts to tackle the obesity crisis by suing governments that try to promote healthier diets, the head of the World Health Organization has said. Tedros Adhanom Ghebreyesus, the WHO director general, accused global food companies of obstructing the adoption of vital public health measures and costing countries billions of dollars in healthcare and legal costs in the process….”

Maternal & child Health

Countries urged to strengthen breastfeeding support and health systems to give every child a healthy start in life

https://www.who.int/news/item/31-07-2026-countries-urged-to-strengthen-breastfeeding-support-and-health-systems-to-give-every-child-a-healthy-start-in-life

Joint statement by UNICEF Executive Director Catherine Russell and WHO Director-General Dr Tedros Adhanom Ghebreyesus ahead of World Breastfeeding Week.

“… Encouragingly, breastfeeding rates around the world are going up. Exclusive breastfeeding in the first six months rose from around 37 per cent in 2012 to over 47 per cent today. In the past five years, the prevalence of breastfeeding up to two years of age rose from 38 per cent to 50 per cent. These gains show that sustained investments in policies and programmes for mothers and families are working. Yet progress remains uneven, with many countries lagging behind global targets. Coverage of services supporting breastfeeding remains low, policies are inconsistently enforced, and service quality is often inadequate, especially in low-income, fragile, and humanitarian settings….”

“The evidence is clear: cost-effective interventions include skilled breastfeeding support in health systems, community-based counselling, maternity protection policies, and protection from the exploitative marketing of commercial milk formulas.”

“The returns are significant. Scaling up breastfeeding could prevent almost 400 000 child deaths and around 140 000 maternal deaths each year. Every US$ 1 invested in breastfeeding promotion generates an estimated US$ 59 in economic returns through lower health-care costs, improved cognitive development, higher educational attainment, and increased lifetime earnings….”

“This World Breastfeeding Week, under the theme, “Breastfeeding for a Sustainable Start in Life: Strengthen What Works,” UNICEF and WHO are calling on countries to: strengthen health systems to provide quality breastfeeding support for mothers and newborns; expand community-based counselling and peer programmes; fully implement and enforce the International Code of Marketing of Breast-milk Substitutes; invest in paid maternity leave and supportive workplace policies. integrate breastfeeding interventions into antenatal, perinatal, and postnatal health-care services; and sustain breastfeeding support in humanitarian and fragile contexts….”

PS: “WHO and UNICEF, through the Global Breastfeeding Collective, will launch an updated global investment case for breastfeeding. The investment case, produced in collaboration with Nutrition International, gives policymakers, donors and advocates a current economic argument for closing the financing gap in protecting and supporting breastfeeding….”

APA – Africa CDC mobilizes to eliminate preventable maternal deaths

https://apanews.net/africa-cdc-mobilizes-to-eliminate-preventable-maternal-deaths/

(1 August)

“The Africa Centres for Disease Control and Prevention (Africa CDC) is holding a three-day regional workshop in Cotonou, Benin Republic aimed at accelerating efforts to improve maternal and child health and advance the continent’s goal of achieving “zero preventable maternal deaths.” “

“Organised in partnership with the African Union Commission, member states and several development partners, the workshop brings together government officials and experts from West, Central and North Africa to validate the findings of the first continental assessment of policies, financing mechanisms, governance and service delivery related to sexual, reproductive, maternal, neonatal, child and adolescent health (SRMNCAH). The findings of the assessment will contribute to a continental report designed to guide public policies, strengthen government accountability and accelerate progress in reducing preventable maternal and neonatal deaths….

“… The initiative is part of the African Health Security and Sovereignty Agenda (AHSS) and supports the programme led by Tanzanian President Samia Suluhu Hassan, African Union Champion for Maternal and Child Health. The programme is built around three major objectives: eliminating preventable maternal deaths, ending preventable neonatal deaths, and ensuring that no child remains unvaccinated….”

“… According to Africa CDC, 53 of the African Union’s 55 member states took part in the continental assessment, described as one of the most comprehensive ever conducted on reproductive, maternal, neonatal, child and adolescent health in Africa….”

Lancet Regional Health Africa – The Freetown Charter: strengthening accountability and digital transformation for maternal, newborn and child health in West Africa

Virgil Kuassi Lokossou et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00098-2/fulltext

« West Africa bears a disproportionately high burden of maternal, newborn, and child mortality; sub-Saharan Africa accounts for about 70% of global maternal deaths. Weak accountability, fragmented information systems, inadequate financing, and limited implementation capacity hinder progress. Against this backdrop, the adoption of the Freetown Charter on Maternal, Newborn and Child Health Digitalisation and Accountability by Economic Community of West African States Ministers of Health in April 2026 represents an important opportunity to strengthen regional governance for maternal, newborn, and child health. “

“What distinguishes the Charter from previous regional commitments is its focus on implementation architecture rather than targets alone. The Charter links maternal, newborn, and child health outcomes to digital health infrastructure, maternal, perinatal, and child death surveillance and response, domestic financing, legislative reform, accountability mechanisms, health workforce readiness, and pandemic preparedness. It recognizes that preventable maternal deaths, stillbirths, newborn deaths, and under-five mortality are driven not only by resource constraints but also by weaknesses in governance, data use, and service delivery….”

« A central feature is the institutionalization of maternal, perinatal, and child death surveillance and response as a core health-system function. Building on maternal death surveillance and response approaches, the Charter promotes integration of maternal deaths, stillbirths, newborn deaths, and under-five mortality into a unified surveillance system linked to the Integrated Disease Surveillance and Response framework. This approach treats preventable maternal and child deaths as sentinel events requiring systematic investigation and corrective action….”

Planetary Health

HPW – Climate Crisis in ‘Overdrive’ as Fossil Fuels Fan El Niño, UN Chief Warns

https://healthpolicy-watch.news/climate-crisis-in-overdrive-as-fossil-fuels-fan-el-nino-un-chief-warns/

“As wildfires rage across continents, heatwaves claim thousands of lives and ocean temperatures shatter records, UN Secretary-General António Guterres warned on Friday that the climate crisis has entered “overdrive.” “This is only a warm-up act,” he said. “El Niño is strengthening, adding fuel to a planet already on fire with scorching heat domes, apocalyptic wildfires and record hot seas.””

“New forecasts from the World Meteorological Organization (WMO) show El Niño, the naturally occurring climate pattern that amplifies global temperatures and disrupts rainfall, is developing into a strong event at unprecedented speed….”

Lancet (Comment) – Intersectionality in climate and health equity research

Aaron Koaya, R Guinto et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01417-0/fulltext

“Intersectionality is increasingly used in climate justice and health equity research, and some work has begun to bring these fields together. However, clearer guidance is still needed on how to operationalise intersectionality in climate and health equity research….”

Therefore, we propose a three-level framework for applying intersectionality in climate and health equity research: outcomes, processes, and systems…..”

AI & health

Lancet Digital Health (Comment) – Global health suffers when corporate AI sovereigns reign

T Caplan et al ; https://www.thelancet.com/journals/landig/article/PIIS2589-7500(26)00092-0/fulltext

Comparing with the East India company from centuries ago.

“Today, the world’s largest technology firms are at the precipice of a similar transition: towards becoming firms that function as corporate sovereigns whose power derives from the control of indispensable digital infrastructure and the algorithms that shape the attention economy, rather than from physical territory…”

Access to medicines, vaccines & other health technologies

See also the related abovementioned info from the IAS26 debates, where access was a key issue.

South Africa: African Development Bank and Biovac sign $15 million agreement to advance Africa’s first end-to-end cholera vaccine production

https://www.afdb.org/en/news-and-events/south-africa-african-development-bank-and-biovac-sign-15-million-agreement-advance-africas-first-end-end-cholera-vaccine-production-95738

“Financing will help triple Biovac’s annual production capacity up to 500 million doses, create 340 jobs, and strengthen South Africa’s role as a continental vaccine manufacturing hub.”

Miscellaneous

Guardian – Anti-LGBTQ+ laws are on the rise across west Africa, campaigners warn

https://www.theguardian.com/world/2026/aug/02/anti-lgbtq-laws-are-on-the-rise-across-west-africa-campaigners-warn

“Activists in the region say politicians regard LGBTQ+ people as ‘the easiest scapegoats to maintain their power’.”

Reuters – As life expectancy rises, talks start on a UN treaty to protect older persons

https://www.reuters.com/world/americas/life-expectancy-rises-talks-start-un-treaty-protect-older-people-2026-07-17/

(17 July). In case you missed this.

“UN projects over-65s will double in 50 years; New UN treaty seeks to address ageism; Heatwaves and COVID-19 deaths added pressure for treaty.”

“A United Nations meeting this week heard calls for an end to ageism and better protection against what campaigners ‌say are hidden abuses as negotiations began on a treaty to strengthen the rights of older persons. The week of talks in Geneva which ended on Friday were initiated and chaired by Argentina in efforts to combat exclusion, discrimination and neglect as life expectancy rises. The U.N. projects that the number of people over 65 will double in the next 50 years to become a fifth of the world’s population….”

“… “This goal is to build an instrument that strengthens the dignity, protection, and the rights of millions of older persons globally.” Brazil, Slovenia, the Philippines and Gambia are the proposed treaty’s other main backers, and Chile and South Africa were among countries that voiced support in the week-long talks. Negotiators are set to meet again in Geneva in October and it is not clear how long negotiations might last. It can take years for such treaties to be agreed on.”

PS: “Although there are already human rights treaties that have non-discrimination clauses based on race and gender, none exist for age.”

Global health governance & Governance of Health

Devex – Exclusive: US withholds dues to UN, again

https://www.devex.com/news/exclusive-us-withholds-dues-to-un-again-113057

“The move follows U.S. anger over reappointment of U.N. high commissioner for human rights.”

The Conversation – Africa shaped the global 2030 development agenda. How it can influence what comes next

A G Gebrihet; https://theconversation.com/africa-shaped-the-global-2030-development-agenda-how-it-can-influence-what-comes-next-287922

“… The UN has already begun preparing for that discussion. The Pact for the Future invites the High-level Political Forum, under the auspices of the General Assembly, to consider in September 2027 how sustainable development should be advanced by 2030 and beyond. This gives the African Union and its member states about a year to agree on their priorities and influence the debate before its main ideas are settled. Will Africa help write it, or simply respond to it?…

“We study Africa’s leadership in global development debates. A recent study led by Hafte Gebreselassie Gebrihet examines how the Common African Position, a shared set of African priorities for the negotiations that produced the SDGs, influenced the post-2015 development agenda. It shows that Africa has helped shape a global development framework before. In 2014, African governments adopted the common position while negotiations on the goals were still under way. It gave African negotiators a shared set of priorities before the final agreement was reached….

“…. The Addis Ababa Declaration, adopted in April 2026 at the Africa Regional Forum on Sustainable Development, calls for active and collective African engagement in shaping the post-2030 framework. The declaration links the process to African priorities and the AU’s Agenda 2063. It sets out initial ideas for the next framework. It also asks Mauritius to present the declaration and its main messages at the 2027 summit and other international meetings. But the declaration is a starting point, not a new common position. Turning it into a formal continental negotiating position will require leadership from heads of state. The African Union Commission must coordinate the process. Governments must also consult widely and agree on priorities….”

With 5 lessons.

WHO – BRICS elevates traditional medicine with landmark declaration and new expert working group

https://www.who.int/news/item/27-07-2026-brics-elevates-traditional-medicine-with-landmark-declaration-and-new-expert-working-group

(27 July) “The 16th BRICS Health Ministers’ Meeting, held in Chandigarh, India, on 23–24 July 2026, has produced the most significant political recognition of traditional medicine) in the history of BRICS health cooperation. For the first time, the Health Ministerial Declaration contains a dedicated section on traditional, complementary and integrative medicine (TCIM), endorsing a new BRICS expert working group on this topic to enhance dialogue, collaboration and exchange among Member States. ….”

“… The outcome also reinforces the growing alignment between BRICS and the WHO Global Traditional Medicine Centre, which has become a key international platform for advancing research, capacity building and international cooperation in traditional medicine. By linking BRICS cooperation to the objectives of the WHO’s Global Traditional Medicine Strategy 2025–2034, the Declaration strengthens the global architecture supporting the safe, effective and evidence-informed use of traditional medicine. …”

PS: “The 2026 BRICS Summit will be held in New Delhi on 12–13 September under the leadership of Indian Prime Minister Narendra Modi…”

Guardian – Ed Miliband indicates development and climate will be at heart of UK foreign policy

https://www.theguardian.com/business/2026/jul/26/ed-miliband-development-climate-crisis-uk-foreign-policy-world-bank-seat

“Exclusive: Foreign secretary to take up World Bank seat and play active role in shaping changes to global lender.”

Geneva Health Files – The Achievement and Reckoning of Spain’s Feminist Health Agenda

Merlin Ince; https://newsletter.genevahealthfiles.com/the-achievement-and-reckoning-of-spains-feminist-health-agenda/?ref=geneva-health-files-newsletter

Via Priti Patnaik: “ thoughtful analysis of the feminist underpinnings in the Global Health Strategy laid out by Spain. This piece has been reported and written by my colleague Merlin Ince.”

Excerpt: “… This is the global health environment in which Spain’s March 2026 decree can be understood. While the Trump administration was cutting reproductive health funding and withdrawing from multilateral institutions, Spain was writing reproductive rights into law for every person in the country regardless of status, and taking its first seat on the WHO Executive Board in more than twenty years. Health Minister Mónica García named the moment directly. Spain’s commitment to the WHO, she said, was a response to a global health architecture under strain, shaped by the United States’ withdrawal and the ongoing genocide in Gaza. Her government’s domestic record, she made clear, is Spain’s greatest tool for equity and its most explicit statement of what the country stands for….”

Ince concludes: “The reckoning is now arriving in Geneva. For the diplomats, policymakers, and global health professionals who shape the multilateral health system, Spain’s trajectory raises questions that cannot be deferred. Universal health coverage is under threat. Reproductive rights are being stripped from millions, as seen most recently through a draft African Charter on Family, Sovereignty and Values, endorsed by parliamentarians from twenty African countries in Ghana in June 2026. It explicitly calls for withdrawal from the Maputo Protocol on women’s rights. The outgoing UN Special Rapporteur on the Right to Health described it as the first continent-wide patriarchal push to dislodge human rights frameworks in Africa. The foundations of multilateral cooperation are under unprecedented strain. In this environment, the global health community now sits with a body of evidence that shows what feminist governance can deliver. Spain has shown what is possible….”

Lancet Global Health (Health Policy) – From fragmentation to integration: regional health governance in southeast Asia

Jie Wang et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00176-2/fulltext

“Southeast Asia’s regional health governance has evolved into a dense but weakly integrated system of overlapping institutions. This Health Policy paper maps the regional health governance of the Association of Southeast Asian Nations (ASEAN) as an evolving health regime complex, tracing the historical origins of regional health governance to the early 20th century and examining developments from 1980 to 2024. The study also identifies two structural features: functional specialisation along with persistent fragmentation and structural asymmetry, in which external actors dominate technical and agenda-setting roles while ASEAN retains coordination authority. Although recent reforms under the ASEAN Post-2015 Health Development Agenda have improved institutional alignment, system-wide coherence remains poor. Strengthening regional health governance will require institutional rationalisation to reduce duplication and strengthen underdeveloped functions, alongside a rebalancing of external engagement to restore regional ownership of policy priorities. The analytical approach developed in this Health Policy paper offers a transferable framework for other regions facing institutional proliferation. Policy efforts should shift from expanding arrangements towards managing complexity through coordination, functional differentiation, and clearer authority structures.”

Global health financing

Project Syndicate – The Middle-Income Health Trap

T Achoki & W O Ochieng ; https://www.project-syndicate.org/commentary/middle-income-health-trap-too-rich-for-aid-still-too-poor-to-support-public-health-by-tom-achoki-and-walter-o-ochieng-2026-07

“Many countries that graduate from low- to middle-income status soon find themselves stuck in the position of being too rich to qualify for aid, too poor to secure reliable market-based financing, and too indebted to expand public-health spending. But it doesn’t have to be this way.”

Excerpts:

“… Middle-income countries now account for over 70% of the world’s poor, for most deaths from tuberculosis, and for a still-high share of deaths from HIV and non-communicable diseases. Yet they receive a shrinking share of global health assistance, which is increasingly concentrated in a small number of fragile, low-income states. If graduation to middle-income status reliably coincided with robust tax systems, deep capital markets, and comprehensive insurance schemes, it would make sense for recent grads to fend for themselves. But many middle-income countries face rising debt-service costs and collect less than 15% of GDP in taxes, owing to their large informal sectors. They may be richer on paper, but their health ministries are often poorer in practice….”

“When donor-funded programs supported by institutions such as Gavi or the Global Fund taper off, governments are expected to assume full financial responsibility for vaccines, antiretrovirals, and malaria control, often within the space of a few budget cycles. But such costs are often large, recurrent, and have low visibility, which weakens political incentives to prioritize them over other spending….”

“… To be sure, exit strategies are now typically accompanied by technical assistance and bridge financing, with “transition planning” becoming the latest buzzword. But the underlying logic remains unchanged: graduation is treated as an administrative event rather than a political and fiscal one. But income per capita is a poor proxy for state capacity. A country can grow rapidly in GDP terms while remaining unable to raise revenue, regulate markets, or sustain complex delivery systems. Health financing depends on all three capabilities.”

“… There are alternatives. Donor organizations should adopt pragmatic eligibility criteria that are more attuned to countries’ disease burdens and fiscal capacity than to projected income status. At the same time, global health institutions should offer longer, more predictable transition periods to account for the recurrent costs related to health-care delivery. Recipient countries should advocate for debt relief to be integrated into health transitions, rather than treated as a separate macroeconomic issue. In return, they should commit to improving tax-collection systems and efficiently allocate a significant portion of those resources to proven health programs…..”

World Development Perspectives – Fiscal space for HIV and health in a polycrisis era: A descriptive macro-comparative analysis of financing asymmetries

Charles Birungi et al; https://www.sciencedirect.com/science/article/abs/pii/S2452292926000652?dgcid=author

“COVID-19 output shocks were shared, but fiscal responses were highly unequal. High-income countries spent 428 times more per capita than low-income countries. Real GDP understates fiscal pressure from import bills and depreciation. Concessional finance and special drawing rights (SDRs) cushioned but did not close fiscal gaps. HIV sustainability requires sequenced financing, not abrupt transition.”

CGD – We Can Spend $50 Billion a Year Effectively

Rachel Glennerster and Leah R. Rosenzweig; https://www.cgdev.org/blog/we-can-spend-50-billion-year-effectively

“The AI boom could see anywhere from $37 billion to $100 billion in annual philanthropic spending over the next few years. The question is, how can this money be spent effectively? A new blog series from CGD makes the case for highly cost-effective areas that philanthropists may want to consider funding. This first blog in the series looks at large-scale implementers, the role of intermediaries, and quick wins philanthropists may want to consider supporting.”

“On a recent trip to the Bay Area, many people we met shared the same concern: how can we effectively spend the wave of new philanthropic funding which is about to hit? Which organizations can absorb this amount of money? … “Nan Ransohoff estimates a “third wave of American philanthropy” will generate $37 billion to $100 billion per year in intended philanthropic spending. Not all of it will be spent on global poverty, but we think a lot of it should be because the impact per dollar is high…..”

PS: this new blog series didn’t make the ‘highlights section’ – I’m sure you understand why.

Other blogs in the series so far:

· CGD (blog) – Use New Philanthropy for a Maximum Vaccination Strategy (C Kenny)

“This second blog in the series makes the case for a maximum vaccination strategy focused on developing and rolling out new vaccines for diseases that affect the world’s poorest people.”

· CGD (blog) – Protect Women and Newborns: Scale What Works, Fund What’s Next (A Bansal)

UHC & PHC

SSM Health Systems – Strengthening empowered people and communities as a core component of the primary health care approach: A scoping review of WHO policy and operational guidance (2018–2024)

https://www.sciencedirect.com/science/article/pii/S2949856226001248

By Lama Bou-Karroum, Farraz Khalid et al.

SS&M – The political economy of universal health coverage reform in Kenya: executive dominance, elite alignment, and populist strategy (2004-2023)

Zilper Audi-Poquillon; https://www.sciencedirect.com/science/article/pii/S0277953626006337

“Study explains why Kenya’s 2023 SHI reform was enacted while a similar SHI proposal failed in 2004. Shows how executive control and institutional bypass changed veto points, expediting enactment. Demonstrates how elite alignment – including Treasury buy-in enabled adoption. Conceptualises populist strategy as a stream-coupling mechanism.”

Pandemic preparedness & response/ Global Health Security

HP&P- When should a public health emergency of international concern (PHEIC) be declared? The case of the 2018-2020 Ebola outbreak in the Democratic Republic of the Congo

B F Pagotto; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag094/8741599?searchresult=1

“… Criticism over the lack of transparency in the decision-making process to determine a public health emergency of international concern (PHEIC) has accompanied the mechanism since the category was first activated. For the 2018–2020 Ebola epidemic in North Kivu and Ituri, Democratic Republic of the Congo, this criticism intensified: it took four Emergency Committee (EC) meetings and nearly a year for the World Health Organization (WHO) Director-General to declare a PHEIC. The North Kivu case is an emblematic case of the complexities surrounding such determinations, complexities that the opacity and inconsistent application of the IHR criteria across PHEIC history have made difficult to examine. What shaped the EC’s assessment, and what does this reveal about how PHEIC determinations are made…”

Planetary health

Climate Change News – UN bid to keep 1.5C alive exposes deepening divisions over fossil fuels

https://www.climatechangenews.com/2026/07/29/un-bid-to-keep-1-5c-alive-exposes-deepening-divisions-over-fossil-fuels/

“Vulnerable island nations and the poorest countries want the Belém Mission to 1.5 to drive fossil fuel phase-out, while Arab states call for more investment in oil and gas.”

“As countries weigh in on the “Belém Mission to 1.5”, a new process launched at COP30 last year to address the global shortfall in climate ambition, submissions show that small island nations and least developed countries (LDCs) want the initiative to help speed up a shift away from fossil fuels. Their calls for a focus on emissions-cutting measures in the energy sector are supported by the EU and the UK…”

“But the “like-minded developing countries” (LMDC) bloc – which includes China, India – and Arab states led by Saudi Arabia have warned against singling out specific energy sources or using the mission to assess how individual countries are performing on emissions cuts. Instead, they want its scope narrowed to identifying primarily what rich countries should do to cut their own emissions and provide more climate cash to developing nations….”

Carbonbrief – Climate change is driving a ‘shift’ in childhood malaria risk across Africa

https://www.carbonbrief.org/climate-change-is-driving-a-shift-in-childhood-malaria-risk-across-africa

“Rising temperatures are redistributing the risk of childhood malaria in sub-Saharan Africa, resulting in areas of “new risk” in the east and south of the continent, but also “relief hotspots” in western Africa. This is according to a new study, published in Nature, which provides the “most comprehensive look to date at the impact of climate change on any infectious disease”….”

“The research finds that since the year 1900, climate change has resulted in one extra case of malaria for every 1,000 children in sub-Saharan Africa on average. Over the 21st century, climate change is expected to drive down malaria rates across the continent on average, as temperatures rise above the optimum range for mosquitoes. However, the authors emphasise that continent-wide averages hide more detailed local trends. They find that cooler parts of Africa face an increase in malaria risk, as rising temperatures have made the regions more suitable for malaria-carrying mosquitoes, while warmer regions see a suppression in malaria cases.”

PS: “The lead author tells Carbon Brief that this is the first study to use “attribution” – a field of climate science which uses models to compare conditions in a world with global warming to one without – to assess the impact of climate change on malaria. …

“…. The study also reveals that climate change is not the main driver of shifting malaria risk in Africa, with public health measures and government policy making a more significant impact. … The “most important” message from the study, according to another expert, is that to eliminate malaria entirely, “effective surveillance, prevention and treatment remain substantially more influential – and more actionable – than climate change alone”.

Lancet Planetary Health (June issue)

https://www.thelancet.com/issue/S2542-5196(26)X2006-X

Editorial: Biodiversity: actions lagging behind aspirations

HPW – ‘Fire-Breathing Dragon Clouds’: The Health Threat of Wildfire Smoke Choking Europe and the World

https://healthpolicy-watch.news/fire-breathing-dragon-clouds-health-threat-wildfire-smoke/

“Nine miles south of the picturesque French city of Bordeaux, firefighters are at war with a phenomenon straight out of an apocalyptic epic. Scientists call them pyrocumulonimbus, or PyroCbs. NASA calls them the “fire-breathing dragon of clouds”.” “ The port capital of Nouvelle-Aquitaine, normally bustling with tourists at peak season, is instead drowned in smog, so thick residents are forced to wear the N95 and FFP2 masks many hoped would be a thing of the past as the COVID-19 pandemic subsided….”

“A NASA satellite passing over the burning pine forests of the south-western Gironde region last Friday showed the PyroCb driving smoke into the city’s skies was visible from orbit. Until this month, these fire systems had been recorded almost exclusively in Australia and North America….”

· Related: UN News – Wildfire smoke poses hidden health threat

“Wildfires are often associated with the destruction they leave behind, but the smoke they produce can pose a serious health threat far beyond the fire zone, the World Health Organization (WHO) has warned.”

Covid

Nature – Can long COVID be prevented? Two drugs finally show promise

Nature

“The results of rigorous clinical trials suggest that two drugs can prevent an infection with COVID-19 from developing into long COVID, a chronic condition characterized by fatigue and cognitive impairment. The first trial reported that paxlovid, an antiviral COVID-19 treatment, reduced the risk of long COVID developing after three months by 40%. Another reports that the diabetes drug metformin reduces the risk of long COVID at six months after infection by around half. The trial results have divided physicians — some think the results are promising enough to start prescribing the drugs for this purpose; others disagree.”

Infectious diseases & NTDs

Nature Editorial – Polio will come roaring back if the task of eradicating it isn’t finished soon

https://www.nature.com/articles/d41586-026-02308-8

“Eliminating polio is within reach — if countries see it as an essential public-health priority.”

Stat (Opinion) – Ten years after WHO recognition, mycetoma remains one of the world’s most neglected diseases

Stat;

“Researchers have made progress, but it’s fragile and fraught.”

Ten years ago, the World Health Organization added mycetoma to its official list of neglected tropical diseases. Caused by bacteria or fungi, the disease enters the body through tiny openings in the skin — even a thorn’s pinprick — then slowly eats away surrounding tissue and bone. It’s endemic in Africa, Asia, Europe, and Latin America. A new First Opinion essay argues that, despite some progress made by researchers, our understanding of the disease is still fragile and fraught. “The next 10 years of mycetoma care will determine whether it remains a story of neglect or becomes one of collective action,” writes Borna Nyaoke-Anoke, who leads research on the disease. …”

Nature (News) – How mosquitoes are conquering the world — in four charts

Nature

“Mosquito-borne diseases are breaking records as climate change and other human influences allow the insects to expand their range.”

Mental health & psycho-social wellbeing

Nature Medicine – Global economic burden of depression in 154 countries from 2025 to 2050

Z Cao et al ; https://www.nature.com/articles/s41591-026-04548-7

“A macroeconomic modeling analysis across 154 countries estimates that depression will impose a US$12 trillion global economic burden between 2025 and 2050, equivalent to around 0.5% of the annual global GDP.”

Neonatal and child health

Plos Med – Expanding the Developmental Origins of Health and Disease beyond maternal behaviors

Alice Rhiannon Lee et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005208

« Developmental Origins of Health and Disease (DOHaD) research has long emphasized maternal pregnancy behaviors as key determinants of child health. New evidence recently published in PLOS Medicine suggests the greatest opportunities to improve child health may lie in tackling socioeconomic disadvantage rather than maternal behavior alone. »

Access to medicines & health technology

Plos GPH – The role of faith-based organizations in the pharmaceutical systems of low-and-middle-income countries – A scoping review

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006835

By Zana Wangari Kiragu, Veronica Wirtz et al.

Conflict & Health – Essential medicines in conflict-affected settings: a systematic review of accessibility and affordability across fragile health systems

https://link.springer.com/article/10.1186/s13031-026-00825-x

by T K Lin et al.

Human resources for health

Human Resources for Health – From task-shifting to cornerstone: the evolution of Public Health Officers Education in Ethiopia

K C Debessa; https://link.springer.com/article/10.1186/s12960-026-01089-5

Review.

Decolonize Global Health

Plos GPH – Beyond paper walls: From diagnosis to action on visa inequities in global health

Shawna Novak et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006964

“Visa inequities in global health have moved from the margins of academic discourse to the centre of a growing reform agenda. While recent literature has established that visa regimes function as structural determinants of global health participation, a critical gap remains: the solution pathways proposed to date remain dispersed across commentaries, editorials and toolkits rather than consolidated into a coordinated operational framework that institutions, conference bodies and funders can act on at scale. This Essay consolidates and builds on that emerging consensus to propose a Global Mobility Equity Framework comprising four interdependent and scalable domains: equitable convening, inclusive participation infrastructure, institutional accountability and distributed visa support systems. Drawing on documented cases spanning the International AIDS Conference, the World Health Summit, the Consortium of Universities for Global Health, and clinical training pathways for foreign medical graduates, we demonstrate that visa barriers impose cascading professional, financial and institutional costs that are systemic in pattern rather than exceptional in nature. We further show that virtual and hybrid conferencing, while promising, does not independently resolve underlying inequities related to connectivity, time zones, language access and the networking disparities that shape career trajectories. … Adopting this framework is a necessary condition for a more representative and effective global health system.”

Migration & Health

International Journal of Health Planning & Management – Inclusion of Refugees Into National Health Systems: Enablers, Barriers and Lessons From Six Country Case Studies

Sophie Witter et al; https://onlinelibrary.wiley.com/doi/10.1002/hpm.70109

“In this article, we analyse the inclusion of refugees in six low and middle-income country (LMIC) health systems (Kenya, Kurdistan Region of Iraq (KRI), Mauritania, Pakistan, Peru and Zambia)….”

Papers & reports

Lancet Public Health – Advancing Health Equity for Sex Workers

https://www.thelancet.com/series-do/health-equity-for-sex-workers

A four-paper Series about advancing health equity for sex workers.

IJHPM – Power in Global Health: A Narrative Review, Relational Framework, and Systems-Based Analysis

M T Eshete, G Tomson et al ; https://www.ijhpm.com/article_4907.html

« This narrative review examines how power is conceptualized and operationalized in global health discourse, identifies systematic analytical gaps, and proposes a relational framework to address them. »

« In global health, power is pervasively invoked but rarely operationalized. We organized the reviewed texts into six thematic domains: (1) power as a determinant of health; (2) structural power (class, race, gender, geopolitical hierarchies); (3) power asymmetry; (4) power and governance for health; (5) power and health securitization; and (6) power constellations and health outcomes. Across these domains, we find that discussions of power remain largely qualitative and often stop short of clear operationalization. The Causal Loop Diagram (CLD) translates these insights into interacting feedback loops, illustrating how specific power constellations are associated with particular patterns of policy response and health outcomes, highlighting potential leverage points for governance reform. »

WHO Bulletin – A transdisciplinary research agenda for resilience

Anne-Sophie Jung et al ; https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.26.295811.pdf?sfvrsn=4af60f80_5

“…. This article aims to set a conceptual agenda, drawing on an ongoing transdisciplinary collaboration between Fundação Oswaldo Cruz, University of Leeds, University of Toronto and Imperial College London. Our shared concern is that dominant framings of resilience, built around episodic preparedness, measurement frameworks and recovery from acute crises systematically miss the more persistent forms of resilience that constitute everyday life in health and social care systems. We argue that the conceptual centre of gravity in resilience research must shift from shock to the ordinary. We propose that the analytical work missing from current discussions is a clearer explanation of how chronic stressors interact with system functioning, not as isolated events to be repelled, but as accumulating pressure that demands continuous recalibration…”

Journal of Global Health – What makes embedded implementation research work? A multicountry synthesis of UNICEF-supported initiatives in low- and middle-income countries

https://jogh.org/2026/jogh-16-04265

By ASM Shahabuddin et al.

HP&P – Beyond evidence: how actor dynamics and power shape knowledge translation for health policy in Kenya

F Hassan Guleid et al; https://academic.oup.com/heapol/article/40/8/819/8220457?login=false

“Actor roles and influence in knowledge translation (KT) is shaped by institutional mandates that affect their agency in KT-policy processes. KT is embedded in, and is constitutive of, policy-making: it reflects, maintains, or challenges institutional structures and power hierarchies. Efforts to improve KT should navigate institutional structures, enable boundary spanning roles, and shift power dynamics.”

Editorial: Catching up on the past 10 days (IHP News #891)

Kristof Decoster — Mon, 03 Aug 2026 06:54:20 +0000

Dear Colleagues,

As I took a week off last week, I owe you a catch-up issue (covering the past 10 days, more or less). With plenty of focus obviously on the 2026 AIDS conference in Rio – among others with a Featured article by my colleague Caroline De Schacht (who was ‘on the ground’ in Brazil).

Later this month (second half of August) IHP takes some more holidays. We’ll follow a similar approach – stay tuned then for a catch-up issue somewhere early September. But at least till mid-August, you should get your regular update on Friday morning.

Enjoy your reading.

Kristof Decoster

Weekly topics: IHP news 890: Highlights of the week (IHP News #890)

International Health Policies — Fri, 24 Jul 2026 05:53:27 +0000

Structure of Highlights

· 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….”

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.”…”

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…..”

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.

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…..”

“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….”

· 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®=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:

a more robust, rules-based IDA graduation process;
updated creditworthiness assessments at the IBRD to support an increase in the pace of IDA graduations; and
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…..”

“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….”

“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 .”

Editorial: 80-year anniversary of the WHO constitution, an AU extraordinary summit on health, “Dantesque scenarios” & much more (IHP News #890)

Kristof Decoster — Fri, 24 Jul 2026 05:53:26 +0000

Dear Colleagues,

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

Weekly topics: IHP news 889: Highlights of the week (IHP News #889)

International Health Policies — Fri, 17 Jul 2026 05:39:21 +0000

Structure of Highlights

· 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.”

“… 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.”

(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. “

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.”

(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.”…”

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….”

“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…..”

“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.”

Editorial: Launch WHO office in Tokyo, HLPF on SDGs in New York, GF Board meeting in Geneva, Accra Reset in Dakar, the ‘wisdom of the crowds’ & plenty more (IHP News #889)

Kristof Decoster — Fri, 17 Jul 2026 05:39:20 +0000

Dear Colleagues,

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

Weekly topics: IHP news 888: Highlights of the week (IHP News #888)

International Health Policies — Fri, 10 Jul 2026 05:28:09 +0000

Structure of Highlights

· 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.

(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….”

“Devex asked the State Department about the Global Fund arrangement but was told the department “does not comment on internal deliberations.” … “

“Here’s where it gets interesting: The multilateral funder isn’t calling the arrangement a waiver — much like OCHA, the U.N.’s humanitarian body, which told us in May that no conditions had been placed on a $1.8 billion U.S. pledge, but didn’t say whether it had received a waiver. Does the wording matter? In one sense, no. These organizations can use U.S. funding where the needs are. But it matters how these arrangements were reached — both for transparency and for the many other organizations still trying to navigate the policy….”

Global Fund – Global Fund Executive Director Selection Process Continues on Schedule

https://www.theglobalfund.org/en/updates/2026/2026-07-07-global-fund-executive-director-selection-process-continues-schedule/

PS: “The Board is expected to appoint the next Executive Director at its 56th Board Meeting, to be held in Geneva from 28-30 October 2026. The incoming Executive Director is expected to assume office during the first quarter of 2027.”

“ The election of the new executive director for the Global Fund to Fight AIDS, Tuberculosis and Malaria will move forward on schedule, according to a statement released by the organisation on Tuesday, 7 July. This announcement follows rumours that the nomination process might be restarted after the names of several US candidates were who were reportedly shortlisted had been revealed to Health Policy Watch…”

“Because the multibillion-dollar agency relies heavily on taxpayer contributions to procure lifesaving medicines, some critics have maintained that the Global Fund leadership race should be conducted in a more transparent manner. Defending its restrictive protocols, the Global Fund statement contended that absolute confidentiality is essential to protect the privacy of high-profile applicants and safeguard the integrity of the proceedings by the Executive Director Nominating Committee (EDNC). …

PS: “The strict confidentiality rules stem from a costly historical precedent, supporters of the process say. During the 2017 leadership transition, the institution was forced to completely restart its executive director search after leaks to the media….”

· And via a Lancet World Report – Search for new Global Fund Executive Director intensifies

“Whoever succeeds Peter Sands will have to steer the Global Fund through a new era of cuts from traditional donors. John Zarocostas reports from Geneva.”

“Peter Sands has been the head of The Global Fund since 2018: his tenure is due to finish at the end of this year. According to insiders familiar with the process, candidates to replace him include Mark Dybul, former Global Fund Executive Director (2012–17); John Nkengasong, a Cameroonian–American virologist and former US Global AIDS Coordinator (2022–25); Ashwin Vasan, former New York City Health Commissioner; Matshidiso Moeti, former WHO Regional Director for Africa; and an unnamed internal candidate. The process is confidential and no candidate has publicly announced a bid….”

“… Around $12·68 billion has been pledged so far against a target of $18 billion to save up to 23 million lives. Global Fund insiders say the gap is unlikely to be closed. “I think the elephant in the room is how to manage the relationship with the United States”, Suerie Moon, Co-Director of the Global Health Centre at the Geneva Graduate Institute in Switzerland, told The Lancet. The USA has traditionally been the largest donor to The Global Fund….”

Also with views of Ellen ‘t Hoen, M Kazatchkine, J Ratevosian, R Malpani.…

PS: ““The secrecy surrounding the election of the Executive Director of The Global Fund, and many other global health agencies, is by design”, Rohit Malpani, a public health consultant, told The Lancet. “The tax-paying public, who expect transparency and democratic decision making in how their own leaders are elected, don’t even know these institutions exist. For those people who do know, they have informal means to influence a final decision. And the institutions themselves have invented their own form of public participation by placing representatives of non-governmental organisations and communities on their Board of Directors”. This is “not an acceptable substitute” for a fully transparent process and usually devolves into political horse trading between donors, said Malpani.”

Lancet Editorial – Ending HIV: a reality check

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01375-9/fulltext

“The fifth UN High-Level Meeting on HIV/AIDS (June 22–23) saw the agreement of a new Political Declaration on HIV/AIDS. In it, countries expressed commitments to end AIDS as a public health threat by 2030, mobilise adequate resources, achieve the 95–95–95 targets, and accelerate equitable access to comprehensive HIV prevention, among other provisions. Speaking to the press ahead of the meeting, Winnie Byanyima, Executive Director of UNAIDS, identified the four foundations of global HIV control that she hoped countries would support: multilateralism, sustained financing, protection of rights, and access to innovations. The difficulty for the Declaration is that each of these four dimensions is facing stark opposition, if not outright reversal….”

The Editorial concludes: “Setting ambitious targets is a hallmark of global health. The drive to meet them shapes political, economic, and health agendas and they have helped to spur some of the most transformative advances in human wellbeing. But care is needed to avoid a sliding from the ambitious into the unrealistic. We need to do all we can to bring HIV/AIDS under control. The challenges to that aim will not be overcome without a serious injection of honesty into discussions of where the community now is and where it goes from here.”

Lancet Letter – The African Medicines Agency: time for integration with the African Vaccine Regulatory Forum

C Wiysonge et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01075-5/fulltext

“Andrew Green’s World Report¹ on the African Medicines Agency (AMA) highlights both its promise and the considerable challenges ahead in harmonising regulatory systems, strengthening national regulatory authorities (NRAs), and improving access to safe and effective medical products across Africa. The establishment of the AMA is a historical milestone in Africa’s pursuit of health sovereignty and regulatory convergence. However, the AMA’s success will depend on how effectively it builds on and integrates existing continental regulatory platforms, especially the African Vaccine Regulatory Forum (AVAREF). … … Green rightly underscores persistent regulatory fragmentation across Africa and the need for harmonisation to enable timely access and stimulate pharmaceutical investment. Nevertheless, without deliberate alignment between AMA and AVAREF, there is a risk of duplication, inefficiencies, and institutional competition. The priority should therefore be integration of existing platforms into a coherent continental system, rather than parallel structures….”

IJHPM – TICAD9 and the UHC Knowledge Hub: Strengthening JapanAfrica Health Cooperation

A K Abubakar et al ; https://www.ijhpm.com/article_4889.html

“The Tokyo International Conference on African Development (TICAD), Japan’s main development framework for partnership with Africa since 1993, provides an important platform for responding to these challenges. The Ninth Tokyo International Conference on African Development (TICAD9), held in Yokohama in August 2025, came at a time when Africa’s health priorities require more coherent and accountable forms of international cooperation. At the December 2025 UHC High-Level Forum in Tokyo, the UHC Knowledge Hub was formally launched as a joint initiative involving Japan’s Ministry of Finance, Japan’s Ministry of Health, Labour and Welfare, the World Bank, and the World Health Organization (WHO). This Viewpoint argues that TICAD9 gives Japan an important opportunity to strengthen its health partnership with Africa. Japan’s most useful contribution is institutional support: helping African governments strengthen health financing, reduce fragmentation, and hold partners accountable within African-led frameworks. The UHC Knowledge Hub is central to this opportunity because it brings health and finance actors into the same policy space. However, Japan must respond to Africa’s structural constraints while also recognizing the policy innovations, institutions, and priorities that African countries bring to the partnership.”

Authors conclude: “… At a time when the wider aid architecture is becoming less reliable, Japan-Africa health cooperation has renewed importance. TICAD9 is distinctive because it builds on longstanding political trust and multilateral legitimacy, while the UHC Knowledge Hub gives the partnership a timely focus on health financing as African countries advance stronger domestic financing and country-led health systems on the path to 2030. In this context, co-creation matters because it moves cooperation beyond donor-recipient relations toward a partnership shaped by mutual interest and African ownership. Progress should be reviewed against time-bound signals linked to financing plans, durable capacity building, and African-led accountability mechanisms. Africa’s demand is clear: partnerships that expand fiscal space, enable access to technology, and, more importantly, remain accountable to African-led priorities. The test for TICAD9 and the Hub is whether they can help make this form of cooperation routine.”

Tim Schwab – Congress probes Bill Gates on Epstein, STDs, penis, & extramarital affairs

https://timschwab.substack.com/p/congress-probes-bill-gates-on-stds

“The House Oversight Committee’s interview of Gates shows him to be an unreliable narrator, but doesn’t bring Epstein’s victims any closer to justice. It’s time to expand the federal probe.”

One of the key questions is still: why is the treatment Larry Summers got, including from the global health community, so different from Gates’…? As it seems (also from the extracts presented here) that Gates, like Summers, has been for years a ‘pal’ of Epstein (and so doing much more than just ‘exploring avenues for global health funding’…)

Journey towards Health sovereignty

Lancet GH – Country ownership without fiscal justice is responsibility without resources

K Tumlinson & M Pai; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00175-0/fulltext

Also one of the reads of the week. « … Any serious agenda for country ownership should therefore include global wealth taxation, sustained distributive justice programmes, debt cancellation, debt restructuring, grant-based financing, and reparative transfers. Otherwise, the call for sustainability risks becoming morally inverted: countries already harmed by colonialism, structural adjustment, extractive trade regimes, and the climate crisis created by the Global North are conveniently asked to become self-reliant precisely as external financing is withdrawn and debt service expands….”

« … All global health practitioners should treat debt justice as a health financing issue, not as a separate macroeconomic debate. Donors and multilateral institutions should prioritise grant-based support for health system strengthening and promote debt cancellation. High-income countries should tax concentrated wealth, support redistributive financing, and recognise reparative financing as partial redress for historical and ongoing extraction, not charity. Appropriate metrics could include fiscal space indicators: debt service as a share of revenue, health spending relative to debt payments, domestic financing for commodities and workforce, and external financing through public systems rather than parallel non-governmental organisations….”

Ofon- Who Really Shapes Health Policy in Africa? Government or Donors

Abasiofon Ita; https://ofon1.substack.com/p/who-really-shapes-health-policy-in?r=4w30hd&utm_medium=ios&triedRedirect=true

Nice Substack analysis, based on interviews with a number of experts (L Gostin, S Abimbola, S Sekalala, N A Sam-Agudu, W Menson, H Barroy).

A few excerpts:

“What Can Realistically Change: The experts interviewed for this analysis point less to a wish list than to a sequence. The order matters, because several of the obvious fixes fail when they are attempted in the wrong one.

• Fix budget execution before chasing budget support. Barroy’s threshold is concrete: a credible budget, execution above 85%, and a working financial management system. Pushing donors to route money through a treasury that releases a fraction of what it appropriates (Nigeria released about 15% of its 2024 capital health allocation) invites failure that gets blamed on ‘country systems.’ Earn the confidence first, then ask for the channel.

• Treat the revenue base as the real constraint, not willpower. Menson’s point is that a minister cannot allocate money the state never collected. A continent averaging 16% tax-to-GDP cannot legislate its way to 15% health budgets on paper alone. Solidarity levies on airline tickets, alcohol and mobile services, already piloted under Africa CDC’s plan, widen the base that any future health budget draws from.

• Legislate a floor, but a credible one. A binding 10% minimum written into law, tied to budget cycles, beats a 15% political pledge (i.e. Abuja) that has been ignored for 24 years with no consequence. Gostin’s reading is that the Abuja commitment failed partly because it was never built to bind; a domestic statute can do what a continental declaration could not.

• Sequence the donor exit around capacity, not calendars. Sam-Agudu’s warning is that handoffs fail when a government is told to absorb a program it never had the staff or supply chains to run. Transition timelines should track the National Primary Health Care Development Agency’s revitalisation of facilities, not a donor’s fiscal year. A handoff dated to a budget deadline rather than a capacity milestone is a stockout waiting to happen.

• Integrate vertical programs into primary care. Running HIV or malaria infrastructure parallel to the wider system is expensive and fragile, and it is what pulls nurses toward donor-funded conditions and away from the clinics most people use. Rwanda’s integration model is the reference point.

• Ring-fence health in IMF negotiations. Governments agreeing loan conditions should protect health spending from the macroeconomic targets that the Cambridge evidence shows have measurably cut it.”

PS: “ The experts who work inside the system converge on an uncomfortable agreement. Sam-Agudu places the larger share of responsibility on African governments that spent two decades without building independence. Menson locates the binding constraint in fiscal capacity and debt. Barroy shows that even good financial plumbing does not move donors on its own. Gostin confirms the central pledge was never built to bind. Abimbola reframes the whole question by insisting that a poor country’s first health task is to stop being poor, which means health policy that starts with food, water, shelter, schooling and jobs rather than a single donor-funded disease…”

Trump 2.0, US Global Health Strategy & bilateral health agreements

Via AVAC’s Global Health Watch newsletter: “…. new articles and analyses of US bilateral health agreements under the “America First Global Health Strategy” suggest the Administration’s vision for global health is shifting from supporting epidemic control to managing country transitions. …” “ thepieces reflect a move toward implementation of the new global health agreements….”

Devex – Will the US funding deal rescue South Sudan’s health system?

A Green; https://www.devex.com/news/will-the-us-funding-deal-rescue-south-sudan-s-health-system-112885

“The $166 million health financing agreement between South Sudan and the United States has raised concerns that the overall amount is too low and questions about whether Juba can actually deliver on its end of the bargain.”

Independent – 75% of Americans want Trump to reverse US aid cuts over Ebola outbreak, poll finds

Independent;

“ Survey finds significant number of those are Trump supporters, with 72 per cent also backing the restoration of some or all global health funding worldwide…”

“… The survey, conducted by Echelon Insights on behalf of The Rockefeller Foundation, found that 75 per cent of respondents backed restoring funding to tackle the outbreak. The support extended across the political spectrum, with just over half, at 52 per cent, identifying as supporters of US President Donald Trump, who made cutting billions from US aid funding a priority upon returning to the White House last year….”

World Cup Football

Nature (World View) – Time to give hydration breaks the red card? What science says about keeping cool

https://www.nature.com/articles/d41586-026-02097-0

“Inappropriate use of cooling breaks in sport is undermining trust in heat-health research.”

“… cooling breaks should be driven by heat-stress risk and designed around effective cooling, not broadcast schedules or commercial pressures….”

NCDs & Commercial Determinants of Health

Guardian – Progress against cancer not shared by poorer countries, WHO report finds

https://www.theguardian.com/global-development/2026/jul/08/health-who-global-persistent-inequities-progress-cancer-prevention-diagnosis-treatment-care

‘Persistent’ inequities found to exist in access to prevention, diagnosis, treatment and care, annual global review says.”

Some stats: “…. There are an estimated 20.6m cases, and 10m deaths, from cancer every year. Figures are projected to rise to nearly 35m cases by 2050. In richer countries, 85% of those diagnosed with breast or childhood cancers will survive at least five years but the figure drops to less than 30% in poorer countries….”

“In low- and lower-middle income countries, between 9% and 54% of the WHO’s top-20 priority cancer drugs are available, compared with between 68% and 94% in high-income countries, the report found. In 23 countries there are no radiation facilities. Diagnosis rates were lower in sub-Saharan Africa than in wealthier regions, but deaths from cancer were disproportionately high.”

“Two-thirds of countries do not cover cancer in universal health coverage packages, and high costs mean up to 90% of patients in some settings abandon treatment, the report said….”

A global survey of patients and their families found widespread financial hardship, mental health challenges and strain on caregivers….”

· See WHO – Global status report on cancer 2026: the future we choose together

· And more coverage & analysis via HPW – By 2050, There Will be 35 Million Annual Cancer Cases Without More Action, Warns WHO

“ The report is the first comprehensive analysis of the global status of cancer prevention and control, projections of future trends – and progress made since 2010, the baseline year chosen for the analysis….”

The Milbank Quarterly – The Political Economy of Wellness: Commercial Determinants of a Burgeoning Industry

N Karreman et al ; https://www.milbank.org/quarterly/articles/the-political-economy-of-wellness-commercial-determinants-of-a-burgeoning-industry/

“Wellness has grown into a multi-trillion-dollar industry encompassing a multitude of products and practices that affect health and well-being. Applying a lens of commercial determinants of health to wellness is useful to examine its intersection with systems of capital production, corporate interests, and neoliberal norms of personal responsibility. The global digital revolution has fueled both the growth of the wellness industry and the spread of health misinformation, posing regulatory, social, and political challenges. As wellness movements gain prominence in American and global policymaking, attention to these intersections is crucial to understanding consequences for health policy.”

Habib Benzian – The Republic of Coca-Cola

Habib Benzian;

“What if one of the most powerful states in global health has no flag, no voters, and no obligation to either?”

SRHR

Project Syndicate – Low-Cost Solutions to Maternal Mortality Already Exist

I M Nsofor; https://www.project-syndicate.org/commentary/increase-funding-for-proven-simple-solutions-to-maternal-mortality-by-ifeanyi-m-nsofor-2026-07

“As foreign aid declines, policymakers in lower-income countries must increasingly focus on making better use of scarce resources. When it comes to maternal mortality, that means investing in simple, proven, and affordable interventions for postpartum hemorrhage, pre-eclampsia, and obstructed labor.”

“Declining foreign aid has exacerbated the crisis. As calls for local resource mobilization grow louder, the focus should shift to cost-effectiveness. Instead of investing in expensive hospital-centered models, policymakers should scale up funding for affordable interventions that address the leading causes of maternal mortality, which include postpartum hemorrhage, hypertensive disorders such as pre-eclampsia, unsafe abortion complications, obstructed labor, and sepsis. The challenge is no longer identifying solutions, but rather ensuring that proven interventions reach every woman in need, especially in resource-constrained settings….”

HPW – Facing Threats to Sexual and Reproductive Health Rights – Some Countries Show A Way Forward

https://healthpolicy-watch.news/facing-threats-to-sexual-and-reproductive-health-rights-some-countries-show-a-way-forward/

With coverage of a World Health Assembly high level (side) event on sexual and reproductive health rights in May. A few excerpts & quotes:

“…. against the [current] threats and setbacks, there are also inspiring models of progress in low-and middle income countries such as Barbados, Guyana and Malawi, offer models that deserve wider attention, Guyana’s UN Ambassador in Geneva, Ramsammy said. …”

“Let me urge that we refrain from viewing SRH strictly and merely as a health issue,” Ramsammy said. “Providing voluntary access to contraception and a safe birth environment is not just a medical necessity, it is economic and social capital. …”

“… Processes like the Human Rights Council’s Universal Periodic Review (UPR) can also be harnessed to accelerate progress, Ramsammy and other members of the high level panel convened by the Global Center for Health Diplomacy and Inclusion (CeHDI), also emphasized. …” “The UPR is a peer review assessment every four or five years by HRC member states of progress in human-rights related legislation, policies and practices – including obligations of governments to the right to health and public health measures. A recent analysis of the impacts of UPR recommendations across three review cycles (2005–2023) found the recommendations were associated with accelerated improvements in maternal health among high-burden countries. Critical SRHR indicators included in the analysis were maternal mortality rates (MMR), skilled birth attendance (SBA) and contraceptive prevalence (CPR)….

PS: Rammsammy : “While an informal benchmark of 10% for SRHR has been cited by international parliamentarians and advocacy groups, only 23% of donors allocated more than 5% of their ODA to SHRH, he noted. “So I think the call here is that we reiterate and strengthen that commitment,” Ramsammy added. “

· And a link: UN News – Restoring dignity: Senegalese surgeon and Burundian foundation win reproductive health awards

Child health

Lancet Health Policy – Children in all policies: lessons from a global collaboration to promote the health and wellbeing of children and future generations

Sarah L Dalglish et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00856-1/fulltext

“Currently children’s needs, perspectives, and rights are not adequately included in public policies, with negative consequences for the health and wellbeing of children and future generations. The 2020 WHO–UNICEF–Lancet Commission reviewed threats to children’s health and concluded that children’s needs and voices should be centred in all policies for a sustainable future. Since 2021, Children in All Policies 2030, a global collaboration of policy makers, scientists, and advocates, has implemented the Commission’s recommendations by fostering new approaches to participatory, intersectoral policy making across diverse countries. Efforts to implement the Commission’s recommendations encountered challenges including flawed assumptions in prevailing policy-making models, failure to fulfil children’s right to participate, and an ongoing scarcity of intersectoral policy integration. Eight lessons on what works for improving policy making and implementation emerged: use creative means to involve children, patiently assemble coalitions, prepare to seize political opportunities, harmonise global data to bridge UN partnerships, create national political and technical platforms, use media to change cultural perceptions, use strategic framing to overcome sectoral barriers, and embrace joint learning. Harnessing people’s consideration and concern for children and future generations and engaging children’s voices represents a powerful political opportunity to reach current development goals and ensure a healthier, more sustainable future.”

NTDs

WHO – Historic resolution on neglected tropical diseases adopted by the United Nations Human Rights Council

https://www.who.int/news/item/07-07-2026-historic-resolution-on-neglected-tropical-diseases-adopted-by-the-united-nations-human-rights-council

(7 July) “Resolution 62/27 on “Human rights and neglected tropical diseases” was adopted today by the Human Rights Council (HRC) at its sixty-second session in Geneva. The first ever HRC resolution dedicated to all neglected tropical diseases (NTDs) was adopted by consensus, after being put forward by six African countries where the burden of NTDs is significant; the group was led by Malawi, and included Burkina Faso, Gambia, Kenya, Morocco and the United Republic of Tanzania….”

“The non-binding measure creates a new basis for demanding stronger policies and budgets, but governments must turn recognition into action.”

“On 7 July, at its 62nd session in Geneva, the UN Human Rights Council adopted its first resolution devoted specifically to human rights and NTDs. It formally recognises the close links between NTDs and rights, elevating them beyond the health sector and acknowledging them as issues of dignity, equity, inclusion, and justice including health, water, sanitation, housing, education and work….”

Planetary Health

HPW – As El Niño Intensifies – WMO Warns Policymakers to Brace for Escalating Impacts on Health Worldwide

https://healthpolicy-watch.news/as-el-nino-intensifies-wmo-warns-policymakers-to-brace-for-escalating-impacts-on-health-worldwide/

“The El Niño conditions that bring extreme rainfall, heat waves and drought to different parts of the world are set to intensify further during the July-September period this year, said the World Meteorological Organization (WMO). While the Indian subcontinent has to brace for below-normal rainfall, parts of Africa and southern Europe will see above-normal rainfall, according to WMO’s latest update, published [last week on ] Friday….

““El Niño conditions are already underway and are forecast to strengthen rapidly into a strong event – as accurately anticipated by WMO forecasts. This will intensify the chances of drought and heavy rainfall and the risk of heatwaves on land and marine heatwaves in many regions of the world,” said WMO Secretary-General Celeste Saulo…. Both drought and flooding pose big threats to food production in already food insecure parts of the world, while heavy rains that cause flooding create displacement and exacerbate outbreaks of infectious and water-borne diseases such as cholera. Extreme heat, too, exerts mounting pressure on food production, Qu Dongyu, Director-General of UN’s Food and Agriculture Organization has warned….”

The Conversation – A Super El Niño is coming: 5 hard‑won lessons the world can learn from Africa

T Mabhaudi et al ; https://theconversation.com/a-super-el-nino-is-coming-5-hard-won-lessons-the-world-can-learn-from-africa-286294

“… African countries have spent decades coping and adapting to repeated cycles of droughts, floods, rainfall variability and food insecurity. The continent has built valuable experience in managing multiple harsh conditions. The world needs to pay more attention to the knowledge, practices and adaptation strategies that African communities, institutions and researchers have developed through experience. As climate impacts intensify globally, these experiences offer valuable lessons for building resilience…..” Listing 5 lessons.

CESR – The new legal era of climate finance: from charity to justice

http://www.cesr.org/the-new-legal-era-of-climate-finance-from-charity-to-justice/

“Climate finance is no longer a matter of political goodwill. A growing body of international law is making clear that it is a legal obligation grounded in human rights.”

“That shift was at the heart of discussions at the 62nd session of the Human Rights Council, where governments and civil society examined how climate finance can better support the realization of human rights. CESR contributed to the upcoming Secretary-General’s synthesis report on actionable pathways in mobilizing sufficient climate financing and associated challenges and opportunities in the pursuit of the full realization of human rights for all people, and our Executive Director, Dr. Maria Ron Balsera, joined the Council’s annual panel on the human rights impacts of climate change, which this year focused on “Facilitating actionable pathways for gaining momentum in climate financing in the context of addressing the adverse impacts of climate change on the full realization of human rights for all people”. In her intervention, Maria argued that climate finance is not simply about mobilizing more money. It is about power: who pays, who benefits, and who decides. Those questions are rooted in histories of colonial exploitation, unequal economic governance, and corporate impunity; and they determine whether climate action advances justice or reinforces inequality. At CESR, we believe a human rights approach transforms the debate. It shifts climate finance from charity to justice, clarifying who owes what to whom, strengthening transparency and accountability, and ensuring that those most affected are at the center of decision-making….”

HERA (report) – Counting the cost of heat: the case for urgent solutions for cities

https://heranow.org/resources/counting-the-cost-of-heat-the-case-for-urgent-solutions-for-cities/

“HERA’s first-of-its-kind analysis of the costs and benefits of targeted action on the impacts of extreme heat.”

PS: HERA or ‘Climate Resilience for All’ is a women-led climate adaptation NGO dedicated to strengthening and supporting women and vulnerable communities from the impacts of extreme heat.

“Heat-related economic impacts are projected to intensify three- to five-fold by 2050 without adaptation • Across Central & Southern Asia, Eastern & South-Eastern Asia, Sub-Saharan Africa, and Latin America & the Caribbean, informal women lose $57 billion per year in heat-related productivity loss. This is set to rise by 44% by 2050. • Heat Response Plans offer excellent value for money, with returns of up to 90 times their cost. A representative portfolio of low-cost interventions (including labor protections, heat insurance, urban green space, cool roofs, and a Heat Response Plan) could reduce heat-related mortality by 36%….”

“Across four cities analyzed in this study – Ahmedabad, Bangkok, Monterrey, and Freetown – heat incurs annual economic losses worth as much as 4-8% of city GDP. Without targeted action, these effects are expected to intensify three- to five-fold by 2050, driven by climate change, urbanization, and population ageing. The burden is not shared evenly – and women bear disproportionate risks and impacts. Extreme heat amplifies existing social and economic inequalities, with women, especially those working in the informal sector, facing heightened exposure and the least protection from its effects. Women are more vulnerable to heat through a combination of compounding factors, including physiological sensitivity (especially during pregnancy ), economic insecurity (earning less income and holding fewer assets), a heavier burden of unpaid care, norms that restrict clothing and movement, greater risk of gender-based violence, and more limited access to cooling, healthcare, social protection, and safe working conditions. The impacts on women’s health and finances are significant – and most acute for those in the informal sector, who lack protections that could otherwise mitigate their losses…”

Climate Change News – Tropical forest protection fund at risk after UK stalls on pledge

https://www.climatechangenews.com/2026/07/03/tropical-forest-protection-fund-at-risk-after-uk-stalls-on-pledge/

“The Brazil-led TFFF was launched at COP30 as an innovative financial model to keep rainforests standing, but is still short on startup cash.”

“A new global rainforest fund, unveiled by Brazil at COP30, will likely struggle to meet its initial funding target this year, after the UK failed to announce an expected pledge during London Climate Action Week and other donors have been slow to come on board….”

“The Tropical Forest Forever Facility (TFFF) was launched on the sidelines of last November’s UN climate summit as an innovative mechanism to fund rainforest protection. Instead of relying on grants, it seeks to raise public and private money, invest it in financial markets, and then pay rainforest countries a share of the returns. The facility has so far raised $6.8 billion but needs to mobilise at least $10 billion by the end of 2026, under conditions set by Norway to unlock its pledge. If the fund falls short of this goal, the Norwegian contribution of up to $3 billion in loans over 10 years will not be disbursed….”

Access to Medicines, vaccines & other health technologies

Semafor – Africa’s vaccine sovereignty goal is set for its biggest hurdle

P Adepoju; https://www.semafor.com/article/07/02/2026/africa-moves-ahead-with-vaccine-manufacturing-ambitions

Neat (wide-ranging) analysis. “ … Africa’s vaccine manufacturing ambitions are entering a different phase. The question is no longer whether the continent can build factories, but whether it can build markets for what those factories produce….”

DNDi – Brazil, Malaysia, and Thailand set to start global clinical trial to test promising dengue treatment developed by Serum Institute of India

https://www.dndi.org/press-releases/2026/brazil-malaysia-and-thailand-set-to-start-global-clinical-trial-to-test-promising-dengue-treatment-developed-by-serum-institute-of-india

“Following a licensing agreement signed between the Serum Institute of India (SII) and DNDi, a Phase III clinical trial is expected to begin early next year, with the aim of developing a safe, effective, and globally accessible therapeutic for dengue. “

Devex (Opinion) – The HIV prevention approach needs reprioritization, not acceleration

W Parker; https://www.devex.com/news/the-hiv-prevention-approach-needs-reprioritization-not-acceleration-112855

“Following an HIV funding crisis, the global response is accelerating a new product instead of asking what countries can afford, sustain, and prioritize.”

“The HIV funding crisis should have forced a hard reassessment of prevention priorities, but instead, a biomedicalized HIV prevention model is being reinforced without accounting for its limits. In April, the U.S. President’s Emergency Plan for AIDS Relief and the Global Fund announced plans to expand access to lenacapavir, the long-acting HIV preexposure prophylaxis, or PrEP, aiming to reach 3 million people by 2028. … “

“… The urgent question is what to prioritize to keep people living with HIV healthy, reduce new infections, and build responses that countries can sustain. That question should be central to global HIV policy. Yet global health institutions are leaning heavily into one prevention measure that has not been broadly tested in the field. There is no question that lenacapavir has been shown to work in trial conditions. What needs further scrutiny, however, is whether a new product should sit at the center of prevention priorities before thorough assessments of where it will avert the most infections, analyses of its feasibility for implementation — which services and priorities it may displace — and how it ultimately fits into sustainable national systems….

“The way forward: Country-led priority-setting: The institutions best positioned to mobilize residual donor funding are often those organized around product introduction. The Coalition to Accelerate Long-Acting PrEP is a case in point: it brings together the Global Fund, PEPFAR, Unitaid, UNAIDS, the World Health Organization, and AVAC to accelerate access to new PrEP products. That kind of architecture can move quickly, but it is not the same as country-led priority setting. Countries still need to decide what prevention mix is affordable, sustainable, and most likely to reduce infections….”

Warren concludes: “… The global HIV response has proven many times that it can mobilize around a new product. The harder test now is whether funders and global institutions can govern differently by supporting countries to decide where lenacapavir belongs alongside treatment scale-up, viral suppression, condoms, community-level prevention approaches and primary health care integration.”

Stat – In private meeting, Trump officials push to onshore generic drugmaking

https://www.statnews.com/2026/07/08/trump-officials-want-to-make-generic-medicines-in-the-us/

(gated) “Officials worry China or other nations could cut off U.S. supplies of critical medicines.”

“… Last week, pharmaceutical leaders filed into a meeting room in the Eisenhower Executive Office Building, next to the White House, for a meeting with Secretary of State Marco Rubio, health secretary Robert F. Kennedy Jr., and HHS Chief Counsel Chris Klomp. The administration officials had a message for the industry: It’s time to bring production of essential medications back to the U.S. — or at least closer to home. The meeting, described by an administration official and two people familiar with the event, focused on increasing U.S. control of the supply chains for the 86 medicines deemed essential by the health department’s Assistant Secretary for Preparedness and Response….”

Digital Health & AI and health

HPW – Digital Regulation for Youth Health: Joint Statement by WHO and France Demands Urgent Action

https://healthpolicy-watch.news/youth-health-digital-governance/

“A lack of youth online safety is a global public health crisis that demands systemic platform regulation to protect children from harm, according to a joint declaration by the French government and the World Health Organization (WHO). They demand urgent digital governance to mandate safe platform redesigns, as nations struggle to enforce easily bypassed social media bans.”

“While online environments can offer educational and social benefits, poorly governed digital spaces pose grave risks to the physical and mental development of youth, French President Emmanuel Macron and WHO Director-General Dr Tedros Adhanom Ghebreyesus said in the statement released last week. They warn that features including infinite scrolling, autoplay, and push notifications increase the risk of addictive behaviour….”

“…The leaders warn that unregulated digital marketing exposes vulnerable adolescents to harmful products, echoing public health advocates who accuse the tobacco, alcohol and sugary drink industries of flooding social media to evade advertising regulations. … Furthermore, Macron and Tedros note that, despite its opportunities, generative artificial intelligence acts as a force multiplier for major risks facing youth online, with its long-term impact on children’s emotional development, including their ability to form real life relationships and capacity for empathy, remaining uncertain…. They advocate for a precautionary approach to digital platform design, insisting that such measures are “pro-child” rather than anti-innovation, emphasising that preventing exposure to illegal, extreme, and graphic content is a public health imperative.”

“… This push for comprehensive digital governance comes as legal and regulatory pressure against social media platforms is mounting….”

UN News – From AI to ‘killer robots’: UN chief issues urgent governance call

https://news.un.org/en/story/2026/07/1167873

“UN chief António Guterres appealed on Monday for far-reaching, worldwide controls on Artificial Intelligence, as increasingly powerful AI chips that are designed for civilian use shift to the battlefield, where “killer robots” are already the norm.”

“Addressing the inaugural UN Global Dialogue on AI Governance in Geneva, the Secretary-General also insisted on the need for greater accessibility for the billions of people unable to access the revolutionary tech. He insisted that any future agreement must be “worthy of global trust” and put safety first – and especially children’s – to protect them from digitally-generated manipulation and abuse. Echoing that call, the President of the General Assembly, Annalena Baerbock, urged collective action to counter the “sinister” side of AI, noting that a reported 99 per cent of deepfakes are sexual in nature and 96 per cent target women and girls…”

“Other priorities for global checks and balances on AI should include locked-in access to the self-learning tech for developing countries, while all AI data centres should be powered by renewable energy by 2030, the UN chief stressed….”

PS: “Monday’s inaugural Global Dialogue on AI in Geneva …. involves companies, researchers, technical experts and civil society to discuss how to put humanity at the core of the transformative technology. A second Dialogue is scheduled for May 2027 in New York.”

“Amid broader international efforts to govern artificial intelligence, the United Nations is holding a Global Dialogue this week in Geneva, arguing it will give all countries a seat at the table.”

“… So far, there’s been little global coordination on how to manage AI’s runaway success, and Guterres has been pushing, over his second term, to position the UN as the institution best placed to play this convening role. Amid the financial crisis and geopolitical fractures weighing on the multilateral body, the outgoing UN chief wants to ensure the UN takes a leading role in helping govern a technology that will shape humanity’s future – one of the final pieces of his legacy he hopes to leave behind.”

Miscellaneous

Cidrap News – WHO launches database to track sexually transmitted infections

https://www.cidrap.umn.edu/sexually-transmitted-infections/who-launches-database-track-sexually-transmitted-infections

“The World Health Organization (WHO) has launched a new database that organization officials hope will help improve understanding of the prevalence of sexually transmitted infections (STIs) in low- and middle-income countries (LMICs). The STI Prevalence Atlas, launched late last week, tracks five of the most common STIs: chlamydia, gonorrhea, herpes simplex virus type 2 (the main cause of genital herpes), syphilis, and trichomoniasis. ….”

Guardian – Less drugs, less care, less food: how aid cuts have hit Uganda’s 2m refugees

https://www.theguardian.com/global-development/2026/jul/09/how-aid-cuts-have-hit-uganda-2m-refugees

“Africa’s largest refugee population has seen rations and healthcare slashed as funding levels drop.” “Less drugs, less care, less food.”

“The International Rescue Committee (IRC) says funding cuts have pushed the country’s health system to the brink. In 2025, the IRC’s Uganda health budget was about $18m (£13.6m), the bare minimum to keep critical services running, according to local sources. In January, it fell to $4m, forcing the IRC to close health clinics in 11 refugee settlements and lay off about 80% of its staff, leaving people even more vulnerable to diseases such as cholera, measles and mpox….”

Guardian – Men’s average testosterone levels have halved in last 50 years, say scientists

https://www.theguardian.com/society/2026/jul/07/mens-average-testosterone-levels-have-halved-in-last-50-years-say-scientists

“Exclusive: Researchers warn of ‘major crisis in male reproductive health’ partly driven by obesity and diabetes.”

“Total testosterone levels in men declined by 54% between 1972 and 2019, according to data presented at the annual meeting of the European Society of Human Reproduction and Embryology in London on Tuesday. Rising levels of obesity and diabetes are expected to play a part, but the team behind the work suggest that environmental factors such as endocrine-disrupting chemicals – which can be found in various household items – and global heating could also be factors in the apparent striking decline….”

Global health events

Alliance – Seizing power: health policy and systems research at the World Health Summit Regional Meeting 2026 in Nairobi

https://ahpsr.who.int/newsroom/news/item/09-07-2026-seizing-power-health-policy-and-systems-research-at-the-world-health-summit-regional-meeting-2026-in-nairobi

“As external financing for health contracts sharply, the Alliance for Health Policy and Systems Research used the World Health Summit Regional Meeting (27–29 April 2026) to talk about how African governments are taking greater ownership of their systems, and that locally grounded research is part of what makes that possible. Across two public sessions and a closed roundtable on the future of health systems, the connecting idea was health sovereignty. “Empowerment is people taking and seizing power; it is not given freely,” the Alliance’s Executive Director, Dr Kumanan Rasanathan, told delegates, acknowledging that frustrations with the global health architecture were “really boiling over – but our joint challenge is to build something better for this new era”….

Global health governance & Governance of Health

Health & Human Rights News

https://www.hhrjournal.org/health-and-human-rights-news/

“Dr Mariângela Simão of Brazil has been appointed by the UN Human Rights Council as the fifth Special Rapporteur on the right to health, commencing her three year term on 1 August. Like her predecessor Dr Tlaleng Mofokeng, Simão is a medical doctor. In addition to her background in maternal and child health and public health, Dr Simão had extensive experience in the construction of Brazil’s National Health System and has held in senior roles in UNAIDS and the World Health Organization.”

UNRISD – Call for Papers (2025): Reclaiming Multilateralism: Leadership from the South

https://www.unrisd.org/en/activities/news-items/call-for-papers-reclaiming-multilateralism-leadership-from-the-south

The call for papers led to three papers. “…. These insightful papers provide an in-depth examination of how recent G20 presidencies led by countries of the global South — Indonesia, India, Brazil and South Africa — have shaped global policy agendas by advancing priorities such as international tax reform, while also exploring broader dynamics of influence, coalition-building and knowledge production within and beyond the G20. ….” Make sure you check out:

· WP: Leadership from the South: Comparative Lessons from G20 Presidencies on International Tax Reform

· WP: Tracing the Billionaire’s Tax Across Four G20 Presidencies: From Corporate Custodianship to Global Justice Addressing Inequality

ECDPM (Brief) – Global Europe: A geopolitical instrument in need of strong development safeguards

P Van Damme; https://ecdpm.org/work/global-europe-geopolitical-instrument-need-strong-development-safeguards

“Philippe Van Damme examines the substantive challenge in regulating the Global Europe instrument: reconciling EU geopolitical ambitions with its commitments to a rules- and values-based international order.”

Devex Pro – How Japan spends its development aid

How Japan spends its development aid

(gated) “Japan trimmed its aid budget again last year, but unlike several of its peers, it didn’t tumble down the donor rankings. Even after cutting official development assistance from $16.5 billion to $15.6 billion, it remained the world’s fourth-largest donor.”

“Japan’s aid model also looks very different from that of most major donors, writes my colleague Alecsondra Kieren Si. Rather than relying primarily on grants, it lends. In 2024, roughly $7.8 billion of its bilateral aid came as loans, while about $5.7 billion was provided as grants.”

“The biggest winner? Asia, which received $8.4 billion in bilateral aid, with India alone accounting for $2.5 billion — nearly a fifth of Japan’s total bilateral aid. The transport and storage sector attracted the largest share of funding. Japan also remained a major multilateral backer, channeling billions of dollars to the World Bank, regional development banks, the United Nations, the Green Climate Fund, and The Global Fund to Fight AIDS, Tuberculosis and Malaria. Even as global aid contracts, Tokyo continues to play by its own rulebook.”

Third World Quarterly (Introduction) – The emergence and politics of polyalignment

Jessica DiCarlo et al ; https://www.tandfonline.com/doi/full/10.1080/01436597.2026.2676304

“In the Second Cold War between the US and China, middle ground countries are overwhelmingly refusing to choose sides. However, despite resultant talk of ‘new non-alignment’, they do not seek to keep major states at arm’s length, as in the first Cold War; rather, they seek to build and maintain connections with rival players as much as possible, reflecting their attachment to the deep networks created under globalisation in the decades since 1989. This article introduces the concept of polyalignment to guide analysis of the present era. Polyalignment describes both an extant condition arising from the complex interconnectivity established under globalisation and efforts to manage and perpetuate such connections. The article historically traces the shift from non-alignment to polyalignment, highlighting the impact of globalisation and state transformation on states’ external ties and on their capacity to exert centralised control over their foreign relations, factors typically neglected in work on ‘new non-alignment’ and ‘hedging’. The article introduces a special issue that explores cases of polyalignment in Europe, the Middle East, Africa, Latin America and South and Southeast Asia.”

Annals of Global Health – Advancing Women’s Global Health Leadership: Lessons from a Tripartite Model

Kamla Ross McGregor et al; https://annalsofglobalhealth.org/articles/10.5334/aogh.5285

“Women in the Global South remain underrepresented in high‑level leadership positions in global health. Three academic institutions developed the Women in Global Health Leadership Fellowship (WGHLF) to build and strengthen the capacity of emerging women leaders in global health in Kenya and South Africa….”

UHC & PHC

Lancet Primary Care – June issue

https://www.thelancet.com/issue/S3050-5143(26)X2006-4

· Start with the Editorial: A call for investment in primary care data

“To enable equitable dissemination of primary care data, stronger investment and political will are needed in the construction and maintenance of nationally representative primary care datasets globally. Through cross-country and regional collaboration, countries can build more representative datasets for research that can expose health inequities and allow longitudinal health monitoring. Such data are key to developing locally relevant primary care strategies fit for the future….”

Health Research Policy & Systems – Global partnerships for local impact: Strengthening HTA capacity in Asia and Africa through collaborative experiences

Lapad Pongcharoenyong et al; https://link.springer.com/article/10.1186/s12961-026-01504-2

“Health technology assessment (HTA) is recognized as a critical tool for informing health policy decisions and advancing sustainable universal health coverage (UHC). For over a decade, the Health Intervention and Technology Assessment Program Foundation (HITAP) has undertaken systematic efforts to strengthen HTA capacity across Asia and Africa. This study reviews HITAP’s experience in capacity strengthening to inform strategies for effective international collaboration and capacity-building in low- and middle-income countries….”

Global Social Policy – Financialisation of the health sector: The case of public–private partnerships in India

M Nundy et al ; https://journals.sagepub.com/doi/10.1177/14680181261462490

“This paper traces the evolution of public–private partnerships (PPPs) in India’s health sector during the past four decades. These partnerships have been transformed because of their engagement with commercialisation and financialisation. Drawing on political economy frameworks and policy analysis, it argues that PPPs cannot be understood as technical instruments. They are institutional expressions of broader neoliberal reforms that reshape the role of the state and expand market influence in health systems. The paper identifies four phases of neoliberalism in India—pre-liberalisation, liberalisation, post-liberalisation, and more recently deepening of financialisation….”

Health Systems & Reform – Mexico’s New Health Reform: El Servicio Universal de Salud

Michael R. Reich; https://www.tandfonline.com/doi/full/10.1080/23288604.2026.2688285

“On April 7, 2026, Mexican President Claudia Sheinbaum initiated a new nation-wide health reform, creating a national Servicio Universal de Salud (SUS) that promises to expand access to health services, improve efficiency across agencies, strengthen the quality of public-sector care, and improve population health outcomes…..”

Stat – Obamacare rolls shrank dramatically in many states over the past year, new federal data shows

https://www.statnews.com/2026/07/06/obamacare-rolls-shrank-dramatically-affordable-care-act-states/

“Ohio and Oklahoma each lost nearly one-third of enrollees.”

“ States across the country saw steep drops in the number of people covered by the Affordable Care Act over the past year, with Ohio and Oklahoma each losing nearly one-third of enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the January expiration of enhanced subsidies….”

“The data, posted in late June by the Trump administration and first reported on by The Associated Press, reveals how changes in each state’s insured population led to around 2.6 million fewer Americans having Obamacare plans in February compared with the same time last year….”

Nature Health – How geospatial science can boost equitable access to healthcare

S Blower et al ; https://www.nature.com/articles/s44360-026-00167-1

« The World Health Organization should include a wider range of data for their Geolocated Health Facilities Data Initiative, so that the spatial accessibility of healthcare can be accurately measured.”

Pandemic preparedness & response/ Global Health Security

Telegraph – Several viruses capable of infecting humans discovered every year, study reveals

https://www.telegraph.co.uk/global-health/science-and-disease/viruses-capable-of-infecting-humans-discovered-every-year/?s=09

“Two to three new viruses capable of infecting humans have been discovered every year, a major new study from three universities has found. The study, which analysed historical medical papers over the last 100 years, found that at least 239 species of human-infecting viruses have been found since the turn of the 20th century….” Meta-review by researchers from the universities of Edinburgh, Glasgow, and Peking.

… The pace of discovery has accelerated significantly in recent years as technology and science improve, including the identification of dangerous pathogens like new mutations of bird flu, Zika virus, and Covid-19….”

TGH – How Industry Can Help Prevent the Next Cruise Ship Outbreak

Y T Yang ; https://www.thinkglobalhealth.org/article/how-industry-can-help-prevent-the-next-cruise-ship-outbreak

“Critical disease-outbreak intelligence sits inside private firms, and an outbreak escrow system could securely hold that data to be shared in an emergency…”.

“The bottleneck in the [Hanta] outbreak was not detection or biology; it was the institutional handoff between the commercial actors holding the data and the public authorities needing it. The response exposed the need to redesign current disease-surveillance systems before the next pandemic. An “outbreak escrow” database held by a third party would respect passenger privacy while preparing cruise lines to respond to future threats….”

“Critical outbreak intelligence now sits inside private firms whose default posture is to protect passenger privacy, brand reputation, and legal exposure, rather than populate a public health list of who is sick and who has been exposed…..”

“An outbreak escrow system—a database held by a third party to be released only if specific conditions are met—would ease coordination for high-risk travel settings. Cruise operators, expedition companies, airlines, and travel insurers would be required to maintain standardized, privacy-protected outbreak data packets—manifests, cabin or seat assignments, contact details, onward-travel bookings, and shore-excursion groupings—preformatted to public health specifications. These packets would sit in encrypted escrow, untouched, until a predefined trigger occurred: an unexplained death at sea, a suspected high-consequence pathogen, a severe respiratory cluster, or a medical evacuation involving an infectious syndrome.

When a trigger fires, designated public health authorities, including the flag state (the country where the ship is registered), the next port of call, WHO, and any jurisdiction receiving disembarking passengers, would gain time-limited, audited access….”

Science Insider – British ‘First Fleet’ brought smallpox to Australia—and may have killed millions

https://www.science.org/content/article/precontact-australia-nid

“Two papers pin the deadly disease’s introduction on British colonists and suggest the continent held far more people than previously believed.”

Planetary health

Lancet Planetary Health – May issue

https://www.thelancet.com/issue/S2542-5196(26)X2005-8

Most articles had already been published ‘early online’.

Guardian – Air pollution may cause childhood obesity by disrupting impulse control, study finds

https://www.theguardian.com/us-news/2026/jul/06/air-pollution-childhood-obesity-study

“Babies exposed to higher levels of neurotoxin more likely to have difficulty controlling impulses later, research shows.”

Guardian – Fuel on the fire: why oil companies are profiting as the world gets dangerously hot

https://www.theguardian.com/environment/2026/jul/07/big-oil-companies-profiting-fossil-fuel-global-climate-change

“The scientific consensus is that burning fossil fuels drives the climate crisis, yet the world’s biggest oil companies are planning to increase production.”

“A new analysis shows petroleum companies are racing one another to extract more oil and gas from the ground. Shell, ExxonMobil, Chevron and seven other publicly listed firms aim, on average, to increase production by 14% between 2024 and 2030, according to the Climate Transition Centre at the London School of Economics and Political Science (LSE)….”

Guardian – European countries top ‘scorecard’ on climate progress while US slips to 27th

https://www.theguardian.com/environment/2026/jul/08/climate-change-crisis-europe-us

“Estonia, Luxembourg and UK are the top three in biennial Yale University index in tackling pollution and other issues…” The index has its disadvantages, though.

Infectious diseases & NTDs

Nature Health – Burden of dengue in children in eight endemic countries in Asia and Latin America: a secondary analysis of the DEN-301 trial

R Kastner et al; https://www.nature.com/articles/s44360-026-00163-5

“In an analysis of the placebo arm of the phase 3 DEN-301 TAK-003 dengue vaccine trial among 6,687 children aged 4–16 years, dengue accounted for 5.8% of febrile illnesses, with higher incidence in Asia Pacific (2.7 per 100 person-years) than in Latin America (1.2 per 100 person-years) and 25.4% of confirmed cases requiring hospitalization, showing regional differences in dengue burden.”

Guardian – Catnip lotion as effective as Deet at repelling mosquitoes, study finds

https://www.theguardian.com/global-development/2026/jul/07/catnip-lotion-as-effective-as-deet-at-repelling-mosquitoes-study-finds

“Researchers testing a cheap, homegrown oil in Uganda found what cats knew all along – it worked as well as the artificial chemical used globally.”

“A homegrown catnip lotion has proven “just as effective as Deet” as a mosquito repellant in trials carried out in Uganda. Catnip, or Nepeta cataria, is a common herb from the mint family. The chemical in the plant that causes feline euphoria – nepetalactone – also has insect-repelling properties but this has not previously been commercialised. … … In a study presented at the Society for Experimental Biology conference in Florence on Tuesday, a team working between Uganda and Wales found mosquitoes seeking a blood meal were less likely to land on people wearing lotions made from catnip….”

NCDs

Nature News – How to avoid dementia — what the science really says

https://www.nature.com/articles/d41586-026-02098-z

“Ambitious studies have been examining the protective effects of diet, exercise and socializing — with surprising results.”

PS: “… the World Health Organization will release its new dementia risk-reduction guidelines on 16 July…”

TGH – Heat Stress and Air Pollution Fuel Dementia in Ghana

DM Donkor et al ; https://www.thinkglobalhealth.org/article/heat-stress-and-air-pollution-fuel-dementia-in-ghana

“Ghana’s aging population faces worsening cognitive health, including increased dementia risk, from pollution and high temperature.”

“African populations face a distinctive risk profile for Alzheimer’s characterized by harmful environmental exposures including air pollution and heavy metals…..”

Plos Med – Hypertension and diabetes prevalence, associated factors, care cascade, and quality of life in older adults: A cross-sectional population-based study in The Gambia, South Africa, and Zimbabwe

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004785

By Anthony Muchai Manyara et al.

Social & commercial determinants of health

Globalization & Health – Political prioritization of alcohol and sugar-sweetened beverage taxation in Uganda: Agenda dynamics amidst a shifting funding landscape

https://link.springer.com/article/10.1186/s12992-026-01229-5

By E Sseguja et al.

Vox – The evidence against “ultra-processed” foods is weaker than you think

https://www.vox.com/future-perfect/494045/ultra-processed-foods-science-rcts

“New analysis suggests other factors may explain the harms blamed on “ultra-processing.””

“… . In a recent article published in Science, a group of researchers analyzed data from five landmark randomized controlled trials of ultra-processed foods and found that most of them compared ultra-processed and non-ultra-processed diets that differed in important ways beyond processing. The ultra-processed diets tended to be more calorie-dense and lower in fiber, for example, which can lead to overeating regardless of whether a food is “ultra-processed.” Accordingly, some of the effects that they attributed to processing may have had other causes. These findings matter well beyond an academic fight over food categories. They offer the latest evidence against taking the UPF label too seriously when deciding what to buy — or fear — at the grocery store….”

“… It’s not hard to see why the idea of ultra-processed foods has resonated so deeply. It taps into a justified feeling that food corporations profit at the expense of our health, and it has quite explicitly tried to turn that instinct into a scientific agenda. But a framework that cannot clearly diagnose what makes our food system harmful offers no real leverage against the industry that profits from it…..”

BMC Global and Public Health -Sitting still while the world gets sicker: Rethinking physical inactivity as a public health emergency

K Daniels et al; https://link.springer.com/article/10.1186/s44263-026-00295-6

“Physical inactivity (PI) has emerged as a “forgotten pandemic” in global health. Over a quarter of adults worldwide fail to meet recommended physical activity (PA) levels, a proportion that has remained largely unchanged since 2001. This inactivity drives a rising non-communicable disease burden, deepens health inequities, and generates substantial economic costs. Yet preventive action and dedicated funding remain insufficient. Despite international frameworks and national PA plans, with nearly 75% of countries reporting relevant policies, implementation remains inconsistent and population-wide impact elusive….”

“… A fundamental paradigm shift is required, from fragmented, individually focused initiatives towards a multilevel, systems-based approach that aligns global, national, and local action. PA must be reframed as a societal investment, rather than a lifestyle choice contingent on individual responsibility. Genuine population-level empowerment stems not from placing the burden on individuals, but from creating environments and policies that enable active living. We call on global health leaders to elevate PA promotion to the forefront of political agendas, supported by increased funding, long-term vision, rigorous implementation, and targeted interventions for underserved populations….”

Mental health & psycho-social wellbeing

Science – Chatbots can help perpetuate stigma around certain health conditions

https://www.science.org/content/article/chatbots-can-help-perpetuate-stigma-around-certain-health-conditions

“Negative perceptions of mental illness and other health issues subtly shape outputs from large language models.”

“… A new study finds such health conditions can trigger subtle but potentially damaging discrimination from another source: artificial intelligence (AI) chatbots that are playing a growing role in everything from hiring to health care. Researchers found that popular large language models (LLMs) often produce stigmatizing statements when provided with information about a person’s health. The findings, published this week in Nature Health, add to growing evidence that AI models can help perpetuate—rather than eliminate—harmful stereotypes…..”

Sexual & Reproductive health rights

HPW – From Waiting Room to Labour: How Task-Shifting in Nigeria is Saving Lives

B Abubakar; https://healthpolicy-watch.news/from-waiting-room-to-labour-how-task-shifting-in-nigeria-is-saving-lives/

“A Task Shifting/Task Sharing investment in Kano State in Nigeria is empowering community health workers and improving maternal and newborn outcomes.”

Neonatal and child health

SS&M – Leaving no one behind: An assessment of the rate of decline in child mortality among the richest and poorest children in 38 low-and-middle-income countries

https://www.sciencedirect.com/science/article/abs/pii/S0277953626006350

By Anoop Jain et al.

CGD (blog) – NeoTest: A $60 Million Proposal to Accelerate Neonatal Sepsis Diagnostics and Save Newborn Lives

A Bansal et al; https://www.cgdev.org/blog/neotest-60-million-proposal-accelerate-neonatal-sepsis-diagnostics-and-save-newborn-lives

“… In early 2025, the Center for Global Development and the Market Shaping Accelerator launched a working group chaired by Lord Jim O’Neill and comprising world-leading experts in neonatal care, diagnostics, economics, market shaping, and global health. Together, we have designed a $60 million funding facility to accelerate the development and deployment of a rapid triage diagnostic for neonatal sepsis in low- and middle-income countries (LMICs). Rather than paying researchers upfront, NeoTest pays innovators only when a working product is successfully developed and reaches patients. It deploys capital across three components: A $20 million milestone payment that rewards the first firms to bring a qualifying test to market; A $10 million implementation support fund that builds the country-level infrastructure needed for adoption; A $30 million advance market commitment (AMC) that pays a per-test top-up on qualifying tests used.”

“With $60 million in funding, we estimate the facility would save over one hundred thousand newborn lives over a decade at a cost per newborn life of $1,271. This places it amongst the most cost-effective global health interventions….”

· See also the full NeoTest working group’s report.

Access to medicines & health technology

BMJ GH – Clustering of countries based on national essential medicines lists: cross-sectional study

https://gh.bmj.com/content/11/7/e024404

By A Buadu et al.

Human resources for health

HP&P – Exploring the roles of informal healthcare providers in urban settings to improve access and quality of care for the urban poor: experience from Bangladesh, Ghana, Nepal and Nigeria

https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag087/8728137?searchresult=1

By D D Dadeka, I Agyepong et al.

AI & health

International Health – Parity before scale: governing large language models in global health

Carlos Fernando Mourão et al; https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihag069/8723430?searchresult=1

Authors propose three minimum governance commitments.

Miscellaneous

World Bank (blog) – Women are living longer-policies can help them live better

W Cunningham et al; https://blogs.worldbank.org/en/investinpeople/women-are-living-longer-policies-can-help-them-live-better

“Our recent paper, Prosperous, Healthy, and Dignified: Policy Pathways for Older Women in Developing Countries, takes on this topic and questions two common assumptions: first, that older men and women face the same challenges; and second, that aging policy starts in old age….”

Papers & reports

Health Systems & Reform – Health Systems Research for a New Era: Launch Editorial

Michael R. Reich et al; https://www.tandfonline.com/doi/full/10.1080/23288604.2026.2688953

“Health Systems & Reform is pleased to launch an open discussion and Article Collection on the theme of “Health Systems Research for a New Era: Foundations, Frontiers, Futures”… … With this Collection, Health Systems & Reform seeks ideas for advancing the field of health systems research in this new era of reduced funding and changing priorities…”

“… We are pleased to initiate this collection with a commentary by leaders at two global organizations: the World Health Organization’s Alliance for Health Policy and Systems Research, and Health Systems Global. We appreciate the willingness of the authors of the accompanying commentary to let us initiate this Article Collection with their essay…..” “ “The nine coauthors of the commentary are “embedded” (their word) in specific global organizations, and their essay draws significantly on materials published and conferences organized by both groups. Their positionality frames their perspective, which is normal and not unexpected. The commentary also generated vigorous discussion and debate among the journal’s Editorial Board, motivating us to organize this collection and seek other views on what “the field” is and where “the field” should go. While the commentary describes this field as “Health Policy and Systems Research,” and recognizes that other names are also used, we prefer the broader term of “Health Systems Research,” implicitly assuming that policies are inherently part of a health system’s design, adoption, and implementation (and acknowledging that there are many health policies that might not operate in or through health systems but these are not included here)….”

“We now invite additional submissions—as Research Articles, Commentaries, Policy Reports, and Editorials—from individuals and organizations around the world on this important topic. For this Collection, we propose four broad questions: What distinctive contributions can the field of health systems research make? What are the research priorities for the field, and how should they be set (by whom and according to what criteria)? What competencies do current and emerging researchers in health systems research most urgently need to develop? What defines and differentiates the field of health systems research? What is included and what is excluded?”

Lancet Regional Health Africa – July issue

https://www.thelancet.com/issue/S3050-5011(26)X2005-3

· Editorial: Prioritising the elimination of visual impairment in Africa’s children

“Visual impairment in children is a concerning issue that demands attention to avoid inequities hindering their ability to thrive. However, it is largely preventable and treatable, and although the prevalence is relatively low (4%) in Africa, the negative impacts of visual impairment are profound. In Africa, children with visual impairments often do not get the care they need, which has ramifications on their health, wellbeing, and development that extend through adolescence into adulthood. To echo the calls for eliminating vaccine-preventable diseases, what would it take to eliminate visual impairment in children? This month’s issue draws attention to two areas of disability in Africa, sight and hearing…”

Tweets (via X & Bluesky)

Winnie Byanyima

Re HIV prevention: “The 40+20 Call to Action aims to ensure that by 2030: 40 million people are accessing HIV treatment and achieving viral suppression; 20 million have effective primary prevention; #UnitedToEndAIDS .”

Editorial: Another PABS iteration, the HLPF in New York & a different ballgame (IHP News #888)

Kristof Decoster — Fri, 10 Jul 2026 05:28:08 +0000

Dear Colleagues,

It’s not every week that one gets to feel proud about one’s country. Earlier this week, however, when Team Belgium (ahum) rather convincingly beat “Trump” at the World Cup football, I nearly joined the team’s mocking ‘Trumpalike dance moves’ with my shaky old hips. Even if I admit the victory wasn’t quite yet “Jesse Owens in 1936” : )

Over to ‘the week in global health’ then. In Geneva, the 7th seventh meeting of the Intergovernmental Working Group on the WHO Pandemic Agreement, with focus on negotiating the Pathogen Access and Benefit Sharing (PABS) annex, started on Monday. As deep divides remain on a number of issues, we hope that rich countries’ “Coercive containment” of the Africa Group’s Equity Agenda will be traded for a more constructive stance in the weeks to come. An assertive Africa will accept no less, certainly in the new era of poly-alignment.

It’s a busy week in Geneva, by the way. In the run-up to the Global Fund’s Board meeting (9-10 July), Devex Pro had a scoop on the “Global Fund and the US agree(ing) on a path around the expanded gag rule”. Not sure everybody was happy about the leak, though. Meanwhile, the search for a new Global Fund Executive Director is intensifying.

In New York, the High-Level Political Forum on Sustainable Development (HLPF) kicked off on Tuesday, against the backdrop of another SDG Progress report. Again, you get the impression that any progress mainly happened before 2020. Since then, we’re in a ‘different ballgame’ altogether.

Just a few examples of this new & rather frightening ‘ballgame”: (1) the world currently faces an intensifying (Super) El Niño (and like the riders in the Tour de France, I can’t say I enjoy it much); (2) WHO’s head of health emergencies, Dr Chikwe Ihekweazu, recently said that navigating several public health emergencies simultaneously is a trend which is likely to continue; (3) and oh yes, then there’s AI. At the opening of the first (UN) Global Dialogue on Artificial Intelligence Governance, also in Geneva, UN SG Guterres said a number of important things but one ominous quote in particular struck a chord: “If AI is to be powerful, it must be governed. If AI is to be trusted, those who build it must be accountable. If AI is to be global, it must be fair. And if AI is to serve the future, it must not consume the future. That will require governments to act with urgency. Companies to accept responsibility equal to their power. Scientists to keep bringing evidence into the light. And this Dialogue to become the place where global participation leads to global action. Excellencies, We may be the last generation able to set the terms on which humanity and machines coexist. The door is still open. But it will not stay open long….”

Not wrong, I’m afraid.

While the ongoing World Cup is great escapism in dire times, a recent paper in the European Journal of Social Theory, “Where Have All the Futures Gone?“ by Jens Beckert zooms in on the “loss of the future” in countries in the North. It’s more than a failure of storytelling, he argues. “It reflects deeper social and institutional changes that have eroded our capacity to sustain collective visions of what’s possible. … …. Introducing the concept of “futural anomie,” the paper shows how insecurity, declining civic life, fragmented public spheres, individualization, and shrinking public goods make it increasingly difficult to build the shared expectations that underpin democratic societies and social progress.” His key takeaway: “If we want to rebuild confidence in the future, better narratives alone won’t be enough. We also need to rebuild the social infrastructures and institutions that make collective futures imaginable and achievable.”

Which, for some reason, brings me back to Piketty et al’s recent Global Justice Report. The ongoing Global Health reform efforts? Not so much …

Enjoy your reading.

Kristof Decoster

Weekly topics: IHP news 887: Highlights of the week (IHP News #887)

International Health Policies — Fri, 03 Jul 2026 05:48:14 +0000

Overview of Highlights

· Ebola Emergency: WHO & Africa CDC messages

· Ebola emergency: more analysis, advocacy, reports, news snippets…

· More on PPPR, GHS & other health emergencies

· AMR

· Global Health Reform, the Future of Development Cooperation & post-2030 brainstorm

· More on Global Health Governance & Financing/Funding

· More on the impact of aid cuts & journey towards health sovereignty

· Global Tax Justice

· UHC & PHC

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

· Polio

· NCDs

· Planetary Health (& Climate/Health)

· Human Resources for health

· Access to Medicines, vaccines & other health technologies

· Conflict/War & health

· Some more reports, supplements, …

· Miscellaneous

Ebola Emergency: WHO & Africa CDC messages

Again with two Ebola related subsections – with the first one related to key WHO & Africa CDC messaging over the past week.

Guardian – Whereabouts of nearly 300 people with Ebola unknown in DRC

https://www.theguardian.com/global-development/2026/jun/26/whereabouts-of-nearly-300-people-with-ebola-unknown-in-drc

(26 June) Re Africa CDC’s press briefing from end of last week. “Fears over ‘huge, huge community transmission’ as modelling predicts thousands of cases and deaths by September.”

“The whereabouts of almost 300 people who have tested positive for Ebola in the Democratic Republic of the Congo is currently unknown, according to Africa’s top public health official. The humanitarian crisis amid the conflict in the affected areas means more than 1 million people are living in camps to which health workers have no access, Dr Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention (CDC), said [last week] on Thursday.

Cidrap News – As Ebola deaths top 300, African officials meet to boost regional readiness

https://www.cidrap.umn.edu/ebola/ebola-deaths-top-300-african-officials-meet-boost-regional-readiness

(26 June) “The Africa Centres for Disease Control and Prevention (Africa CDC) is convening a three-day meeting today of African countries in hopes of strengthening regional preparedness for the growing Ebola outbreak in the Democratic Republic of the Congo (DRC), which has now claimed more than 300 lives. The meeting will include officials from the DRC, neighboring Uganda, and 11 other high-risk African Union member states, along with the members of the World Health Organization (WHO) and other key technical partners. The countries will review their national preparedness status, share lessons from the outbreak response, and strengthen collaboration across borders, Africa CDC officials said. ….” “Africa CDC is working with Member States and partners to move from plans to operational readiness at borders, in communities, in health facilities and inside emergency operations centres,” Africa CDC senior official Tolbert Nyenswah, DrPH, said in a press release.

“… Could grow to be largest Ebola outbreak ever: The outbreak, which is now the second largest in the DRC, shows no signs of slowing and currently stands at 1,155 confirmed cases and 304 deaths. … In a press conference yesterday, Africa CDC Director-General Jean Kaseya, MD, MPH, warned that if contact tracing efforts don’t pick up, “for sure it will be the largest Ebola outbreak ever.” “ Kaseya said healthcare workers in the DRC need to be able find and monitor 80% of the contacts of Ebola patients to control the outbreak, but the current figure is only 30%, the New York Times reports….

Geneva Health Files – Ebola Update from the Africa CDC & The WHO

https://newsletter.genevahealthfiles.com/ebol/?ref=geneva-health-files-newsletter

(29 June) “… a comprehensive update on the Ebola emergency, based on briefings from the Africa CDC (25 June) and the WHO (24 June), conducted late last week.” With all the detail.

Via Africa CDC briefing (25 June) eg:

“Pledge Discrepancy: While $910 million has been pledged for the health response, only 13% ($130 million) has been released as real money.

Community Workforce: There is a strategic plan to deploy 20,000 community workers to bolster contact tracing and engagement.

Border Risk: South Sudan, Rwanda, and Burundi are classified as high-risk countries due to their proximity to the epicenters….”

Cidrap News – Ebola outbreak spreads to 4th province in DR Congo

https://www.cidrap.umn.edu/ebola/ebola-outbreak-spreads-4th-province-dr-congo

(29 June) “The Ebola outbreak in the Democratic Republic of the Congo (DRC) has spread to a fourth province, according to media reports. Sources at DRC’s National Institute of Biomedical Research told Agence France-Press that an Ebola case was detected in Haut-Uele province after a patient traveled there from Ituri province, which is the outbreak’s epicenter. Haut-Uele is north of Ituri and borders South Sudan and the Central African Republic. Like Ituri, the province sees heavy cross-border movement and trade, which health officials fear is helping the virus spread. North and South Kivu are the other two provinces in DRC that have reported Ebola cases…”

Africa CDC calls for urgent US$18 million to close the funding gap on critical research ready to commence

https://africacdc.org/news-item/africa-cdc-calls-for-urgent-us18-million-to-close-funding-gap-and-stop-bundibugyo-ebola-outbreak/

“Africa CDC commends the Government of the Democratic Republic of the Congo, clinical investigators, and development partners for the launch of clinical trials evaluating candidate therapeutics for Bundibugyo Ebola virus disease in Bunia this week. This marks an important milestone in the response, demonstrating the country’s commitment to generating the evidence needed to improve clinical care while contributing to the development of medical countermeasures for this rare Ebola virus. However, a funding gap remains for the full implementation of the trials. Africa CDC has therefore called on governments, multilateral development banks, philanthropic organizations, the private sector, and global partners to provide US$16million within days to close a funding gap that threatens clinical trials against the Bundibugyo strain of Ebola, for which there is no licensed vaccine or therapy. …”

“…Financing for the vaccine trials is largely in place. The gap is in therapeutics. Of the US$26 million needed to run the therapeutics trials, US$10 million has been secured leaving a shortfall of US$18 million. This comprises US$16 million to continue and complete the post-exposure prophylaxis study among exposed contacts and $2-3 million to ensure sufficient contract tracing to enable the trial….”

HPW – Ebola Antiviral Trial Begins at Secret Facility Amid Attacks

https://healthpolicy-watch.news/ebola-antiviral-trial-begins-at-secret-facility/

(2 July) “A trial to test two antiviral therapies on patients with Ebola Bundibugyo Virus started to enrol patients on Thursday – but its exact location in the Democratic Republic of Congo’s (DRC) Ituri province remains secret for security reasons. This emerged at a World Health Organization (WHO) briefing on Thursday, at which Director General Dr Tedros Adhanom Ghebreyesus revealed yet another Ebola treatment centre in Ituri had been attacked in the past week….”

“… The PARTNERS trial will assess whether the antivirals, a monoclonal antibody called MBP134 and remdesivir, can improve the outcome and survival rate of people with Ebola in Bundibugyo. It will also evaluate whether combining the two antivirals provides additional benefits….”

“The WHO-sponsored trial is being coordinated by the DRC’s Institut National pour la Recherche Biomédicale (INRB), the Institute of Tropical Medicine in Belgium, and the University of Oxford in the United Kingdom. These two treatments were selected by the WHO Technical Advisory Group “after a thorough review of scientific evidence, including preclinical research and safety data, and evidence from previous outbreak responses”, said the WHO in a statement. …”

· And a link: WHO – WHO adds first diagnostic test for Ebola Bundibugyo virus to its Emergency Use Listing

Ebola emergency: more analysis, advocacy, reports, news snippets…

UNDP – Ebola Outbreak Could Push Nearly One Million More People into Poverty and Cost Africa Billions, warns UN Development Programme

https://www.undp.org/press-releases/ebola-outbreak-could-push-nearly-one-million-more-people-poverty-and-cost-africa-billions-warns-un-development-programme

“New UNDP analysis shows Ebola extends beyond a health emergency. It is also a development and economic crisis triggering severe socioeconomic shocks, particularly for women.”

“A new United Nations Development Programme (UNDP) assessment warns that the Ebola Virus Disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) is sparking a far-reaching socioeconomic crisis which could push 985,000 more people into poverty, with women disproportionately suffering the economic and health fallout. The Ebola crisis also risks eliminating tens of thousands of jobs, disrupting education and healthcare services, and costing African economies up to US$ 3.6 billion if broader regional and global shocks intensify.”

“The report, Rapid Socioeconomic Assessment of Ebola Outbreak in the DRC, warns that the current outbreak of the Bundibugyo Ebolavirus is functioning as a highly regressive poverty shock in the DRC and across neighbouring countries, including Uganda, Rwanda and South Sudan. While the immediate public health threat is severe and requires containment measures such as quarantines, some of the broader restrictions on travel and trade are inadvertently devastating local economies and informal livelihoods….”

“… The analysis shows that the economic damage extends well beyond those infected with the disease, disproportionately harming the most vulnerable populations, who lack the financial buffers to weather the disruption. Even under a baseline scenario where the virus is successfully contained in the DRC and Uganda, the economic damage remains severe, with the DRC projected to see real GDP losses exceeding US$ 1 billion and the loss of 55,000 jobs….” (ps: with two other scenarios)

Lancet Comment – The US Ebola response and the future of global health leadership

Krutika Kuppalli et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01291-2/fulltext

Cfr Kuppali on LinkedIn: “Using the ongoing #Bundibugyo #Ebola outbreak in the DR Congo and Uganda as a case study, we explore how recent shifts in U.S. global health policy are challenging the principles that have long underpinned American leadership in global health ….” (and consequences).

“This outbreak is unfolding amid major changes to US global health policy, challenging principles that have historically underpinned its leadership in global health….”

Kuppali et al argue: “… The USA should reaffirm a global health strategy grounded in evidence, reciprocity, and partnership… …… The choices made by the USA will affect not only the trajectory of this outbreak, but also the future of global health cooperation. The principles that have historically guided impactful global health engagement—scientific expertise, international partnership, reciprocity, and investment in preparedness—remain as relevant today as they were during previous health emergencies. …”

HPW – Mind the Gap on Ebola: It’s the People, Not Just the Virus

Gitinji Gitahi (Amref); https://healthpolicy-watch.news/mind-the-gap-on-ebola-its-the-people-not-just-the-virus/

“…. resistance is not born of ignorance. It is a rational response to historical neglect. …. …. Trust rests on three pillars: authenticity, empathy, and logic. In the chaos of an emergency response, establishing these pillars is an immense challenge for even the most dedicated teams….”

Lancet GH – Bundibugyo virus and the cognition gap: rethinking epidemic preparedness in the era of regionalised outbreaks

Francesco Branda et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00182-8/fulltext

“… We propose that the defining vulnerability of the contemporary epidemic response is fundamentally cognitive: the ability of institutions to reconstruct an operational understanding of an evolving epidemic at the same pace at which the epidemic itself unfolds. During the early stages, decision makers need to simultaneously integrate fragmented reports, evolving case definitions, delayed laboratory data, mobility patterns, health-care accessibility, misinformation, and political constraints. We define this gap between epidemic spread and institutional understanding as a cognition gap: the interval during which the epidemic takes hold at the regional level and becomes progressively more challenging to contain.”

They conclude: “The central challenge is not merely to accelerate the development of vaccines and therapies against non-Zaire orthoebolaviruses, although these objectives remain essential. The primary challenge lies equally in building institutional frameworks capable of real-time operational synthesis—systems capable of reconstructing the evolving epidemic reality more rapidly than outbreaks can reorganise themselves through networks of mobility, conflict, and social disintegration. Preparedness should therefore evolve from a paradigm based on detection alone to one centred on understanding, as understanding is a prerequisite for containment.”

And a few links:

· Nature Health (Correspondence) – Community engagement should be the priority for containment of the Bundibugyo Ebola outbreak (by N Ngongo, J Kaseya et al)

· Lancet Infectious Diseases – The Bundibugyo virus disease outbreak: a warning signal for risks to health workers (N Dereje, J Kaseya et al)

More on PPPR, GHS & other health emergencies

PS: as mentioned in the intro, next week the “PABS negotiation train” starts again in Geneva (you’re entitled to humming Kylie Minogue’s “the Locomotion”).

· Via RANI’s newsletter (2 July): New chapter on PABS negotiations

“WHO Member States reconvene on Monday for IGWG 7 (6–17 July) – two full weeks mostly devoted to the Pathogen Access and Benefit-Sharing (PABS) system. Details on the programme of work will be shared Friday, but the Bureau has already published an ambitious new IGWG timeline that aims to finalise the Annex by the end of 2026 and enable the Pandemic Agreement to move toward ratification…..” (sounds rather optimistic)

With also some info on the informal discussions of the past few weeks.

Lancet GH (Editorial) – PABS and the dangerous temptation of more time

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00204-4/fulltext

The Editorial concludes: “The political task is to conclude PABS quickly, but in the strongest possible form. WHO, major powers, middle-power coalitions, and states seeking reciprocity should fill the space left by the USA’s bilateral turn by building a system in which countries sharing PABS materials and sequence information are participants, not recipients, and reciprocity is not left to donor discretion. High-income countries should use their leverage over manufacturers, including public funding, procurement, licensing, and market access, to realise benefit sharing. Concluding PABS is also important for implementing One Health: equitable benefit sharing could strengthen local laboratories, research capacity, and regional manufacturing in spillover-risk settings. As pathogen sequence data become increasingly important for AI-enabled research and synthetic biology, equitable benefit sharing becomes essential. Negotiations must not fail: even an imperfect PABS annex would be preferable to allowing USA-style bilateralism to become the new normal in pandemic governance.”

Africa CDC and WHO AFRO Launch Continental Incident Management Support Team to Strengthen Africa’s Leadership in Public Health Emergency Response

https://africacdc.org/news-item/africa-cdc-and-who-afro-launch-continental-incident-management-support-team-to-strengthen-africas-leadership-in-public-health-emergency-response/

(27 June) “The Ugandan Government represented by its Minister of Health Hon. Dr. Chris Baryomunsi, the Africa Centres for Disease Control and Prevention (Africa CDC), together with the World Health Organization Regional Office for Africa (WHO AFRO), today officially launched the Joint Continental Incident Management Support Team (IMST), establishing a unified operational platform to strengthen Africa’s capacity to prepare for, coordinate and respond to public health emergencies while supporting the ongoing Bundibugyo Virus Disease (BVD) response…..”

“The launch marks a significant milestone in strengthening Africa’s public health emergency architecture and reflects a shared commitment by Africa CDC, WHO AFRO and African Union Member States to build faster, more coordinated and country-led responses to increasingly complex public health threats. It also reinforces regional preparedness and cross-border collaboration as essential pillars of Africa’s health security….”

“Hosted at the Infectious Diseases Institute (IDI), Makerere University in Kampala, the co-located IMST will support Uganda, the Democratic Republic of the Congo (DRC) and neighbouring at-risk countries through integrated technical assistance, operational coordination and multidisciplinary expertise. Guided by the principles of One Team, One Plan, One Budget and One Monitoring and Evaluation Framework, the IMST brings together specialists in surveillance, laboratory systems, case management, infection prevention and control, emergency logistics, emergency operations, Risk Communication and Community Engagement (RCCE), information management and partner coordination to strengthen outbreak response across the region….”

HPW –UN Member States Have an Unmissable Responsibility to Better Protect Us Against Outbreaks and Pandemics

H Clark et al ; https://healthpolicy-watch.news/un-member-states-have-an-unmissable-responsibility-to-better-protect-us-against-outbreaks-and-pandemics/

On the importance of a PPPR monitoring mechanism. « …. Over the last decade, outbreak and pandemic monitoring bodies and tools have been activated in the wake of crises. Many perform much-needed functions. But the approach has led to a fragmented system characterised by gaps and overlaps. Important information is available, but often it does not reach the right people at the right time, and it too seldom informs plans and investments to strengthen essential systems. (see figure 1, below) The result is a monitoring landscape that provides a patchwork of siloed information, rather than timely, actionable insights and a cohesive roadmap. On 18 May, during the 79th World Health Assembly (WHA) in Geneva, senior representatives from member states, international organizations, and expert institutions came together to consider how pandemic prevention, preparedness and response (PPPR) monitoring can better inform action and investment….”

« … Two of the key global monitoring bodies providing important insights, The Global Preparedness Monitoring Board (GPMB) and The International Pandemic Preparedness Secretariat (IPPS), are set to close soon as their mandates come to an end. This will add to widening holes in our knowledge and in our collective safety. Without action, these closures risk setting back global monitoring efforts at a time when they are needed most….”

« … So how do we move from what we have towards a comprehensive monitoring ecosystem that provides a full picture? Charting this path is essential to all our safety. …… In future, such a model could identify additional threats, and guide investments to avert a full pandemic. … This year, there is an opportunity to establish a comprehensive monitoring mechanism that will provide a clear overview of outbreak and pandemic risk and readiness, including through identifying risks from animal spillovers, to country, regional and global preparedness, response to health emergencies, and recovery…. … September’s UN High-Level Meeting on Pandemic Prevention, Preparedness and Response must provide the political mandate to establish such a mechanism. Monitoring must extend beyond health ministries and embrace a whole-of-government and whole-of-society approach, reflecting the reality that pandemic threats emerge at the intersection of human, animal and environmental health, and that preparedness depends on many sectors. »

« Monitoring cannot be reduced to a box-ticking exercise, nor a process where those with money are scrutinizing those without. It’s about identifying collective gaps in PPR which require collective action. A publication by GPMB leadership in the Lancet described the principles of effective and coordinated monitoring. A recent brief by The Independent Panel highlights the need to shift to a mutually beneficial approach: one that moves from blind spots to understanding pandemic risk; from basic data collection to actionable insight; from a top-down imbalance to a federated system driven by national priorities, and from compliance to mutual trust and accountability…. … None of this requires a large new institution or a major additional burden on countries. Nor does it displace or duplicate existing valuable efforts; rather, it would seek to unify them in a coordinated manner and provide ready access to timely insights. What it would need is a well-resourced secretariat with a sustained mandate, access to modern data tools, including AI, that can synthesise across fragmented sources, and connect to scientists, practitioners, civil society and policymakers in countries, regions and global capitals….”

Stat – Marburg outbreak is reported in Uganda, threatening to complicate Ebola response in region

https://www.statnews.com/2026/06/30/marburg-virus-cases-ugandan-ebola-outbreak-zone/

“The outbreak is said to be localized.”

“Uganda formally reported to the World Health Organization on Tuesday that it had detected a Marburg disease outbreak in the western part of the country, a spokesperson for the Geneva-based global health agency told STAT. The development could further complicate the effort to contain what is already the third-largest Ebola outbreak on record in Central Africa. Both diseases are viral hemorrhagic fevers….”

PS: “The Ugandan government has not yet publicly disclosed a Marburg outbreak. But the U.S. embassy in the Ugandan capital, Kampala, issued a health alert on Monday, saying it had been made aware of a possible case of Marburg in the country. The alert was a level 4 advisory alerting Americans they should not travel to Uganda….”

Stat (Opinion) – What Ebola and Marburg are teaching us about the next pandemic

K Kuppalli et al ; https://www.statnews.com/2026/07/01/ebola-virus-outbreak-bundibugyo-marburg-testing-krutika-kuppalli/

“Ecological and societal conditions driving infectious disease emergence are getting more complex.”

“The fact that public health officials must even consider the simultaneous circulation of multiple high-consequence pathogens during a single regional emergency highlights a reality that our preparedness systems have failed to fully embrace: Pathogens do not organize themselves according to our testing algorithms.”

“… For decades, the global health community’s approach to outbreak diagnostics has been largely reactive and pathogen-specific…” “ “… While these investments have saved countless lives, they have also reinforced a dangerous assumption: that the next outbreak will resemble the last one. History repeatedly tells us otherwise….”

“The ecological and societal conditions that drive infectious disease emergence are becoming increasingly complex. Climate change, conflict, environmental disruption, urbanization, population displacement, and increased human-animal interactions are creating opportunities for pathogens to emerge in new places and in new combinations. The regions currently affected by the BDBV outbreak sit at the intersection of these forces. Eastern DRC has experienced repeated outbreaks of Ebola, Marburg, mpox, plague, anthrax, and other emerging infections over the past two decades. In such environments, clinicians do not encounter neatly categorized pathogens. They encounter patients….”

“A patient presenting with fever, gastrointestinal symptoms, hemorrhage, respiratory failure, encephalitis, or shock does not arrive labeled as having Ebola, Marburg, influenza, coronavirus, or a pathogen that has yet to be discovered. Yet our diagnostic systems often require us to decide which pathogen we believe is causing illness before we can determine what is actually there. This approach no longer makes clinical or public health sense.”

“… What is urgently needed is a shift from pathogen-specific diagnostics toward pathogen-agnostic diagnostic systems….” Read what this would entail.

CGD (blog) – Getting the World Bank’s New At-Risk Financing Plans Across the Finish Line

R Glennerster et al ; https://www.cgdev.org/blog/getting-world-banks-new-risk-financing-plans-across-finish-line

“Between 60 percent and 75 percent of the delay in vaccine deliveries to low- and middle-income countries (LMICs) during Covid-19 can be explained by them signing purchase agreements later than high-income countries. This partly reflects lending restrictions adopted by the multilateral development banks (MDBs) on using MDB financing to purchase vaccines before regulatory approval. The World Bank is now finalizing a Day Zero Financing Framework that would help make sure that does not happen again. The framework would enable at-risk financing—the use of World Bank financing to buy medical countermeasures before they have received regulatory approval. At-risk financing was one of the five key recommendations of the recent G20 High-Level Independent Panel on Financing Pandemic Preparedness and Response Financing, and was recently endorsed by Gavi.”

“Here we set out some ideas to help secure agreement among key global health stakeholders, paving the way for Board approval ahead of the World Bank’s Annual Meetings in Bangkok….” (in October).

Devex Op-ed – What screwworm and Ebola tell us about the cost of isolationism

Daniele Nyirandutiye; https://www.devex.com/news/what-screwworm-and-ebola-tell-us-about-the-cost-of-isolationism-112826

“Two outbreaks on two continents are moving faster than our fractured systems can keep up. That is not a coincidence; it is a pattern, and the window to respond to it responsibly is closing quickly….”

Re screwworm: “… In the U.S. states of Texas and New Mexico, the New World screwworm — a flesh-eating parasitic fly whose larvae burrow into animals’ flesh — has been detected in livestock and domestic animals for the first time in decades. …”

“…. The dismantling of USAID and termination of more than 5,200 contracts crippled global health programs, including the Central America initiatives that kept the screwworm at bay. The U.S. also withdrew from the World Health Organization, removing itself from the early-warning and coordination systems that global outbreak detection depends on….”

…. Three targeted steps would make an immediate difference. With one being, “One, the administration should carve out an exception for the WHO’s Global Outbreak Alert and Response Network, immediately allowing the U.S. to detail staff, access surveillance data, and restore the collaborative channels that detection depends on. Such a step would protect Americans without requiring a resolution to the larger WHO relationship….”

Lancet – Andes hantavirus: operationalising science in real time

P Lydon et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01227-4/fulltext

“The 2026 outbreak linked to the MV Hondius highlighted a persistent weakness in epidemic preparedness.The key lesson was not the potential for human-to-human transmission, which is already well established, but that timely evidence generation still depends largely on reactive mobilisation of the global research community. To address this gap, WHO has integrated research coordination directly into its emergency response architecture through the Emergency Response Framework (ERF) and Incident Management Support Teams (IMSTs). This integration reflects an important shift: research is no longer treated as a parallel scientific activity but as a core operational component of outbreak response. Effective integration, however, requires standing research systems that can be activated immediately rather than assembled during a crisis….”

“In response to the need for a standing research system that can be activated, WHO’s Research and Development Blueprint established Collaborative Open Research Consortiums (CORCs) by priority viral families with epidemic pandemic potential. Launched in 2024, CORCs were designed as operational scientific communities capable of rapid activation during emergencies. CORCs connect expertise across the medical countermeasure pathway, from diagnostics, therapeutics, and vaccines….”

Plos GPH – Globalisation, rising authoritarianism, declining solidarity, and retreating multilateralism: A perfect storm for amplifying the risk of outbreaks

Winfred Dotse-Gborgbortsi & Madhukar Pai; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006783

“ International organisations such as the World Health Organisation (WHO), transnational disease surveillance systems, and shared financing mechanisms were designed to manage those risks collectively, and across geographical borders. That architecture is now crumbling, and two concurrent outbreaks, the Hantavirus outbreak linked to the MV Hondius cruise ship and Bundibugyo Ebola in the Democratic Republic of Congo (DRC), illustrate what happens when globalisation’s risks persist while its safeguards, safety nets, and global solidarity erode….”

In the remainder of the article, the authors focus on “Solidarity in action: What we should be doing”: “….The word “solidarity” is used frequently in global health. What exactly is solidarity? The Global Health Solidarity Project’s framework describes it as actively standing with others, not just in words but through meaningful action and shared commitments. It recognises that health is interconnected across borders, differences, and inequalities, and is built on trust, mutual respect, and inclusive decision-making. By working together toward common health goals, solidarity seeks not only to improve health outcomes but also to address the structural inequalities and power imbalances that drive health inequities. As illustrated in Fig 1, global health solidarity in action should involve concrete actions, not just vague affirmations or declarations. For example, Global North nations must provide timely emergency funding to international agencies (such as WHO, Gavi, and CEPI) that respond to disease outbreaks and other global health emergencies….. “

With some more examples of ‘solidarity in action’.

AMR

UN News – New WHO plan urges stronger action against fungal disease

https://news.un.org/en/story/2026/06/1167842

“The World Health Organization (WHO) has published new guidance to help countries confront the rising burden of fungal disease and antifungal resistance – one of the most neglected global health threats, yet still largely absent from national health plans. “

“The new Blueprint for strengthening responses to fungal disease and antifungal resistance, issued on Tuesday, sets out practical steps to improve prevention, diagnosis, treatment and surveillance. Fungal diseases affect more than 300 million people each year and are associated with high mortality, long-term illness and major losses in health and productivity worldwide. They range from common conditions such as ringworm and nail infections to severe invasive diseases that can be deadly, especially for people with weakened immune systems, those receiving intensive care, people living with HIV, transplant recipients and cancer patients. “

“Meanwhile, antifungal resistance is a growing threat, driven in part by the widespread use of antifungal medications and their analogues across human, animal and plant health, as well as environmental exposure to antifungal chemicals. Despite this toll, WHO said fungal diseases are often missing from national health treatment policies, global burden-of-disease estimates and most strategies on antimicrobial resistance (AMR), universal health coverage and One Health – the UN agency’s initiative for action across human, animal, plant and environmental health. …”

Global Health Reform, the future of international cooperation & post-2030 brainstorm

· We start with a LinkedIn post by Anders Nordström (looking forward to July).

“July may prove pivotal for the trajectory of reforms of the international system for health, even in the absence of negotiations of political declarations or high-level forums. Important developments are underway for the two major reform initiatives: The Accra Reset High-Level Panel will convene in Senegal to draft its report and recommendations. At the same time, WHO Member States are expected to nominate representatives for that process .”

“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 https://lnkd.in/dthPusMY Accra Reset has consistently stood out for its potential to drive transformative change. Led by countries of the Global Majority, it confronts the fundamental issue that many dialogues avoid – the entrenched power imbalances that have shaped, and continue to shape, international cooperation for health. …” The Accra Reset considers how sovereign governments can maximally leverage existing domestic capacities, affirming that the primary relationship in any health system should be the one between governments and their citizens, not governments and global institutions. This link between health, development and power is not only strategic, but also honest and realistic. The High-Level Panel’s direct mandate from incumbent Heads of State gives it a degree of political clout that many previous reform efforts have lacked. The ambition is not to generate another set of aspirational ideas or yet another report, but to catalyse political action.”

“The question now is if the Panel’s efforts will truly become the antidote to the status quo. This will greatly depend on the substance of its recommendations and the way they are socialised. To distinguish itself from past approaches, the Panel could put forward recommendations that:
– Clearly articulate national responsibilities based on full country ownership;
Advance a vision of health financing with domestic resources as the core source;
– Explicitly affirm the need to transition away from direct international development assistance in most settings;
– Set firm expectations for international institutions, and outline structural reforms required to meet those expectations;
– Constructively describe the role of non-state actors in global health governance; and
– Establish credible accountability mechanisms from the outset.

“Notably, the strength and impact of the Panel’s recommendations will not depend solely on their content. It is crucial that the recommendations are the product of consultations with key actors, an iterative and agile way of working, and a deep understanding of today’s international landscape. Expectations are already forming and many stakeholders will develop their view on the recommendations even before they are published. Communication should be a critical part of the work itself….”

Geneva Solutions -Sunset or new dawn? UNAids fights for survival

https://genevasolutions.news/global-health/sunset-or-new-dawn-unaids-fights-for-survival

“Thirty years after its founding, the UN is considering shutting down its leading organisation focused on HIV/Aids just as the very epidemic it was built to end intensifies. …. … UNAids’ coordinating board meets this week with the organisation’s future on the agenda. The meeting comes amid a push by the UN chief António Guterres to quickly wind it down as soon as 2026 as part of his efforts to shrink the UN system. But the board has pushed back and is exploring alternatives. What UNAids looks like next year or in 2030 remains an open question.” Excerpts:

“… UNAids itself has been hard hit by the US cuts. Last year, it had to shrink its workforce by more than half from 600 to just under 300. Its headquarters in Geneva, once home to 127 staff, now just runs with 19 after many were relocated to Bonn. A US package ratified by Trump in January included $45 million for UNAids – less than half of what it received in 2024 under the Biden administration – offering some relief while highlighting the risk of relying on a large, unpredictable donor…..”

“… It’s against this backdrop that Guterres floated his proposal to “sunset” UNAids and fold its work into other UN bodies like the World Health Organization. The organisation’s coordinating board – composed of 22 governments, six UN organisations and five civil society representatives – has resisted. In January, it set up a working group to come up with an alternative path, one that integrates it better into the broader UN system while preserving what makes UNAids distinctive – the formal role of civil society and people living with Aids/HIV in its governance structure, a rare arrangement in the multilateral world. The working group’s interim report, published this month and expected to be discussed at a board meeting this week, says operation as before is “neither advisable nor feasible”, citing factors including resistance to multilateral cooperation, the decline in international HIV assistance, but also a push for country-led and financed responses. But the report is equally categorical in rejecting the sunset proposal, arguing that a “rushed or under-resourced transition risks doing serious damage to the global HIV response and undermining the UN’s credibility”. It further points to the problematic use of the word “sunset” at a time when the HIV crisis is far from over….”

“… The options being explored, according to the document, include downsizing the secretariat further, turning it into a “leaner partnership or hub” within the UN system, transferring work to partner agencies or – further down the line – a merger with another existing health partnership. A final proposal is expected in October….”

“An interim report outlines several pathways for the future of UNAIDS — from a smaller secretariat to a U.N.-hosted hub or merger — while rejecting calls to sunset the agency by the end of 2026.”

“The future of UNAIDS remains uncertain, but a working group tasked with providing recommendations for its transition is exploring several options, including further downsizing the secretariat, turning it into a hub hosted within the United Nations system, or merging it with another health entity. These options are laid out in an interim report that will be discussed by UNAIDS’ board this week…”

PS: “Among the options laid out in the report is transitioning the UNAIDS secretariat into a small hub or partnership, hosted within the U.N. system, that would provide a centralized space where donors could contribute to the U.N. global HIV response. Potential hosts that emerged include UNOPS, the World Health Organization, the U.N. Development Programme, and the Office of the U.N. Secretary-General. Another option is merging UNAIDS with an existing health partnership, such as the Stop TB Partnership and RBM Partnership to End Malaria — formerly Roll Back Malaria — although the working group said this option is still “in an early phase” as they have not yet discussed it with these entities….”

“For country-level coordination of the HIV response, one option is placing HIV advisers within U.N. resident coordinator offices. UNAIDS has already piloted this approach in five countries, but the results showed it was hampered by limited resources and a lack of technical, administrative and policy support from the secretariat.”

“The working group said preserving the secretariat’s core functions — including political leadership, advocacy, coordination, data analysis, and support for communities living with and affected by HIV — should remain a priority. At the same time, it is exploring whether some responsibilities could be transferred to the U.N. agencies that cosponsor the program, while also assessing donors’ willingness to fund separate U.N. entities….” “It also wants to preserve the role of civil society, communities and people living with HIV in the governance of any future model, which it has identified as “non-negotiable.”…”

Devex – Exclusive: Turf battle stalls UN merger mania

https://www.devex.com/news/exclusive-turf-battle-stalls-un-merger-mania-112822

(26 June) “U.N.’s development chiefs are clashing in struggle over the fate of UNOPS and UNDP amidst a funding retreat by donors.”

“In April, the United Nations top brass met behind closed doors at the world body’s Manhattan headquarters to take the pulse of one of U.N. Secretary-General António Guterres’ most ambitious development reform initiatives: the merger of the U.N.’s two development agencies, the U.N. Development Programme, UNDP, and UNOPS. It didn’t go well, according to an account of the meeting shared with Devex. The heads of the two agencies turned up with vastly different visions for what a single organization should look like.”

“The standoff at U.N. headquarters underscored the challenges Guterres is facing in trying to drive through an ambitious proposal to merge UNDP, UNOPS, and two entities — the U.N. Population Fund and UN Women — in the face of rising skepticism and outright resistance from civil society, diplomats, and the leaders of some of the affected agencies. It has also fed doubts among U.N.-based officials and diplomats that Guterres’ consolidation efforts will succeed, particularly at a time when his authority lessens as he enters his final months in office….”

PS: “The competition between De Croo (UNDP) and da Silva (UNOPS), meanwhile, has spilled into public view, with the two development leaders making their conflicting cases directly to U.N. governments at a public June 8 meeting of the executive board that oversees the activities of UNDP, UNOPS, and the U.N. Population Fund, or UNFPA….”

Devex – UNFPA and UN Women propose alternatives to a merger

https://www.devex.com/news/unfpa-and-un-women-propose-alternatives-to-a-merger-112846

(gated) “The document, seen by Devex, proposes several areas for coordination and collaboration between the two agencies. But without changing their mandates or creating a new structure.”

“Faced with a potential merger, UN Women and the United Nations Population Fund, or UNFPA, have identified areas to better align, collaborate, and potentially save costs as an alternative to being consolidated into one entity. A document, seen by Devex, listed how the two entities can jointly work together at the country level, address gender-based violence, collaborate on data and data systems, and share services and resources — all without affecting their mandates or creating a new structure. …”

UN Foundation – Ebola and the New Politics of Global Health Cooperation

M Moss; UN Foundation;

“As outbreaks of Ebola and Andes hantavirus make headlines, governments are engaged in a consequential debate about the future of global health cooperation.”

“These outbreaks also arrive at a moment when governments are engaged in a consequential debate about the future of global health cooperation. At the 79th World Health Assembly, Member States agreed to extend negotiations on the Pathogen Access and Benefit Sharing (PABS) system and launched a new process to examine reforms to the global health architecture (GHA). At first glance, these discussions appear distinct. One focuses on pathogen samples, genetic sequence data, and access to medical countermeasures; the other, on institutions, governance, and coordination. Yet both are grappling with the same fundamental question: What should international health cooperation look like in an increasingly multipolar world?”

“The Ebola outbreak offers a useful lens to consider this question. … … As the Ebola outbreak in Congo has expanded, it has exemplified the central themes countries are debating in Geneva. Governments increasingly want stronger national ownership of health systems and stronger regional capacity to prevent and respond to emergencies. However, outbreaks of this magnitude still require international coordination, technical expertise, financing, and surge support. The debate about how this cooperation should be organized –– the distribution of responsibilities, resources, and benefits –– sits at the heart of both the PABS and GHA discussions.”

“Much of the public conversation surrounding these efforts has focused on governance arrangements, financing mechanisms, legal frameworks, and implementation timelines. Beneath this technical language lies a broader discussion about sovereignty and interdependence.”

“… The new emphasis on local and regional ownership as the organizing principle of global health is also shaping conversations about the role of international institutions. Member States still regard the World Health Organization (WHO) as the world’s leading source of technical guidance, normative standards, and political convening. Some countries, however, would like to see WHO move away from the operational role it has gradually taken on over the past decade, preferring to strengthen regional and national actors so they can lead on implementation and operational delivery. The Ebola response illustrates the complexity of this transition. In resource-constrained settings, the distinction between normative and operational functions can become blurred. Outbreaks test assumptions about how international organizations can support regions and countries without displacing national ownership…..”

“…. Ultimately, the central question underpinning both debates becomes: How can countries exercise greater agency and self-reliance while still accessing the external resources, technology, and investment needed to strengthen health systems and response capacities?…”

“… Taken together, these themes suggest that the debates unfolding in Geneva are about much more than the mechanics of global health cooperation. The ambitions expressed in the PABS negotiations and GHA deliberations extend well beyond the health sector, requiring coherence in trade policy, intellectual property, technology transfer, and long-term financing. These are not challenges that health ministries can solve alone in months or years. They are long-term political projects measured in decades…”

German South-North Commission seeks strong partnerships for a multipolar world

R A Radovan, O Scholz et al ; https://www.thenationalnews.com/opinion/2026/06/30/german-commission-seeks-strong-partnerships-for-a-multipolar-world/

“The German government is launching a new South-North Commission on Development at today’s Hamburg Sustainability Conference (HSC). Bringing together voices from the Global South and the Global North, the commission aims to contribute to a more co-operative and inclusive international order….”

The “… new South-North Commission … builds on the legacy of the Independent Commission on International Development Issues – better known as the North-South or the Brandt Commission – which ran from 1977 to 1980 under the chairmanship of former German chancellor Willy Brandt.

It spelt out a principle that remains strikingly relevant today: “The challenge for the next decades will not be met by an adversary system of winners and losers – North versus South or East versus West – but only by one founded on human solidarity and international co-operation among all.””

“The new South-North Commission draws inspiration from this historic legacy, with its focus firmly on the future. It seeks to foster a new dialogue on the defining structural questions of our time: what could a genuinely co-operative and effective international order for the 21st century look like? What framework can succeed the Sustainable Development Goals? And how must our institutions and partnerships evolve to turn these ambitions into reality? Answering these questions requires an integrated approach that brings together issues too often treated in isolation – from development finance and climate action to trade, conflict prevention and resilience.”

“… Up to 20 commissioners from various sectors will work together to develop a set of recommendations, culminating in a report to be presented by the end of 2028. These proposals will feed into ongoing international reform efforts – from the UN and the multilateral development banks to the international financial architecture – and will help to shape the post-2030 agenda….”

(gated) “With donor governments pulling back on aid, Germany is betting that a commission gathering countries from the global north and south can help reset the terms of global cooperation.”

“… former German Chancellor Olaf Scholz, the other co-chair of the new commission, argued that today’s geopolitical and economic realities require a fundamentally different approach, pointing to the rising economic and political weight of emerging economies. “The global south is much more powerful than at that time,” he said, noting the shift in global growth dynamics and the strategic importance of critical minerals such as lithium, copper, and cobalt. “It is something we have to understand in a different way.””

“Details of the commission’s membership and budget remain unclear, however. The co-chairs said commissioners will be drawn largely from the global south, including major economies such as India, Brazil, Indonesia, and South Africa, though names have not yet been announced. While members will serve pro bono, funding will be required for meetings and a secretariat. The commission has said funding will come from the German development ministry, but Scholz would not provide a budget amount. …”

“Several attendees told Jesse that they are worried about whether this has support from the center-right — and leading — party of the German government, considering that only center-left figures are part of the commission so far. Scholz denied any trouble within the government, however. “This is a commission that is supported by the whole government of Germany,” he told Jesse. “It is an activity that is not partisan.”…”

Lancet Planetary Health – Wellbeing for people and the planet: how to value everyone and everything on a thriving planet beyond 2030

Kate E Pickett et al; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00048-3/fulltext

“Synthesising evidence across disciplines, we argue that human beings are evolutionarily wired for cooperation and relational wellbeing, and not perpetual consumption and status competition. This argument underpins a post-2030 shift in a global development paradigm that places multidimensional wellbeing, of people and the planet, at its core. We outline three mutually reinforcing systemic shifts: deliberative democracy that gives communities real power to shape collective futures; economic democracy that redirects finance, enterprise design, and fiscal policy towards equitable, regenerative outcomes; and transformed land and resource governance that recognises ecological limits and the rights of nature. By aligning institutions with the cooperative nature of humans and the Earth’s regenerative capacity, societies can achieve flourishing lives for all within planetary boundaries, offering a scientifically grounded agenda for the decades beyond 2030.”

More on Global Health Governance & Financing/Funding

HPW – EXCLUSIVE: Three Candidates Vying for Global Fund Leadership in Contentious Race

https://healthpolicy-watch.news/candidates-global-fund-leadership/

“As the Global Fund to Fight AIDS, Tuberculosis and Malaria heads into a secretive but highly contentious election of a new Executive Director, the names of three candidates who are reportedly on the shortlist, all US citizens, have surfaced. They include former Global Fund Executive Director Mark Dybul, former Trump appointee William Steiger and a former NYC public health official, Ashwin Vasan. “ A few excerpts:

“…Whoever emerges victorious from the current election must immediately confront a $5.36 billion funding gap for the next three-year cycle. And separate from the details of who may be nominated, some voices are calling for greater transparency in the process of finding a new leader for an agency that drives a massive pooled procurement mechanism supporting market-shaping pharma contracts for drugs and other supplies required by the world’s poorest nations….”

“… Meeting behind closed doors, the Global Fund’s Executive Director Nomination Committee (EDNC) convened in the first week of June 2026 to evaluate the long-list of candidates for the top post and create an initial short list. Those candidates will be interviewed in a first-round of interviews in July, followed by a second round in September, when the “short-list” is to be narrowed to four-five candidates, according to an official Global Fund timeline. A final appointment decision, is scheduled for the Board meeting of 28-30 October.”

“… The ED Nomination Committee operates under a highly restrictive framework, assisted by the executive search firm Russell Reynolds Associates. The Global Fund declined to comment on the candidates, how many are on the present shortlist, or other aspects of the process, pointing to its strict confidentiality….”

“So far, all the top contenders mentioned by sources familiar with the proceedings are also US citizens, and at least two of those reportedly have US government backing. Considering the importance of the US as a donor, and the Trump administration’s clear linkage between funding and political influence, support from Washington may very well turn out to be one of the most important factors in the final selection…. … At the same time, the US administration is increasingly bypassing the multilateral system, and allocating its own global health aid budget largely on the basis of bilateral agreements – with over 30 signed so far. That could put any new Global Fund leader in the uncomfortable position of steering between the Global Fund’s multilateral mission and US priorities, as well as drug procurement preferences, in the coming years.”

PS: “As these high-profile names from the United States emerge, European member states that are also among the Global Fund’s largest donors are struggling to maintain their traditional influence in the agency’s orbit. The ED Nominating Committee reportedly removed the only applicant endorsed by the German government from the shortlist during its early June meeting. The dismissal of the German-endorsed contender emerged as a source of intense frustration in Berlin, sources familiar with the process told Health Policy Watch. …”

Gavi Board meeting underlines commitment to country sovereignty, fragility and health security

https://www.gavi.org/news/media-room/gavi-board-meeting-underlines-commitment-country-sovereignty-fragility-health-security

“Board agrees to maintain ambitious targets for Gavi 6.0, including reaching 500 million children, preventing 8–9 million deaths and further reducing under-five mortality by 10%. Programmatic decisions underline commitment to country leadership and support for fragile and humanitarian contexts . Additional US$ 189 million in support approved for sustainable African vaccine manufacturing, enhancing supply resilience and health security. Decisions include innovations that will help Gavi, countries and health workers deliver on 6.0 targets – such as digital payments for vaccination campaigns and flexible liquidity through the European Investment Bank Frontloading Facility.”

“… The Board also approved a package of measures to boost Gavi’s African Vaccine Manufacturing Accelerator (AVMA)….”

“… The Board confirmed enhanced support for sustainable African vaccine manufacturing, approving the use of an additional US$ 189 million – beyond the US$ 1 billion dedicated to Gavi’s African Vaccine Manufacturing Accelerator (AVMA) – to strengthen demand for African-made vaccines and support critical ecosystem strengthening activities. The majority of this financing – US$ 139 million – will be dedicated to buying African-made vaccines, which will simultaneously supplement Gavi’s vaccine procurement budget. An additional US$ 50 million in targeted financing will support three partners – the African Centres for Disease Control and Prevention (Africa CDC), African Medicines Agency (AMA) and WHO – who will work together to address barriers to the accelerated development of a vaccine manufacturing ecosystem on the continent….”

WSJ – Warren Buffett Skips Midyear Donation to Gates Foundation as He Awaits Epstein Review

WSJ;

“Billionaire expected to delay decision on his ‘lifetime’ pledge to see results of Gates Foundation’s review.”

“For the first time in two decades, Warren Buffett is skipping his usual midyear donation to the Gates Foundation so the famed investor can wait to see the findings of a review into the foundation’s ties to Jeffrey Epstein, according to people familiar with Buffett’s plans. Buffett, 95 years old, is delaying his decision until later in the year, possibly until when he puts out his Thanksgiving letter, the people said…

PS: “The Gates Foundation has retained law firm WilmerHale to review its ties to the late sex offender, and its findings are expected this summer…”

Geneva Health Files – “Recipients Reluctant To Bite The Hand That Feeds Them”: Tim Schwab on the Gates-Epstein Saga & What It Means for Global Health

Geneva Health Files;

“Interview with American journalist Tim Schwab, where he addresses the imperative to discuss philanthropist billionaire Bill Gates, and the fall out on global health as a result of Gates’ documented association with – financier and convicted sex offender, Jeffrey Epstein. We believe this interview not only sheds light on the precariousness of global health financing as shaped by select donors such as Gates, and more importantly, on the grave violations of rights of women and girls victimized in the Epstein power play.”

PS: “… Schwab thinks Gates’ political capital is waning…..” “ …“So, on the global stage we’re seeing his political capital taking a huge hit. This, again, has consequences on global health—because so much of what the Gates Foundation does is trying to politically influence public health policies at the government level…..”

PS: “… I get that for folks working in global health it is difficult to say ‘no’ to the Gates Foundation’s money. But I wish more of the field was really being honest about the problems with saying ‘yes.’ Asking the global poor to depend on billionaires to access public health is not just a bad model in theory, but a terribly fragile model in practice. We never should have allowed a single man to have the level of influence Gates has…. …… The Epstein scandal—and the many other scandals the foundation has been involved in over the years—raise very important questions about what, if any, role the Gates Foundation, or any billionaire-led philanthropy, should have in public health. … …. Billionaires are flawed and fickle—and they are mortal. Over time they will die or fall into disgrace or change their mind. If you make your organization, or your entire field, dependent on a billionaire, you’re building an extremely vulnerable and totally unsustainable model. The ultimate harms, of course, flow to the poorest people on Earth. …”

The Bundibugyo Outbreak Is a Warning: Africa Remains Underprepared

L Engelbert Bain; https://www.linkedin.com/pulse/bundibugyo-outbreak-warning-africa-remains-luchuo-engelbert-bain-xzmnf/

“I have argued elsewhere that Africa CDC at this stage of its existence and mandate cannot deliver beyond its means: funding, expertise, mandate clarification, and state of maturity. Indeed, because of the hope that the continent has in it, it should be well funded – inside – out, and held accountable to deliver. https://luchuoengelbertbain.com/fund-africa-cdc-from-within-and-hold-it-accountable-a-call-from-a-firm-believer-in-its-promise/ In all honestly, are African Union States doing enough to fund Africa CDC. The answer is no. No sovereignty agenda without getting serious….”

J Ratevosian – Does the UN Political Declaration on HIV/ AIDS Even Matter Anymore?

https://ratevosian.substack.com/p/does-the-un-political-declaration

Great analysis of last week’s UN Political declaration (and everything around it).

“It’s complicated. And what disappointed me most had nothing to do with the Declaration.”

Excerpt: “… What a Political Declaration Is — and Isn’t: The 2001 Declaration of Commitment on HIV/AIDS helped unlock the political will and financing that built PEPFAR and the Global Fund. The 2011 and 2016 declarations produced the 90-90-90 and 95-95-95 targets that still organize the global response today. Political declarations have mattered. But they have mattered because of what came after them . They worked when a declaration unlocked new dollars, when it moved a government to act, when it gave advocates a hook to hold power accountable. So the real question is not whether governments can still negotiate language. It is whether the global health machinery behind the AIDS response, the financing, implementation, diplomacy, and accountability system that turns declarations into action, still functions….”….

But there’ s a lot more in this (recommended) analysis.

“… The following highlights the key aspects of the 2026 UN Political Declaration on HIV/AIDS…”

Devex Check-up – Peter Sands tells us what he really thinks about cofinancing requirements: ‘A world of magical thinking’

https://www.devex.com/news/devex-checkup-how-would-the-us-get-back-into-who-if-it-wants-to-112818

“There’s a growing narrative in global health that countries should mobilize more domestic resources as official development assistance declines. But The Global Fund to Fight AIDS, Tuberculosis and Malaria Executive Director Peter Sands cautions that many countries simply aren’t in a position to make that transition.”

“His example? South Sudan. “I’m like: ‘What planet?’ I mean … there is no money,” he said during a session last week at Novo Nordisk Foundation’s event in Denmark. Instead, he said, the poorest countries end up using World Bank financing to “pretend” they’re meeting domestic cofinancing requirements — something he says is “not helping anybody at all.” Transition discussions, he argued, also need to grapple with governance challenges, corruption, and weak program implementation. “Unless we sort of are honest about where these are problems, and then deal with them, we are in a world of magical thinking,” he said.”

“Whether Sands is digging at anyone in particular is unclear. But the reality is the Global Fund requires cofinancing from grant recipients, although it offers partial or full waivers in some circumstances. Gavi, the Vaccine Alliance also requires cofinancing, with contributions based on countries’ ability to pay. The U.S. government, under its new bilateral health agreements, also now requires cofinancing from countries — including South Sudan, which plans to coinvest nearly $20 million of its resources as the U.S. invests more than $146 million in its health sector over three years….”

Devex Invested: World Bank board makes big decisions

https://www.devex.com/news/devex-invested-world-bank-board-makes-big-decisions-112831

“The board rejects the IFC accountability mechanism’s findings and drops a climate finance target. “

“After months of negotiations, speculation and political pressure, the World Bank’s climate saga has finally reached its next chapter. The bank’s Climate Change Action Plan, or CCAP, including its 45% climate finance target, was due to expire today as the United States pushed hard for the institution to roll back parts of its climate agenda. “

“We now know the outcome. The 45% target is a thing of the past. CCAP, however, will be extended indefinitely. In a statement, the World Bank said it is retiring the 45% climate “co-benefits target,” arguing that the move is in line with its broader shift toward measuring outcomes rather than inputs….”

PS: Related: Climate Change News – World Bank’s climate work can endure without finance target, experts say

“Even though the global lender has ditched a headline goal for its financing with climate benefits, it has decided to continue its climate action plan in the face of US pressure.”

Guardian – Nigel Farage’s anti-WHO campaign moves to US with allies added to board

https://www.theguardian.com/politics/2026/jun/27/nigel-farage-action-on-world-health-campaign-who-us-board

“Relocation of Action on World Health raises questions over why Reform UK leader is involved in a US pressure group.”

“Nigel Farage’s campaign against the World Health Organization (WHO) is moving to the US with a new board of lobbyists, raising questions over why the Reform UK leader is involved in an American pressure group. … The Action on World Health campaign, co-founded by Farage, is relocating to the US state of Delaware as a charitable foundation and grassroots non-profit….”

“… Farage is the honorary chair of Action on World Health, which is pushing for the replacement of the WHO, an organisation it claims is too close to China, “compromised by private funding” and “far left”…..”

PS: “In 2024, the Guardian revealed Action on World Health had links to the nicotine industry….”

Devex Opinion – Africa must negotiate with China — not just adopt its governance rulebook

Al Kags; https://www.devex.com/news/africa-must-negotiate-with-china-not-just-adopt-its-governance-rulebook-112787

“Beijing’s governance vision echoes many African priorities. But accepting China’s language without defining Africa’s own risks repeating mistakes made with Western-led development frameworks.”

“This month, China released a white paper outlining President Xi Jinping’s vision for global governance. From the perspective of Addis Ababa, Abuja, or Nairobi, much of the paper’s content reflects Africa’s long-standing demands: sovereign equality, a more representative United Nations Security Council, reform of the International Monetary Fund and World Bank, and a reinvigorated focus on development. As Western aid declines, there may be a temptation to accept this initiative. However, Africa should not simply embrace it. The appropriate approach is to negotiate the terms, not to join unconditionally….”

RANI / ODI Global – EU Official Development Assistance delivers for both donors and partners

https://rani.co/eu-official-development-assistance-delivers-for-both-donors-and-partners/

“A new briefing published today by ODI Global and rani (Resilience Action Network International) highlights the dual economic and development value of EU Official Development Assistance (ODA), demonstrating clear benefits for both partner countries and the EU economy.”

“The analysis finds that for every €1 invested in EU development assistance, approximately €1 in exports is generated. In addition, around 60% of this spending is estimated to flow back into the EU economy through increased GDP. The briefing comes at a critical moment, as Ireland assumes the EU Presidency and negotiations intensify on the next EU long-term budget (the Multiannual Financial Framework or ‘MFF’). The briefing shows that, at the European Commission’s proposed €200 billion allocation for the Global Europe Instrument (2028–2034), investment could increase EU GDP by 0.10% annually, or €115.5 billion over seven years. This underlines that development funding supports poverty reduction and stability in partner countries while also strengthening EU competitiveness, resilience, and economic growth. …”

The Global Health Paradox – The Language of Power

Habib Benzian ; on Substack;

“Global health speaks many languages. It still thinks in one.”

“Institutions like the United Nations and the World Health Organization operate with six official languages, and that matters in ways that are often underestimated. It signals balance, respect, a commitment to a plural world. Yet it coexists with a different layer of reality in which ideas are produced, shaped, and stabilized in English before they are ever translated into something else, a dynamic that has been examined in recent analyses of language and power in global health. By the time a document circulates in multiple languages, its logic is already set. …. Multilingualism governs what is visible, but English governs what is made….”

“… The language in which ideas are made is not the same as the languages in which they are distributed. … … The issue is not that global health lacks multilingual policies or that it has failed to implement them. It is that these policies operate at a different level from the processes that shape decisions. Multilingualism ensures access and signals fairness, and those are not trivial achievements. But they do not fully address how ideas are generated, contested, and fixed.

English structures the workflow. It shapes the speed of interaction, the sequencing of arguments, and the ability to define problems early in the process. The system does not need to exclude anyone explicitly. It only needs to reward certain forms of expression consistently enough that they become the default pathway to influence.”

Benzian concludes: “Global health has changed who is present more than it has changed how thinking is structured. It has diversified participation and made that diversity visible, while leaving largely intact the linguistic framework through which ideas are formed. This essay was written in English. So is almost everything that circulates in the world it describes. That is not irony. It is the point.”

D Clarke – The Integrity Dividend: Why Anti-Corruption Became a Financing Strategy

https://www.linkedin.com/pulse/integrity-dividend-why-anti-corruption-became-financing-david-clarke-nsdqe/

“… In an era of contracting resources, money lost to corruption is no longer a moral abstraction. It is a recoverable financing source. Costing that loss is not an accounting exercise for its own sake. It is the construction of the business case for reform. Every figure attached to leakage is also a figure attached to what better governance would return. Call it the integrity dividend….”

More on the impact of aid cuts & journey towards health sovereignty

IMF Country Focus – Aid Is Falling Fast. What Can African Countries Do?

C Aoyagi et al ; https://www.imf.org/en/news/articles/2026/06/22/aid-is-falling-fast-what-can-african-countries-do

« Cuts are deep, broad, and driven by donors—leaving policymakers with few easy options. »

« … Sub-Saharan Africa had the highest aid dependency globally in 2024. On average, aid accounted for 3 percent of GDP at the regional level. But that average hid sharp differences. In low-income countries and fragile states, aid often reached the equivalent of 6 percent of GDP or more, and in some cases far higher….”

« Over half of that aid was used to finance essential services such as health, education, and humanitarian assistance. And because development partners and non-governmental organizations (NGOs) often deliver services directly to people in need, aid cuts can also curtail the very systems that people rely on…”

« … IMF-administered surveys covering 28 African countries suggest four broad policy responses: (1) Some governments are not replacing lost aid, allowing programs to lapse. This limits immediate fiscal strain but carries high social costs. (2) Many are reprioritizing spending, often cutting public investment—easier politically, but damaging to future growth. (3) Others are borrowing more, including domestically, increasing debt risks. (4) Some are stepping up revenue mobilization, though results take time.

Each option comes with trade-offs….”

Devex – Can South Africa survive a post-PEPFAR future?

https://www.devex.com/news/can-south-africa-survive-a-post-pepfar-future-112820

“As the United States prepares to withdraw HIV funding from South Africa, experts warn that the country’s response could fall backward.”

PS: “In South Africa, where more than eight million people live with HIV, the government finances the bulk of the response to the disease. This includes paying for most lifesaving anti-retroviral medication for the nearly 6.2 million people on treatment. Washington had funded just under 20% of South Africa’s response until 2025, helping the country fill key gaps in services. These included clinical and outreach services for marginalized communities and programs to provide preexposure prophylaxis, or PrEP, and other prevention options….”

“… Observers said the government has struggled to sustain all of the U.S.-funded services. ..”

PS: “In addition to the gaps it has introduced in prevention and treatment services, the PEFPAR cuts also threaten South Africa’s robust HIV research network, including ongoing investigations into novel HIV prevention methods, such as vaccines, that the U.S. program was supporting. Research efforts have been further undermined by reduced support from the U.S. National Institutes of Health for research in South Africa and by cuts to PEPFAR-supported data systems that were crucial “to understanding what was working for modeling,” Bekker said. “When the data goes away, it has an impact on the research writ large.””

“These cuts have global implications, since research conducted in South Africa offers global benefits. South Africa was one of only two African countries that hosted clinical trials for lenacapavir, the long-acting injectable form of PrEP that is now being rolled out around the world. “It was bidirectional,” Bekker said. “That now is crumbling. That is going to leave another huge gap.”…”

· Related: TGH – United States Pulls Funding for South Africa, Threatening HIV Defenses (By Emily Bass et al)

“Abruptly ending all U.S. foreign aid for health to South Africa will deepen care disruptions and could lead to a surge in new HIV infections.”

· And see a Lancet World Report for more detail – USA to phase out PEPFAR support in South Africa

Lancet GH – Sustaining progress in HIV care in Africa with a transition to enabled self-care: a modelling study

A Phillips et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00088-4/fulltext

« The funding crisis for HIV services in east, central, southern, and west Africa means that innovative strategies for continuing prevention and care for HIV are needed. One such strategy is enabled self-care: the provision of free HIV self-tests, pre-exposure prophylaxis (PrEP), tenofovir–lamivudine–dolutegravir for post-exposure prophylaxis (PEP), and antiretroviral therapy (ART) provided in local pharmacies and by community-based health workers. We modelled the introduction of a policy of transition to enabled self-care compared with continuation of current service provision.”

Interpretation of the findings: “Introduction of community access to self-tests and antiretroviral drugs through a transition to enabled self-care is very likely to be cost-effective in most settings in east, central, southern, and west Africa; enable incidence declines to be sustained at reduced cost; and increase equity of access to HIV services. Policy makers who wish to consider such a policy will need to evaluate its feasibility in their own country settings.”

“As global HIV programmes confront a period of fiscal constraint, the modelling analysis by Andrew Phillips and colleagues offers a timely and policy-relevant proposition: that a transition to enabled self-care could sustain, and potentially accelerate, progress towards HIV epidemic control in sub-Saharan Africa. At stake is not only the trajectory of HIV incidence and mortality but also the future architecture of HIV service delivery….”

PS: “… Enabled self-care should be viewed as a complement to, rather than a replacement for, existing health services. Hybrid models that integrate self-care with facility-based care, particularly for individuals requiring clinical monitoring, management of advanced disease, or tailored prevention interventions, are likely to offer the greatest benefit. Maintaining core system functions, including viral load monitoring and linkage to care, will remain essential to long-term epidemic control….”

Concluding: “… Enabled self-care offers a pathway to reimagine HIV programmes as more resilient, accessible, and person-centred systems, capable of sustaining progress even as external funding declines. The challenge now is that of translation, ie, moving from modelling to policy and from policy to practice. With thoughtful implementation, strong community engagement, and continued investment in health systems, enabled self-care could mark a pivotal shift in the global HIV response, one that aligns efficiency with equity and innovation with sustainability.”

Global Tax Justice

Extreme Wealth Line Project – two foundational papers

Via Ingrid Robeyns (LinkedIn):

“The Extreme Wealth Line project is a transdisciplinary initiative aiming at the introduction of an extreme wealth line (EWL), just like we have an extreme poverty line. https://lnkd.in/dp_HHdcM.
The project has now published its two foundational papers, as LSE-III working papers #171 and #172: https://lnkd.in/es43DbQ8…”

LSE Working paper 171 – Foundations for a harm-based extreme wealth line

LSE Working paper 172 – The bottom line and the top line: insights from poverty measurement for developing an extreme wealth line

Guardian – Number of billionaires globally soars by 13% amid AI shares boom

https://www.theguardian.com/news/2026/jun/30/number-of-billionaires-world-ai-wealth-ubs

“Billionaires’ wealth grew by 25% on average in the year ended in April, research from Swiss bank UBS finds.”

PS: “James Mazeau, an economist at the bank, said billionaires had benefited from the AI boom in the stock market….”

UHC & PHC

BMJ Editorial – Dangers of finance capital in healthcare

David McCoy et al; https://www.bmj.com/content/393/bmj-2026-210213

“Proponents of finance capital overstate the benefits for universal health coverage.”

“With governments across the world lacking the hundreds of billions of dollars needed annually to achieve basic universal health coverage, development agencies have been calling for the greater use of finance capital: capital that expects a financial return on investment. Turning to entities such as commercial banks, venture capitalists, wealth funds, and private equity firms to expand access to healthcare in low and middle income countries marks a radical shift in development policy by bringing a form of finance designed to extract profits into the heart of the public mission to achieve universal health coverage….”

Listing three dangers.

“First, the demand from private investors for profitable returns can result in harmful behaviours such as cutting back on the quality or safety of healthcare, raising prices for the payers of healthcare, worsening the terms and conditions of health workers, and denying lifesaving access to emergency care….. Second, mobilising finance capital to plug public financing gaps may be costly. Getting financial players to invest in expanding universal health coverage, especially in poorer countries, typically requires governments and development financing institutions to reduce their financial risk by, for example, offering subsidies, tax breaks, or minimum revenue guarantees. Furthermore, although a fair distribution of risks and benefits across public and private investors is theoretically possible, there are many examples of arrangements tilted in favour of private invest … A third danger is the potential negative health systems impacts of “assetisation.” This is the process by which profitable or potentially profitable elements of the health system are carved out as “assets” for investors, while unprofitable services or patients are left to the public and non-profit sector….”

Trump 2.0 & US Global Health strategy & bilateral health agreements

Devex – State Department’s foreign aid chief heads to the White House

https://www.devex.com/news/state-department-s-foreign-aid-chief-heads-to-the-white-house-112830

“Jeremy Lewin has led the State Department’s foreign aid bureau for the last year. He’s now headed to the National Security Council, where he will help lead Western Hemisphere affairs.”

“… Lewin had no government experience before entering USAID, and days after doing so, he officially told the agency’s staff that they would be fired by either July 1 or Sept. 2 of that year. By mid-April, Lewin was transferred from USAID to the State Department, where he took the reins of a foreign assistance bureau just beginning to rebuild itself. Ever since, he has been at the center of the Trump administration’s efforts to rebuild the U.S. foreign assistance system, promoting private sector investment, securing American economic and security interests, and directing an increasing share of giving to faith-based organizations….”

“…. in recent weeks, the State Department has shifted gears, writing multibillion-dollar checks called “macro awards” to large U.N. agencies, including the World Food Programme and UNICEF. At the same time, Lewin coordinated the launch of bilateral health agreements with more than 30 governments worth more than $20 billion in U.S. and partner country coinvestment funding….”

Devex – Immigration hardliner takes over US foreign aid

https://www.devex.com/news/immigration-hardliner-takes-over-us-foreign-aid-112852

“Andrew Veprek, who has pushed immigration and refugee restrictions at the State Department, is expected to take over foreign aid programs when Jeremy Lewin transitions to the White House.”

PS: “… Veprek is a close associate of Stephen Miller, the White House deputy chief of staff for policy and an architect of the administration’s immigration and refugee agenda. At the State Department, Veprek has pushed to reengineer the U.S. government’s refugee and humanitarian assistance tools into a system for restricting immigration and removing refugees from the United States….”

Devex Pro – USAID’s $19B closeout plan held up on Capitol Hill amid scrutiny

https://www.devex.com/news/usaid-s-19b-closeout-plan-held-up-on-capitol-hill-amid-scrutiny-112833

“Sen. Jeanne Shaheen, the top Democrat on the Senate Foreign Relations Committee, is renewing her hold on the agency’s plan to spend up to $19 billion winding down foreign assistance programs.”

“USAID’s $19 billion closeout plans are being held up on Capitol Hill as Sen. Jeanne Shaheen, the top Democrat in the Senate Foreign Affairs Committee, restated her hold on the funds last week.

“The Administration’s plan to use upwards of $19 billion of previously appropriated funds is an extraordinary use of taxpayer dollars,” Shaheen wrote in a letter to Jeremy Lewin, the State Department’s foreign assistance chief, and Eric Ueland, the acting administrator of the U.S. Agency for International Development. “Using billions of dollars to shut down U.S. foreign assistance programs — rather than to carry out the international development, health, security or economic work for which these funds were intended — demands the utmost scrutiny by Congress,” she continued.”

US State department – Implementing the Trump Administration’s America First Global Health Strategy in South Sudan

https://www.state.gov/releases/office-of-the-spokesperson/2026/06/implementing-the-trump-administrations-america-first-global-health-strategy-in-south-sudan/

(June 27) “On June 25, the United States and South Sudan’s Revitalized Transitional Government of National Unity (RTGoNU) signed a three-year bilateral health cooperation Memorandum of Understanding (MOU) through the Trump Administration’s America First Global Health Strategy, advancing our global fight against infectious diseases including HIV/AIDS and other emerging health threats. … Working with Congress, the Department of State intends to provide more than $146 million to prevent the spread of infectious diseases in South Sudan. The RTGoNU in South Sudan will invest nearly $20 million in South Sudanese health systems…..”

PS: “America First Global Health Strategy Memoranda of Understanding (MOUs) signed so far represent more than $20.8 billion in new health funding, including more than $12.9 billion in U.S. assistance alongside more than $7.8 billion in co-investment from recipient countries, building on decades of progress fighting HIV/AIDS, malaria, tuberculosis, and other infectious diseases around the world. As of June 27, the State Department has signed 33 bilateral global health MOUs with Angola, Bolivia, Botswana, Burkina Faso, Burundi, Cambodia, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, the Dominican Republic, El Salvador, Eswatini, Ethiopia, Guatemala, Guinea, Honduras, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mozambique, Niger, Nigeria, Panama, Papua New Guinea, the Philippines, Rwanda, Senegal, Sierra Leone, South Sudan, Tajikistan, and Uganda….”

US State Department – United States and Tanzania Advance Global Fight Against Infectious Diseases Through Bilateral Health Memorandum of Understanding

US State department

(1 July) “The United States, working with Congress, intends to provide more than $1.3 billion over five years under this MOU, and the United Republic of Tanzania intends to increase its domestic expenditures by $1.8 billion in national funds over the same time period….

PS: check out the updated KFF tracker (as of 1 July) on the bilateral health agreements.

Bloomberg – White House Adds Pandemic Response Staff as Ebola Cases Rise

Bloomberg;

“The Trump administration has brought on two new pandemic response officials at the White House as it faces multiple infectious disease threats. Sara Brenner is leading the Office of Pandemic Preparedness and Response, and Rachel Idowu is the director for bioresponse at the National Security Council. The administration’s effort to bolster staff on biosecurity comes as it responds to outbreaks including a deadly Ebola outbreak and a hantavirus threat.”

TGH – NIH Budget Cuts Threaten HIV Research

S Hannah & M Warren; https://www.thinkglobalhealth.org/article/nih-budget-cuts-threaten-hiv-research

“AVAC leaders warn that the Trump administration’s proposed funding cuts to the National Institutes of Health could derail the vaccine needed to end HIV.”

“Despite the need for sustained investment in HIV science, the Trump administration continues to dismantle this powerful piece of public health infrastructure. The president’s fiscal year 2027 budget request proposes a $5 billion budget cut for the National Institutes of Health (NIH), which has historically funded nearly 80% of publicly funded vaccine research globally and is the single largest funder of HIV vaccine research worldwide…..”

“…The president’s current budget request includes a 28% cut to the National Institute of Allergy and Infectious Diseases (NIAID) and a nearly $600 million reduction to the Office of AIDS Research (OAR), which coordinates HIV research across the NIH. The accompanying Congressional Budget Justification (CBJ) issued by the NIH offers no explicit mention of HIV vaccine research and indicates a shift away from basic science and vaccine development. It also signals the potential for a dramatic shift of the NIH’s budget and priorities away from basic and clinical science toward implementation science, with an emphasis on how best to use existing tools, including LEN, to end the HIV epidemic in the United States and limit international research collaborations….”

PS: “HIV vaccine research today is in a new era focused on early-stage, iterative discovery approaches designed to induce broadly neutralizing antibodies (bNAbs) and T-cell responses. These strategies represent a scientifically sophisticated path forward and consensus on the intricate science needed to successfully develop a vaccine….”

Devex – Senate Democrats ask Trump to rejoin WHO amid Ebola outbreak

https://www.devex.com/news/senate-democrats-ask-trump-to-rejoin-who-amid-ebola-outbreak-112817

“The senators said WHO “remains the body best positioned to surveil the outbreak and stand up an effective international response.””

The bill doesn’t have much chance for the moment in a Republican controlled Congress.

PS: “ In a separate letter, the senators also urged Rubio to “support a blanket waiver” that would allow the State Department, the CDC, and other relevant U.S. agencies to work with WHO in response to the Ebola outbreak….” ““Without WHO coordination, the U.S. lacks key tools needed to help keep Americans safe from the outbreak,” they wrote.”

International Health – From global solidarity to strategic nationalism? The implications of ‘America First’ global health for low- and middle-income countries

Justin Onyebuchi Nwofe et al ; https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihag062/8713524

« … The 2025 America First Global Health Strategy does not introduce entirely new governance instruments but more explicitly prioritizes bilateral agreements, co-financing requirements, and performance-based partnerships within global health cooperation. This commentary examines how the strategy formalizes and intensifies existing dynamics of strategic bilateralism and analyses its implications for low- and middle-income countries. We argue that the significance of the strategy lies less in new governance mechanisms than in the scale, visibility, and political framing of existing ones. While this approach may strengthen domestic ownership and programme integration, it may also reshape bargaining dynamics, fiscal responsibilities, and coordination structures within global health systems. »

Polio

BMC Infectious Diseases – Polio transition in the African Region: progress, challenges and prospects for health systems integration

T Nomwanghe et al; https://link.springer.com/article/10.1186/s12879-026-13357-9

« The Global Polio Eradication Initiative (GPEI) has made substantial progress towards global eradication of polio. As regions, including Africa, approach the final stages of this goal, countries must ensure that essential polio functions are sustained and effectively integrated into national health systems. To support this transition, the World Health Organization(WHO), through its regional offices, has guided countries using the Polio Transition Global Vision and its Monitoring and Evaluation Framework. This paper reviews progress made in transition planning across 15 polio transition priority countries in the WHO African Region and anticipated challenges, opportunities, and prospects for integrating polio assets and essential functions into broader health systems. »

Results: “… Over the past decade, none of the 15 priority countries consistently achieved ≥ 90% routine polio containing vaccine coverage. Only Burkina Faso and Kenya have been closest to these coverage levels in the region. Timely shipment of polio samples remains a consistent challenge, particularly in countries where GPEI support has declined. The regional International Health Regulations(IHR) average capacity score remains suboptimal, averaging 51, below the global score over the last 10 years. These underscore weaknesses in epidemic preparedness and response capacities… »

« … Progress on polio transition in the African region remains limited, with gaps in immunization, emergency preparedness and financing, gaps made riskier by declining donor support…”

NCDs

WHO Afro – On the road to 2030: Health experts renew commitments to transform care for severe noncommunicable diseases in Africa

https://www.afro.who.int/countries/united-republic-of-tanzania/news/road-2030-health-experts-renew-commitments-transform-care-severe-noncommunicable-diseases-africa

“Health experts, policymakers, civil society organizations, development partners, and people living with noncommunicable diseases (NCDs) from across Africa have renewed commitments to accelerate action against severe chronic diseases and strengthen access to quality care at all levels of the health system.”

“Meeting in Dar es Salaam from 23–25 June 2026 for the 3rd International Conference on PEN-Plus in Africa (ICPPA 2026), participants called for stronger political leadership, increased domestic investment, and expanded access to prevention, diagnosis, treatment, and long-term care for people living with severe NCDs, particularly childhood-onset conditions.”

“The renewed commitments come at a critical time. More than 100 million people in sub-Saharan Africa are living with severe chronic diseases such as type 1 diabetes, rheumatic and congenital heart disease, sickle cell disease, and cancer. Yet access to basic specialized care remains limited, with services largely concentrated in major urban centres, leaving millions of people in low-resource rural areas without access to proper diagnostics—much less the life-saving care they need—and facing even greater financial hardships in their search for both.”

“Against this backdrop, participants highlighted the importance of scaling up PEN-Plus, an innovative African-led model that brings advanced diagnostics and treatment closer to home for those millions by decentralizing care for severe NCDs to first-level referral hospitals and integrating clinical services available to people living with severe NCDs. Currently, twenty countries in the WHO African Region are either initiating or implementing PEN-Plus….”

The Lancet: Blood pressure and cholesterol levels in adults over 40 with obesity increasingly similar to adults with normal BMI, study suggests

Lancet – Metabolic traits in obesity and normal BMI in industrialised countries: a multi-country analysis of national population-based studies

Cfr the press release:

“In several high-income countries including England and the USA, adults over 40 years old with obesity now have blood pressure and unhealthy cholesterol levels approaching, or healthier than, people with a normal BMI, a significant shift from 30 years ago.
This trend coincides with a greater rise in cholesterol-lowering medication (such as statins) and blood pressure medication use among adults over 40 with obesity compared to those with a normal BMI, pointing to medication as a likely driver of the blood pressure and cholesterol level convergence.
For adults under 40 years old, the study found little change in the gap between blood pressure and unhealthy cholesterol levels in people with obesity and those with normal BMI, likely because young adults rarely receive cholesterol or blood pressure medication regardless of their BMI.”
Authors say these findings suggest the cardiovascular risks associated with obesity in some countries have been reduced in older adults, however they highlight other risks associated with obesity remain, including diabetes, kidney and liver diseases, and cancers.

PS: Coverage via Stat – Statins and blood pressure drugs changing health risks of obesity, study suggests

Planetary Health (& Climate/health)

Carbon Brief – Q&A: What change of power in Colombia could mean for world’s fossil-fuel transition

https://www.carbonbrief.org/qa-what-change-of-power-in-colombia-could-mean-for-worlds-fossil-fuel-transition/

“Over the last four years, Colombia has emerged as one of the most vocal advocates for the world to transition away from fossil fuels. Under the leadership of leftist politician and economist Gustavo Petro, it became the first major oil-and-gas producer to commit to halting all new fossil-fuel expansion. In April, the nation hosted a first-of-its-kind meeting of countries on transitioning away from fossil fuels, alongside the Netherlands, in the Caribbean city of Santa Marta. The meeting concluded with a promise for a new “Santa Marta process” spearheaded by Colombia and the Netherlands, a movement of countries that would continue to push for a transition away from fossil fuels at home – and at international climate talks.”

“But on 21 June, an ally of Petro suffered defeat in a presidential election runoff against Abelardo de la Espriella, a hard-right populist and favourite of US president Donald Trump, who has pledged to boost oil production and pursue “fracking to the max”.”

“Below, Carbon Brief examines what the loss could mean for Colombia’s stance on fossil fuels, as well as international efforts to transition away from coal, oil and gas, including at the COP31 climate summit in Turkey in November….”

HPW – The Climate-Health Crisis Needs Money, Not More Declarations

https://healthpolicy-watch.news/the-climate-health-crisis-needs-money/

Coverage & analysis of the G7 meeting in Paris last week.

“On the day France recorded its hottest temperature on record, a coalition of health ministers, officials and advocates huddled in a sweaty, half-full auditorium in Paris to take stock of a campaign they have spent a decade waging: the fight to put human health at the centre of the world’s response to climate change. The meeting was a high-level gathering of the Alliance for Transformative Action on Climate and Health (ATACH), the WHO-hosted network of 106 countries launched at COP26 in Glasgow in 2021. …”

“Convened under France’s G7 presidency, the summit’s task was to look ahead to COP31 in Antalya in Türkiye in November, to gauge what fights the health community should place at the top of its agenda. …. … While part of the meeting carried the air of a victory lap, it was also a reckoning with the one thing recognition has not delivered: money. “Finance is the weakest one, and I think this is a key point for this meeting,” said Elena Villalobos Prats, the WHO official who built much of ATACH’s architecture…..”

““It’s not just a plea for external support to come to countries,” Prats added. “It’s really about making sure that ministries of health, that now understand what the problem is, have the capacity and the resources to do something about it.”

“…The health community has hailed each declaration and framework as a breakthrough. Yet none is binding, all are voluntary, and none sits inside the formal UN negotiations where targets are set, international legal obligations are made, and money is committed. And the money required is astronomical. The World Bank estimates climate change could cause up to 15.6 million additional deaths between 2026 and 2050 and inflict $8.6 trillion to $15.4 trillion in health costs by mid-century. WHO calls it “the greatest single risk to humanity.”…”

“Twelve of 20 climate-health indicators are now at catastrophic levels, including a sharp rise in heat-related deaths globally….”

“…ATACH currently counts 106 member countries, more than half the nations that turn up to the climate talks, but membership demands little and delivers less.”

“… Türkiye, which holds the COP31 presidency, used the meeting to lay out what it wants from Antalya. Rather than a departure from the pattern, it plans to attach health more firmly to the summit’s action agenda, the voluntary track that runs alongside the negotiations proper.

“We aim to focus on designing the healthcare system we need by adding a new building block to the Belem action plan,” a senior official from Türkiye’s health ministry told the meeting. That building block, published as a COP31 priority titled “Dynamic and Resilient Health Systems,” runs to seven goals spanning resilient infrastructure, disease surveillance, early-warning systems, artificial intelligence, a trained workforce, cross-sector coordination and “sustainable financing.” It sets no targets, attaches no figures, fixes no timeline and names no mechanism to deliver any of it. The priorities largely restate the pillars of the Belém plan, which in turn restated the Baku and Dubai declarations before it. ….”

“… The French Development Agency puts the cost of adapting the world’s health systems to climate change at $22 billion. The UN climate body’s estimate runs higher, at $26.8 billion to $29.4 billion a year by 2050.”

PS: “A major focus was France’s “One Health & Beyond” declaration, launched earlier this year to embed health considerations into climate governance frameworks such as Nationally Determined Contributions (NDCs), National Adaptation Plans (NAPs), and the second Global Stocktake. …”

Devex – Why did the US State Department stop sharing air quality data?

https://www.devex.com/news/why-did-the-us-state-department-stop-sharing-air-quality-data-112810

Coming back on news from earlier this year. “The U.S. has stopped publicly sharing air quality data collected at embassies around the world, leaving many countries without trusted pollution measurements.”

“ In March 2025, the State Department stopped sharing air quality readings from U.S. embassies and consulates through its public mobile applications, AirNow and ZephAir. The move ended the U.S. Global Air Quality program, which had provided trusted, independent pollution data from more than 70 diplomatic posts in over 50 countries…”

HPW – London Climate Week: Improving Air Quality Starts With City-Level Actions

https://healthpolicy-watch.news/london-climate-week-improving-air-quality-starts-with-city-level-actions/

Including an update on ‘Breathe Cities’. “… In 2018, Mayor Khan launched Breathe London, in collaboration with the joint WHO-UN Environment Programme’s BreatheLife initiative, which linked nearly 80 cities and regions around the world in ambitious clean air and climate commitments. ‘Breathe London’ aimed to improve measurement of air quality across the city and engage with communities to act. Then in 2021, at COP26, the UN climate conference in Glasgow, Khan called for the creation of an initiative to invest in cities around the world to clean their air and enhance public health. That helped to spark the Breathe Cities initiative supported by Bloomberg Philanthropies, the Clean Air Fund and C40 Cities. “

“Breathe Cities now includes a network of 16 cities that aim to replicate the success of Breathe London. The cities have received financing commitments totaling $75 million from its sponsors, including $45 million announced at London Climate Week. The initiative provides equipment and technical support for cities to expand air quality monitoring; develop their own Clean Air and Reduced Emissions zones; restrict highly polluting vehicles; support cleaner household heating solutions; and build public awareness. …”

“Representatives from cities such as Bogota, Mexico City and Rio de Janeiro told Climate Week about the progress made and challenges they still face in reducing air pollution to levels now common in London….”

WHO – New SDG data shows stalled progress on air pollution and health

https://www.who.int/news/item/29-06-2026-new-sdg-data-shows-stalled-progress-on-air-pollution-and-health

“WHO’s updated indicators reveal stark disparities between low- and high-income countries.”

“WHO has recently launched updated data on the Sustainable Development Goal (SDG) indicators tracking the link between air pollution and health. The release of data on ambient and household air pollution highlights critical inequalities: while fine particulate matter (PM2.5) levels dropped globally until 2020, they have since remained largely unchanged, with low- and middle-income countries facing significantly higher exposure risks than high-income nations, increasing risks for public health and the environment….”

Euronews – Heatwaves are killing tens of thousands in India. Officials are barely counting them

https://www.euronews.com/2026/06/10/heatwaves-are-killing-tens-of-thousands-in-india-officials-are-barely-counting-them

“Experts warn that official heatwave death figures are grossly underestimated.”

“A recent study underlines the dangers of these worsening highs. It estimates that a single day of extreme heat causes approximately 3,400 excess deaths nationally in India. A five-day heatwave is linked to nearly 30,000 extra deaths, according to the paper published in the Frontiers in Environmental Health journal last month.”

PS: “… Official counts of heatwave deaths in India are much lower – between 500 and 1,500 annually nationwide – but experts warn these are grossly underestimated. This is due to a lack of uniform tracking and a failure to take indirect impacts into account, such as the exacerbation of underlying health conditions….”

“The study is the first to attempt to rectify this by providing detailed numbers for all of India’s 765 districts. It also captures the full hidden impact of heat by taking into account all excess deaths during a heatwave, rather than only those directly attributable to heatstroke or heat-related disasters….”

Economist Enterprise – A threat to health inclusivity: climate change exacerbates health exclusion

Economist Enterprise;

“Premature deaths linked to climate change are on the rise and over 90% of these deaths occur in developing economies. From the rise of pollution and infectious disease prevalence to food insecurity and increased stress on healthcare systems, the interconnectivity between climate change and health is undeniable—and climate change is exacerbating existing health disparities. Marginalised groups, vulnerable populations and people living in lower-income economies, who are already more susceptible to major systemic shocks, experience disproportionate climate change-related economic and health consequences, and are bearing the brunt of the burden.

The Phase 2 Health Inclusivity Index assesses the extent to which 40 countries have taken steps to ensure that good health is accessible to all individuals. It considers both the policy environment for health inclusivity and whether populations are feeling the impacts of this policy on the ground, allowing us to quantify health disparities. Through a global survey of over 42,000 people across the index countries and a series of focus group discussions with marginalised populations, the index captures lived experiences of health inclusion—and exclusion—and explores how populations perceive the impacts of climate change on their health. …”

“…People in low- and middle-income countries are more affected by climate change in immediate and measurable ways. Low- and middle-income countries bear the brunt of climate change effects, with seven in ten respondents expressing concerns about the impacts of climate change on their health, compared with six in ten respondents in high-income nations. Respondents in low- and middle-income countries were also more likely to report that climate change has negatively affected their food security, source of income and ability to keep a comfortable temperature at home.”

“Marginalised populations—especially migrants and refugees—face greater climate- related health impacts. … … Younger generations are more worried about the impact of climate change than older generations.”

Lancet Planetary Health (Editorial) – How we imagine the future matters

https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00066-5/fulltext

“Those working to address major societal challenges such as climate change, ecological collapse, and persistent poverty and inequality face a deep tension between the scale of these problems and our apparent capacity to respond. In short, today’s political and economic norms—the ‘Overton Window’ of currently acceptable policy options—can seem nowhere near equal to the scale of these challenges. This mismatch creates a kind of cognitive dissonance. Judged against prevailing socio-economic and political norms, which shapes people’s sense of what futures are feasible, the changes required can seem so radical as to appear highly improbable. Yet from an understanding of the risks and harms; seven of nine planetary boundaries have already been transgressed, while the basic needs of many people still go unmet. It seems absurd to claim that meaningful action is too radical. To foresee such harms and still fail to act for lack of political imagination, will, or capacity, is a profound societal failing…”

“… The point here is not to suggest that any future outcome is truly inevitable, but rather to recognise that how we understand and think about the future is foundational to how we interpret planetary health evidence and formulate policy responses….”

Human Resources for Health

WHO – National health workforce accounts: health workforce levels and trends 2026

https://iris.who.int/items/bb4009bc-943c-4116-88e3-fe4f6cf1a400

Via LinkedIn: “With three key findings:

(1) The Progress is Real- Since the NHWA launched in 2017, health workforce data availability has grown nearly 20-fold. Today, 206 countries have appointed focal points, and 178 countries actively reported data in 2025. This is a testament to what sustained global coordination can achieve.

(2) But Deep Inequalities Persist-
The African Region has the lowest health worker density across all occupations — doctors, nurses, dentists, and pharmacists — while high-income countries lead by a wide margin. Health worker density remains tightly correlated with national income. This is not a data problem. It’s a policy and investment problem.

(3) Ageing: The Hidden Crisis
Here’s what deserves more attention: both our populations and our health workers are ageing simultaneously. In high-income countries, nearly 1 in 3 medical doctors is expected to retire within the next decade. Meanwhile, 67 countries will face a projected gap of 832,000 health workers by 2030 — just to maintain current age-adjusted coverage levels.”

And: … The bottom line: A 52% increase in global health worker density since 2006 is progress worth celebrating. But it masks a growing structural imbalance that no single country can solve alone.

BMJ Feature – Why German doctors are being prepped for war

https://www.bmj.com/content/393/bmj-2026-846473

“The ongoing Russia-Ukraine war has sparked fears of a spillover affecting Germany. Christine Ro reports on the measures being taken to prepare doctors for deployment and conflict on home soil.”

Access to medicines, vaccines & other health technologies

BMJ Editorial – WHO’s misguided push for complementary and alternative medicine

C A Philips et al ; https://www.bmj.com/content/393/bmj-2026-100062

« Use of traditional medicine must follow evidence of efficacy and safety. »

A few excerpts from this editorial (which already sparked some debate on Bluesky):

“The BRICS economies, including India and China, committed to further collaboration to integrate traditional medicine in healthcare, at a meeting in May 2026. The meeting was held by India’s Ministry of Ayush (ayurveda, yoga and naturopathy, unani, siddha, and homeopathy). Globally, interest in complementary and alternative medicine (CAM)—that is, unproved, non-standard interventions—is surging, with the market projected to reach $359bn by 2032. “

“In December 2025, a multilateral declaration endorsed the World Health Organization’s Global Traditional Medicine Strategy 2025-2034, aiming for “universal access to safe, effective” traditional medicine. This proposes integrating CAM into national health systems and universal health coverage through strengthening evidence, tightening safety regulation, expanding workforce, and building a global library of traditional knowledge…”

Re “… Colonisation and epistemicide: “Some proponents of CAM correctly identify ongoing power asymmetries from historical colonisation; “epistemicide” describes colonisers’ destruction and devaluing of traditional healthcare knowledge. CAM in healthcare might improve patient experience but not necessarily objective outcomes. The randomised controlled trial is not colonial oppression; it distinguishes interventions that work from those that do not. Traditionally used artemisinin became standard malaria treatment through scientific evaluation, not deference to tradition…..”

« WHO’s strategy insufficiently distinguishes CAM as traditional knowledge for hypothesis generation from validated knowledge that is ready for integration. An ideal CAM strategy should mandate efficacy and pharmacovigilance, including adverse event reporting. Existing large CAM workforces worldwide should be retrained in evidence based priorities for primary care, including screening, vaccination, identifying chronic disease, and maternal health. Research funding should prioritise independent trials, with negative results published. WHO’s CAM library should document harms alongside claims of benefit, while disclosing commercial conflicts of interest. And WHO’s messaging must remain unequivocally aligned with scientific consensus—a proved tool against misinformation that mixed messaging undermines….”

The editorial concludes: “Globally, CAM is the predominant healthcare option for billions of indigenous, rural, and underserved people, likely reflecting constrained access to evidence based care instead of informed choices. The ethical response is not uncritical endorsement of CAM but to expand access only to interventions that withstand standard scientific scrutiny as effective and safe. Patients everywhere deserve nothing less… »

Advancing global health innovation through Europe-Africa collaboration

https://dndi.org/publications/2026/advancing-global-health-innovation-through-europe-africa-collaboration/

“Eight Product Development Partnerships (PDPs) are joining forces to call for sustained investment in the European and Developing Countries Clinical Trials Partnership (EDCTP) under the next EU Framework Programme for Research and Innovation and other EU funding frameworks under discussion….”

GAVI – Gavi launches new supply chain strategy to boost vaccine availability and reach remote communities

https://www.gavi.org/news/media-room/gavi-launches-new-supply-chain-strategy-boost-vaccine-availability

“New immunisation Supply Chain Strategy seeks to build on recent years’ momentum and help countries ensure vaccines reliably reach people safely, reliably and on time – including under-served communities. Efforts in areas such as real-time cold chain monitoring are helping protect more than US$ 1.7 billion worth of vaccines each year, with one in six children globally benefitting, while private sector partnerships are improving efficiency and delivery performance. Through closer alignment of systems and operations, Gavi and partners are implementing a “merger at the last mile,” where global health initiatives bring together their distinct activities into a unified approach.”

The Lancet: Currently approved mRNA vaccines are safe and effective, with promise for future disease prevention and treatment, new review confirms

Lancet Review – Safety and efficacy of mRNA vaccines: a mechanistic and public health perspective

Cfr the press release:

“A comprehensive new review that assessed billions of doses of currently approved mRNA vaccines affirms that these vaccines provide protection against COVID-19, including severe COVID-19, across diverse populations, including children, pregnant women, and immunocompromised people. Booster doses extended and strengthened protection for existing SARS-CoV-2 subvariants through May 2023.”

“The review reinforces existing evidence that mRNA vaccines are safe; serious adverse events are rare and substantially outweighed by protection against severe disease, hospitalisation, and death. The review also highlights that mRNA technologies have potential future uses for vaccines against influenza, RSV, and other infectious diseases, as well as for personalised cancer vaccines and RNA-based therapeutics.”

“The authors emphasise the importance of equitable access, strengthened and expanded manufacturing to low- and middle-income countries, and advanced storage and distribution for mRNA vaccines. The authors also call for continued clear communication about mRNA vaccine safety and effectiveness to sustain public trust, improve vaccine uptake worldwide, and address ongoing misinformation about mRNA vaccines.”

UNAIDS – Brazilian LGBTQIA+ organizations demand equitable access to lenacapavir

https://www.unaids.org/en/resources/presscentre/featurestories/2026/june/20260626_Brazil_LGBTQIA_len

“Brazilian LGBTQIA+ organizations participating in the Pride Parade, led by the São Paulo LGBT Pride Association (APOLGBT-SP), have called for universal access to lenacapavir. … These organizations are stressing that the anticipated high cost of the antiretroviral drug could prevent its incorporation into Brazil’s Unified Health System (SUS), potentially deepening inequalities and undermining the country’s response to the HIV epidemic.  …”

KFF Tracking Poll on Health Information and Trust: Update on Common Vaccine Myths

A Montero et al; KFF

« People who don’t have a trusted health care provider are more likely than people with one to believe or lean toward believing several common myths about vaccines, a new KFF Tracking Poll on Health Information and Trust reveals. Similarly, people who use social media or artificial intelligence (AI) chatbots at least weekly for health information are more likely than those who don’t to endorse these false vaccine claims….”

Conflict/War & health

Plos Med (Perspective) – The well-worn path from armed conflict to measles resurgence

José E. Hagan; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005156

« Armed conflict weakens immunization, surveillance, and socioeconomic resilience, increasing measles risk during and after war. Protecting routine vaccination in crises is a core emergency response. »

Some more reports, supplements,…

HP&P (Supplement) – Changing Health Systems: Advancing Justice and Sustainability through Research, Policy and Practice

https://academic.oup.com/heapol/issue/41/Supplement_1

· Introductory (HSG) Blog – Launching the Special Supplement: Changing Health Systems: Advancing Justice and Sustainability through Research, Policy and Practice (by Nanuka Jalaghonia, Partnerships and Engagement Manager, Health Systems Global | Stephanie M Topp, Director, JCU Centre for Rural Remote and Tropical Health Systems | Kabir Sheikh, Director, UCL Centre for Global Health Systems and Policy)

“Health Systems Global (HSG) and Health Policy and Planning (HPP), with the support of the International Development Research Centre (IDRC), are pleased to announce the publication of a Special Supplement – Changing Health Systems: Advancing Justice and Sustainability through Research, Policy and Practice. … This supplement distills and spotlights some of the rich debates and discussions from the Eighth Global Symposium on Health Systems Research (HSR2024). … The Symposium’s focus on Building Just and Sustainable Health Systems: Centering People and Protecting the Planet reflected many of the questions facing the global health community today: how health systems can adapt and evolve while remaining equitable, responsive and sustainable. ..”

“The discussions captured in this supplement, Changing Health Systems: Advancing Justice and Sustainability through Research, Policy and Practice, contribute to these ongoing conversations and highlight the role of research, policy, and practice in supporting meaningful health system change…. Edited by Stephanie M. Topp, Chair of the HSR2024 Symposium and Kabir Sheikh, Health Systems Research Editor of Health Policy and Planning, with the support of relevant section editors, this collection of papers demonstrates the diversity of topics, disciplinary perspectives and research approaches that define the field of Health Policy and Systems Research. …”

· Introductory editorial by S Topp et al – Changing health systems—advancing justice and sustainability through research, policy and practice

“… The papers in this supplement—part of the legacy of the 8th Global Symposium on Health Systems Research in Nagasaki 2024 (Health Systems Global 2024) engage with these questions by examining how health systems respond to and shape change across diverse contexts, including informal urban settlements, decentralized governance reforms, sanction-constrained economies, and environmentally vulnerable settings. Drawing on a range of analytical and methodological approaches within health policy and systems research (HPSR), the papers explore how governance arrangements, institutional incentives, and knowledge practices influence reform trajectories in practice. The discussion that follows draws out several cross-cutting themes from the collection that characterize justice and sustainability not as static policy goals but as processes negotiated through institutional arrangements, political economy dynamics, everyday implementation realities, as well as our own reflexive research practice….”

PS: “Across the collection, a consistent theme is the central role of national and subnational arenas in shaping consequential health system change. While global institutions, financing mechanisms, and normative agendas remain influential, the papers demonstrate that the practical dynamics of reform—how policies and services are interpreted, negotiated, and enacted—are largely shaped within domestic political, institutional, cultural, and geographic contexts. This perspective reflects a long-standing orientation within HPSR, which views health systems as socially and politically embedded institutions shaped by national governance arrangements, administrative traditions, and local political economies. “

“… In doing so, this special collection offers a corrective to the tendency in contemporary global health discourse to privilege global architectures—multilateral initiatives, international financing mechanisms, and transnational policy agendas—as the primary drivers of system change. The papers instead foreground the role of domestic institutions and dynamics, showing how national and local processes shape justice and sustainability outcomes by influencing whether and how reforms expand access, redistribute resources, or reinforce existing inequities. Taken together, the collection reaffirms the value of empirically grounded, contextually attentive research and a core insight of HPSR: that advancing justice and sustainability depends on how policies are negotiated, institutionalized, and enacted within the settings where health systems operate.”

“… Finally, this special collection reflects on the role of research itself in shaping health system change, with two methodological contributions…”

“… Across diverse contexts considered by papers in this collection a common lesson emerges: justice and sustainability are negotiated through power relations and institutional practice. Reform does not unfold linearly from policy design to outcome. It is mediated by national and subnational actors who interpret, adapt, resist, and reshape policy within historically embedded structures. …”

UN News – Global drug use reaches record high as increasingly potent synthetic drugs spread

https://news.un.org/en/story/2026/06/1167817

“More people are using drugs than ever before, while synthetic substances are reshaping illicit markets and exposing vulnerable communities to greater health risks, according to the UN World Drug Report 2026, released [last week] on Friday.”

“An estimated 331 million people used drugs in 2024, equivalent to 6.2 per cent of the world’s population aged 15 to 64, up from 5.2 per cent a decade ago. …

“Cannabis remained the most widely used drug, with 256 million users, followed by opioids (63 million), amphetamines (32 million), cocaine (25 million) and ecstasy (21 million). The report also highlights the rapid evolution of synthetic drugs…..”

PS: “ The report stressed that the harms associated with drug use are shaped not only by the substances themselves but also by poverty, homelessness, poor mental health and unequal access to healthcare. …”

Miscellaneous

IISD – HLPF Prepares to Advance Transformative, Coordinated Actions for SDGs

https://sdg.iisd.org/news/hlpf-prepares-to-advance-transformative-coordinated-actions-for-sdgs/

“HLPF 2026 will draw from the outcomes of several major summits, including the Pact for the Future, the Sevilla Commitment, and the Doha Political Declaration. The Forum will contribute to the discussions leading to the 2027 SDG Summit, which will address how to advance sustainable development by 2030 and beyond….”

“The UN system, Member States, and stakeholders are intensifying preparations for the 2026 session of the UN High-level Political Forum on Sustainable Development (HLPF), convening in New York, US, from 7-15 July. Themed, ‘Transformative, equitable, innovative and coordinated actions for the 2030 Agenda for Sustainable Development and its Sustainable Development Goals for a sustainable future for all’…”

Guardian – Rapid spread of AI may worsen global inequality, UN warns

https://www.theguardian.com/technology/2026/jul/01/un-report-ai-inequality

“A new United Nations report warns that the development of artificial intelligence may exacerbate global inequality and proposes a shared framework for how to responsibly develop AI, as adoption and investment into the technology accelerates unevenly across the world.”

“The sweeping analysis from the independent international scientific panel on AI, established by the UN general assembly last year as “the first global scientific body on AI”, details AI’s risks and opportunities – from transformative capabilities in agriculture and education, to catastrophic outcomes when bad actors deploy AI to commit fraud and influence elections….”

Nature (News) – Have people stopped trusting science? The data tell a surprising story

https://www.nature.com/articles/d41586-026-01977-9

“Some say there’s a global crisis of trust — but research reveals where the real problems lie.”

TGH – Genomic Medicine: A New Frontier for Health Care in Africa

M M Diagne et al ; https://www.thinkglobalhealth.org/article/genomic-medicine-a-new-frontier-for-health-care-in-africa

« Building Africa’s capacity for human genomic sequencing could improve cancer care, product development, and precision medicine. »

Global health governance & Governance of Health

CGD – Bipartisan or Bust: Reform Principles for the Next Generation of US Foreign Assistance

E Collinson et al; https://www.cgdev.org/blog/bipartisan-or-bust-reform-principles-next-generation-us-foreign-assistance

“…. Reflecting on critiques of past US aid—including those leveled by actors on both sides of the aisle—here are six core reform principles that should underpin a more effective approach to US international assistance. While many of these principles echo past US and global reform initiatives, the current moment of disruption offers new opportunities for a step change in approach. …”

EPRS (Briefing) – WHO at a crossroads

https://www.europarl.europa.eu/RegData/etudes/BRIE/2026/789356/EPRS_BRI(2026)789356_EN.pdf

Briefing of the European Parliamentary Research Service – with focus on the WHO-EU relationship.

European Journal of Public Health – You aren’t going to like what comes after America: Europe and global health after 2025

Scott Greer; https://academic.oup.com/eurpub/article/36/4/ckag061/8706796?login=false

In case you missed this. Among others, on the EU’s explicit GH strategy, and its implicit one.

Excerpt: “The EU’s global health policy priorities are formally presented in its 2022 Global Health Strategy, a joint production of the DG for health (SANTE) and international aid (INTPA) that was ratified in 2024 Council Conclusions. The document is complex, containing many strong policy tools and statements, including a commitment to multilateralism and values such as gender equality. But look at it in the context of the EU as a whole, not just SANTE and INTPA. Powerful EU policy instruments, especially trade, are not discussed in the Strategy. In the areas beyond the spotlight of the strategy, we can see another, less explicit, strategy. In this second strategy, the goal is strategic autonomy. That means urgently reshoring medical supply chains so that the EU is not dependent on fickle third countries and defending intellectual property, fully protected, in the hands of European companies…”

Chapter – Who Holds the Power? NGOs, Pandemic Governance and What COVID-19 Revealed for Future Treaties

https://www.intechopen.com/online-first/1248089

by BA Moskov et al.

UHC & PHC

WHO expands Health Inequality Monitoring Network, doubling global membership

https://www.who.int/philippines/news/detail-global/30-06-2026-who-expands-health-inequality-monitoring-network–doubling-global-membership

“Network grows to 24 leading institutions, strengthening countries’ capacity to monitor and address health inequalities.”

“The World Health Organization (WHO) has expanded its Health Inequality Monitoring (HIM) Network, doubling membership from 12 to 24 institutions across all regions. The expansion marks a significant step in strengthening global capacity to monitor health inequities and support countries in advancing health equity and universal health coverage. … … Launched by WHO in June 2025, the HIM Network brings together leading academic institutions, national statistical agencies and public health organizations to strengthen health inequality monitoring worldwide….”

International Health -Free primary health care in Ghana: a model for repositioning community-based health systems in Africa

Abdirahman Mohamed Adan et al; https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihag061/8715188?searchresult=1

“On 15 April 2026, Ghana launched its Free Primary Health Care Initiative, representing a pivotal opportunity to reposition community-based primary health care systems across Africa by removing point-of-care fees and leveraging the long-standing Community-based Health Planning and Services (CHPS) infrastructure…. “

Nature Health – Nepal’s political transition creates an opportunity for health system reform

E R Zhang et al ; https://www.nature.com/articles/s44360-026-00161-7

“Nepal’s post-transition government opens a window for phased health reforms, including insurance and supply-chain stability, stronger primary care, and tackling the rising burden of non-communicable diseases.”

Pandemic preparedness & response/ Global Health Security

Lancet GH – Incidence of symptomatic Lassa virus infection in West African countries (Enable 1.0 Lassa Research Study): a prospective, multisite, cohort study

The Enable Lassa Research Programme (Enable 1.0) Consortium ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00090-2/fulltext

Interpretation of the findings: “Symptomatic Lassa virus infection occurs infrequently in West Africa, meaning large vaccine trials are required to measure efficacy. Trials should target children, who are at higher risk of Lassa fever, alongside the further development of targeted school-based health education and household-level risk communication programmes in endemic communities. The high prevalences of malaria co-infection and hearing loss after infection warrant further exploration in future trials and reinforce the need for integrated community fever management strategies that include Lassa fever as a differential diagnosis.”

Planetary health

Guardian – Global boom in livestock farming since 2006 is piling pressure on nature, report finds

https://www.theguardian.com/environment/2026/jul/02/huge-rise-mammals-poultry-livestock-farming-worldwide-nature-report

“Wildlife at risk as demand for cropland and water grows to feed 50% rise in farmed animals, campaign alliance says.”

“The number of mammals and poultry farmed worldwide has increased by half in the last two decades, research shows, and the amount of cropland used for feeding livestock has increased by about a quarter. These increases are putting rising pressure on natural systems, threatening wildlife and plant species and adding to the climate crisis. The rising demand for meat comes at a time when agricultural land is already becoming less fertile, with an area the size of Canada now suffering degradation….”

“These findings, from an alliance of campaigning organisations called Stop Financing Factory Farming, come 20 years after the publication of the UN Food and Agriculture Organization’s seminal report on animal farming, Livestock’s Long Shadow. The researchers have updated key aspects of the report, and found that most trends are moving in a negative direction….”

Ecological Economics – The false certainties of climate policy: Rethinking risk and cooperation in an uncertain future

John-Oliver Engle et al; https://www.sciencedirect.com/science/article/abs/pii/S0921800926002296

“Although the Paris Agreement’s temperature targets are widely endorsed, they are based on three problematic assumptions: that current climate governance arrangements will likely be successful, that climate sensitivity is predictable enough for policy planning, and that policy pathways will remain stable over time. These “false certainties” distort risk assessment and undermine effective climate governance. We argue that embracing uncertainty strengthens cooperation by increasing salience, supporting stress testing, and exposing shared vulnerabilities. Drawing on recent behavioral and negotiation research, as well as the concept of climate storylines, we propose reorienting climate negotiations toward plausible worst-case scenarios and deep uncertainty. Specifically, we advocate for three institutional innovations: a formal scenario stress-testing track within COP negotiations; a requirement for Parties to include scenario-based resilience strategies in their nationally determined contributions (NDCs); and an IPCC-UNFCCC task force to translate deep uncertainty into structured decision-support tools for negotiators. Implementing our propositions would improve resilience, build trust, and ground international climate policy in more realistic planning frameworks.”

Journal of Industrial ecology – Varieties of degrowth: an analysis of archetypes

https://link.springer.com/article/10.1007/s44498-026-00115-y

“The concept of degrowth rejects perpetual economic growth in favor of planetary health and social wellbeing. As the degrowth scholarship matures and responds to newly arising circumstances, perceptions about the concept are becoming more varied and nuanced. This phenomenon has not been studied systematically, potentially limiting theoretical and practical progress. To address this gap, this study identifies clusters of perceptions about degrowth, presented as archetypes and derived from a literature review and analysis of data from 40 in-depth semi-structured interviews. Four archetypes are identified: eco-reformist, systemic change, transformation, and sufficiency-based degrowth. ….”

Via LinkedIn (author): “Eco-reformist degrowth – which uses market reforms and business innovation to green the current system. Many circular start-up founders would probably feel quite at home in this camp
Systemic change degrowth – which relies on strong government intervention to restructure the economy
Transformative degrowth – which focuses on shifting societal values, supported by institutions
Sufficiency-driven degrowth – which emphasizes grassroots action, local living, and reduced consumption. (Arguably the most RADICAL variety)…”

Earth System Governance – Power dynamics and the politics of climate finance: An analysis of decision-making in the green climate fund

Ahmed et al; https://www.sciencedirect.com/science/article/pii/S2589811626000285

“This paper examines the politics of decision-making within the Green Climate Fund (GCF), revealing how structural power asymmetries, strategic negotiation, and ideological biases shape outcomes. Drawing on a qualitative analysis of board meeting transcripts, survey responses of accredited entities, and a review of imposed conditions on approved proposals, the study reveals that although the GCF is formally grounded in principles of consensus and inclusivity, board deliberations in practice reflect patterns of distributive bargaining. Developed country board members routinely leverage their financial and institutional influence to define key concepts, such as “efficiency,” “climate rationale,” and “paradigm shift” and to impose conditionalities that disadvantage low-income countries. These dynamics particularly hinder equitable access to adaptation finance, where requirements like co-financing and private sector alignment place disproportionate burdens on vulnerable nations. Civil society observers and developing country members, while procedurally present, are often sidelined in substantive decision-making. Ultimately, the GCF serves not as a neutral technical platform but as a contested site of geopolitical power…”

The Conversation – Can climate shocks change how people feel about paying taxes?

E Nicholatti et al ; https://theconversation.com/can-climate-shocks-change-how-people-feel-about-paying-taxes-284097

“… Our research has focused on taxation, inequality, public finance and climate-related shocks in sub-Saharan Africa. In a recent study we examined an underexplored consequence of climate-related disasters in Africa: their effect on tax morale, in other words people’s willingness to pay taxes voluntarily.”

“… The findings reveal a complex picture. They show that disasters don’t all affect tax morale in the same way. Droughts and extreme temperatures are associated with lower tax morale. Floods, by contrast, go with slightly higher tax morale. Repeated exposure to multiple climate-related disasters is associated with an overall decline in tax morale. We also found that disasters are associated with rising economic inequality. When inequality increases, trust in public institutions declines and tax morale weakens. The results of our analysis support this argument by incorporating the climate-disaster dimension. Climate-related disasters exacerbate inequality. In turn this erodes trust in public institutions and ultimately reduces tax morale.”

“Although climate disasters tend to reduce tax morale, our analysis shows that the institutional environment may mitigate the impact. On this issue we focused on Kenya, Benin and South Africa. …”

Mpox

Plos GPH – Simulating a potential mpox outbreak: Implications for control in non-endemic settings

Philip Cherian, et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006630

« We construct a model for mpox outbreaks in low and middle-income countries where the disease is non-endemic, using India as an example. We simulate potential outbreak scenarios using BharatSim, a flexible agent-based simulation framework. The spread of mpox is modelled as being driven primarily through sexual contacts within a subnetwork of men who have sex with men (MSM), embedded within a larger network representing their household and workplace contacts…”

AMR

Lancet Regional Health Africa – Landscape analysis of antimicrobial resistance research in Tanzania

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00080-5/fulltext

By Amos Lucky Mhone et al.

NCDs

Guardian – Sitting for more than 30 minutes at a time linked to higher risk of cancer death

https://www.theguardian.com/science/2026/jul/02/sitting-minutes-cancer-death-risk-study

“Sitting for longer than half an hour at a time each day raises the risk of dying from cancer, a study suggests.”

“Researchers who tracked more than 90,000 people over a decade found that sitting or lying down while awake for more than 30 minutes in one period each day was associated with an increased risk of cancer death. The risk increases for every additional hour of continuous inactivity, the findings suggest. However, the researchers also found breaking up periods of sedentary behaviour longer than 30 minutes with bursts of physical activity could help reduce the risk. Getting up every half-hour, even for a short walk around the office, could do wonders for your health, they said.”

Cfr a study in Plos Med.

Devex – What is ‘lean diabetes’ — and why does it matter?

https://www.devex.com/news/what-is-lean-diabetes-and-why-does-it-matter-112793

“Across much of the African continent, many people with Type 2 diabetes aren’t overweight — and some are even underweight. This has implications for how the disease is screened for, prevented, and treated.”

“The diabetes epidemic in Africa doesn’t look like the textbook case of the disease, and this has implications for how the disease is screened for, prevented, and treated, he said. Researchers have dubbed the disease “lean” diabetes….”

Lancet Regional Health Africa – Achieving World Health Organization Global Breast Cancer Initiative targets: a situational analysis and action plan in Nigeria

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00081-7/fulltext

By Anya Romanoff et al.

Social & commercial determinants of health

Journal of Global Health –The role of alcohol control policy on the level of alcohol consumption in member states of the Association of Southeast Asian Nations 2000–2022: identifying trends and country clusters for further analyses

https://jogh.org/2026/jogh-16-04150

By J Rehm et al.

Plos GPH – Implementing the World Health Organization – Framework Convention on Tobacco Control Article 5.3: A qualitative study in 17 Indian states

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006522

By Upendra Bhojani et al.

Qualitative Health research – Institutional Determinants of Health: Adolescent Health Crises as Sites of Social Intervention and Practical Reform

https://journals.sagepub.com/doi/10.1177/10497323261461519

By Matthew Wolf-Meyer et al.

Globalization & Health – Addressing the commercial determinants of unhealthy beverage exposure: a systems thinking approach

M R Winkler et al ; https://link.springer.com/article/10.1186/s12992-026-01228-6

“The beverage industry plays an influential role in the US. Certain beverages, such as sugar-sweetened, have long been recognized as key contributors to poor population health with inequitable impacts. In response, multiple US initiatives have attempted to address these problems through public awareness campaigns and policies, such as taxes. Yet, the persistent and increasing reliance on unhealthy commercial products produced by the beverage industry suggests additional progress is needed. Leveraging a systems thinking approach, this study aimed to map out the complex forces limiting progress and driving inequitable impacts of unhealthy commercial beverages in the US to inform innovative thinking about future actions….”

Sexual & Reproductive health rights

BMJ GH – Changes in the use of basic obstetric care in sub-Saharan Africa: evidence from demographic and health surveys using an Oaxaca-Blinder approach

https://gh.bmj.com/content/11/6/e021049

“…This paper examines the progress made in basic obstetric care in four sub-Saharan African countries (Burkina Faso, Côte d’Ivoire, Ghana and Senegal), and investigates the sources of this progress to better inform future policy actions that will help achieve the Sustainable Development Goal 3 targets related to maternal and child health….”

Neonatal and child health

Guardian – Screen time can damage under-twos’ development, landmark study suggests

https://www.theguardian.com/society/2026/jun/27/screen-time-damage-under-twos-development-study

“Exclusive: Researchers call for urgent investigation of risks to babies of tablets, smartphones and other digital devices.”

“Screen time for babies and toddlers under the age of two has been linked with long-term negative effects on health and quality of life and should be avoided, according to a landmark study. It warns that using screens during that period may lead to wide-ranging developmental concerns and calls for further urgent investigation of the risks smartphones, tablets and other digital devices pose to infants….”

Lancet GH (Comment) – Severe anaemia in African children: look beyond under-fives

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00157-9/fulltext

· Comment linked to a new Lancet GH study – Severe anaemia and invasive bacterial infections in Kenyan children: a 26-year hospital surveillance observational study

“Severe anaemia in hospitalised Kenyan children is multifactorial, increasingly affects older children, and is strongly associated with pathogen-specific bacteraemia and increased mortality. …”

Access to medicines & health technology

Health Economics – The Effects of Compulsory Licensing: A Case Study of HIV Drugs

Nicolau Martin-Bassols et al; https://onlinelibrary.wiley.com/doi/10.1002/hec.70123

« This study examines the association between compulsory licensing and the commercial accessibility and affordability of HIV medications across 11 countries from 2002 to 2022….”

Cfr South Centre: “New study confirms that compulsory licenses have contributed to improved availability of HIV drugs through commercial channels, with meaningful effects on prices…”

BMJ Analysis – Health costs of the UK-US trade deal on pharmaceuticals

https://www.bmj.com/content/394/bmj-2026-340588

“Samuel Cross, Karl Claxton, and Andrew Hill argue that diversion of billions of NHS funding to pay more for new drugs under the UK-US trade deal will harm public health and result in thousands of excess deaths. “

· Coverage via the Guardian – US-UK drug deal could result in 229,000 excess deaths in England, analysis suggests

Human resources for health

Discover Health systems – The global health implications of proportionate co-investment in health workforce migration

I Ayesiga et al; https://link.springer.com/article/10.1007/s44250-026-00399-8

Review.

Papers & reports

WHO Bulletin – July issue

https://pmc.ncbi.nlm.nih.gov/search/?term=((%22Bulletin+of+the+World+Health+Organization%22%5BJournal%5D)+AND+104%5BVolume%5D)+AND+7%5BIssue%5D

In the editorial section, Herry Susanto et al. outline preparedness requirements for the current Bundibugyo virus disease outbreak. Check out the rest of the issue.

International Journal for Equity in Health – On the impact of inequity on the attainment of health results in the African Region: a methodological exploration

H Karamagi et al ; https://link.springer.com/article/10.1186/s12939-026-02935-7

Check out the results.

HHR – Women’s Rights and Gender Equality: A Global Index to Monitor Government Action

J Shantosh et al; https://www.hhrjournal.org/2026/06/09/womens-rights-and-gender-equality-a-global-index-to-monitor-government-action/

“Globally, gender inequality is deepening, with nearly 40% of countries experiencing regression between 2019 and 2022 and significant backlash against women’s rights in 2025. The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) provides a legally binding framework for accountability, yet the potential of the Committee on the Elimination of Discrimination Against Women—the body that monitors state compliance with CEDAW—is constrained by the absence of systematic monitoring tools. This paper introduces the CEDAW Index, an artificial intelligence-supported digital dashboard designed to strengthen accountability by consolidating state reports, civil society shadow reports, and committee concluding observations….”

SS&M – Epidemiologic approaches to policy research – examinations of single policies, policy clusters, and policy climates: conceptualization, measurement, and analysis

Dougie Zubizarreta et al; https://www.sciencedirect.com/science/article/abs/pii/S027795362600612X

“… To date, much of the literature has examined single policies; however, there is growing interest in examining alternative ways of conceptualizing policy exposures, namely as policy clusters or policy climates, to better capture how policies are enacted (and experienced) in “real-world” contexts. To advance this work, greater clarity is needed regarding how different approaches to policy conceptualization, measurement, and analysis align with distinct research questions and goals, ranging from identifying specific, manipulable policy levers to informing ways of extending the “policy space” beyond already existing laws to support broader social change. In this essay, we help fill this gap by outlining key issues related to policy exposures, including conceptualization, methods for measure development, and analytic approaches for understanding the relationship between policies and health….”

With focus on the US.

Speaking of Medicine -A new Gates Foundation Collection in PLOS on Wastewater & Environmental Surveillance in Low-Resource Settings

https://speakingofmedicine.plos.org/2026/06/12/a-new-gates-foundation-collection-in-plos-on-wastewater-environmental-surveillance-in-low-resource-settings/

Global Health Action – Why has the United States of America not ratified the United Nations Convention on the Rights of the Child? The veto fulcrum as a new health policy analysis framework

Lia Harris; https://www.tandfonline.com/doi/full/10.1080/16549716.2026.2686031#abstract

“The United Nations Convention on the Rights of the Child (CRC) enshrines health as a human right among other rights for children, fulfilled by each member state legally endorsing its principles through ratification of the Convention. Only the United States of America of all of the UN state parties has not ratified the CRC. This study aimed to determine the reason(s) the CRC has not been ratified by the USA….”

“This research has forged a new policy framework, the veto fulcrum, which examines political systems where political actors as veto players have extraordinary power to make executive decisions against public opinion, and against good health policy. … Revising Walt and Gilson’s health policy triangle and drawing on Tsebelis’ veto player theory a new policy analysis framework approach is introduced – the veto fulcrum – which highlights the intimate correlation between actors and processes and their relative importance over content and context factors in policy decisions….”

Health Research Policy & Systems – Mapping evidence for health policy and systems decision-making: a spectrum approach bridging tacit and scientific knowledge across local and global contexts

D Waithaka et al; https://link.springer.com/article/10.1186/s12961-026-01502-4

“The spectrum approach positions evidence along two axes: tacit to scientific (the extent to which evidence is independent of individual experience, documented and generated through systematic, transparent and reproducible processes) and global to local (in relation to the decision setting). Positioning evidence along axes rather than in binary categories allowed us to distinguish evidence that varies along these dimensions, visualize the forms of global and local evidence available and where gaps exist, and reflect more explicitly on the applicability of different evidence sources to specific decision contexts…”

Tweets (via X & Bluesky)

Genevieve Guenther

(part of a thread on Bluesky)

“The “air conditioning debate” is a climate culture war started by center-right and liberal commentators, which drives attention away from the existential need to phase out fossil fuels. Try not to get swept along (as I am right now lol) but stick to the message: govt action to end coal, oil, & gas.”