IHP - Recent newsletters, articles and topics

Weekly topics: IHP news 898: Highlights of the week (IHP News #898)

International Health Policies — Wed, 23 Sep 2026 04:58:07 +0000

Structure of Highlights

· Read of the (1^st part of the) week

· UNGA 81: General news, reports, …

· Run-up to the UN HL meeting on PPPR

· PABS negotiations: wrap-up of the latest round

· More on PPPR

· Ebola emergency DRC

· Run-up to the World Health Summit in Berlin

· WHO DG race

· Global Health Reform

· Post-2030 brainstorm & the Future of Development Cooperation

· More on Global Health Governance & Financing/Funding

· Global Tax Justice

· Trump 2.0, US Global health strategy & bilateral health agreements

· PHC

· SRHR

· Child Health

· Human Resources for Health

· NCDs & Urban Health

· Mental health

· Planetary Health

· Conflict/War & health

· Access to medicines, vaccines & other health technologies

· AI & health

· Lancet Collection – New roadmap integrates arts into global health and wellbeing

· Miscellaneous

Read of the (1^st part of the ) week

In a busy week like this one, there are actually many reads of the week – and we should certainly include the hard-hitting & witty Ebola analyses by Mukesh Kapila on HPW (part 1 & 2) (see further in this newsletter).

Nevertheless, to begin this newsletter issue, we chose this one:

Habib Benzian – The End of the UHC Financing Consensus

Substack;

“What comes after growth, aid, and optimism?”

“It is not a policy or a target. It is a belief about time: that the future will be richer than the present, and that a richer future will pay for the promises we make today. Expand Universal Health Coverage (UHC) now; growth will fund it later. Commit to ambitious targets now; tomorrow’s fiscal space will close the gap. Protect the poor now; a larger economy will make it affordable. For most of the past quarter century, that belief was reasonable. It is now breaking. Global health has begun to recognise the financing shock, but much of the way it plans, budgets, and talks about universal health coverage still assumes that constraint is temporary and expansion will resume.”

“Call it the temporal bargain: the quiet agreement that better outcomes tomorrow justify difficult decisions deferred today. It is one of the key ideas in global health financing, precisely because it is rarely made explicit. You cannot debate an assumption you cannot see. For most of the past quarter century, global health operated on a remarkably simple version of that bargain. Economic growth would create fiscal space. Fiscal space would allow governments to spend more on health. Development assistance would bridge the gap in the meantime. As countries became wealthier, universal health coverage would gradually expand, bringing essential services to larger shares of the population and reducing dependence on out-of-pocket spending….”

“You can see the moment that direction of travel began to fail in data buried on page 24 of a new World Bank report, Investing in Health: Pathways for a Fiscal Pivot…. “ Read why.

Benzian concludes: “… That does not mean universal health coverage is unattainable. It means the path toward it may look very different from the one most plans assume: one that depends less on faith in future growth and more on the political choices made under present constraint. Less promise of eventual expansion, more discipline about protecting essential functions under pressure. Less waiting for favourable conditions to return, more willingness to confront the world as it actually is. Because what is shifting is not simply health financing policy. It is the set of assumptions on which an entire era of global health was built. The debate is no longer simply about how to fund universal health coverage. Increasingly, it is about whether the political and economic conditions that made the UHC project imaginable in the first place can still be taken for granted. We learned to plan for a better future paid for by more. Now we must plan for one paid for by less.”

UNGA81 – General news, reports, …

More or less chronologically, since the end of last week – till Wednesday morning.

· UN – General Assembly High-Level week Overview of key events.

Guardian – Global leaders urged to join initiative to fight extreme inequality

https://www.theguardian.com/inequality/2026/sep/18/global-leaders-urged-to-join-initiative-to-fight-extreme-inequality

(18 Sept) “More than 1,500 academics and economists from 100-plus countries are urging global leaders to join an initiative against extreme inequality, calling current unfairness “a policy choice that can be reversed”. Before the UN general assembly in New York next week, the experts have signed an open letter backing the International Panel on Inequality (IPI)….”

Devex Pro– UNGA is here — and here’s what’s at stake

https://www.devex.com/news/unga-is-here-and-here-s-what-s-at-stake-113348

(gated) « During a Devex Pro Briefing, experts previewed the 81st U.N. General Assembly — from the race for a new leader to the race for financial survival.”

Excerpt:

“… history will be made one way or another with the selection of a new secretary-general on the horizon when António Guterres passes the baton in December.
Richard Gowan described the changing of the guard as “a glimmer of hope.”
“Nobody thinks that just changing secretary-general is going to solve all the problems of the organization,” he said. “Guterres has done his best to keep the organization afloat. He has managed to sort of stop it from going bankrupt, despite some very severe financial headwinds. But there is a sense that you need someone new, and that at least a new U.N. leader can sort of bring some clarity to where the organization can go from here.”…”

United Nations Foundation – A Mandate for Renewal Global Public: Opinion on the United Nations and the Selection of the 10^th Secretary-General

https://s3.amazonaws.com/media.unfoundation.org/2026/09/A-Mandate-for-Renewal_Full-Report-2.pdf

Key findings on p. 4-5.

UN News – Less than 4 years from development goals deadline, progress shows what’s possible

https://news.un.org/en/story/2026/09/1168371

(18 Sept) With coverage of the SDG annual moment.

Starting from Benin’s example. “For Benin, making progress on the UN’s Sustainable Development Goals (SDGs) has meant finding new ways to finance development. The West African country has increased domestic revenue by 0.5 per cent of GDP each year for the past decade, issued Africa’s first SDG bond in 2021 and used the resulting funding to expand access to education and drinking water, Aristide Medenou, Benin’s minister of economic cooperation, said on Friday…. …Even as the world remains far from achieving the SDGs, Mr. Medenou said Benin offers a concrete example of governments translating commitments into beneficial policies.”

“… the UN’s most recent progress report indicated that progress on the goals is slow and uneven – of the 139 targets with available trend data, 36 per cent are on track or making moderate progress….”

“Progress was never automatic,” UN Secretary-General António Guterres said on Friday. “It was earned through the determination of people, communities and countries.”…”

“At UN Headquarters in New York, UN officials and world leaders highlighted both the gains made over the past decade – and the scale of the remaining challenge….”

PS: “… The world faces a $4 trillion annual SDG financing gap, while official development assistance fell by a record 23 per cent in 2025. In many countries, debt payments outstrip spending on social services….”

‘Powerful headwinds’ to SDG progress: ;.. Mr. Guterres said the lives that have been improved by SDG implementation demonstrate that multilateral cooperation can produce tangible improvements when governments act. … He explained that the pursuit of the goals has helped reduce child and maternal mortality, prevent millions of new HIV infections, and expand access to education, social protection, renewable energy and other services. But progress faces “powerful headwinds” such as conflicts, weakened international cooperation, the climate crisis, attacks on the rights of women and girls, and debt and investment constraints, Mr. Guterres said….”

· Related: NPR – Will even one of the U.N.’s 17 ‘sustainable development goals’ be met by 2030? (wide-ranging analysis)

Quote: ““In my view, the goals worked where money, technology and political will lined up,” says Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health. Since 2015, he notes, roughly a billion people have gained access to safe drinking water, and 1.2 billion have decent sanitation. Electricity now reaches 92% of the world and 74% are connected to the internet. New HIV infections have fallen by 30%, and AIDS-related deaths by 35%. The proportion of births attended by a trained health professional is on track to reach 90%. “For the first time, more than half of humanity has some form of social protection [such as a pension, cash assistance, maternity or disability benefits, unemployment support or health coverage],” he says….”

UN News – The right to development: Why equity, not charity, is a human right

https://news.un.org/en/story/2026/09/1168367

Analysis ahead of the High-level Meeting to Commemorate the 40^th Anniversary of the Declaration on the Right to Development (23 September).

“Since 1986, the UN has recognised development not merely as economic growth, but as a human right that belongs to us all. It encompasses economic, social, cultural and political rights aimed at reducing inequality and creating a fairer world. … … It’s 40 years since the UN agreed on the 1986 Declaration on the Right to Development. Member States will meet on 23 September at the UN in New York to renew the global commitment to ensuring that every person has a fair chance to live with dignity, opportunity and hope. …”

“The meeting will bring together world leaders to reflect on progress made over the past four decades and to discuss how countries can work together to reduce poverty, expand opportunities and address inequalities that continue to prevent millions of people from fully benefiting from economic and social development….”

Devex – UN’s sprawling development system faces ‘existential threat’

https://www.devex.com/news/exclusive-un-s-sprawling-development-system-faces-existential-threat-113218

“U.N. bigwig says Trump austerity “rampage” part of wider global reversal on development aid.”

“For Amina Mohammed, the United Nations deputy secretary-general, it’s crunch time for the U.N.’s development mission. “We are facing an existential threat,” she said at a town hall meeting of the U.N. Development Programme, or UNDP, in September 2025, citing the decline in funding for U.N. development work. If the U.N.’s chief development agency can’t do a better job of demonstrating its relevance in an era of dwindling resources, she warned, “we will end up being a museum,” and people will “point to the building where we used to exist,” according to a video of the session shared with Devex…. … … The town hall meeting, along with other closed-door sessions reviewed by Devex, provides an unvarnished account of the U.N. leadership’s thinking on the challenges of promoting the world body’s development agenda. It also set the stage for a last-ditch effort by the outgoing Mohammad and her boss, U.N. Secretary-General António Guterres, to salvage development reforms that have struggled to gain traction for years. They’re now hoping to secure some $190 million in the 2027 budget later this year to underwrite the bureaucracy that coordinates the U.N.’s development activities in the field….”

“… But the wider reform effort has already faced skepticism from key donor states — which are looking to cut budgets and not take on new financial obligations — and the U.N. humanitarian agencies that fear the reforms threaten to usurp their role in delivering assistance around the world. “The system currently in place is working and introducing additional constraints will reduce, not enhance our collective impact on the ground,” five of the largest U.N. humanitarian agencies, including UNDP, UNICEF, and the World Food Programme, wrote this spring in an internal paper on the reform of U.N. development field operations. “Current reforms should not be about centralization but about clarity, balance and responsibility,” they also wrote, according to a copy of the paper obtained by Devex….”

“Some countries are seeking to slow the reform process down, running out the clock by the time Guterres and Mohammed step down at the end of December. Earlier this month, the Group of 77, a coalition of more than 130 countries, plus China, said the “necessary conditions are not yet in place” to approve Guterres’ proposal to merge key development agencies, including UNDP and UNOPS, as well as the U.N. Population Fund, or UNFPA, with UN Women….”

“…The U.N. debate over the future of the U.N.’s development mission comes against a background of financial scarcity and growing pressure from donors to cut costs and streamline operations. U.N. revenues are projected to decline by 21% by 2027, according to a U.N. estimate…”

“… Secretary-General Guterres has undertaken a broader series of reform initiatives, dubbed UN80, that include a cost-cutting proposal to merge some of the U.N.’s principal development agencies, in addition to the plan to restructure development field operations. Those initiatives, however, encountered headwinds, as member states, U.N. agency chiefs, and U.N. workers push back, voicing concern that the changes are either too expensive or that they will make the U.N. less capable of delivering on its anti-poverty goals. The fight is about competing visions of the U.N.’s future role, but it’s also about money, turf, and jobs…”

“… To manage its activities in countries, the U.N. relies on some 130 resident coordinators, or RCs, who fashion development strategies with local governments and coordinate the delivery of services with other U.N. agencies to achieve the Sustainable Development Goals. These RCs are viewed as the frontline lieutenants in the global war on poverty. But they don’t control how money is spent in the field. Mohammed’s reform would empower them with a far greater say in what projects are funded. It would also expand her own office’s role in overseeing the U.N.’s global development operations….”

“… In August 2026, Mohammed presided over a virtual town hall gathering of many of the more than 1,600 workers who make up the resident coordinator system. Her remarks were aimed at convincing a skeptical audience that the new set of reforms, dubbed a recalibration, would move the SDGs in the right direction. … … The recalibration — which has been presented as a means of strengthening the resident coordinators — involves bolstering the role of regional offices and headquarters, and would require changes across the development system. U.N. overseas missions — which often house representatives from more than 20 U.N. agencies — would be slimmed down. Some positions in the field would be reclassified, downgraded, or abolished….”

“Any loss of on-the-ground expertise would be offset by creating a system of “on-demand” experts across the U.N. system that could be dispatched to a country to advise the resident coordinator on complex technical issues. The bureaucracy overseen by Mohammed would play a lead role in coordinating the system….”

PS: “the U.N. humanitarian agencies, which have strong, long-established direct relations with donor states, are reluctant to cede independence to U.N. headquarters and the resident coordinators. “The system currently in place is working and introducing additional constraints will reduce, not enhance our collective impact on the ground,” the five U.N. humanitarian agencies wrote in an assessment of the reform proposal for the resident coordinator system. The agencies also raised concerns that the new reform, which they contend is “not cost neutral,” would potentially place an additional financial burden on agencies already facing “dramatic reduction in agency budgets — some by as much as 25%.”…”

FT – Multilateralism is not idealism, it is a necessity

Luiz Inácio Lula da Silva, António Costa, William Ruto and Mark Carney; https://www.ft.com/content/d9e6c07e-7d84-4e41-a9a2-0d0ac2319dd2

“We need to strengthen our system of co-operation, not replace it.”

“…. No country, however powerful, can manage [these] challenges alone. Cooperation is therefore not an act of idealism, it is a practical necessity. The question is not whether multilateralism can survive, but how it must evolve to meet the realities of our time. In this context, we are coming together with a new initiative: ‘Partners for Multilateralism’. P4M is not about creating another exclusive bloc or another international bureaucracy. Its purpose is the opposite: to create a flexible, open framework for countries from different regions and political traditions that are willing to work across divides, to build coalitions for reform and to translate shared principles into practical action. P4M will support the reform of the UN and other multilateral institutions, to make them more representative, legitimate, effective and trusted. It aims to strengthen co-operation between regional organisations, contribute to peace and security, improve global economic governance and develop common approaches to emerging challenges, from AI and climate change to health security and digital transformation. P4M will seek to renew and strengthen the multilateral system, not replace it; build bridges and bring together countries that may disagree on many issues but share a commitment to the basic principles enshrined in the UN Charter. Principles that are not negotiable, like sovereign equality, territorial integrity, the peaceful settlement of disputes, the prohibition of the threat or use of force, international humanitarian law, sustainable development, human rights and fundamental freedoms….”

Run-up to the UN High-Level meeting on PPPR (25 September)

The main global health event of the UNGA week, scheduled for Friday. Some reads ahead of the meeting, with the NUS/Lancet PRIME Commission the main one. In the backdrop, the pandemic agreement (& PABS negotiations -see next subsection) also play a key role, obviously.

GAVI – Global health reform and last-mile integration: the missing link in pandemic preparedness

https://www.gavi.org/vaccineswork/global-health-reform-and-last-mile-integration-missing-link-pandemic-preparedness

(18 Sept) “As the UN General Assembly’s High-Level Week kicks off, global health reform is back on the agenda, but the real test will not be in New York conference rooms. It will be in whether reform reaches the last mile.”

Lancet – The NUS–Lancet PRIME Commission: transforming pandemic readiness for equity

Sara Calderón-Larrañaga et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01146-3/fulltext

« The National University of Singapore (NUS)–Lancet Pandemic Readiness through Institutions, Mobilising Communities, and Equity (PRIME) Commission redefines pandemic readiness and offers a practical blueprint for whole-of-society pandemic planning and implementation. Drawing on the hard lessons of the COVID-19 pandemic, the Commission brings together evidence from 20 countries, including interviews with members of diverse communities and groups, future scenarios, and epidemiological modelling. By integrating lived experience with systems analysis and forward-looking evidence, the Commission sets out how governments, institutions, and communities can move from formal plans to people-centred protection across all stages of a health crisis.

PRIME turns the often-invoked whole-of-society idea into a structured framework for action across sectors and levels of governance. Applying PRIME’s recommendations has the potential not only to save lives, but also to strengthen institutions and community trust for future health emergencies and other 21st-century crises.”

With 10 recommendations, 6 foundational blocks.

PS: “… The central gap addressed by this Commission is the divide between formal readiness and real protection…. … We explicitly distinguish between pandemic readiness and pandemic preparedness. Pandemic readiness should be understood as the comprehensive, whole-of-society capacity to prevent, prepare for, respond to, recover from, and redress the impacts of pandemics across the full cycle. Pandemic preparedness refers to the aspect of pandemic readiness that is concerned with the preparation and maintenance of plans, skills, infrastructure, and other core resources for responding to a pandemic….”

· Related Lancet Editorial – Getting ready for the next pandemic

“On Sept 21, a new Lancet Commission report is published, The National University of Singapore (NUS)–Lancet Pandemic Readiness through Institutions, Mobilising Communities, and Equity (PRIME) Commission. Launched alongside the 81st UN General Assembly and in advance of the UN High-level Meeting on Pandemic Prevention, Preparedness and Response, the report aims to redefine how health can be protected before, during, and after a pandemic.”

“The central tenet of the PRIME Commission is people-centred protection, based around asking what people and communities need and acting accordingly, giving people the capabilities to protect themselves, access care, sustain wellbeing and livelihoods, participate in decisions, and recover after a crisis. There are several key messages. …”

The editorial then makes the link with the UN HL meeting on PPPR: “…This year’s UN General Assembly will review whether progress has been made towards the 2023 UN Political Declaration on Pandemics, in which countries pledge to “implement coherent and robust national, regional and global actions, driven by science and the need to prioritize equity and the respect for human rights to strengthen pandemic prevention, preparedness and response, and fully address the direct and indirect consequences of future pandemics”. The High-level Meeting promises to introduce yet another new political declaration, in which (according to a draft obtained by Health Policy Watch) countries “restate our commitment to scale up, promote and strengthen pandemic prevention, preparedness and response and to translate political commitment into concrete, measurable and urgent action”. The text is full of language on multisectorial approaches, cooperation, communities, and mobilising resources, but is weak on concrete commitments. How can “equity” and “human rights” be advanced without specifics on how these principles could be meaningfully achieved and assessed effectively, particularly amid the continued erosion of Official Development Assistance for Health and the weakening of WHO? The NUS–Lancet PRIME Commission will not stop with the publication of this report. It will pilot and evaluate its approach in select countries. The Commission’s future also offers an opportunity to begin forming a better accountability process to help move beyond the impasse of failed treaties and toothless declarations….”

· Coverage via HPW – As Global Pandemic Approach Flounders, Experts Offer Blueprint to Protect All Citizens

“Move would mean deaths would rise in wealthier nations, according to NUS-Lancet Prime commission – which modelled a response to a flu pandemic based on population size, not purchasing power…”

“Researchers modelling a hypothetical global outbreak of flu found that fast-tracking vaccine development could cut deaths from 58.5m to 23.9m. If the vaccines were then distributed equitably, according to population size rather than purchasing power, a further 2.7m lives could be saved overall. However, in high-income countries, that solidarity-based approach would see deaths rise from 2.4m to 3.9m….”

· And a Nature Africa Comment : Africa must put people at the heart of pandemic preparedness (by F Mutapi & M Woolhouse)

“The NUS–Lancet PRIME Commission identifies five reforms to help African countries protect lives and livelihoods during future health crises.”

HPW – Pandemic Agreement Negotiator Warns Against Losing Momentum

https://healthpolicy-watch.news/pandemic-agreement-negotiator-warns-against-losing-momentum/

“As countries continue negotiating the unfinished WHO Pandemic Agreement, one of the original accord’s architects warns that delays could put the process itself at risk. “I think it’s quite risky to have a too-long negotiation because that means that we will lose diplomats and public health experts who were involved at the very beginning,” said Anne-Claire Amprou, French Ambassador for Global Health and former co-chair of the intergovernmental negotiations that delivered the agreement.

“Speaking on a recent episode of Global Health Matters, Amprou joined Lia Tadesse Gebremedhin, former Ethiopian Minister of Health, to take listeners behind the scenes of the three-year negotiations that culminated in the agreement’s adoption in May 2025….”

(with some more messages by both).

DNDi (Policy report) – Implementing article 9.5 of the WHO pandemic agreement

https://dndi.org/wp-content/uploads/2026/09/DNDi-Article-9.5-Policy-Report-2026.pdf

“… the Pandemic Agreement includes several provisions aimed at strengthening the R&D ecosystem. In particular, Article 9.5 requires Member States to develop and implement national and/or regional policies related to the inclusion of access provisions in public R&D funding arrangements for pandemic-related health products. Article 9.5 presents Member States with a landmark opportunity to leverage the power of public funding to drive innovation and access. As one of the few binding ‘shall‘ commitments in the Pandemic Agreement, the obligations under Article 9.5 carry both legal weight and ethical urgency. This publication outlines examples of both well-established and newly emerging policies and practices from which Member States can learn and build as they seek to fulfil these obligations. However, existing approaches do not yet represent an optimal or comprehensive framework of access and innovation conditions for publicly funded R&D, nor is there a one-size-fits-all approach to establishing such frameworks. In practice, policies and practices to secure the successful development of, and equitable access to, the results of publicly funded R&D will need to address multiple considerations across the access and innovation continuum, as appropriate to different national and regional contexts. What this publication’s examples make clear, though, is that Member States do not need to start from scratch: a growing body of practical experience already exists to draw from, adapt, and build upon as national and regional frameworks take shape…”

TGH – Five Ways to Deliver on the Pandemic Agreement’s Promises

S Galloway & S Psaki; https://www.thinkglobalhealth.org/article/five-ways-to-deliver-on-the-pandemic-agreements-promises

“Building the right legal, operational, and financial systems to prevent the next pandemic will require going beyond negotiations in New York or Geneva.

“We propose five actions that countries, regions, and multilateral institutions can take to ensure more timely access to medical countermeasures during an emergency, regardless of what happens in New York or Geneva….”

PABS negotiations: wrap-up of the latest round

WHO (press release) – Member States advance negotiations on pathogen access and benefit-sharing ahead of UN General Assembly meeting on pandemics

https://www.who.int/news/item/18-09-2026-member-states-advance-negotiations-on-pathogen-access-and-benefit-sharing-ahead-of-un-general-assembly-meeting-on-pandemics

Press release after the latest round (which ended on 18 September).

“WHO Member States concluded the eighth meeting of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement today, advancing negotiations on a proposed pathogen access and benefit-sharing (PABS) system that would underpin a faster and more equitable response to future pandemics. The five-day meeting brought together governments and stakeholders in Geneva, where negotiations continued on the PABS annex, focusing on an equitable, feasible and implementable system….”

PS: via Geneva Health Files, a quote from Tedros at the conclusion of this round: “… progress is a bit slow this week, but there is still a forward movement. There is progress, even if it’s if it’s small….”

Geneva Health Files – Sovereign Control Over Pathogen Information: The Design Crux of The Pathogen Access Benefit Sharing System at The WHO [IGWG8 Update]

P Patnaik; Geneva Health Files;

(19 Sept) Must-read analysis of the latest round in Geneva.

PS: “In this edition, we bring you an update on this week’s deliberations at the WHO in Geneva. … The press has been kept out of these discussions entirely. Why would you not want to educate journalists, and promote public understanding and engagement on these issues, is puzzling.”

“Reaching an agreement on the Pathogen Access Benefit Sharing System (PABS), continues to be daunting for WHO member states for a host of reasons, some procedural, some political, but most of all: a current lack of a common vision on the design of the mechanism. The 8th meeting of the Intergovernmental Working Group set up to negotiate the PABS mechanism (an annex to the Pandemic Agreement), unfolded with insufficient progress and persistent divergences in positions, diplomats said….”

With in-depth analysis of the Process; The Politics; Options on the table; Timeline…

Re the latter: “Given the slow rate of progress in these talks, countries privately admit that the possibility of a special session of the World Health Assembly in December is an unrealistic ambition. Some are even beginning to cast a doubt on the May 2027 deadline when the IGWG is scheduled to provide an update on this process….” “Diplomats worry that prolonging the negotiations will make the process more vulnerable to political pressures, and could result in an eventual compromise by countries towards a weak mechanism….

PS: and a tailpiece on AI: “The negotiations took place in a week when American companies warned of risks from Artificial Intelligence calling for safeguards, and the American President Donald Trump dismissing such concerns. … Though countries are busy defining the features of a new PABS system, some diplomats feel that this annex must have provisional language to govern the use of AI and pathogen information…”

BMJ – US plans to stop HIV support for Namibia as African country rejects “colonial” data sharing demands

(11 Sept) ; BMJ;

Flagging here in particular some quotes by F Rahman (who’s making the link with PABS negotiations):

“Namibia’s government officials have rejected a US proposal for access to health data and pathogen information, as the US said that it would phase out financial support for the southern African country. At a negotiation for renewed US support for Namibia’s HIV programme, Namibian officials rejected the demands under a new US bilateral health agreement, citing incompatibility with national laws, sovereignty, and privacy concerns, the Namibian newspaper reported. Shortly after the data sharing impasse, the US announced on 4 September in a joint statement between the two nations that it would no longer fund Namibia’s HIV programme after 2027. Namibia’s decision is consistent with its approach in the pandemic agreement negotiations. “It is admirable,” said the global health lawyer Fifa Rahman. “These deals are deeply colonial and reflect an entitlement to the global south’s genetic resources.” … The latest decision by Namibia could have implications beyond its HIV programme, said Rahman. Namibian officials have played a prominent role in representing African interests in negotiations over the World Health Organization’s pathogen access and benefit sharing system (PABS), which seeks to establish rules for sharing pathogen information and ensuring that countries providing biological materials benefit from the resulting vaccines and other products. But the US bilateral agreements could potentially undermine those negotiations. “Geopolitics has shifted; this approach is stale,” Rahman told The BMJ.”

Ebola Emergency DRC

MSF – Assuming the Ebola disease outbreak in DRC is under control would be a mistake

https://www.msf.org/assuming-ebola-disease-outbreak-drc-under-control-would-be-mistake

(18 Sept) “The Ebola disease outbreak in Democratic Republic of Congo has not been contained, and the number of new cases has not fallen on a national level. While the spread is slowing down in Ituri province, the outbreak is moving into new, underprepared areas. Strengthening the Ebola response is urgently needed, particularly beyond the areas where response capacities are concentrating.”

UN News – Ebola vaccine trial begins in DR Congo

https://news.un.org/en/story/2026/09/1168381

(21 September) “An Ebola vaccine trial is underway in the Democratic Republic of the Congo (DRC), involving frontline health workers and others involved in the response. The UN World Health Organization (WHO) said on Monday that 20,000 doses of the Ervebo vaccine have been allocated for the research vaccination programme in Ituri province.”

“The aim of the trial is to improve understanding of how effective the vaccine is against Ebola Bundibugyo virus – and to protect individuals most exposed to it. … A total of 70,000 doses have been made available to the Congolese authorities to support the outbreak response and related research….”

HPW – When Ebola strikes, HIV care cannot stop

Jean Kaseya, Winnie Byanyima et al; https://healthpolicy-watch.news/when-ebola-strikes-hiv-care-cannot-stop/

“As the Democratic Republic of the Congo (DRC) confronts its 17th and fastest-growing Ebola outbreak, a troubling warning is emerging from community networks in Ituri province. These networks, which support people living with HIV, are reporting an unexpected number of deaths among people living with HIV. The Africa Centre for Disease Control and Prevention (CDC) and UNAIDS are working with national authorities to verify these reports. But the message is already clear: while Ebola is claiming headlines, another health crisis could be unfolding in its shadow….”

“This is a lesson Africa has learned before. Epidemics do not only kill through infection. They also kill when health systems become overwhelmed, clinics empty, medicine supplies are disrupted, and people are too frightened or unable to seek care. … … The country’s revised multisectoral Ebola response plan provides a platform for action and a direct call for partner support. We know what works. Multi-month dispensing of HIV medicines, community-led service delivery and strong referral systems prove effective in maintaining care during crises. The real challenge is implementing these approaches at scale and funding them adequately…. … If we focus solely on Ebola, we risk losing lives to preventable interruptions in HIV treatment and other essential services. If we protect both, we can emerge from this crisis with stronger, more resilient health systems and healthier communities.”

Concluding: “The DRC has the expertise, the leadership and the community networks needed to achieve both objectives. What is required now is the political will and financial commitment to ensure that no one is left behind.”

HPW – DRC’s Ebola Outbreak: The Vast Mobilisation That Doesn’t Measure Itself (Part II)

Mukesh Kapila; https://healthpolicy-watch.news/drcs-ebola-outbreak-the-vast-mobilisation-that-doesnt-measure-itself-part-ii/

One of the reads of the week. Like part 1, a must-read.

“The world has ridden fast to rescue DRC from Ebola. But four months on, nobody can say for sure how many agencies are responding, how many people they employ, how much money has arrived, or what it bought. There are, however, coordinators galore. But the virus is still outwitting them.”

Some excerpts to provide you with a flavour:

“As I write, the response is arguing within itself. Over the space of a few days, the DRC’s health minister announced encouraging signs since cases peaked in the week of 3-9 August, the UN coordinator warned that the peak call was premature, Africa CDC scientists said that the situation is heterogeneous with peaks and declines in different zones, and the WHO chief landed in between with cautious optimism while noting that the outbreak continues to grow. All are reading the same daily situation reports, and all are right within their own remits. A government must show its strategy is working, a coordinator must keep agencies galvanised, a regional agency must be sensitive to constituency concerns, and a global agency must cheer-lead the world. But when the drivers cannot agree on the speed and direction of their train, there is a problem beyond epidemiology….”

“…Putting together patchy data, I estimate that 10,000 to 15,000 people are working on Ebola, ranging from epidemiologists to doctors, nurses to laboratory technicians, and pilots to grave diggers. Not forgetting administrators, accountants, logisticians, and security personnel. But how many are needed to cover all essential action fronts across a vast Ebola-affected zone approaching the size of France and Greece combined? There is no consolidated target, even as advocates plead for more resources. …My projections suggest an additional need for some 10,000 responders of different types i.e. a doubling of current capacity. Practically, this must be overwhelmingly sourced from among the Congolese – suitably trained and financed. We live in a world of dashboards. Would it not be helpful if some authority maintained one to show these numbers and how they tick upwards?”

“…Multiple plans, appeals, and a missing ledger: That brings us to financial confusion. A joint WHO – Africa CDC continental plan asks for $518 million for June to November. This covers 11 countries, not just DRC. On 4 September, the DRC government launched a revised six-month plan costing $1.3 billion. On the humanitarian side, OCHA’s revised plan for DRC calls for $2.1 billion, of which some $300 million is Ebola-related. The Red Cross Red Crescent appeals independently, and IFRC increased its ask to CHF 65 million in August. The largest independent responder – MSF – has a private funding approach. It requires forensic accounting skills to disentangle these plans to verify gaps and overlaps. How do these resourcing envelopes map to priority activities under, to quote Dr Tedros, “one plan, one budget, one team”? “

“…Meanwhile, how much funding has come in? Nobody provides an accurate tally. My own rough calculation suggests that about $1.5 billion out of the ask of $3 billion has been secured. … …the current Ebola financing system is worse than broken. It has gone backwards from the previous DRC outbreak by becoming less transparent even as appeal sizes have grown. Donor aid cuts cannot be blamed for this. This is a mess that some call a lucrative Ebola business, with the host country’s health minister reduced to asking in public where the money is and what is being done with it. Meanwhile, on the ground, problems are being caused by agencies paying different remuneration rates, while health workers have been striking because of not being paid fairly in a timely manner. “

“Two systems, two constitutions: The financing muddle is reflective of a structural problem. Eastern DRC is served by two international machines with separate legal foundations that pull in opposite directions. Global health co-operation rests on respecting national sovereignty under the International Health Regulations (IHR). States report outbreaks, and responses are state-led. That is why Dr Tedros says WHO works under the government’s leadership, and why Africa CDC frames its role as African solutions for African problems….” “The global humanitarian system rests on UN General Assembly resolution 46/182 of 1991 – a political settlement based on four principles, one of which is independence. Thus, humanitarians have the dispensation to negotiate with whoever controls the ground, including armed groups the state is fighting….”

“An epidemic of coordinators: Meanwhile, as the Bundibugyo ebolavirus doubled every two to three weeks, so did the coordinators….” “…August was less frantic on the coordination front, as it is the traditional northern hemisphere holiday season. The virus, of course, took no vacation….”

“In approximate summation, we have around 16 strategic coordination initiatives, each with their own coordinators. Plus coordinators of eight operational clusters and some 11 pillars. The plethora could not avoid being highly productive, with at least three plans and five appeals that now require further coordination to deconflict, update, and track.”

Kapila concludes: “… What is DRC’s 17th Ebola outbreak? On four months of evidence, it is all things. The virus is being confronted by a health system that treats it technically, a humanitarian system that treats it as a caseload, and a development discourse that promises to address underlying causes once both go home. Each answers honestly within its own frame. But none of them own the space between the frames, and that is where the virus proliferates.”

“Meanwhile, muddling through this crisis is not a disgrace. But there is a difference between muddling honestly and unaccountably. Honest muddling publishes its numbers, admits what it does not know or can’t do, and submits to outside scrutiny. What we have instead is a response that cannot say how many agencies are working, how many people they employ, how many more they need, and what it has received or spent. This is not a problem of field workers labouring under risky circumstances with several losing their lives. It is the responsibility of chiefs, communicators, and coordinators in Geneva, Addis, and Kinshasa to sort out.”

Devex Pro – WHO Africa chief: DRC Ebola outbreak could surpass West Africa crisis

https://www.devex.com/news/who-africa-chief-drc-ebola-outbreak-could-surpass-west-africa-crisis-113334

(gated) “Speaking at Devex Impact House on the sidelines of UNGA81, WHO’s Dr. Mohamed Yakub Janabi said the current Ebola outbreak in DRC could become more deadly than the massive outbreak in West Africa.”

Foreign Affairs – Ebola Is Only the Beginning

S Psaki; https://www.foreignaffairs.com/democratic-republic-congo/ebola-only-beginning

“Congo’s Warning for the Global Health System.”

Via LinkedIn:

“In a new Foreign Affairs Magazine piece, I argue that the rapidly spreading Ebola outbreak reveals serious weaknesses in today’s global health system, and I outline the steps needed to better protect ourselves against the biothreats of the future.

We need to: Build a functioning global biosurveillance system … Invest in the capacity of multilateral health institutions to better detect and contain cross-border threats (check out Africa CDC‘s Health Security and Sovereignty Agenda) Proactively develop tests, treatments and vaccines for priority viral families (see: CEPI (Coalition for Epidemic Preparedness Innovations) 3.0) Tackle the known threats – measles, malaria, malnutrition – that are killing people every year with the same commitment that we have to tackling more novel threats. … Prepare for health threats in conflict and emergency settings (International Rescue Committee has great guidance on what is needed)…”

Psaki also flags the increased risk of bioweapons.

Run-up to the World Health Summit in Berlin

Still a few weeks though, and so Deutsche Bahn still has some time to get its act together.

Lancet – 2026 World Health Summit Academic Alliance Declaration: health and peace in a world in turmoil

World Health Summit Academic Alliance; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01760-5/fulltext

“Health and peace are under severe strain amid multiple, interconnected global crises. Health has long served as a bridge between adversaries; in a fragmenting world, it too has become a casualty of division. Armed conflict, humanitarian crisis, forced displacement, climate emergencies, and eroding multilateral cooperation are converging, leading to increasing violations of international agreements, disruptions of health systems, the destruction of health infrastructure, and widening inequalities—with the heaviest toll falling on the most vulnerable populations in low-income and middle-income countries. This declaration reinforces the urgency that health should be understood as a fundamental right for all and an instrument for promoting peace, conflict resolution, unity, and betterment of the world. As the academic backbone of the World Health Summit (WHS), the WHS Academic Alliance—30 leading universities and research institutions across all six continents—sets out the following commitments for the contribution of academic institutions….”

Nature Health (Comment) – Why Europe must step up on global health

Axel Pries, I Kickbusch et al ; Nature Health

“With the USA withdrawing from multilateral cooperation on global health, Europe’s institutions can take on a leadership role based on equitable partnerships.”

“The article calls on European governments to continue to invest in global health.
“Europe should lead a fundamental rethinking of the multilateral system, grounded in equity, partnership and solidarity as well as stronger national and local engagement in preparedness.”
The authors point to Europe’s existing institutional architecture, from EU agencies, individual governments, academia, civil society, philanthropy and the private sector as already well placed to support this shift. What is needed now, they write, is the political will and stronger strategic alignment to put it to use. The article is a direct follow up to a high-level roundtable on Europe’s Role in Reshaping the Global Health Architecture, co-hosted by the Konrad-Adenauer-Stiftung and the World Health Summit last December. It brought together European and international stakeholders to discuss the future of global health cooperation in Europe….”

“We suggest that future cooperation focuses on the

priority areas listed in Table 1 (priority areas and strategic levers for a European global health approach), building on the EU Global Health Strategy while, in some cases, extending beyond its current scope….”

“…The EU Global Health Strategy offers the potential to develop a multi-

dimensional action plan for its members and beyond. It could serve as

the framework to guide European engagement in global health, carried

out by European agencies such as the WHO Regional Office for Europe,

the Health Emergency Preparedness and Response Authority (HERA),

the European Centre for Disease Prevention and Control (ECDC), the

European Medicines Agency (EMA), individual governments, academia,

civil society, philanthropy and the private sector (Box 2). The institu-

tional architecture is already in place; what is needed now is the political will and strategic alignment to use it….”

WHO DG race

With a deadline on 24 September – nominations close then.

Geneva Solutions – Who wants to lead the WHO? Four candidates jostle for top job as deadline nears

https://genevasolutions.news/global-health/who-wants-to-lead-the-who-four-candidates-jostle-for-top-job-as-deadline-nears

With the view of Kieran Bligh, a researcher on the WHO leadership process at George Washington University.

CGTN – Hans Kluge, Belgium’s nominee for WHO director-general, calls for stronger China-Europe health cooperation

https://news.cgtn.com/news/2026-09-20/Belgium-s-WHO-DG-nominee-Kluge-urges-stronger-China-Europe-health-ties-1QzkRqfCSmk/p.html

“Stronger cooperation between China and Europe is important for the future of global health governance, particularly in areas such as artificial intelligence, primary health care and healthy aging, said Hans Kluge, Belgium’s nominee for director-general of the World Health Organization (WHO) and WHO regional director for Europe on special leave….”

PS: “The Boao Forum for Asia Global Health Forum 2026 was held in Haikou from September 15 to 16. Guests from 32 countries and regions attended the event….”

Bloomberg – Ex-Banker Eyeing Top WHO Job Says Agency Can Tap Outside Money

https://www.swissinfo.ch/eng/ex-banker-eyeing-top-who-job-says-agency-can-tap-outside-money/92090066

“The World Health Organization should look beyond its own budget for funds to support itself and member countries, according to Indonesia’s Health Minister Budi Gunadi Sadikin, who is seeking to lead the agency. “The WHO doesn’t have to use WHO money,” Budi said in an interview Friday. “You can use other people’s money,” he added, citing the World Bank, Asian Development Bank, Gates Foundation, Gavi and the Global Fund to Fight AIDS, Tuberculosis and Malaria as possible sources of financing….”

“… (his) mix of finance and health-system experience is central to his case for the WHO role. With development aid shrinking, Budi posits that global institutions need leaders who understand where money comes from and where it goes. …”

“At the WHO, Budi would first bring spending in line with available funds and focus on core jobs such as setting global health standards and aligning countries so they can tackle major threats.

Cuts, however, would only go so far. “Our purpose is not cutting expenses,” Budi said. “Our purpose is to make all the country members feel that WHO is very useful.”…”

“That includes helping governments find money to strengthen their health systems. Indonesia has secured close to $8.5 billion from development banks for health, according to Budi. The WHO could help poorer nations move from grants toward cheaper loans and eventually, more domestic funding.”

“His case also rests on Indonesia’s position between major powers. “We are a non-bloc country. We are accepted by the south, the north, the east and the west,” he said.

That approach would extend to Washington. Budi said the door should remain open to the US and that he knows US Health Secretary Robert F. Kennedy Jr. personally. He would welcome talks if the two meet at the United Nations General Assembly….”

PS: “Countries have until Sept. 24 to nominate candidates, with member states choosing the next director-general in May.”

HPW – As Deadline Nears, Civil Society Urges Spain to Nominate María Neira in WHO DG Election

https://healthpolicy-watch.news/maria-neira-who-chief-nomination/

“With Thursday’s 24 September deadline looming, international scientific societies and civil society leaders are pushing Spain to sponsor a last-minute nomination of Dr María Neira as candidate in the World Health Organization (WHO) Director-General election. …… Despite earlier indications that Spanish authorities would pass on the current election cycle, Health Policy Watch understands that Madrid is deliberating the nomination.”

“… Advocates argue her nomination would expand the candidate field by introducing a recognized climate expert to address the defining health challenges of coming decades, exacerbated by extreme heatwaves and environmental crises. … Backed by an international coalition anchored in Latin America and spanning the Global South, indigenous groups, and Small Island Developing States, supporters contend her entry translates Spain’s 1986 universal health system legacy to the multilateral stage.”….”

Geneva Health Files – WHO’s Next DG Should Be A Medical Doctor, Public Health Leader & Health-Systems Expert [Guest Essay]

Sivakumaran (“Shiva”) Murgasampillay; https://newsletter.genevahealthfiles.com/whos-next-dg-should-be-a-medical-doctor-public-health-leader-health-systems-expert-guest-essay/

Introduction via Priti Patnaik: “In today’s guest essay, we bring you a perspective from a physician with extensive on the ground expertise, on what it is needed to steer the UN’s only technical agency in the midst of deep shifts in global health. Author, a global public health physician with decades of experience in strengthening health systems at district, national, regional and international levels, lays out the complexity that the role of the Director-General of the WHO demands. He locates these elections in the wider trends in global health and outside, and fluently describes the terrain that any DG must navigate, both technical, operational and political. He also provides a nuanced argument on why the ideal candidate “should not just be doctor”, but one who also understands public health, and what it would take to deliver the responsibilities of this role. “A medical degree should not become an inflexible criterion,” he says…”

Global Health Reform

Devex Pro – One year after Accra Reset launch, panel lays out next steps

https://www.devex.com/news/one-year-after-accra-reset-launch-panel-lays-out-next-steps-113345

(gated) “It’s premised on rebuilding a world order where countries set their own health agendas, alongside a global shift to more equitable partnerships.”

“After six months of deliberations, an independent panel of experts convened by the Accra Reset’s presidential council has laid out five political shifts and 10 recommendations aimed at reshaping the global health architecture and advancing countries’ health sovereignty. The recommendations range from countries developing their own national plans for coordinating health efforts within a year to giving them a greater say in decisions about how the functions of international organizations could be combined….”

· Do read the report for yourself: A Sovereign Future for Health

“Country priorities. Collective capability.”

“Five political shifts and ten recommendations for a health architecture organised around sovereign national capability, strong regional functions and genuine global public goods.”

“There are five political shifts and 10 recommendations — aka “the ten commandments of global health reform” — but the big idea running through them is fairly simple: Countries should run the show.”

“Within a year, countries should develop a national health plan with one budget, with international partners aligning their money and initiatives behind it. Governments should increasingly finance health through domestic resources, while external financing focuses on areas such as fragile settings, emergencies, global public goods, and helping countries transition away from aid dependency.”

“… But Mahama also has a warning for countries demanding more control: “Sovereignty does not magically appear because a country signed a donor agreement,” he says. “But let me be equally frank with my brothers and sisters across the Global South. More power moving from western boardrooms in Geneva or Washington into an unaccountable ministry in Accra or Abuja or anywhere else will not magically manifest sovereignty either.” “If we demand control, we must earn it through uncompromising domestic accountability.”

“… The Accra Reset’s panel recommendations go pretty far in proposing reforms for other global health institutions — including potentially consolidating the functions of Gavi, the Global Fund, and three other major multilaterals, and even putting institutional closures on the table…”

· On the latter, see also HPW – Accra Reset’s Plan for Health Sovereignty Includes Closing Some Global Health Bodies

“…. it also proposes that global health institutions “whose main business is passing money, commodities and products to countries” should be “strategically reformed” immediately, in terms of ‘the 4Cs’ – “commit, collaborate, consolidate and close”….”

“First up are the five global health institutions that “account for the largest flows of funds and commodities and most of the burdensome processes experienced at country level”. These are Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Bank’s Global Financing Facility; the Pandemic Fund (also housed at the World Bank) and Unitaid.”

“However, it also notes that disease-specific partnerships “whose separate maintenance is increasingly difficult to justify” are on the chopping block, including UNAIDS, Roll Back Malaria, Stop TB, and the Global Polio Eradication Initiative (GPEI)….” “Also under the microscope are product development partnerships “where rationalisation, merger and sunsetting should be considered”. These include the Medicines for Malaria Venture, the Drugs for Neglected Diseases Initiative (DNDi), the TB Alliance, the International Vaccine Institute, and the Coalition for Epidemic Preparedness Innovations (CEPI).”

PS: “… The report outlines five steps to empower countries to move away from aid dependence. The first step is “practical sovereignty”, where countries “own the decisions, the financing framework and the data required to govern their health systems”. They should not “merely endorse externally financed programmes”, warns the report. Within a year, countries should develop National Health Plans (NHPs) that include multi-year health investment plans, and map domestic and external resources, financing gaps, and “a realistic financing pathway”….”

““Domestic resources become the foundation for core national responsibilities, while external financing is redirected towards managed transitions, capacity development, fragile settings, regional functions, emergencies and global public goods,” the report stresses. “

“In the medium-term, NHPs can start to take on the functions of international organisations over a five- to 10-year period, managed by a country-led process with international partner buy-in. In cases where the global health institution will close, the report calls for “an orderly, time-bound wind-down with clear dates, sequencing, and the destination of all functions is agreed on up front within a foreseeable horizon of five to 10 years”.”

PS: “However, it notes that “global entities in charge of normative guidance such as the World Health Organization (WHO) and those providing global public goods and humanitarian support need to continue.”

· And related, via Devex: Ghana tests the Accra Reset at home

“… on Monday, Ghana’s health minister, Kwabena Mintah Akandoh, said that his country was already putting the reset’s tenets into practice. “We have already started to invest heavily in our health because we want to take our destiny into our own hands,” said Akandoh, speaking at Devex Impact House. That includes increasing domestic resource mobilization through Ghana’s National Insurance Fund — a levy paid by the country’s citizens — which was uncapped last year to rake in more domestic health resources, writes Devex Senior Reporter Sara Jerving. The country is also looking to include a line in its national budget to cover critical immunizations and is boosting efforts to recruit 16,000 more health professionals across the country this year. “We need donors to come on board, we need multilaterals to come on board — but they must align with government priority areas,” he said….”

Devex Check-up – re UNAIDS reform

Devex;

“Something else that won’t be decided this week in New York: the future of UNAIDS.

You may recall that at last year’s UNGA, U.N. Secretary-General António Guterres made a bold proposal: sunset UNAIDS by the end of 2026. Well, with less than four months left in the year, that’s not exactly where things are headed.”

“The word from Geneva is that no decision on UNAIDS’ future will be made this week. The UN80 process has also moved away from talk of “sunsetting” UNAIDS toward transitioning the organization and mainstreaming its capacity.”

“A UNAIDS spokesperson tells my colleague Jenny Lei Ravelo that “the decision on the transition and integration of UNAIDS will be made by UNAIDS board members.” Guterres’ proposal has faced opposition from civil society and some governments on the UNAIDS board. A working group created by the board rejected the sunset proposal and is weighing other options — including shrinking the UNAIDS secretariat into a smaller hub hosted by another U.N. entity, an option sources tell Jenny appears to be supported by several donors. So when might we actually know what happens to UNAIDS? The working group is due to present its final recommendations at a special session of the UNAIDS board in October.”

A global health system fit for a new international order: Proposals for change

Kumanan Rasanathan et al; https://wellcomeopenresearch.org/documents/11-683

A longer and more elaborate discussion of the topics covered in the Nature Medicine piece of last week, here published as a working paper (Open Access).

Plos GPH – Who is really shaping global health reform?

Filipa Alpeza, Afifah Rahman-Shepherd; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007342

Concluding: “… Behind the shifting sands of global health today, there are Global Health Organisations (GHOs) with agency and authority, which they exercise in ways that are consequential for global health reform. While states may provide the political steer for reform, change greatly depends on the buy-in of organisations responsible for implementing it, and a common understanding among the leadership, secretariats, and members of GHOs. We therefore urge the proponents of global health reform to pay much greater attention to the actorness of GHOs and their internal logic, and the GHOs themselves to transparently declare their positions and interests in various reform processes. Finally, we call for the creation of robust accountability mechanisms for delivering on global health reform that operate independently of the organisations affected. Without recognising GHOs as agentic, there is a risk that reform efforts overlook key actors and interests at play, affecting the likelihood of any proposed changes materializing.”

Plos GPH – From Accra to America: Putting development first in global health

Jirair Ratevosian & William Nii Ayitey Menson; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007343

Summary via LinkedIn: “In this new piece, William Menson and J Ratevisosian look at the strategy alongside the Accra Reset and offer recommendations for both the United States and African governments. These include stronger accountability measures, realistic transition plans, meaningful roles for communities, and greater investment in the regional institutions and systems that countries cannot build alone.”

Excerpts: “… One year on, the two agendas offer a useful test. They share an interest in promoting national ownership, but not yet the same vision of sovereignty. The question is whether Washington’s new approach will help countries exercise greater control over their health systems, or simply transfer financial and operational risk to governments, facilities, workers, and patients before they have the resources and capacity to manage it….”

“…The task now is to preserve what worked while building a development-first partnership that puts countries in the lead and strengthens the national and regional systems needed to sustain progress….”

Then they list what a development-first strategy requires.

PS: “If Washington is serious about promoting country ownership, it should recognize Africa CDC, the African Union, regional economic communities, the African Medicines Agency, and regional procurement platforms as central to shaping Africa’s health agenda….”

UCSF – After Global Health: Building the Next Era of Applied Public Health

By Mike Reid and Kelly D. Taylor; https://globalhealthsciences.ucsf.edu/after-global-health-building-the-next-era-of-applied-public-health/

“…. We don’t see applied public health as simply global health with a new label, nor as a continuation of business as usual in domestic public health. We see it as an opportunity to organize ourselves around a different proposition….”

Among others: “ … Local and global is the wrong distinction: One reason we are excited about this approach is that it removes an increasingly artificial boundary between domestic and international health. …. … Transition is now the work…. “

Post-2030 brainstorm & the future of development cooperation

Brookings – Nature, People, and Sustainable Development

Edited by: Homi Kharas, Julie McCarthy, and Ichiro Sato https://www.brookings.edu/articles/nature-people-sustainable-development/

“The living systems that our economies and societies treat as a backdrop are, in fact, the foundation on which development rests. That claim is easy to state, but acting on it is much harder. This volume is about the relationship between nature, people, and prosperity, and why the way the world currently accounts for it is failing all three. “

“This co-edited volume brings together a cross-section of distinguished contributors working on nature finance, nature-based solutions, and nature governance. Three propositions run through the chapters: Nature and ecological integrity are not one sector of development among many, but a precondition for all of it. Our prevailing economic and financial system rewards the liquidation of nature and penalizes its protection. A credible post-2030 agenda will have to change institutions, incentives, and investments themselves, not simply bolt stronger conservation targets onto a framework that still treats nature as external to the economy. “

· For an overview, start with the first chapter – Nature, people and sustainable development: why the next decade must be different (by Homi Kharas et al)

Including: “Nature as the foundation of the post-2030 sustainable development agenda.”

CGD (blog) – When Is Development Cooperation Really Mutually Beneficial?

B Cichoka et al; https://www.cgdev.org/blog/when-development-cooperation-really-mutually-beneficial

“For mutual benefit to build rather than erode support for development, providers may need to adjust their practice. Research shows that mutual benefit is possible, but not every claim is equally credible. We argue that two questions matter most for the legitimacy of mutual benefit projects: can the claimed benefits be verified on both sides, and do they align with or undermine development outcomes? Using these questions, we build a simple framework for assessing claims of mutual benefit and apply it to four common rationales identified across DAC country strategies, highlighting challenges. We end with reflections on what is needed to strengthen trust in cooperation rather than hollowing it out.”

IDOS (German institute of development and sustainability)- Global cooperation under pressure – new report on shaping reforms

https://www.idos-research.de/en/presse/pressemitteilungen/global-cooperation-under-pressure-new-report-on-shaping-reforms/

“New IDOS publication identifies pathways to rebuild international cooperation in times of disruption and to advance sustainable futures.”

“Geopolitical rivalry, conflict, authoritarian nationalism and the systematic erosion of rules-based politics are reshaping the global order and putting cooperation under growing pressure. Yet the picture is more nuanced: while disruptive trends dominate the headlines, reforms are taking shape at the same time. This is the central message of Disruption and Reform: Sustainable Futures at Stake? The Case for Politics of Cooperation and Perseverance, a new publication by the German Institute of Development and Sustainability (IDOS). Drawing on research, policy advice and knowledge cooperation at IDOS and within its partner networks, the volume examines where cooperation is already being adapted and rebuilt – and which actors can help drive these reforms.”

“The authors argue that Germany and Europe should not respond to a changing world by retreating from international cooperation. Instead, they should invest in politics of cooperation and perseverance. This means adapting institutions, building new partnerships and deepening existing ones as well as finding practical ways for countries to work together even when consensus is difficult to reach. The publication highlights transition, middle-power coalitions, new forms of plurilateral cooperation, institutional adaptation, reconfigured partnership and financing architectures, as well as new cultures of cooperation and political leadership.”

· Also with a chapter focused on global health: Global health beyond 2030: protecting ambition in a fragmented world ( by von Haaren, Paula / Christoph Strupat / Srinivasa Srigiri)

Quote: “….. The risk is not only stagnation. A more serious risk is selective rollback. Commitments that seemed relatively stable during the SDG period may become vulnerable in post-2030 negotiations. This applies particularly to sexual and reproductive health and rights, vaccination and climate-related health commitments…”

More on Global Health Governance & Financing/Funding

Devex Pro – Coefficient Giving launches $130M fund to help countries navigate aid cuts

https://www.devex.com/news/coefficient-giving-launches-130m-fund-to-help-countries-navigate-aid-cuts-113317

(gated) “The Health Aid Transition Fund aims to help countries prioritize scarce domestic resources primarily through grants for technical support.”

· Check out the Press release: Health Aid transition.

“… Coefficient Giving is launching a $165 million fund to help low- and middle-income countries decide which donor-funded health programs they can keep, and get more out of the budgets they have, as global aid falls faster than at any point on record….”

“We expect to recommend $165 million in grants over the fund’s first three years, with support from Good Ventures, the Livelihood Impact Fund, and a private donor. …”

· And some more background: A new fund to help countries build out their health systems

“Announcing the Health Aid Transition Fund”. (by Amanda Glassman and Jeremy Klemin)

“The Health Aid Transition Fund will provide technical assistance — cost analyses, finance strategies, support with moving allocated money out the door — to governments as they absorb steep cuts in aid funding. The idea is to provide support during a critical window (hence “transition”), by funding both practical help and high-level advice as countries transition to directly financing and often providing basic health services…..”

P4H- From billions to balance sheets: where will the money for health actually (not) come from – Part 2A

K Chalkidou et al ; https://p4h.world/en/from-billions-to-balance-sheets-where-will-the-money-for-health-actually-not-come-from-part-2a/

(must-read)

Background: “Over the coming weeks, @P4Hnetwork is publishing a 5-part series from WHO’s Performance, Financing and Delivery dept on financing health in the “aid retreat” era. “

“At the scale universal health coverage (UHC) needs, where is the money and how can it be mobilised and directed to the right investment? This blog post launches Part 2 of the P4H series on financing health systems in the age of the aid retreat. Part 2 comprises three blog posts – 2A, 2B, and 2C – and builds on Part 1 of the series, Designing Blended Finance: The Do’s and Don’ts for aspiring Health-System Fund Architects, which explored key considerations for designing blended finance approaches for health systems….”

So Where is the Money not coming from (in the short term)? ODA, philanthropy and the broader structural agenda…

Re Africa’s institutional capital: “Africa’s much-cited domestic institutional capital is reported at a little over US$2 trillion (pension ~$600bn, insurance ~$400bn, sovereign-wealth funds $164bn, reserves $530bn and public development banks $276bn). Most of it is, however, effectively locked….”

“First, what is the potential headline figure? Once South Africa, which dominates the pools but is unlikely to send capital across borders, and the resource-rich North African economies, where the largest sovereign-wealth and reserve balances sit, are set aside, the institutional savings within reach of the lower-income sub-Saharan countries with the greatest need falls to roughly $250bn (see the Annex: pension and insurance less South Africa and North Africa – XLSX), a small fraction of the “$2 trillion” headline.

“…In summary, while the headline pool is significant (though smaller than often cited figures), serious obstacles stand between it and any UHC (infrastructure) financing at scale.”

PS: “In the next post, From Billions to Balance Sheets: Where Will the Money for Health Actually Come From: reducing risk and freeing up lending capacity for the MDBs – Part 2B, we continue our series on financing health systems in the age of the aid retreat, by discussing MDBs: their privileges and constraints, and reviewing recent innovative ways MDBs use to reduce risk and free up incremental lending….”

Results for Development – Strengthening country-led health systems through technical support partnerships and platforms

C Cashin et al; https://r4d.org/blog/strengthening-country-led-health-systems-through-technical-support-partnerships-and-platforms/

Summary via Gina Lagomarsino on LinkedIn: “They make a strong case that we need new ways for governments to fund and access the technical support they need to build stronger health systems. Leaders in low- and middle-income countries are grappling with the loss of traditional donor funding for health. At the same time, many governments are more motivated than ever to build sovereign, sustainable health systems where domestic resources increasingly finance recurrent costs. Most governments recognize that they will need technical support to make this transition — ideally from experts who understand their contexts and can respond to the priorities they themselves have set. But funding for this kind of support has fallen dramatically. There’s an opportunity now to rethink the model rather than simply recreate what existed before: How can governments have more agency in deciding what expertise they need and where it comes from? How can they draw more effectively on local and regional expertise? And how can technical support strengthen lasting institutions and capabilities rather than creating continued dependence on external assistance? Cheryl and Kelechi offer some concrete ideas for what a new model could look like. It’s an important conversation for this moment in global health….”

On Technical support partnerships and platforms.

A few excerpts:

“The collapse of financial support for technical assistance is occurring alongside a deeper transformation in how global health assistance is being governed and financed. Two reinforcing shifts are creating a new landscape. This new landscape presents real opportunity, but also a structural gap that must be addressed….”

“From Technical Projects to Compact-Based Partnerships: The defining feature of the emerging aid environment is a convergence around compact models, that is, government-to-government agreements that commit both parties to specific health investments, co-financing targets, and accountability mechanisms. This is happening in parallel with ongoing health systems investment support from multilateral development banks (MDBs) such as the World Bank, the Asian Development Bank (ADB), and others….”

“The World Bank’s Health Works Leaders Coalition, launched with the Government of Japan and WHO, is building National Health Compacts. These Compacts are government-led five-year roadmaps designed to align domestic and external resources and create accountability for health results. As of December 2025, 15 countries had developed compacts with the World Bank, with more expected later this year. There is limited financing planned, however, to support governments with the technical aspects of executing on the National Health Compacts.”

“The Vacuum in Technical Support for Health System Strengthening: One immediate consequence of recent shifts in global health systems strengthening support is an abrupt vacuum in access to technical expertise for many LMIC governments. Countries mid-stream in complex health system strengthening processes — restructuring health financing, digitizing health information systems, rolling out community health worker programs — may now have no sustained source of financing for the technical support needed to see those processes through, or an architecture through which to access that expertise…. … The expertise exists in national, regional and global institutions, and the financing exists in the form of compacts, MDB operations, bilateral and philanthropic funding. What is missing is the mechanism to connect governments to the technical support they need, in the way they need it, to make these investments succeed.”

“…This moment creates a once-in-a-generation opportunity to build a demand-driven, country-led system for accessing and deploying technical expertise in support of government health system strengthening agendas….”

Cashin et al then list Core Functions of the Technical Support Partnerships and Platforms.

PS: “Nigeria offers a concrete illustration of what a country-led technical support partnership can look like and why the financing and mechanisms to sustain it matter so much. …” Read how.

Guardian – As president of Botswana, I know how we can make malaria a memory in Africa

Duma Gideon Boko; https://www.theguardian.com/global-development/2026/sep/22/president-of-botswana-malaria-africa-children-funding-disease-african-nations

“The disease is soaring as funding is cut. African nations are plugging the gap but they need help with the transition.”

“A full transition to domestic financing of health is the solution. But the lack of financial capacity in many of our countries means that bridge financing will be required during this transition phase to reduce the risk of malaria resurgences across the continent. As we transition to this new model, support from global partners will still play an important and valued role in keeping two decades of hard-fought gains alive long enough for the transition to be completed….”

“This has been done before, at exactly this point in the cycle. Twenty years ago, the World Bank’s Malaria Booster Programme committed more than $1bn to supplement existing resources and support achievement of the UN’s millennium development goals. And it worked. For example, malaria cases among Zambian children under five fell by 29% and deaths by a third. African countries had ambitious plans, and the political will was there, but unfortunately financial resources ultimately fell short of what was needed. Most of Africa faces a similar situation today. The political will and technical knowhow are there, but the financial resources remain insufficient. Africa therefore urges the World Bank to deliver a second Malaria Booster Programme to bridge the gap and support countries to transition to sustainable domestic financing. Countries should also include malaria within their health compacts.”

“The destination is not in doubt. African countries are determined to pay for their own malaria and health programmes, and a growing number are already doing this. Collectively, we must get this transition right…”

World Bank – What Works for Public Sector Reform in Africa? Preliminary Evidence on New Public Management Reforms in World Bank Projects

Diane Zovighian et al; https://openknowledge.worldbank.org/entities/publication/53429ad0-4786-4d8a-985f-5b0fe65c7837

“This paper examines the prevalence and effectiveness of public sector reforms promoting performance-based incentives and greater autonomy in public administrations in Sub-Saharan Africa. Inspired by the New Public Management paradigm, these reforms have been widely adopted despite limited systematic evaluation of their results…. The paper draws on data and information on the design, implementation, and performance of World Bank–financed public sector reform projects in Sub-Saharan Africa implemented between 2010 and 2023, complemented by four qualitative in-depth case studies. The analysis shows that over one-third of World Bank–financed public sector reform projects during this period included at least one New Public Management intervention. The performance of these interventions has, however, been uneven across contexts and reform types. Only 40 percent of the interventions were fully implemented. Performance varied considerably across reform types, with performance-based public financial management reforms performing comparatively better than agencification and performance-based pay reforms. The findings suggest that weaknesses in reform design—including insufficient attention to institutional capacity and implementation constraints as well as political economy dynamics—have contributed to these mixed outcomes. Case studies further show that New Public Management reforms are particularly difficult to sustain in fragile and neo-patrimonial contexts. The paper argues that the diffusion of New Public Management–inspired approaches has often outpaced the available evidence on their effectiveness and highlights the need for more context-sensitive and evidence-based approaches to public sector reforms in Sub-Saharan Africa.”

BMC Global & Public Health – Financing of adolescent health and wellbeing in Bangladesh, Ethiopia and Nigeria: a case study of the Global Financing Facility

O Biermann et al ; https://link.springer.com/article/10.1186/s44263-026-00332-4

Authors identified five themes.

And conclude: “The GFF co-financing model has increased attention to AHW and aligned investors, but progress is insufficient to drive transformative change….”

Global Tax Justice

Economics Nobel Laureates Support letter for Proposition 40, the California billionaire tax

Daron Acemoglu (MIT) Abhijit Banerjee (University of Zurich and MIT) Peter Diamond (MIT) Esther Duflo (University of Zurich and MIT) Paul Krugman (CUNY) Joseph Stiglitz (Columbia University); https://gabriel-zucman.eu/files/prop40letter.pdf

“In November 2026, California will vote on Proposition 40, a 5% one-time tax on the wealth of California’s billionaires. The revenue would help cover the massive funding cuts to California’s Medicaid enacted by Congress in 2025. If it passes, Proposition 40 would be the first-ever tax on billionaire wealth enacted anywhere in the world. California is the right place to take this historic step….”

Trump 2.0, US Global Health Strategy & bilateral health agreements

NYT – White House Moves to Take Control of N.I.H. Grants

NYT;

“Federal officials are drafting an executive order that would place grants under review by an outside panel, the latest effort to redirect billions of dollars in research spending.”

“The White House has begun drafting a new executive order that could further cement President Trump’s ability to control billions of dollars in scientific grants and expand the administration’s pressure campaign against elite universities….” “Discussed at a highly contentious meeting at the White House on Friday, the order aims to create a new external committee with the power to veto awards in the National Institutes of Health’s vast research portfolio that do not conform to Mr. Trump’s political agenda, according to people with knowledge of the effort….”

“ Budget chief Russell Vought reportedly wants more power to veto DEI-related funding.”

CGD – Impact Data Helped Saved PEPFAR. What About Everything Else?

C Kenny; https://www.cgdev.org/blog/impact-data-helped-saved-pepfar-what-about-everything-else

“…. last year demonstrated again that we need quality outcome data as a powerful tool to justify and sustain aid. … “ Let’s “…. compare the treatment of PEPFAR over the last year to much of the rest of the foreign assistance portfolio. PEPFAR is credited with saving more than 26 million lives over the past two decades, an estimate that has been quoted approvingly by the Trump administration. That’s a modeled number, but it is one with a comparatively high degree of confidence behind it precisely because PEPFAR has long run a considerable data collection exercise, so that there can be simply no doubt that the program was delivering lifesaving assistance. It was also comparatively straightforward to forecast where we would see the greatest impact of any significant pause in funding even without access to the data the administration took offline. This strong foundation of data helped considerable and effective advocacy on behalf of PEPFAR on and off Capitol Hill….”

While PEPFAR is in far worse state than before, “… it is in a considerably better place than other parts of the US foreign assistance program, many of which are in sectors where it is simply difficult to generate similarly compelling outcome metrics…”

PHC

Africa CDC – The Arusha Call for Action: Primary Health Care Transformation

https://africacdc.org/news-item/the-arusha-call-for-action-primary-health-care-transformation/

“Adopted in Arusha, United Republic of Tanzania, this 11th day of September 2026, by the participants in the Second International Primary Health Care Conference. “

From Alma Ata, Astana to the Arusha call for action for PHC transformation.

“A Continental Engagement to Finance, Deliver and Sustain Primary Health Care as the Foundation of Universal Health Coverage and Africa’s Health Sovereignty….”

SRHR

Devex – Anti-abortion groups launch coalition on Geneva Consensus Declaration

https://www.devex.com/news/anti-abortion-groups-launch-coalition-on-geneva-consensus-declaration-113344

(18 Sept) “Nearly 60 organizations from the U.S. and across the world have joined forces to support the Geneva Consensus Declaration, a non-binding political agreement that urges countries to reject an international right to abortion. …. Nearly 60 anti-abortion groups from across the world have launched a new coalition to back the Geneva Consensus Declaration, an international political agreement that promotes the health of women and girls, pushes for the family to be “the fundamental unit of society,” and affirms there is no international right to abortion.”

“The group — which is called the Global Coalition for Women’s Health, the Protection of Life, and the Family — was inaugurated at the start of this year’s United Nations General Assembly. Its goal is to support the 43 governments that have signed onto the Geneva Consensus Declaration, and to help those nations promote the document’s principles both within their countries and across the U.N. system…”

Reproductive Health (supplement) – On sustainable SRH services during Covid

https://link.springer.com/journal/12978/volumes-and-issues/22-3/supplement

“This multi-country research was conducted across nine countries – Brazil, Burkina Faso, China, Ghana, Italy, Kenya, Pakistan, Thailand, and the United Kingdom/England … it distils how these countries sustained sexual and reproductive health (SRH) services during COVID-19….”

The supplement lists four game-changers: “Call SRH essential from Day 1. “Non-essential” labelling for SRH services cost lives and deepened inequities. Go flexible and decentralised. Home-based care, mobile outreach and community health workers outperformed rigid facility models. Go digital. Telemedicine, remote follow-up and triage kept care flowing. Make policy adaptable. Task-shifting, extended prescriptions and self-care proved vital.”

Child Health

NEJM – The Epstein Files Transparency Act and the Health of Trafficked Children

N Peoples et al; https://www.nejm.org/doi/full/10.1056/NEJMp2605483

« Policymakers have so far failed to hold perpetrators in Jeffrey Epstein’s trafficking network accountable, but the medical and public health community should confront the resulting health crisis. »

« … The authors argue that trafficking is a structural determinant of child health and as such in the lane of clinicians to not only treat the consequences – often lifelong physical and mental health burdens – but the root causes. The Epstein Files Transparency Act (#EFTA), they say, “offers a rare opportunity to identify perpetrators, pursue accountability and punishment, and thereby prevent further emboldening of child trafficking.”

Human Resources for Health

WHO – One in four doctors nearing retirement age as WHO warns of global health workforce gap

https://www.who.int/news/item/18-09-2026-one-in-four-doctors-nearing-retirement-age-as-who-warns-of-global-health-workforce-gap

“The World Health Organization (WHO) has published the National health workforce accounts: health workforce levels and trends 2026, the first in an annual series of reports offering the most comprehensive global picture of health workforce levels, trends and challenges based on official country data shared through the National Health Workforce Accounts (NHWA). “

“In the past two decades, health workforce density (medical doctors, nursing and midwifery personnel, dentists and pharmacists) has increased by 52% globally, from 44.8 per 10 000 population in 2006 to 67.9 in 2025. There are now more than 70 million health and care workers worldwide. “

“However, this global improvement masks the deep inequities that persist across countries and regions. For instance, the density of medical doctors is 13 times higher, and the density of nurses and midwifery personnel is six times higher, in the WHO European Region than in the WHO African Region. The report underscores that workforce shortages and unequal distribution continue to limit access to essential health services for many people. “

“…Each report, in addition to reporting on annual health workforce levels and trends, will include a thematic focus. The first report examines the implications of both population and health worker ageing for future workforce needs. In some countries, health worker ageing is intensifying the health workforce shortage, projected to reach 11.1 million health workers globally by 2030, while population ageing is increasing service demand. The report also reveals that nearly one in four doctors on average is older than 55 and will retire in the next decade (based on latest available data from 122 countries). In high-income countries, this increases to nearly one in three. Sixty-seven countries will not have enough health workers to maintain population health needs by 2030. “

Quote: ““Ageing is the hidden health workforce crisis that requires urgent attention. It is creating a double pressure on health systems, primarily in high-income countries,” emphasized Dr Diallo. “

NCDs & Urban health

NCD Alliance (Policy brief) – Meeting the moment: NCD funding in a changing world – The role of private philanthropy in financing the response to NCDs

https://ncdalliance.org/resources/meeting-the-moment-ncd-funding-in-a-changing-world-the-role-of-private-philanthropy-in

“Private philanthropy is a major actor in global health and sustainable development. Between 2020 and 2023, global philanthropy for development totalled US$68.2 billion, of which 40% was directed to health: the largest share of philanthropic giving to any sector. However, there is a fundamental mismatch between the financing of NCDs – like cancer, diabetes, cardiovascular diseases, chronic lung diseases, and mental health and neurological conditions – and the disease burden they represent.”

“The purpose of this report is to consider the role that private philanthropies can play in strengthening the NCD response, drawing on examples of what others are doing, signposting potential areas for investment, and stimulating further discussion. This brief identifies five roles through which private philanthropies already strengthen the NCD response, illustrated by case studies showing how different types of funders play each role across diverse contexts. Drawing on a literature review, key informant interviews, and insights from the case studies, the brief then sets out seven actionable recommendations.”

Lancet Public Health (Editorial) – The role of cities in public health

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00198-2/fulltext

Editorial of the new Lancet Public Health October issue.

“Has urban health become a singular public health success? In October, 2016, at the opening of the UN Habitat III conference on housing and sustainable urban development, former UN Secretary-General Ban Ki-moon said that cities were central to “global prosperity, peace and human rights,” and needed to be made “inclusive, safe, resilient, healthy and sustainable”. 10 years later, novel research in this issue of The Lancet Public Health shows that cities are now at the centre of public health both because of their agile governance structures and because of their susceptibility to health-harming urban environments.”

The editorial concludes: “…The work published in this issue is an encouraging sign that cities have enormous potential for proposing and, crucially, implementing innovative plans that can improve population health while generating evidence to inform action at national, regional, and international levels. Cities often see faster returns on economic, environmental, and public health initiatives than countries and regions. In August, the C40 cities reported that they were already reducing their per-capita emissions five-times faster than the global average. When it comes to issues such as the environment, behavioural change, and public health, city mayor-led local actions that produce tangible results might be our best way of convincing national governments that ambitious political commitments deliver measurable progress.”

Mental health

Nature (World View) – Losing your way of life to climate change matters — and we need a way to measure it

M Kumar; https://www.nature.com/articles/d41586-026-02928-0?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=63820038

“Climate losses extend beyond property and income. Policymakers need ways to assess what people value, experience and ultimately stand to lose.”

re climate loss as a mental health issue. And how to measure it properly.

Planetary Health

Climate Change News – Climate change and energy transition rise up national security agenda

https://www.climatechangenews.com/2026/09/22/new-york-climate-week-energy-transition-security-leaders/

“Leaders highlighted the national security risks posed by global warming and fossil fuel dependency at New York Climate Week.”

“Governments need to start addressing climate change impacts and nature loss as a threat to national security and manage shocks before they hit rather than picking up the pieces afterwards, Britain’s foreign minister and other leaders told the opening of Climate Week NYC on Monday….”

Climate Change News – UN chief urges countries to adopt fossil fuel transition plans with timelines

https://www.climatechangenews.com/2026/09/22/un-chief-calls-on-countries-to-adopt-fossil-fuel-transition-plans-with-timelines/

“In his last speech to the UN General Assembly, António Guterres for the first time called on every nation to deliver a plan to phase out coal, oil and gas while protecting workers.”

Climate Change News – Fossil fuel expansion threatens COP31 hosts’ credibility, experts warn

https://www.climatechangenews.com/2026/09/18/fossil-fuel-expansion-threatens-cop31-hosts-credibility-experts-warn/

“Türkiye and Australia are pushing coal, oil and gas at home with no national timeline for their own fossil fuel phase-out.”

Guardian – How Saudi oil scientists ended up working on the world’s most important climate reports

https://www.theguardian.com/environment/2026/sep/21/saudi-arabia-aramco-oil-scientists-ipcc-climate-reports

“Guardian investigation reveals fossil fuel links of IPCC authors, with experts declaring the body’s conflict of interest policy ‘not fit for purpose’.”

PIK – Planetary Health Check 2026 finds mounting pressures across Earth’s life support systems

https://www.pik-potsdam.de/en/news/latest-news/planetary-health-check-2026-finds-mounting-pressures-across-earth2019s-life-support-systems

“Seven breached Planetary Boundaries continue to worsen as record ocean heat, droughts, floods, wildfires and extreme heat reveal an Earth system under strain, according to the latest Planetary Health Check. The annual update is authored by more than 60 scientists and produced by the Planetary Boundaries Science Lab at the Potsdam Institute for Climate Impact Research (PIK)…”

“The Planetary Boundaries describe the interconnected Earth-system processes that must remain within safe limits to preserve the planet’s stability and resilience. Seven of the nine Planetary Boundaries are now transgressed, with ocean acidification the latest to breach its boundary in 2025. All seven are now at their highest recorded levels of transgression….

“New report shows key indicators of Earth’s health are ‘outside the safe operating space’ as climate disaster looms.”

“… The report was released on Monday shortly after the start of Climate Week, a major gathering of politicians, business leaders and activists in New York City that leads up to the UN general assembly….”

Guardian – Poorer nations will be among the last to benefit if global emissions cut to net zero

https://www.theguardian.com/environment/2026/sep/22/climate-inequality-tropics-among-last-places-to-benefit-net-zero

“Scientists found unequal impact of the climate crisis would not be reversed even if implicit goal of the 2015 Paris agreement is achieved.” “… The research coincided with the UN’s refugee agency releasing a report showing how the climate crisis was increasing the risk of people becoming stateless.”

“The climate inequality study, published in the journal Environmental Research Letters, was led by Dr Andrew King and colleagues at the University of Melbourne. … … “If we follow a path that is close to net zero, then the inequality we see in present day warming persists indefinitely,” King said. “The wealthier countries that have caused more of the problem are not those that are the most exposed, even beyond net zero. The regions that have not caused the warming are those that experience the most warming.” King said the fate of the planet’s poorest regions, which tend to be concentrated closer to the equator, would depend on how much greenhouse gas was emitted before the world reached net zero. “Even when we get to net zero, we have still emitted an enormous amount of carbon into the atmosphere and its effects will continue for centuries. We can’t easily undo all that damage,” he said. “Getting to net zero sooner means we are less likely to have that long-term warming after net zero. We need to get to net zero sooner to limit that inequality.” “

PS: “…A separate report on the impact of climate change on the stateless, commissioned by the UN refugee agency and released with the Peter McMullin Centre on Statelessness, called on nations to support “the continuity of statehood” for countries facing extreme climate damage. It said those at risk included Pacific islands that were losing land to rising seas. The agency estimated about 4.5 million people were stateless but said it accepted the number was probably much larger as stateless people were “invisible to official statistics”….”

Project Syndicate – What It Means for Global Warming to Exceed 1.5°C

N Stern; https://www.project-syndicate.org/commentary/climate-overshoot-net-zero-no-longer-enough-by-nicholas-stern-2026-09

“A sobering new report from the United Nations Environment Programme warns that even if governments deliver on all their existing climate pledges, warming could reach 1.8°C later this century. That means humanity must pivot from simply containing global warming to finding ways to reverse it.”

Excerpts:

“…The effects of overshooting 1.5°C will require much larger investments in adaptation and resilience, ranging from higher sea defenses to the development of more drought-resistant crop varieties. Such investment will become a much higher priority, and overall investment needs will become much greater than would have been the case had we met the Paris target. But there are limits to adaptation. Breaching major climate thresholds could lead to conditions so hostile that socioeconomic development itself would be reversed, forcing hundreds of millions of people to move despite whatever adaptation measures are in place….”

“…the UNEP report points out that reversing the 1.5°C overshoot will require us to go beyond net zero to achieve negative emissions, meaning we will eventually need to remove much more carbon dioxide from the atmosphere than we add. Though we can and should expand natural carbon sinks, including forests, these are unlikely to offer the total capacity we will need. Closing the remaining gap therefore will require greater investment in artificial methods of extracting and storing billions of tons of atmospheric CO2. We should also examine carefully the potential of other geoengineering solutions, including those designed to reduce the total amount of solar energy reaching the Earth’s surface. Further research is needed, however, because these options come with significant risks and ethical implications. For example, cooling the planet while leaving high levels of CO2 in the atmosphere would acidify our oceans, with potentially dangerous consequences….”

The Conversation – Climate change is fuelling African conflict – governments are developing a shared response

https://theconversation.com/climate-change-is-fuelling-african-conflict-governments-are-developing-a-shared-response-289088

“Climate change is making life tougher. Across Africa, failed harvests, shrinking water supplies and more extreme weather are leaving millions of people hungry and forcing many from their homes. When communities compete for land and water, the risk of conflict can grow. African governments are now developing a Common African Position on Climate, Peace and Security to tackle these problems together. But will it lead to real change on the ground? Gracsious Maviza and Katongo Seyuba research climate risks and security. They explain how climate change is affecting peace and security across the continent, what the new framework proposes, and what governments must do to make it work.”

Guardian – Huge El Niño projected to cause 450,000 deaths in next six months

https://www.theguardian.com/environment/2026/sep/23/el-nino-450000-extra-deaths-six-months

“New report predicts a heavy toll from Nigeria to the US – and comes on top of existing impacts of the climate crisis.”

The Climate Impact Lab and at the University of Chicago co-authored the report.

“The most affected countries in the next six months are the tropical nations of Nigeria, Indonesia, Sudan, India and Brazil. The US is in the top 20 most affected nations, with 3,500 projected additional heat deaths. More broadly, the Sahel region in Africa and south-east Asia are heavily affected.”

Nature Human Behaviour – Rising health inequities require looking beyond health systems

https://www.nature.com/articles/s41562-026-02565-7

“Global health inequity is increasingly driven by the triple planetary crisis of climate change, biodiversity loss and pollution. To address it, we must place health at the centre of climate and environmental action and develop interventions that target both individual behaviours and structural drivers of inequality.”

· Related: Heidelberg University (press release) – Researchers at Universität Heidelberg call for establishing the health issue at the core of climate and environmental policy

“The worldwide inequality of health opportunities is being further heightened by the triple planetary crisis – climate change, loss of biodiversity and environmental pollution. Hence preventing it is more than a question for health systems; as a central concern it must be embedded in climate and environmental policy….”

Conflict/war & health

Foreign Policy – It’s Time to Update the U.N. Sustainable Development Goals

David Miliband; https://foreignpolicy.com/2026/09/21/united-nations-sustainable-development-goals-sdgs-conflict-aid/

“Countries committed to end poverty. They never accounted for forever wars.”

“World leaders are about to choose a new United Nations secretary-general. Whoever gets the job will inherit an uncomfortable truth: The world body’s promise to end poverty, hunger, and disease is in retreat because today’s leaders are presiding over an era of multiple and growing forever wars. In September 2015, U.N. member states set 17 Sustainable Development Goals, or SDGs, to be achieved by 2030. These sought to end extreme poverty, promote climate action, and set social and economic targets, all while “leaving no one behind.” But the commitment assumed the existence of functioning states, international cooperation, and development systems capable of turning finance into progress. Instead, the world has entered a new global disorder. … “

“Meanwhile, more wars are raging today than at any point since World War II, and they are lasting longer than ever. More than 70 percent of conflicts that have begun since 2020 have continued for more than a year, up from 44 percent in the 2000s. So-called civil wars, or wars within states, are increasingly internationalized through external sponsorship. According to the Institute for Economics & Peace’s 2025 Global Peace Index, 98 countries were entangled in conflicts outside of their borders in the five years prior to the report, up from 59 in 2008. These internationalized wars are nearly four times less likely to end….”

“The SDGs, adopted more than a decade ago, were not built for this era. Indeed, the word “conflict” appears less often than “fisheries” in the SDGs. For instance, both Goal 2 (“Zero Hunger”) and Goal 14 (“Life Below Water”) prioritize fisheries and fishers, while there is no formal target addressing humanitarian food aid or conflict and displacement as drivers of hunger. Yet conflict is the principal force determining whether any development target can be achieved, and it is the main driver of heightened levels of poverty and hunger around the world… Already eight years ago, the International Rescue Committee (IRC), which I lead, warned that more than 80 percent of fragile and conflict-affected states were off track to meet these goals, and nearly 26 million refugees were being left out of the official reporting processes. Since then, the situation has become direr. Research indicates that as of 2021, armed conflict slowed global progress on the SDGs by the equivalent of 18 years. Today, only 15 percent of the 139 SDG targets with sufficient data are on track, with fragile and conflict-affected states lagging furthest behind. Nearly half of all deaths of children under 5 years old have also occurred in those states….”

“… A generation of development gains has been lost to forever wars. As long as the escalation of hard power beats out peacemaking and peacebuilding, human development will take second place on the global stage. But even within those constraints, the international community can do much more to support people caught in conflict. …”

Access to Medicines, Vaccines & other health technologies

Devex – PAHO, Gilead deal expands lenacapavir access for 14 countries

https://www.devex.com/news/paho-gilead-deal-expands-lenacapavir-access-for-14-countries-113341

“The 14 Latin American countries will be able to purchase the HIV prevention injectable lenacapavir through PAHO’s revolving funds, which pool demand for health products across Latin America and the Caribbean and buy them in bulk to lower pricing.”

“Fourteen Latin American countries will gain access to the twice-yearly HIV prevention injectable lenacapavir under a new agreement between the Pan American Health Organization and Gilead, the company behind the drug. The countries — Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela — will be able to procure the drug through PAHO’s regional revolving funds, which pool demand for health products across its member states in Latin America and the Caribbean to negotiate lower prices through bulk purchasing.”

“These countries are not covered by Gilead’s voluntary licensing agreements, meaning they can’t access generic versions of the drug. Those agreements allow generic manufacturers to produce and sell lenacapavir in 120 countries, including 24 countries in Latin America and the Caribbean….”

PS: “According to PAHO, Gilead has “also committed to advance a technology-transfer process in Brazil with the aim of facilitating local production of Lenacapavir in the future,” though it did not provide details on how or when that would happen…..”

Ps: “Organizations including Médecins Sans Frontières have criticized the limitations of Gilead’s licensing agreements. The international humanitarian medical organization welcomed the latest deal between the company and PAHO, but raised concerns that it still leaves the company “in control of the supply of lenacapavir” in the region. MSF also raised concerns about how much Gilead will charge for the drug, saying it expects the price to be significantly higher than the roughly $40 per person per year anticipated for generic versions. In the United States, lenacapavir is priced at about $28,000 per person per year….”

· For more, see AVAC’s newsletter from last week: Lenacapavir Access Pathway

“ Two new agreements from Gilead Sciences, the developer of lenacapavir, this week could expand access to lenacapavir for HIV PrEP (LEN), both for the current every six month injectable and a potential once-yearly option still in development. Gilead and the Pan American Health Organization (PAHO) announced new steps to establish a procurement pathway through PAHO’s Regional Revolving Funds that will allow 14 countries in Latin America and the Caribbean – including Argentina, Brazil, Peru and Mexico (all of which participated in one of the pivotal efficacy trials) – to procure twice-yearly LEN. This mechanism complements the 24 countries already covered in the region by Gilead’s existing voluntary licensing agreements. Gilead also committed to advance a technology-transfer process in Brazil, although timelines, prices, and volumes were not defined in the release. Separately, Gilead expanded its six royalty-free voluntary licenses for lenacapavir to include the investigational once-yearly formulation being studied in the Phase 3 PURPOSE 365 trial. This would extend once-yearly LEN generic plans for 120 high-incidence, resource-limited countries before efficacy results or regulatory approval. “

On the latter: “… At the same time, expanding voluntary licenses to the prospective once-yearly formulation while it is still in Phase 3 development is an important step forward in early access planning and could shorten the gap between approval and generic supply, should the once-yearly formulation prove safe and effective. This early licensing approach mirrors Merck/MSD’s recent licensing agreements for their investigational monthly oral PrEP option, alimatravir. …”

AI & health

Telegraph – Global fund utilises AI to tackle malaria, TB, and HIV amid aid cuts

https://www.telegraph.co.uk/global-health/science-and-disease/global-fund-ai-tackle-malaria-tb-and-hiv-aid-cuts/

“The organisation, which fights malaria, tuberculosis, and HIV in poor countries, said it had to quickly “adapt” amid a funding shortfall.”

“Artificial intelligence (AI) is helping to soften the blow from aid cuts, according to one of the world’s biggest development funds. The Global Fund, which raises and invests billions of pounds to reduce the burden of HIV, tuberculosis (TB) and malaria globally says new AI-driven products like portable pregnancy scanners are helping to mitigate the funding gap. …”

“… The Global Fund is managing a $6 billion (£4.4bn) shortfall for the period 2026 to 2028 and has been forced to make difficult decisions to continue their work, it confirmed this week…. But Mr Sands said investments in tools to tackle infectious diseases – including those driven by AI – are starting to pay off. … One tool the Global Fund has invested in is the rollout of handheld, AI-powered digital X-ray machines that can more quickly and accurately diagnose people with tuberculosis within minutes. …”

PS: “The fund, which sources most of its money from wealthy governments and philanthropic foundations, said it was prioritising treatment over prevention programmes this year amid the cuts….”

Lancet Collection – New roadmap integrates arts into global health and wellbeing

https://www.news-medical.net/news/20260921/New-roadmap-integrates-arts-into-global-health-and-wellbeing.aspx

“Researchers have developed a roadmap for integrating the arts across health and wellbeing systems globally, from population health and prevention to community pathways and clinical care. Based on a wealth of international evidence, the roadmap is outlined in the Jameel Arts & Health Lab–Lancet Global Collection on Arts and Health….”

“The first paper, “The arts as a global health resource: key priorities for future research” synthesises evidence showing that engagement with music, dance, visual arts, theatre and other cultural activities can contribute to mental, physical and social health across the life course, from health promotion and prevention to the management and treatment of illness. The authors argue that the field has now reached a critical stage requiring strategic, systems-level integration.”

“The second paper, “Developing roadmaps for advancing practice, research, and policy in the arts and health”, moves from evidence to action. It calls for equitable access to arts engagement, its inclusion in population-level prevention, stronger community pathways, evidence-based arts interventions in clinical care, and sustained cross-sector investment and research.”

“The Collection will be presented in New York during Healing Arts at UNGA, NYC 2026, held alongside the United Nations General Assembly….”

Miscellaneous

BMJ Opinion – Afghanistan’s restrictions on women are becoming a public health emergency

https://www.bmj.com/content/394/bmj-2026-100932

“Girls denied education today become women with poorer health, write Nadia Akseer and colleagues.”

“These policies should not be viewed solely as human rights concerns, which have been the focus of much of the international discourse. They also represent one of the most profound public health threats facing Afghanistan today….”

Global Policy- Unpacking the Humanitarian Reset: Data Governance under Austerity

Kristin Bergtora Sandviks; https://www.globalpolicyjournal.com/blog/21/09/2026/unpacking-humanitarian-reset-data-governance-under-austerity

Kristin Bergtora Sandviks argues that as aid shrinks, attention must shift to the digital governance regimes produced by the Humanitarian Reset and their consequences for vulnerable populations.”

“… the Humanitarian Reset is also generating new modes of humanitarian governance. Following AI in Aid: Experimentality, Maldata, and Data Extrapolation this is the second of three comments for Global Policy on the restructuring of the humanitarian digital space….”

“In Humanitarian Extractivism: the digital transformation of aid (2023) I argued that this transformation was extractive in the way it enabled Big Aid, states, and tech companies to appropriate the personal data and digital bodies of vulnerable populations, producing ethical, legal, and security risks. Since then, the humanitarian landscape has changed significantly. 2025 was a watershed year for the sector, demanding renewed analytical attention to the logic of reform, problem framing, and policy dilemmas. Now, there is a need for unpacking policy developments and tradeoffs made in the name of austerity and expediency. These developments have so far received limited critical scrutiny. This commentary starts from the observation that austerity, rather than expansion, has become the primary driver of data governance. As funding dries up and humanitarian staff are laid off, the quality and availability of baseline data falters, with data deserts emerging as a result. Yet, this is not only a move from data overabundance to data scarcity. Rather, it signals the emergence of a different form of extractivism, co-constituted through the politics of exclusion: Humanitarian Extractivism 2.0. This shift is both technical and political, reshaping resource distribution, the exercise of authority, and how humanitarian outcomes are determined….”

Global health governance & Governance of Health

Devex – Grynspan vows ‘meaningful reform’ of a ‘top-heavy,’ risk-averse UN

https://www.devex.com/news/grynspan-vows-meaningful-reform-of-a-top-heavy-risk-averse-un-113362

“U.N. secretary-general candidate Rebeca Grynspan tells Devex the agency needs “meaningful reform,” with fewer resources at the top, more in countries, and a greater willingness to take risks to resolve conflicts.”

“The former Costa Rican vice president and head of U.N. Trade and Development, or UNCTAD, received the most support for the job in the latest informal Security Council straw poll on Sept. 18, with nine “encourage” votes, five “discourage” votes, and one “no opinion.”…”

Devex – UNDP chief hails ‘multilateral turning point’

https://www.devex.com/news/undp-chief-hails-multilateral-turning-point-113365

(gated) “Alexander De Croo, the administrator of UNDP and former prime minister of Belgium, tells Devex Impact House that the multilateral system remains vitally important, and said the United Nations needed a “multilateral turning point.”..”

“For the past two years, multilateral institutions, particularly the U.N., have been heavily criticized by their largest funder, the United States. Funding to the U.N. began falling even before Donald Trump became U.S. president for a second time in 2025. But De Croo suggested that while world leaders may question the methods of the U.N., they do not question the need for the work itself.”

Foreign Affairs – Shrink the UN

Richard Gowan; https://www.foreignaffairs.com/united-nations/shrink

“The Next Secretary-General Must Get Back to Basics.”

“The small crop of candidates to succeed Guterres include senior UN trade official Rebeca Grynspan, Director General of the International Atomic Energy Agency Rafael Grossi, and Guyana’s Ambassador to the UN Carolyn Rodrigues-Birkett. Regardless of who wins, Guterres’ successor will need to develop a new playbook for revitalizing the organization. Any serious effort must acknowledge an unpleasant reality: as long as the world remains competitive and chaotic, the UN’s ability to forge wide-ranging international agreements will remain constrained. The next secretary-general’s best hope may thus be to relinquish some of the organization’s previous lofty ambitions and slim down, prioritizing international crisis prevention and conflict resolution, the efficient provision of humanitarian aid, and achievable international development goals. A UN that jettisons time-consuming diplomatic processes and inefficient bureaucracies for a few core functions may disappoint ardent advocates of global governance. But it also may be the only version of the organization still viable in an era of great-power competition and austerity….”

WHO welcomes strong health commitments at the 2026 BRICS Summit

https://www.who.int/news/item/21-09-2026-who-welcomes-strong-health-commitments-at-the-2026-brics-summit

WHO comes back on the BRICS summit from last week.

CGD (blog) – After Sweden’s Election: Could a Development Superpower Return?

By Anita Käppeli & Göran Holmqvist; https://www.cgdev.org/blog/after-swedens-election-could-development-superpower-return

“… While the Social Democrats, Centre Party, Left Party, and Green Party largely agree on development policy, there’s considerably less consensus on other policies and government roles. Whether they can find a compromise will determine whether they form Sweden’s next government. If they succeed, Sweden’s development policy could change direction decisively. The four parties broadly support gradually restoring Sweden’s commitment to spend 1 percent of gross national income (GNI) on official development assistance (ODA), refocusing aid on poverty and fragility, and moving away from conditionality mechanisms between aid and migration management and export promotion. That would represent a big shift after the last four years in which Sweden restructured and reduced its aid significantly. But restoring Sweden’s global development leadership will require more than reversing budget cuts. A new government would need to decide what kind of development actor Sweden wants to be in a world which has changed considerably since the Social Democrats were last in charge. In this blog, we look back at Sweden’s aid policy shift over the past four years, explore where the potential coalition partners align, and consider the choices and challenges facing the next government….”

IJHPM – The US Withdrawal From the WHO: A View From Latin America and the Caribbean on Multilateral Fragility, Reciprocal Benefit, and Regional Resilience; Comment on “The U.S. Withdrawal From the World Health Organization: Implications and Challenges”

Esteban Ortiz-Prado; https://www.ijhpm.com/article_4927.html

“The 2025–2026 withdrawal of the United States from the World Health Organization (WHO) represents one of the most consequential disruptions to global health governance in the postwar era. In the Americas, its effects are already visible: The Pan American Health Organization (PAHO) is facing delays and funding cuts; the Region lost its measles-free status in November 2025; and President’s Emergency Plan for AIDS Relief (PEPFAR)-supported HIV services have been reduced in Central America and the Caribbean. Additionally, the United States also benefits from multilateral cooperation through disease surveillance, vaccine strain selection, and the early detection of threats. Recent outbreaks outside the region demonstrate that weaknesses in international surveillance can become risks within its own borders. Therefore, we propose reforming WHO governance, diversifying its funding, strengthening regional institutions, and establishing clear frameworks for private-sector participation in global health.”

Global health financing

Transition Cannot Sit at the Edge of the Grant: Lessons for Global Health Institutions

B Orya; https://www.linkedin.com/pulse/transition-cannot-sit-edge-grant-lessons-global-health-breshna-orya-ytfve/

“Five years ago, when I returned to the Global Fund after working at Gavi, I used the word transition in a Country Coordinating Mechanism meeting. It landed almost like a political faux pas, and I found myself explaining what I meant. I had forgotten that the word carried very different weight in the two institutions….”

HP&P – Political drivers of fragmentation in health financing in low- and middle-income countries: a conceptual framework and narrative review

S Mazumdar et al ; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag111/8825331?searchresult=1

“Fragmentation in health financing remains a persistent obstacle to equity, efficiency and financial protection in many low- and middle-income countries (LMICs). This paper develops a conceptual framework to explain how political and administrative arrangements shape fragmentation across the core financing functions of revenue raising, pooling, purchasing and benefit design. “

PS: “The Mexico and India illustrations show how reforms can expand coverage while leaving important forms of fragmentation in place….”

UHC & PHC

UNU (report) – Self-Care Pathways to Universal Health Coverage and Financing Equitable Development

N Goldin et al; https://unu.edu/publication/self-care-pathways-universal-health-coverage-and-financing-equitable-development

“How investing in self-care can strengthen health systems, protect household finances and support equitable development.”

Planetary health

BMJ Opinion- Climate resilience requires health systems that work for women and marginalised communities

C Hirsch, S H Mayhew et al; https://www.bmj.com/content/394/bmj-2026-100922

“Rukiga District in Southwest Uganda is an area that is highly vulnerable to the effects of climate change. Communities there are part of something extraordinary. Under an innovative project funded by the UK Government’s Darwin Initiative, frontline healthcare workers are trained to provide not just usual maternal care, but also to provide information about how to mitigate the worst effects of climate change to protect food and livelihoods. Working with community members, healthcare workers identify the populations most vulnerable to climate change. … “

“… This is what genuine, community owned climate resilience looks like. Yet, as leaders gather for New York Climate Week and discussions around climate action take the global stage, this vital form of infrastructure is being dangerously ignored….”

“The reality on the ground is stark: climate change is causing a reproductive health crisis….”

“… international climate adaptation strategies still treat health systems as secondary social investments, rather than essential climate infrastructure. …… We need a fundamental shift in how climate adaptation is defined and funded. We call on governments, international financial institutions, and climate funders to take three immediate steps. Firstly, governments must explicitly include family planning, reproductive and maternal, newborn and child health infrastructure in their climate adaptation strategies, including through national adaptation plans, primary healthcare services, and community health networks with the same urgency as other infrastructure. Secondly, international climate funds, including the Green Climate Fund and bilateral adaptation budgets, must break down traditional silos and allocate explicit budget lines for gender responsive, community owned health initiatives, including reproductive health. Finally, funders must shift the decision making power, bypassing rigid, top down bureaucracies, to put resources directly into the hands of local women and grassroots health workers who are most knowledgeable about the challenges faced by their communities, and therefore best positioned to design and manage their own community’s health resilience….”

Lancet Comment – Beyond rescue: building a resilient health system after Nepal’s 2026 flood

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01907-0/fulltext

By Abhilasha Karkey et al.

NCDs

Lancet GH – Burden of non-communicable diseases and their attributable risk factors in Africa from 1990 to 2023: a systematic analysis for the Global Burden of Disease Study 2023

GBD 2023 Africa NCD Collaborators; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00109-9/fulltext

Interpretation of the findings: “Our findings underscore the complex and evolving nature of the NCD burden in Africa, where modest declines in age-standardised mortality and DALY rates since 1990 have been substantially offset by rising absolute counts of deaths and DALYs—a paradox driven predominantly by rapid population growth and demographic changes. That more than half of all NCD deaths and over a third of DALYs remain attributable to modifiable risk factors—principally high systolic blood pressure, dietary risks, and air pollution—suggests that a substantial and actionable proportion of this burden is preventable through available and effective interventions, carrying urgent implications for African governments, ministries of health, and global health partners, who must take decisive action to meet health commitments.”

Lancet GH – Global inequalities in cardiometabolic care and achievable cardiovascular risk reduction by wealth, region, and sex: a pooled analysis of individual participant data from 76 countries

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00244-5/fulltext

By Bamba Gaye et al.

Human resources for health

Plos Med – Global, regional, and national impact of epidemic disasters on health workforce equality between 1990 and 2019: An ecological and modeling study

Manman Chen et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005134

“Global distribution of human resources for health (HRH) is highly unequal and less resourced regions may particularly be vulnerable to disastrous emergencies. We examined HRH losses attributable to epidemics of infectious diseases, both globally and geographically.”

Concluding: “…Epidemics of infectious diseases are associated with HRH losses globally, particularly in low- and middle-income countries, further aggravating the global inequity in the health workforce.”

NEJM – A New Approach for the Indian Health Service — Academic Physician Staffing

Matthew Tobe et al; https://www.nejm.org/doi/full/10.1056/NEJMp2604375?query=featured_secondary_home

“The Indian Health Service has limited options for recruiting physicians to its most understaffed sites. Partnerships with academic medical centers could help address long-standing physician shortages.”

Decolonize Global Health

Global Health Action – Shifting power in global health research: a checklist for research funders

Ramya Kumar & David McCoy; https://www.tandfonline.com/doi/full/10.1080/16549716.2026.2728852

“This paper introduces a checklist for research funders aimed at tackling some of the structural and political dimensions of inequity in global health research. Grounded in a framework that understands ‘decolonising global health’ across three intersecting dimensions (colonialism within global health, colonisation of global health, and colonialism through global health), the checklist is structured into six strategic areas: (1) shifting power within the health research ecosystem; (2) prioritising health equity in the research portfolio; (3) redressing historical underinvestment in health research systems; (4) addressing potential conflicts of interest that could undermine equity; (5) equitably distributing the outputs of global health research; and (6) reporting on research outcomes and impact. Acknowledging that decolonization would require a full dismantling of the existing aid/funding system, the checklist attempts to broaden the present discourse on decolonising global health research by placing the onus on funding agencies to adopt and implement measures to address structural inequities within the funding ecosystem.”

AI & health

WHO – New WHO report calls for stronger ethics oversight of AI-related health research

https://www.who.int/news/item/21-09-2026-new-who-report-calls-for-stronger-ethics-oversight-of-ai-related-health-research

“A new WHO report, Artificial Intelligence-related health research: ethics review and oversight, provides recommendations for researchers, ethics committees, regulators, funders and policy-makers to help ensure that AI-enabled health research is conducted responsibly and for the benefit of all. The report was jointly developed by WHO experts working in research ethics, science and digital health and AI….”

Papers & reports

HP&P – The Health Economics Section: scope and future

P Binyaruka et al ; https://academic.oup.com/heapol/article/41/8/1353/8816773?searchresult=1

“This editorial reflects on the evolution of the Health Economics Section in Health Policy and Planning over the past 5 years by examining the major themes, publication patterns, and geographical distribution of published articles. It also identifies emerging priorities, underexplored areas, and highlights potential areas for future health economics research. In doing so, the editorial aims to stimulate broader scholarly engagement and encourage submissions that address the evolving financing, equity, and sustainability challenges facing health systems globally, particularly in low- and middle-income countries (LMICs)….”

Annals of Global Health -Spiritual Care in Serious Illness: A Narrative Review of Low- and Middle-Income Country Evidence

Ryan Meachen et al; https://annalsofglobalhealth.org/articles/10.5334/aogh.5384

Review.

The Quarterly journal of Economics – Fairness Across the World*

Ingvild Almås; https://academic.oup.com/qje/advance-article/doi/10.1093/qje/qjag044/8787618?login=false

Among the findings: “…. Meritocratic fairness views – accepting inequality more when it reflects effort or ability than luck – are much more prominent in richer Western societies. …”

Editorial: UNGA81 – part one (IHP News #898)

Kristof Decoster — Wed, 23 Sep 2026 04:58:06 +0000

Dear Colleagues,

As “UNGA week” tends to be rather busy, we decided to come up with a mid-week issue covering and compiling most of the global/planetary health and related news so far. The 81^st UNGA General Debate opened yesterday under the theme “Restoring trust, managing transformation: a United Nations that delivers for all.”.

I’ll keep comments for Friday’s issue, just flagging here that for readers who find the newsletter a bit overwhelming, there’s usually also a relatively short AI summary (cfr top of the newsletter for the link).

It ain’t perfect, but then again, as I’m sure you’ve noticed, nothing is really perfect on this planet : ) #understatementoftheweek

Enjoy your reading, and stay tuned for part two on Friday!

Kristof Decoster

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

International Health Policies — Fri, 18 Sep 2026 04:41:28 +0000

Structure of Highlights

· PABS negotiations: a new round (14-18 Sept)

· Run-up to the UN HL meeting on PPPR

· Ebola emergency DRC

· More on PPPR

· BRICS summit in Delhi

· WHO DG race

· Global Health Reform

· More on Global Health Governance & Finance/Funding

· The Future of Development Cooperation

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

· More on the impact of US aid cuts

· Decolonize Global Health

· Social determinants of health

· SRHR

· Human Resources for Health

· Planetary health

· 2026 Goalkeepers report (& more on AI & health)

· Access to Medicines, Vaccines & other health technologies

· Some more reports

· Miscellaneous

PABS negotiations: a new round (14-18 Sept, Geneva)

With below some coverage & analysis of the opening day (and additional analysis).

· WHO – Eighth meeting of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement

HPW – As Pandemic Talks Resume, EU Diplomat Sharply Criticises ‘Ideological Polarisation’

https://healthpolicy-watch.news/as-pandemic-talks-resume-eu-diplomat-sharply-criticises-ideological-polarisation/

(11 Sept) State of affairs (from a European point of view at least) ahead of this new round.

“EU negotiator Americo Zampetti warns that ideological polarisation over pathogen access threatens to derail the WHO Pandemic Agreement.”

“On the eve of the eighth round of talks on an annex to the Pandemic Agreement, the European Union’s (EU) chief negotiator has warned that “ideology” is blocking consensus. Negotiators meet at the Intergovernmental Working Group (IGWG) at the World Health Organization (WHO) headquarters in Geneva from 14-18 September to thrash out the pathogen access and benefit sharing (PABS) system. …”

“…. The deadlock is between two camps represented by the EU on the one hand, and an alliance of the African region and Group of Equity countries on the other…..”

“We are in a world which is very polarised across this particular issue,” Americo Zampetti, Minister Counsellor for Global Health at the EU Delegation to the United Nations, told a recent European Parliament subcommittee briefing this week (7 September). “The whole agreement, let’s say the mother agreement, is kept hostage by this annex which is very, for lack of a better word, ideologically driven,” Zampetti added….”

“Other negotiation observers, including Knowledge Ecology International (KEI) and global health academics, have also urged parties to find a more pragmatic solution to the standoff….”

“… ‘Transactional approach’: …. These nations (i.e. cfr the federated model) want manufacturers to pay a subscription to be part of a PABS system, alongside mandatory technology transfers and non-exclusive licences for pandemic-related vaccines, treatments and diagnostics. “This transactional approach seems to us very unsuited to get to good results,” said Zampetti. “We need to have common sense prevail.”…”

PS: “Despite the friction, both competing models share a common technical foundation, based on a WHO Coordinated Laboratory Network for physical samples, WHO-recognised sequence databases, and Unique Persistent Identifiers to ensure end-to-end traceability of pathogen resources….”

PS: “Meanwhile, academics writing in a recent commentary in The Lancet warn that the delay in reaching agreement is enabling the bilateral agreements to “bypass multilateral systems operationally but also reduce reliance on collectively negotiated multilateral frameworks, such as the Pandemic Agreement”. This could weaken the collective bargaining power of low-income and middle-income countries, they warn….”

HPW – Developing Countries Unite Over Need for Binding Contracts with Pharma at Pandemic Talks

https://healthpolicy-watch.news/developing-countries-unite-over-need-for-binding-contracts-with-pharma-at-pandemic-talks/

(14 Sept) Must-read coverage of the opening day.

“Contracts, contracts, contracts. Virtually all the regional blocs that addressed the start of the eighth round of the pandemic agreement talks on Monday stressed that any pathogen access and benefit-sharing (PABS) system needs to include standard contracts with pharmaceutical manufacturers. These would set out the terms of accessing dangerous pathogens, as well as how to share any “benefits” – vaccines, therapeutics and diagnostics – that were developed from this knowledge. However, the powerful European Union (EU), which did not address the opening session, opposes such contracts and what its chief negotiator, Ambassador Americo Zampetti, has described as a “transactional approach” to the PABS negotiations.”

“…The World Health Organization’s (WHO) African Region, Group of Equity, Eastern Mediterranean Region (EMRO), and South East Asia Region (SEARO) all spoke of the need for “legal certainty” that such contracts will ensure….”

PS: “Arguing for the “federated” approach, Namibia told the opening of the Intergovernmental Working Group (IGWG) that Europe’s Genomic Data Infrastructure (GDI) project was based on countries retaining sovereignty over pathogen information. Some €40 million has been invested in the GDI over the past four years, uniting 70 institutes across 24 European countries. “This is the design of a federated model, where the data is held at national level,” said Namibia’s Taime Sylvester. “Its aggregated and non-sensitive information is openly discoverable through a federated query system, with controlled access guaranteed to approved users in both public and the private sectors,” said Sylvester. “We are not asking to build something new. We are asking that this meeting of IGWG8 begins from what already exists.” “

“… Algeria repeated Africa’s proposal, describing it as a “federated model as the architecture for the [PABS] system as a whole: sovereign national nodes, common rules for all, a shared index, access on agreed terms, and obligations that travel with the material and the information”. “We did not conceive this architecture in isolation. Federated systems are today the operating choice of several public genomic and health data infrastructures. What we propose is therefore not a regional approach, but a common solution applicable to all parties on the same terms, in which international cooperation strengthens the sovereign rights of states.”…”

“… However, several non-state observers of the talks support a more pragmatic approach, involving more open access to pathogen information with strings attached to any commercial products developed as a result when they are ready for sale. Championing this approach is Knowledge Ecology International (KEI), which proposes that manufacturers obtain contracts with the WHO, “not as a condition of having access to PABS materials and digital sequences, but as a condition of registering and selling products” to address pandemics or public health emergencies of international concern (PHEIC). Supporting KEI’s position was Medicines Law and Policy’s Ellen ‘t Hoen, who asked the IGWG opening whether member states would engage with the proposal – with co-chair Ambassador Tovar Nunes Da Silva assuring her that they would….”

Also with the view of CEPI.

And, surprise, surprise: “… Industry rejects ‘contractual requirements’: The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) urged negotiators to “focus on practical, open, and workable mechanisms that strengthen preparedness and accelerate scientific collaboration between public and private researchers”. It called for a PABS system that preserves “open, de-linked access, interoperability with existing databases and laboratory networks, and multiple pathways for accessing pathogens and sequence information”. “Contractual requirements, restrictive access conditions, or burdensome compliance measures introduced as a precondition for research risk creating delays precisely when speed matters most,” the IFPMA’s Grega Kumer told IGWG 8.

PS: “Top leadership present: Several countries sent their top diplomats to the opening of the Geneva talks, signalling their seriousness. This included new ambassadors to the UN in Geneva, Ireland’s Laurence Simms and South Africa’s Zaheer Laher, as well as the EU’s Zampetti. France’s Ambassador Anne Claire Amprou, former chair of the Intergovernmental Negotiating Body (INB) that negotiated the Pandemic Agreement, was also present, as was her counterpart, Precious Matsoso, who is now part of the South African delegation.”

Geneva Health Files – Positions Taut, Bureau Half-Filled: PABS Talks resume at the WHO

https://newsletter.genevahealthfiles.com/positions-taut-bureau-half-filled-pabs-talks-resume-at-the-who/?ref=geneva-health-files-newsletter

(15 Sept) “WHO member states are meeting this week in Geneva to continue negotiations on the Pathogen Access and Benefit Sharing System in the midst of some challenges: positions between countries on conceptual matters continue to be distant; and concerns on process persist.”

On Process: “Even as there is demonstrated political will to engage in these negotiations, there are practical challenges in the conduct of these discussions. This week, Intergovernmental Working Group is facing a unique situation: the six-member Bureau has at least three vacant spots. The meeting was opened by Co-Chair Tovar da Silva Nunes of Brazil. …”

“… Positions Taut: As the 8th IGWG meeting opened this week, developing countries firmed up their previously stated positions in formal statements. No opening statements were made by developed countries, although informal conversations suggested that their positions had not altered since the previous meeting in July. … “

“Both sides acknowledged that the unfolding Ebola emergency had so far failed to make an impact on these talks. “Each side is drawing their own lessons from Ebola, and is using the outbreak to serve their own narratives,” a developed country diplomat told us. …”

And a link:

· TWN – WHO PABS: Developing Countries Rally Behind Equal Footing, Contracts and Federated Model (17 Sept)

TWN – WHO: EU, Norway & allies’ PABS positions breach human rights, warn health and legal experts

S Sashikant et al ; https://www.twn.my/title2/health.info/2026/hi260902.htm

Coverage of a TWN webinar from last week.

“A group of prominent public health lawyers and civil society leaders warned that the positions taken by several developed countries in the ongoing negotiations on the establishment of a Pathogen Access and Benefit-Sharing (PABS) system in the context of the Pandemic Agreement, are inconsistent with their binding obligations under international human rights law, in particular the right to health and the right to benefit from scientific progress. The warning was delivered at a webinar held on 10September by AIDS Healthcare Foundation (AHF), the Geneva Global Health Hub (G2H2) and Third World Network (TWN) to discuss a formal complaint that 16 civil society organisations (CSO) submitted to the UN Special Rapporteur on the Right to Health on 2 July, ahead of the last session of the Intergovernmental Working Group (IGWG) negotiating the PABS instrument. The complaint targets the negotiating positions of the European Union, Norway, Japan and Switzerland….”

Run-up to the UN HL meeting on PPPR (25 Sept, New York)

Via HPW – Tedros urges approval of UN draft declaration on pandemics before the General Assembly

At a WHO press briefing on Wednesday.

“Tedros urged WHO and UN member states to approve a draft resolution on Pandemic Prevention, Preparedness and Response, due to be considered at a High Level Meeting of the UN General Assembly on 25 September, saying that the declaration could help move the world from the kind of ‘ad hoc’ actions that have been a feature of the Ebola response to more coherent measures.

“The world remains insufficiently prepared,” the WHO head declared. “In the draft declaration, countries are committing to expand research and geographically diversified production, so vaccines, diagnostics, and treatments can be available, affordable, and accessible within the first 100 days of a pandemic threat. “The draft declaration also calls for a one-health approach, inclusive community engagement, action against misinformation, stronger implementation of the [WHO] International Health Regulations,” Tedros added, referring to the rules that require countries to inform WHO promptly about any outbreak posing an epidemic risk, and coordinate its response.” And it calls for timely completion of the Pathogen Access and Benefit-sharing (PABS) annex to the WHO pandemic agreement – “which member states are negotiating here in Geneva as we speak,” he said. “It’s essential that countries finalize negotiations so the Pandemic Agreement can begin the ratification process and enter into force.”…”

· As a reminder: Lancet GH – From commitment to governance: what should the 2026 UN high-level meeting on pandemic preparedness deliver? (early online before)

OECD – The Economic Case for Pandemic Preparedness and Response: Beyond Lockdowns

https://www.oecd.org/en/publications/the-economic-case-for-pandemic-preparedness-and-response_b7b3852e-en.html

“This report examines the potential consequences of future pandemics on population health, health system resilience and the economy across 51 OECD, EU/EEA and G20 countries, using advanced epidemiological and economic modelling techniques and scenario-based analyses. It assesses the extent to which eight non-pharmaceutical interventions (NPIs) for community infection prevention and control can mitigate health and economic consequences in the early phases of five types of outbreak scenarios before pharmaceutical interventions or vaccines are available at scale.”

“The central message is clear: in the OECD, investing, on average, almost 6 USD PPP per capita per year in pandemic preparedness and response is a smart investment for both public health and economic resilience. Early implementation of NPIs such as hand hygiene, mask use and physical distancing can save more lives and limit economic disruption than delayed action, which may necessitate the introduction of lockdowns to regain control of transmission. Robust disease surveillance and stockpiling systems are essential for enabling timely and effective response…”

“…. the report makes a strong economic case for investing in preparedness before the next pandemic emerges. … the report is launched shortly before the forthcoming United Nations High-Level Meeting on pandemic prevention, preparedness and response.”

Ebola Emergency DRC

More or less with chronological updates (from key agencies), and then some more reads & analysis. The first ‘cautious optimism’ in months..

Cidrap News – DR Congo’s Ebola outbreak spreads to 7th province as cases, deaths mount

https://www.cidrap.umn.edu/ebola/dr-congo-s-ebola-outbreak-spreads-7th-province-cases-deaths-mount

(11 Sept) “The Ebola outbreak in the Democratic Republic of the Congo (DRC) has spread to a seventh province as cases rise to 6,843, including 3,310 deaths, according to media reports today. The newly affected province, Sud-Ubangi, is in the northwestern DRC, on the border with the Central African Republic and Congo-Brazzaville…

“…At a media briefing yesterday, the Africa Centres for Disease Control and Prevention (Africa CDC) warned that the outbreak is rapidly spreading beyond the epicenter. While new cases and deaths have declined in recent weeks in hard-hit Ituri province, where the outbreak originated, they have risen sharply in neighboring North Kivu and Haut-Uele….”

Cidrap News – Ebola outbreak in DR Congo grows to 7,200 cases as government officials suggest transmission has peaked

https://www.cidrap.umn.edu/ebola/ebola-outbreak-dr-congo-grows-7200-cases-government-officials-suggest-transmission-has-peaked

(14 Sept) “ The Ebola outbreak in the Democratic Republic of the Congo (DRC) has hit another milestone, with 7,200 cases confirmed by the government today and spread of the virus to a seventh province, South Ubangi, late last week. Minister says peak of outbreak was third week of August.”

“Of the confirmed cases, nearly half, or 3,475 people, have died from their infections with the Bundibugyo strain of the virus. Contact-tracing rates hover around 88%, still too low for transmission control. On Saturday, DRC Minister of Communication Patrick Muyaya wrote on X that there were signs the outbreak was slowing. “The peak has been reached since the beginning of the third week of the month of August. Ten out of 61 health zones have not recorded any cases for at least 21 days. The main hotspots such as Nia Nia, Nizi, and Mongbwalu, are recording a continuous slowdown in transmission.””

Reuters – UN sees some progress in Congo Ebola fight, but too early to call peak

Reuters;

(15 Sept) « Still a “deadly and massive outbreak”. UN officials are a bit more cautious….

“UN special Ebola coordinator Julien Harneis told a Geneva press briefing: “It remains a deadly and a massive epidemic. There are some areas of progress, but nonetheless, in other areas, we continue to see growth in cases…”

“Asked whether the epidemic had reached a turning point, WHO’s Olivier le Polain said: “It’s too early to confidently say we have passed a peak.”

(15 Sept) “The deadly Ebola virus outbreak in DR Congo continues to spread across the vast country despite some success in containing it, aid officials said on Tuesday, in a renewed call for international support to help responders on the ground. “

Cfr Mr Harneis, on financing: “The veteran aid coordinator warned that the $1.3 billion humanitarian response is only 49 per cent funded, while Ebola “makes things much worse for all Congolese, “from worsening hunger levels to falling attendance at health centres, increases in maternal mortality” and interrupted treatment for people living with HIV/AIDS. “If you don’t provide the care, if you don’t finance the care, if you don’t provide the technical resources, then Ebola is a live enemy and will come back at us,” he warned, adding that another $1 billion will be needed to sustain the response beyond the first six months. “

Reuters – Ebola response making progress in Congo, but outbreak ‘far from over,’ WHO says

Reuters;

(16 Sept) Tedros himself also expressed some cautious optimism on Wednesday. “ The World Health Organization said on Wednesday there were encouraging signs measures to contain an Ebola epidemic in Democratic Republic of Congo were gaining ground, though it warned the outbreak ‌was “far from over.” “

“Transmission was declining in the most affected parts of Ituri province, WHO Director-General Tedros Adhanom Ghebreyesus said….”

“Improved surveillance could lead to an increase in detected cases, while contact-tracing efforts had also increased, said Maria Van Kerkhove, WHO’s acting director of epidemic and pandemic threat management. “We have many, many months ahead of us,” Van Kerkhove said. “This ‌is ⁠far from over.””

“More than 3,000 healthcare and frontline workers had already been vaccinated with Merck’s Ervebo, said Meg Doherty, WHO’s director of science, research, evidence and quality for health….”

· Also coverage via HPW of this WHO press conference on Wednesday – Bundibugyo Virus Outbreak Shows Signs of Containment in Northeastern DRC – Still Expanding Elsewhere (16 Sept) With some more detail.

Reuters – Ebola outbreak in Congo is still serious, African health body says

Reuters;

(17 Sept) Africa CDC view (on Thursday). “The ongoing Ebola outbreak in Democratic Republic of Congo is still serious, with data indicating gaps in infection prevention and control, ‌Africa’s top public health agency said on Thursday….”

“While data from Africa Centres for Disease Control and Prevention showed a slight decrease in cases in the two previous weeks, Director-General Jean Kaseya said the outbreak was not yet under control. “The data could not confirm that the peak of the outbreak has been reached, and the transmission is not yet consistently controlled ‌across ⁠all affected areas,” Africa CDC’s Emergency Consultative Group said. However, Kaseya praised a slight drop in infections in the eastern Ituri province.”

“He said comments from Congo’s health officials were based ⁠on incomplete data and that they would need to see a sustained decline in cases before saying the peak had passed….”

“Four months after the Ebola outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo was designated a Public Health Emergency of Continental Security (PHECS), the Africa CDC Emergency Consultative Group (ECG) has completed an independent scientific review and issued recommendations for the next phase of the response.”

“After reviewing the latest epidemiological, operational and scientific evidence, the ECG supports a position of cautious optimism. Declines in cases and deaths in some hotspots, including Ituri, are encouraging, but the situation remains heterogeneous, with increases in some health zones, particularly in North Kivu. The available data do not yet confirm that the outbreak has reached its peak. The Group therefore recommends maintaining the PHECS, scaling up response intensity, consolidating gains, addressing persistent community deaths and gaps in contact identification, strengthening community ownership, and protecting and restoring essential health services….”

HPW – DRC’s Ebola Lessons: Learned and Unlearned (Part I)

Mukesh Kapila; https://healthpolicy-watch.news/drcs-ebola-lessons-learned-and-unlearned-part-i/?feed_id=1061&_unique_id=6aa7ce4192094

One of the reads of the week. And this is only part I !

“The lethality of the Ebola outbreak in the Democratic Republic of Congo (DRC) is not just in its genome. Neither is it entirely explained by the country’s internal instability and defunded, broken health infrastructure. Have we allowed the virus to outsmart us by overlooking past lessons?”

BMJ Editorial – Ebola business narrative and the cycle of distrust

Sophie Harman et al ; https://www.bmj.com/content/394/bmj-2026-100849

“Credibility and trust are key to transforming the response.”

“Global health leaders have called for additional support for frontline health workers and effective coordination of the response, and for donors to speed up the dispersal of pledged aid. Some $264m has been disbursed, but an estimated $518m is needed for the immediate response and another $882m for the humanitarian crisis. Missing from these calls is an urgent need to tackle one of the greatest challenges to the response: the “Ebola business” narrative and the cycle of mistrust it perpetuates. The term “Ebola business” first appeared during the 2014 West African Ebola outbreak, to connote widespread corruption and mismanagement…”

PS: “Within global health diplomacy, Ebola is a crucial test case for the efficacy of the multilateral system. The outbreak again shows the need for effective pandemic preparedness and response, and the type of collective health security exemplified by the Pandemic Agreement. A successful Ebola response led by WHO would give states an incentive to trust multilateral processes and ratify the agreement. Failure will create further fissures between and across member states, undermine trust, and set the ratification process back years. The cycle of distrust can be broken….”

And: “… To address the gender burdens of the emergency, WHO must support national agencies in collecting and publishing gender disaggregated data, and agencies with expertise on sexual and reproductive health and continuity of essential services must not be marginalised in the response plan. The unfolding maternal mortality crisis may warrant adding a standalone pillar for maternal and child health….”

HPW – Doctor Calls for Psychological Support for Ebola Survivors and Families

https://healthpolicy-watch.news/doctor-calls-for-psychological-support-for-ebola-survivors-and-families/

“After a gruelling recent Ebola infection, Dr Patrick Oparpio, a gynaecologist based in Bunia in the Democratic Republic of Congo (DRC), has urged health authorities to offer psychological support for Ebola survivors and their families….”

Lancet Comment – Compassionate care for patients with Ebola virus disease

Nelson K Sewankambo et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01770-8/fulltext

“Compassionate care asks what health systems owe a person who is sick, frightened, separated from family, recovering, or dying. Although, compassionate care is a clinical and moral obligation, it is under pressure in this outbreak. We identified six recurring challenges to compassionate care and propose potentially low-cost untested practical responses to be evaluated during the outbreak….”

More on PPPR

Bloomberg – Congo’s Ebola Crisis Spurs IMF to Consider Pandemic Financing Reforms

Bloomberg;

“The International Monetary Fund is considering making pandemic preparedness reforms part of its financing program for the Democratic Republic of Congo. Congo is working with the World Health Organization and World Bank on measures that could be incorporated into the IMF’s Resilience and Sustainability Facility.”

“The country’s Ebola outbreak has expanded to confirmed infections and deaths across six provinces, with Congo and its partners estimating they need $1.3 billion over six months to contain the outbreak….”

“… Congo is working with the World Health Organization and World Bank on measures that could be incorporated into the IMF’s Resilience and Sustainability Facility at a future review, according to a report it released Tuesday. Discussions have focused on developing a strategy for financing pandemic prevention and response.”

“Public health shocks in the DRC are recurrent rather than exceptional,” the Washington-based lender said, citing repeated outbreaks of Ebola, cholera, measles and other diseases. Without stronger preparedness and more effective financing and coordination, future health emergencies could “threaten macroeconomic stability.”…”

BRICS summit in New Delhi

BRICS New Delhi Declaration: Building for Resilience, Innovation, Cooperation and Sustainability (September 12)

Declaration

On health, do read items 50-59 in full.

Economic Times – Leaders of BRICS countries call for stronger cooperation in health, endorse initiatives on TB

https://health.economictimes.indiatimes.com/amp/news/policy/leaders-of-brics-countries-call-for-stronger-cooperation-in-health-endorse-initiatives-on-tb/134177013

Recommended analysis from a health angle. “In the New Delhi Delhi Declaration after their meeting, the leaders said they reaffirmed their commitment to advancing universal health coverage through “resilient, inclusive and people-centred approaches”.”

· Related read: Brics is rewriting the Global South’s health playbook (by V Bhanu, in First Post)

“The Delhi declaration places health resilience alongside economic growth, technology and global governance.”

“The New Delhi Declaration adopted at the 18th Brics Summit does more than recognise health as a developmental priority. It begins to outline a distinctly Global South approach to public health — one that combines universal health coverage, disease prevention, local manufacturing, digital technology, research and stronger national health systems.”

“For India, which chaired Brics in 2026 under the theme “Building for Resilience, Innovation, Cooperation and Sustainability,” this is an important diplomatic outcome. The declaration places health resilience alongside economic growth, technology and global governance. That shift matters. Health cooperation among developing countries has often centred on individual diseases, medicines or emergency responses. The New Delhi Declaration attempts something broader. It connects tuberculosis with research and technology. It links obesity with prevention. It brings mental health into primary care. It connects universal health coverage with digital health, regulation, workforce capacity and local production. The result is not yet a new health institution. But it could become the foundation of a new health architecture….”

PS: “The implementation test: The New Delhi Declaration has ambition. Its weakness, like most summit declarations, lies in execution. Brics now has missions, roadmaps, networks, working groups, compendiums and proposed collaborative platforms. The next step must be measurable delivery. The grouping should identify a small number of flagship health outcomes for the next three years. TB research, obesity prevention, digital health interoperability, mental health integration and regulatory cooperation offer obvious starting points. Each should have timelines, institutional ownership and measurable indicators…..”

· And a link: WHO – BRICS leaders advance commitment for traditional medicine in New Delhi Declaration

“Global Health Reform Traditional, complementary and integrative medicine (TCIM) has received its strongest endorsement yet by the BRICs group of countries. The leadership statement, issued at the close of the New Delhi meeting on 12 September 2026, dedicated a full paragraph to TCIM, recognizing important commitments agreed by BRICS health ministers in July 2026, including a BRICS expert working group on TCIM. “

“The BRICS New Delhi statement signals an important progression from policy recognition towards concrete operational cooperation among Member States. For the first time, BRICS leaders have formally welcomed the proposed establishment of a BRICS Expert Working Group on TCIM under the BRICS Health Track, creating a platform for dialogue, collaboration and exchange among Member States. …”

WHO – Countries move to strengthen public health institutions and services amid mounting pressures

https://www.who.int/news/item/14-09-2026-countries-move-to-strengthen-public-health-institutions-and-services-amid-mounting-pressures

(must-read) Update on EPHFs – with also BRICS related info.

“As health challenges grow more diverse and complex, and public budgets tighten, WHO Member States are increasingly looking to more integrated public health capacity and services that can better promote and protect people’s health, prevent illness and respond to emerging threats. More than 120 countries have identified building institutional capacity to deliver essential public health functions (EPHFs) as a medium-to-high priority for WHO support.

“…Building national institutional capacity to deliver EPHFs is a dedicated output of WHO’s Fourteenth General Programme of Work (GPW14) – WHO’s global strategy for 2025–2028….”

“…Growing international momentum: The EPHF agenda is also gaining momentum through multilateral cooperation. The 16th BRICS (Brazil, Russia, India, China and South Africa) Health Ministers’ Declaration, adopted in July 2026 under India’s chairship, recognized NPHIs as National Centres of Excellence for essential public health functions and endorsed an operational framework for the BRICS Network of NPHIs.”

“The Declaration highlights the importance of universal health coverage (UHC) packages as a foundation for sustaining the pathway towards health for all, health security and other social development goals (SDGs). Moreover, it underscores technical cooperation among public health institutes as a shared priority. WHO’s existing work on EPHFs provides a basis for engagement with the BRICS Network of NPHIs and other multilateral initiatives including the International Association of National Public Health Institutes. It also creates opportunities to expand South–South cooperation and institutional partnerships, including with India, China and other BRICS members and partners.”

PS: “Amid growing resource constraints, multilateral development banks (MDBs) have a critical role to play in financing on the right terms and with the right priorities, aligned with the UHC mission and governments’ own systems and plans. The prospect of a BRICS New Development Bank financing window dedicated to digital determinants and social determinants of health (DD-SDH) health infrastructure – supporting primary health centres; water, sanitation and hygiene (WASH); and housing with a pro-poor focus – is a welcome development….”

BRICS finance chiefs are pushing for reforms to the IMF and World Bank to give emerging economies a “stronger voice”

https://www.globalbankingandfinance.com/brics-finance-chiefs-urge-reform-global-development/

“BRICS finance chiefs convening in Mumbai on Sept 11 called for reforms to global development banks like the IMF and World Bank, demanding greater voice for emerging economies, payment system interoperability, and digital currency linkages.”

WHO DG race

HPW – The Networks that Shape the Early Digital Campaigns for WHO Director-General Election

https://healthpolicy-watch.news/networks-early-digital-campaigns/

(must-read, obviously) “The race to lead the World Health Organization (WHO) is intensifying. Early digital campaign data reveals an active contest to capture the pivotal African vote and outreach to established United States, European Union and corporate networks. While the full field of contenders is still taking shape ahead of the nomination deadline, digital engagement metrics already highlight geographical and institutional fault lines.”

“Our analysis examines the contrasting leadership models and digital campaign themes established in the candidates’ initial announcements, and maps their core networks across state and diplomatic accounts. It also tracks their competing bids for the pivotal African regional vote, evaluates their strategic reach into US and European policy circles, and unpacks the distinct corporate, academic, and civil society networks reacting to their campaigns. Here is what the data reveals….” (ps: analysis based on LinkedIn)

Excerpt: “Ultimately, the divergence between the active platforms of Balkhy and Kluge highlights a critical strategic contrast in how the prospective candidates envision leading the WHO through its next era:

· Balkhy’s campaign relies on a foundation of clinical authority and biosecurity expertise, targeting scientific excellence and frontline epidemic containment. Backed by a highly disciplined GCC sovereign core and key ties within Washington’s health security circles, her model offers the organization institutional stability and sovereign financial backing.

· Kluge’s campaign, positioned at the intersection of European public administration, multinational industrial partners, and progressive civil society, relies on diplomatic agility and open-door dialogue. Yet, because his platform functions as a public policy forum, his candidacy is directly bound to the friction of systemic WHO reform, internal staff grievances, and post-colonial African demands for structural financial autonomy.

Meanwhile, Qatari candidate Hanan Mohamed Al-Kuwari has remained largely absent from social media channels, whereas Indonesian Health Minister Budi Gunadi Sadikin has featured prominently in high-level policy commentary….”

Global Health Reform

Nature Medicine – Rethinking the global health system for a new international order

Kumanan Rasanathan, JA Rottingen et al; https://www.nature.com/articles/s41591-026-04622-0

Must-read. “In this Comment, we argue for a global health system that recognizes and supports countries as the primary agents of action, oriented around global public goods and collective action, and served by a leaner set of global and regional institutions. We present a potential vision for the functions and distribution of labor in the system to inform ongoing reform discussions and draw critique, dissent and amendment.”

PS: “…Here we aim to answer the questions we posed a year ago on the functions of the global health system. We build on our previous taxonomy of global health system functions and contexts and propose three cross-cutting, linked domains for action (Fig. 1), aspiring to support ongoing deliberations by providing reform options for critique, dissent and amendment….”

For a quick summary of the Nature Medicine article.

Kumanan Rasanathan – Can we reform the global health system?

https://www.linkedin.com/pulse/can-we-reform-global-health-system-alliance-hpsr-xu7fe/

Alliance Exec director & First author of abovementioned Nature Medicine article. And one of the reads of the week:

“… Almost two years since rapid reductions in global health funding triggered the current round of deliberations on the global health architecture, I understand why some might question whether global health reform is possible. Over the last thirty years, the global health architecture has evolved through the establishment of new organizations to serve identified needs, but many good-intentioned attempts at increasing coherence or addressing flaws have had minimal impact.

But given we have just published a further paper on reform of the global health system, clearly, I feel that change is possible. There are three reasons I think this time could be different. First, the current crisis changes the incentives – less money for global health actors enforces the need to prioritize and increase efficiency (with the Alliance being no exception). Second, the rapid changes in geopolitics with a more multipolar international order makes the current model where the bulk of global health funding comes from a handful of countries (whose populations are increasingly unwilling to bear these costs) increasing untenable. Third, and most importantly, countries want to see change as manifested in the call for ‘health sovereignty’ and most nations’ capacities for health have substantially improved in this ‘golden age of global health’.

So, the current attempts at global health reform might just be able to tackle the underlying distribution of power in global health decision-making, which previous efforts have ignored….”

PS: “… Yet, there is an overarching reason we need to reform the global health system that perhaps draws too little attention – beyond funding cuts and issues of sovereignty. That, for all the progress and successes over the last thirty years, the global health system is not delivering for billions of people … The most important reason we must reform the global health system is that we need to do much better in promoting, protecting and delivering people’s health. Amidst the undeniable harms caused by the recent funding cuts, we must not squander the chance to do so.”

Lancet Comment – The Accra Reset must turn sovereignty into country power

E Okereke et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01864-7/fulltext

Another must-read.

“…. Launched in 2025 and anchored by heads of state, the Accra Reset frames sovereignty as a measurable discipline of negotiation, execution, and accountability. Its health architecture now connects three mechanisms. The High-Level Panel on Reform of the Global Health Architecture and Governance (HLP-GHAG) defines what must change. The High-Level Consultative Group and Reform Interlock Observatory track whether institutional commitments become visible inside countries. The Health Investment National Gateways Enabler converts reform into executable national investment compacts. The HLP-GHAG is due to report with its recommendations for change to the Presidential Council at the UN General Assembly on Sept 21, 2026. These interconnected structures create a rare opportunity for a reset. The test will be whether they move country leadership from principle to enforceable power….”

“On July 12, 2026, ten senior African women working across public health, academia, civil society, policy, and development finance met in an independent informal consultation under the Chatham House Rule to share their perspectives about the Accra Reset and its implications for the African continent….”

“… Our conclusion was clear: country leadership cannot depend on the goodwill of external institutions. Countries need to exercise the authority and strengthen the capacity to set and implement priorities, monitor compliance, and reject programmes or agreements that cut across national interests. We propose five practical shifts to convert that conclusion into action….”

“First, governments need full visibility and regulatory oversight of external health financing, programmes, and agreements operating within their countries. … Second, governments need permanent capacity to negotiate the terms of external health financing and partnerships, and to translate nationally agreed health priorities into funded, executable programmes…. Third, the alignment of external partners’ funding and programmes with nationally agreed health priorities, indicators, and delivery systems must be measurable and consequential…. Fourth, governments should include Africa’s assets in health negotiations when strategically relevant and with the necessary legal backing. … Fifth, health reform must be linked to financial reform. Debt service, weak revenue systems, high capital costs, and global financial rules constrain fiscal space….”

Devex (Opinion) – Global health agrees on reform. Now, who will give up power?

Ebere Okereke; https://www.devex.com/news/global-health-agrees-on-reform-now-who-will-give-up-power-113294

“Global health institutions increasingly agree that countries should lead. The harder question is what they are prepared to give up to make that possible.”

“So, who decides? This is where what I call a “power audit” comes into play….”

Partnership for International Politics and Diplomacy for Health – A new brief on the future of health financing

https://globalhealthdiplomacy.se/a-new-brief-on-the-future-of-health-financing

“A new vision for how the world finances health is taking shape — one in which countries lead, domestic resources form the foundation, and international cooperation is built around shared priorities rather than dependency.”

“Our new brief, The future of health financing, offers a perspective on that question, and on what it will take to turn this moment into lasting reform. It builds on a series of roundtables convened between December 2025 and March 2026, which brought together more than twenty leaders from economics, finance, global health and politics under the Chatham House rule, and draws on the wider reform discourse now unfolding. At its heart is a simple argument: the debate is not only about money, but about power — who sets priorities, who is accountable, and on whose terms countries cooperate. “

“The brief sets out three interdependent parts of a future financing model — domestic resources as the foundation, development assistance as a strategic and time-bound complement, and global public goods financed collectively for the benefit of all. It considers how, in practice, change can be delivered.”

PS: “As reform processes conclude and new institutional leadership arrives, the next eighteen to twenty-four months present a rare opportunity. Each funding decision, governance reform and institutional change has the potential to make financing for health more fit for the future.”

More on Global Health Governance & Finance/Funding

NYT – The Doctor Pressuring African Leaders to Own the Ebola Response

https://www.nytimes.com/2026/09/12/world/africa/jean-kaseya-africa-cdc.html

(must-read) “International agencies and foreign donors have long driven campaigns to defeat diseases like Ebola. Dr. Jean Kaseya, the head of the Africa C.D.C., wants to change that.”

Broad-ranging analysis of Kaseya’s leadership so far, criticism, and how he wants Africa CDC to develop further.

PS: “… only 21 percent of the agency’s funding comes from African governments, Dr. Kaseya said, leaving it reliant on foundations and other donors….”

Oxfam – IMF-required austerity cuts quadrupled over past decade, and new Fund policy is poised to push for even deeper and harsher cuts

https://www.oxfam.org/en/press-releases/imf-required-austerity-cuts-quadrupled-over-past-decade-and-new-fund-policy-poised

Must-read. “The International Monetary Fund (IMF) has required borrowing countries to quadruple the size of their austerity cuts over the past decade, while simultaneously weakening the protection afforded to social spending in its loan programs, reveals new Oxfam analysis. These cuts undermine vital spending on public services – from healthcare to education and housing – that protect low-income communities.”

“The findings come ahead of the conclusion of the IMF’s 2026 Review of Program Design and Conditionality, amid fears that the Fund could return to 1980s-style structural adjustment by demanding “frontloaded” cuts, which require governments to slash public spending in bulk at the start of a program rather than phasing in cuts over multiple years….”

“Oxfam’s analysis shows that median annual IMF-required austerity cuts (“budget-balance targets”) increased from 0.21 percent of GDP between 2012 and 2017 to 0.85 percent of GDP between 2018 and 2025, a four-fold increase. Between 2018 and 2025, the IMF required nearly half of countries (25 out of 54) to cut public spending by more than 2 percent of GDP over the course of their program, compared to just one-third (12 out of 42) between 2012 and 2017. Low-income countries spend on average 0.8 percent of GDP on social protection while spending on education remains below 4 percent of GDP….”

“Oxfam warns that the IMF could now seek to embed “frontloaded fiscal adjustment” as a core requirement across future programs….”

… The IMF relies on “social spending floors” to address the harmful impacts of its programs. These floors typically require minimum spending on basic safety nets for targeted, poorer populations. Oxfam’s analysis shows that while more programs now include these floors, the protection they offer is shrinking. The median IMF-required social spending floor fell from 25 percent of current spending between 2012 and 2017, to 11 percent between 2018 and 2025.”

“The IMF is in danger of regressing to the dark ages of structural adjustment,” said Oxfam International Senior Policy Advisor Nabil Abdo. …”

“… Oxfam is urging the IMF Board of Executive Directors, ahead of its 14 September meeting, to reject a return to structural adjustment under the guise of “frontloaded fiscal adjustment” and to ensure its programs don’t exacerbate inequality. The IMF should prioritize alternatives to austerity, including progressive tax policies like taxes on wealthy individuals and corporate windfall profits, to build sustainable revenue without pushing millions more people into poverty. “

“Over 130 civil society organisations from around the world have today published an open letter to the IMF’s executive board, warning against a return to frontloading austerity in IMF programmes.”

Project Syndicate – The Program Redesign the IMF Needs

M Guzman & J Stiglitz; https://www.project-syndicate.org/commentary/three-issues-for-imf-review-of-program-design-by-martin-guzman-and-joseph-e-stiglitz-2026-09

“The International Monetary Fund’s guidelines for program design are more salient than ever, given widespread debt distress in developing countries. As the Fund undertakes its first major evaluation since 2019, it should focus on three features of its lending, all of which need to be reformed.”

“The International Monetary Fund is conducting a Review of Program Design and Conditionality, its first major evaluation since 2019, before the COVID-19 pandemic. The IMF review should address at least three critical features of IMF program design—with a view to reforming all of them….”

“The first is policy conditionality. IMF financing is supposed to play a stabilizing role, meaning that it should enable countercyclical macroeconomic policies in countries that do not have access toother sources of financing. It should never be used to meet payments on unsustainable debt…”

“… What we should not see is IMF financing supporting programs that include contractionary fiscal policies—for example, cuts to investment in public infrastructure, education, and health—while the government continues repaying debts to the private sector or to other creditors that refuse to provide financing to roll over those debts. This has become a worrying pattern in many developing countries, as explained last year in the Vatican’s Jubilee Report for Pope Francis. In some recent years, multilateral financing for developing countries seems to have supported an outflow of funds to the private sector, rather than an expansion of domestic investment….”

“… The second feature of program design concerns contingency plans. Programs are based on baseline assumptions, but reality is uncertain, and there can be significant deviations from those assumptions—all the more so in a global environment that has become highly unpredictable….”

“… The third feature of program design that the Fund must address is ownership. This is a critical criterion for IMF exceptional-access lending—that is, lending above certain limits. IMF loans bind successive governments and even generations. Ownership should mean genuinely broad political and social support, not merely the incumbent government’s assent, or even commitment, to implement the agreed-upon policies. After all, the government’s agreement may be based on a calculus of its own survival, rather than the country’s long-run well-being. We have seen cases where politics has seemed to influence lenders as well, even the IMF.”

“One possible criterion of ownership would be parliamentary approval of the agreement reached between a government and the IMF. In an era marked by democratic backsliding, transparency, public accountability, and ownership are especially important today….”

Devex – The Global Fund ramps up its procurement role

https://www.devex.com/news/devex-checkup-another-casualty-of-pepfar-cuts-113309

“Buying power: The Global Fund to Fight AIDS, Tuberculosis and Malaria is ramping up its procurement role. The U .S. bilateral health agreements and their implementation plans seem to envision a role for the Global Fund in procuring health products. And at its latest meeting, the Global Fund’s board approved the creation of a prefinancing mechanism to help countries place health product orders via wambo.org, the fund’s procurement platform, while they wait for national budget funds to become available.”

“But does this risk putting the Global Fund at odds with growing calls for greater regional and country sovereignty — including the emergence of regional procurement platforms such as the African Pooled Procurement Mechanism, led by the Africa Centres for Disease Control and Prevention? Global Fund Executive Director Peter Sands said he sees the fund’s procurement work as complementary rather than competitive. “The approach we’re taking is what we call collaborative procurement,” he said during a press conference this week. “Essentially we are working to support the development of national and regional procurement platforms. … But we also think that there is likely to be an ongoing role for a global procurement platform for a number of reasons…”

Devex – Aid’s Lucky charm

Devex;

“Ireland has taken over the rotating presidency of the Council of the European Union, putting Dublin in the driver’s seat in determining the direction of the EU. Its presidency runs from July to December, and this time around, Ireland has made international development a defining part of its agenda.”

“It hopes to sustain Europe’s aid budget at a time when, across the world, support for foreign assistance seems to be withering away — and to do so by cementing the bloc’s seven-year budget strategy in the months to come. As Ireland settles into the EU Council presidency, much of the pressure to make good on its development ambitions falls on Neale Richmond, Ireland’s minister of state for international development.”

“Despite its comparatively small aid budget — €1.88 billion in 2025 — Ireland has long been a proponent of foreign aid. According to a 2024 study, over 70% of the country’s population believe in the value of foreign assistance, and Ireland intends to use its role at the helm of the EU Council to push that belief forward. “We’re not being unrealistic — our blunt, sole aim is to make sure there’s an EU development program in the next round,” says Richmond. “We’re not asking for massive increases. We just want to save European development.””

“The European Union is in the middle of a two-year process to develop its next budget, writes my colleague Jesse Chase-Lubitz. That budget — which is referred to as the Multiannual Financial Framework — dictates how money will be parsed out over the next seven years. And right now, European nations are deadlocked over how much should go toward development cooperation and humanitarian aid. “As politicians, we’ve lost some of our inner conviction that this is the right thing to do,” Richmond tells Jesse. “We need to push back on false narratives — and on the excuse the Trump administration has handed too many European governments to cut their budgets or reprioritize toward defense and domestic spending. It shouldn’t be that easy.”…”

Frontiers in Public Health – Private capital in a public field: A qualitative study of philanthropic influence in Germany’s global health governance

H Herdkamp et al; https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1960171/abstract

“Over the past two decades, Germany has emerged as a key contributor to global health initiatives and has developed close working relationships with international foundations, particularly the Gates Foundation and the Wellcome Trust. This study examines how global health stakeholders in Germany perceive the evolving role and influence of international philanthropic foundations within the country’s domestic global health landscape and explores the implications for global health governance….”

ECPR – How the Gates Foundation Sustains European Donors’ Political Support for Global Health Initiatives

K Storeng et al https://ecpr.eu/Events/Event/PaperDetails/90222

(only abstract so far – presented paper).

“…. Building on our recently published research on the Gates Foundation’s network diplomacy and policy and its advocacy grants in its European focus countries (the UK, Germany and France), this paper examines how the Gates Foundation has constructed a political advocacy apparatus to support the replenishment of the global health initiatives it has co-founded and backed over the past 25 years. We argue that the Foundation has successfully built advocacy coalitions which, through targeted campaigns, have elevated global health initiatives from the technocratic to the political arena in European donor countries and secured successful replenishments, even amid significant cuts to overseas development assistance. Empirically, the paper presents an in-depth case study of Gavi’s 2025 replenishment campaign in Norway, a co-founder and consistent funder of Gave and the Global Fund. We analyze the Gates Foundation’s “network diplomacy” with the state apparatus alongside its support for civil society and knowledge institutions to amplify political backing….

“… Overall, we demonstrate that the Gates Foundation’s policy and advocacy strategies play a central role in sustaining political and financial support for specific global health initiatives, fostering alignment between donor governments’ global health budgets and the Foundation’s own priorities. This raises important questions about the political influence of a foreign private foundation – controlled by one of the world’s wealthiest individuals – on European democratic decision-making.”

AJHESP – Can national health compacts reduce aid dependency? Comparative insights from Uganda, Ethiopia, and Rwanda

Bernard Jackson Zikanga; https://www.africanjhesp.org/content/article/2/1/full/

“… national health compacts are intended to strengthen government stewardship, partner coordination, policy alignment, and mutual accountability. Despite differences in the maturity of their coordination arrangements, Uganda, Ethiopia, and Rwanda continue to rely substantially on external resources to finance their health systems. Rwanda’s experience demonstrates that strong country-led coordination can coexist with high levels of aid dependence. The findings indicate that health compacts primarily influence the governance of financing rather than the sources of financing, which are determined largely by domestic revenue mobilization and fiscal capacity. While health compacts can improve aid effectiveness, their contribution to financing sustainability depends on complementary reforms that strengthen domestic resource mobilization, public financial management, fiscal space for health, and sustainable financing of the health workforce.”

The author concludes: “national health compacts can improve aid effectiveness, country ownership, and coordination of external assistance, but they do not by themselves reduce aid dependency. Sustainable progress towards financing sovereignty requires complementary reforms in domestic resource mobilization, fiscal space for health, public financial management, and health workforce financing.”

LSE (blog) – Beyond the Technical Fix: Why Managing Domestic Politics is the Key to Unlocking Health Taxes

https://blogs.lse.ac.uk/activism-influence-change/2026/09/14/beyond-the-technical-fix-why-managing-domestic-politics-is-the-key-to-unlocking-health-taxes/

“Will Klemperer and Douglas Mushinge argue that health taxes on tobacco, alcohol and sugary drinks are technically well-justified but politically fraught. Reform succeeds or fails based on domestic politics rather than just evidence. Drawing on comparative analysis across Kenya, Tanzania, Uganda and Zambia, they lay out five political questions policymakers should address, arguing that political economy analysis should sit at the centre of health tax reform, not as an afterthought to the technical case.”

Concluding: “… The debate over health taxes has become dominated by technical questions: tax rates, revenue projections and disease burdens. Those questions matter – but they are no longer the principal constraint. In many countries, governments already know what the evidence says. What they need is a politically viable route to implementation. The next frontier is therefore political, not technical. Success will depend on understanding who wins and who loses, identifying reform windows, building durable domestic coalitions and tailoring strategies to national political realities rather than importing generic models. Political economy analysis should no longer be treated as a useful add-on to health tax reform. It should sit at its centre.”

Future of Development Cooperation (& post-2030 brainstorm)

Jonathan Glennie – Naturally together

Substack;

Very cool read, on the world as it should be sooner rather than later…. “The SDGs told us what matters. The next era should be about how we change our ways of thinking and doing to build a better world.”

“The SDGs’ greatest achievement was not managerial but normative. In 2015 the governments of the world agreed on an unusually expansive definition of progress. …. The universality of that statement was especially important. … … This was the paradigm shift of 2015. It should not be discarded simply because the machinery built around it proved imperfect. The more useful question for the period after 2030 is therefore not what should replace the SDGs, but what the world has learned about how to live by the principles they established.”

“… That is the starting point of Naturally Together, a new paper from the Global Cooperation Institute, written by my colleague Ben Phillips and commissioned by WWF International. Its title captures two forms of interdependence that international policymaking still has difficulty holding in its head at the same time: our dependence on one another and our dependence on nature…”

“Over eight decades, the international community has constructed a surprisingly coherent, if institutionally fragmented, body of commitments. Human-rights agreements describe how people should be treated. The SDGs set out many of the social, economic and institutional conditions of a flourishing society. The climate regime recognises one set of physical limits within which that society must operate; the global biodiversity framework recognises another. They emerged through different negotiations, institutions and political coalitions, but intellectually they are pieces of the same puzzle. The puzzle is simple to state and difficult to solve: how should billions of people live well together on a single planet? Seen this way, human rights, development, climate and biodiversity are not rival agendas competing for ministers’ attention. They are different dimensions of the same project. International organisations may have separate conference rooms for them; the planet does not.”

“… The next phase should therefore pay less attention to constructing another comprehensive list and more to the transformations capable of advancing several objectives at once….”

“Four such shifts seem particularly important…. From extractive to regenerative; from fragmented to integrated policymaking; From short-termism to stewardship; From concentrated power to shared agency.”

Global Partnership for Effective Development Cooperation – After Eight Years, New Global Data Reveals the State of Development Effectiveness

https://www.effectivecooperation.org/resources/reportlaunch

“The Global Partnership for Effective Development Co-operation launches Making Development Co-operation More Effective Progress Report 2026, its first progress report since 2019, alongside a new interactive Data Portal and a High-Level Dialogue on 6 October 2026.”

“For the first time in eight years, the international community has a comprehensive, evidence-based picture of whether development co-operation is being delivered effectively — and the findings are a call to action. Released by the Global Partnership for Effective Development Co-operation (GPEDC) and co-published by the OECD and UNDP, Making Development Co-operation More Effective Progress Report 2026 draws on the results of the 2023–26 monitoring round with reporting from 44 partner country governments, 93 development partners, as well as by civil society organisations, trade unions, and private sector representatives from a wide range of countries.
Arriving more than twenty years after the launch of the Paris Declaration monitoring survey, the report lands at a moment defined by overlapping crises, geopolitical fragmentation, and unprecedented cuts to official development assistance. At a time when development resources are under severe strain, the question of how effectively partners work together has never been more consequential. “

“ The evidence is sobering…..” : “Development co-operation recorded on partner country budgets has fallen sharply (from 61% in 2018 to 41% in 2026), progress on untying aid has stalled, and development partners’ use of country data and systems remains low and declining.

“There are encouraging signs: More partner country governments, 45% compared with 31% in 2018, now have systems in place to track and publicly report budget allocations for gender equality and women’s empowerment, reflecting real progress on SDG indicator 5.c.1. The quality of public financial management systems has improved in key areas. Almost all partner countries now have a national development plan in place — most setting out clear priorities, targets and results indicators. These foundations show that where there is commitment, the principles of development effectiveness are being translated into practice.”

“From evidence to action: Through Action Dialogues, 25 partner country governments are turning monitoring findings into concrete, jointly agreed reforms to improve predictability, transparency, and the use of country systems. “

PS: “The report will take centre stage at the Global Partnership’s High-Level Dialogue (HLD) on Advancing Effective Development Co-operation on Tuesday, 6 October 2026 (13:00–16:00 CET, online), held in the margins of the 81st UN General Assembly.”

ECDPM – Development cooperation in a changing European strategic environment

https://ecdpm.org/work/development-cooperation-changing-european-strategic-environment

One of the reads of the week. “Alexei Jones and Andrew Sherriff argue that development cooperation should neither be insulated from wider European interests nor simply absorbed into them. Its future will depend on Europe’s ability to clarify what development cooperation is for, recognise its unique contribution and manage the trade-offs between different objectives and interests.”

“… The paper identifies ten factors likely to shape European development cooperation over the coming decade….”

CGD – The Development Leaders Conference 2026: From Rethinking Development to Rebuilding It

A Käppelli et al ; https://www.cgdev.org/blog/development-leaders-conference-2026-rethinking-development-rebuilding-it

“… development leaders will gather in Madrid on 28–29 October for the 2026 Development Leaders Conference (DLC), co-hosted by the Center for Global Development (CGD) and the Spanish Agency for International Development Cooperation (AECID). … Ahead of the meeting, we look at how the development cooperation landscape has shifted since leaders last gathered and how those changes will shape the discussions in Madrid….”

Vox – Rethinking development cooperation: The case for a ‘balance sheet’ approach

A Latortue et al; https://voxdev.org/topic/institutions-political-economy/rethinking-development-cooperation-case-balance-sheet-approach

« As global aid budgets shrink, the Future of Development Cooperation Coalition proposes a ‘development balance sheet’ that reframes low- and middle-income countries not as aid recipients but as economic actors managing their own assets and liabilities….”

Guardian – ‘Sweat the asset’: new development minister plots path to make UK aid count

Guardian;

“Kirsty McNeill reaffirms Labour’s 0.7% of GDP pledge and promises value for money to allay voter concerns.”

Devex: Why the new UK aid minister thinks ‘development’ is outdated

Devex;

“Kirsty McNeill has laid out a vision for international aid that is based on “mutual interest” between the global north and south.”

“In a speech on Monday evening, recently minted U.K. development minister Kirsty McNeill said the concept of “development” is outdated, and suggested that she should be known instead as the “minister for security through solidarity.”

““The era of development is over, and the era of mutual interest and shared resilience is upon us,” said McNeill, a former executive director at Save the Children. … The “mutual interest” framing stands in contrast to the rhetoric from some recent U.K. governments, which have argued that aid should be spent “in the national interest.”…”

CGD – Don’t Change ODA Graduation Rules To Score Assistance to Rich Small States

C Kenny et al; https://www.cgdev.org/blog/dont-change-oda-graduation-rules-score-assistance-rich-small-states

Kenny reacts to Carsten Staur (DAC chair) ’s reaction from last week : ) “The OECD’s Development Assistance Committee (DAC) chair Carsten Stauer suggested on Monday that any changes to ODA graduation rules would be limited to highly aid dependent countries nearing the high-income cutoff:…”

Kenny: “… even under the current rules gradation is not automatic, and must be agreed by members. And there is nothing that prevents any DAC donor from providing assistance to a country that has graduated from the ODA threshold. Given all of that, it is surely possible to leave the current graduation rules as they are, but clarify and codify DAC discretion on graduation dates. The committee could agree that otherwise ODA eligible financing to highly aid dependent countries that pass the income threshold will remain ODA eligible on a sliding percentage scale over a period of years. Negotiation within the group could involve the definition of highly aid dependent and the number of years over which that sliding scale would run….”

“We would suggest as an opening gambit of defining aid dependence as net bilateral flows equal to a minimum of 10 percent of GNI alongside a 10-year transition.”

Trump 2.0, US Global Health strategy & bilateral health agreements

HPW – One Year of America First Global Health Strategy: Controversy, Secrecy and Suffering

https://healthpolicy-watch.news/one-year-of-the-america-first-global-health-strategy/

Analysis of one year America First GH strategy. “Country controversies, secret terms, opaque procurement, and massive unspent congressional funds have characterised the first year of the America First Global Health Strategy.”

“Services are weaker than they were a year ago, HIV testing is down, treatment of children living with HIV is down, and community-based prevention is gutted,” said Emily Bass, expert consultant for Physicians for Human Rights (PHR), about the change in US policy….”

Cidrap News – Advocates, lawmakers call for release of congressionally approved global health funds

https://www.cidrap.umn.edu/hivaids/advocates-lawmakers-call-release-congressionally-approved-global-health-funds

“The clock is ticking on more than a billion dollars in congressionally approved funding for global health programs that’s being held up by the Trump administration. According to an analysis by Partners in Health, the Office of Management and Budget (OMB) is withholding $1.35 billion in bilateral funding that was previously approved by Congress for tuberculosis (TB), malaria, HIV, and maternal and child health programs. The funding is set to expire on September 30, the end of the federal government’s fiscal year. The group says the continued withholding of the money could have a devastating impact in countries that rely on the funding….”

“… Partners in Health also warned that the State Department has been delaying routine funding of the Presidential Emergency Plan for AIDS Relief (PEPFAR), the program that is estimated to have saved 26 million lives since it was established by the George W. Bush administration in 2003. The group estimates that, through July of this year, PEPFAR has spent $2.3 billion less than it did two years ago. “If we hit September 30th with that level of a gap, we’re going to see huge drop-offs in service delivery around the world,” Lin said….”

TGH – Tracking the “America First” Bilateral Health Agreements

https://www.thinkglobalhealth.org/article/tracking-the-america-first-bilateral-health-agreements

Update of the tracker (as of 10 Sept). “Think Global Health’s analysis found gaps between country needs and new cofinancing commitments with the United States.”

US State department – New U.S Health Partnership with Vietnam Under the Trump Administration’s America First Global Health Strategy

https://www.state.gov/releases/office-of-the-spokesperson/2026/09/new-u-s-health-partnership-with-vietnam-under-the-trump-administrations-america-first-global-health-strategy/

“On September 11, the United States and Vietnam signed a five-year bilateral Health Cooperation Memorandum of Understanding (MOU) under the Trump Administration’s America First Global Health Strategy (AFGHS), advancing our new model of co-investment in global health. Through this MOU, the Department of State, working with Congress, plans to provide $98,750,000 in life-saving global health assistance over the next five years, including $21,385,000 in dedicated Global Health Security funding, to support Vietnam’s transition to full country ownership of its HIV/AIDS and tuberculosis programs while strengthening its capacity to detect and respond to emerging and re-emerging infectious disease threats. Vietnam is well-positioned to assume this responsibility and concurrent to this MOU, their annual health expenditure is projected to grow by approximately $10.5 billion over the five-year MOU period, from $23.3 billion to $33.8 billion. This five-year partnership ensures that the gains achieved through more than two decades of U.S. support are preserved, owned, and sustained by Vietnam’s own health institutions. As Vietnam charts a new path for its health care system, this partnership is expected to deliver measurable results over the next five years….”

Devex Pro – Devex Debrief: The conservative revolt against Trump’s aid plans

https://www.devex.com/news/devex-debrief-the-conservative-revolt-against-trump-s-aid-plans-113279

(gated) “Many Republicans cheered the dismantling of USAID. Some aren’t thrilled with what’s replaced it.”

“ It may not be his problem anymore, but the conservative backlash against Jeremy Lewin’s decision to channel the bulk of U.S. humanitarian aid through the United Nations is moving from the corridors into public view. The former acting undersecretary for foreign assistance, humanitarian affairs, and religious freedom at the U.S. State Department turned heads when he announced $2 billion in U.S. funding to the U.N. Office for the Coordination of Humanitarian Affairs late last year. In May, the State Department added another $1.8 billion to that funding partnership. This week, Brett Schaefer and Danielle Pletka of the D.C.-based think tank American Enterprise Institute joined a growing chorus of conservative voices taking issue with this arrangement in a working paper titled “The Trump Administration Must Act to Prevent Subsidizing Terrorism Via the United Nations.” They blasted the State Department and its former acting undersecretary, alleging that the new framework “has fundamentally weaker oversight than even the deficient procedures that allowed U.S. funding to facilitate terror in Gaza” — a reference to claims that funding for UNRWA, the main aid agency for Palestinians, was diverted to Hamas….”

Devex – Scoop: US pays the UN $800M in budget dues

https://www.devex.com/news/scoop-us-pays-the-un-800m-in-budget-dues-113315

“The payments avert the prospect of the U.S. losing its vote in the U.N. General Assembly, but leave Washington with billions in back dues.”

“The Trump administration has finally paid the United Nations more than $800 million to cover the costs of its regular budget dues for 2025, along with a fraction of its peacekeeping obligations, Stéphane Dujarric, the U.N.’s chief spokesperson, told Devex. On Tuesday morning, the U.S. delivered a payment for $725 million to cover the cost of its share of the U.N.’s 2025 regular budget, which is shared among the 193 member states through mandatory assessed contributions. Washington paid an additional $102 million on Friday for some of its peacekeeping fees, which come from a separate U.S. account. The peacekeeping payment is intended to cover a portion of the U.S. dues for U.N. missions in Haiti and the Democratic Republic of Congo.”

“The regular budget payment is more than a year and a half late, and it represents only a fraction of the billions of dollars the U.S. still owes the U.N. for unpaid arrears. But it will avert the prospect of the U.S. losing its vote at the U.N. General Assembly for failing to pay its dues for two full years. It will also temporarily ease a U.N. cash crisis. The payment comes one week before President Donald Trump is scheduled to address the U.N. General Assembly in New York….”

“… But it only puts a small dent in the United States’ growing arrears at the world body, which have surpassed $4 billion. After today’s payment, the U.S. still owes $1.635 billion in regular budget dues, including some $800 million for 2026. The U.S. also owes about $2.89 billion in peacekeeping dues, according to U.N. figures provided to Devex.”…”

Devex – Exclusive: Luke Lindberg chosen to lead World Food Programme

https://www.devex.com/news/exclusive-luke-lindberg-chosen-to-lead-world-food-programme-113293

“The Trump administration nominee was selected to lead the world’s largest humanitarian agency, according to an internal U.N. notification obtained by Devex.”

· Related analysis in HPW – What Will Trump Pick Mean for World Food Programme and Humanitarians? (originally on the New Humanitarian)

Devex – Trump nominates Elliott Hulse for Millennium Challenge Corporation CEO

https://www.devex.com/news/trump-nominates-elliott-hulse-for-millennium-challenge-corporation-ceo-113307

“The former U.S. Treasury and World Bank communications official now awaits a hearing and Senate confirmation.”

More on the impact of US aid cuts

Devex – 90% of LGBTQ+ groups have lost funding since 2025, new report finds

https://www.devex.com/news/90-of-lgbtq-groups-have-lost-funding-since-2025-new-report-finds-113287

“A year and a half after USAID cuts began, advocacy groups say the fallout has moved from “catastrophic” to a lasting structural crisis. …Ninety percent of LGBTQ+ rights groups across the globe have lost funding since the Trump administration overhauled U.S. foreign aid, new research has found.”

“In its new report, Breaking Point, New York City-based advocacy group Outright International found that one year after the cuts began, only 3% of nearly 230 organizations surveyed can describe themselves as “stable.”… …… Among the organizations affected by the cuts, 49% lost more than half of their total budgets, while 75% lost more than a quarter, Outright found. Organizations based in countries with the harshest conditions for LGBTQ+ people — including widespread discrimination, the least impartial justice systems, and the deepest divisions among social groups — were roughly two to three times more likely to have been affected by aid cuts.”

Devex – How cervical cancer screening became a PEPFAR casualty

https://www.devex.com/news/how-cervical-cancer-screening-became-a-pepfar-casualty-113288

“Women with HIV are more vulnerable to cervical cancer, which is why PEPFAR had supported screening for the preventable disease. Amid funding cuts, much of that work has gone.”

“… Prior to the cuts, PEPFAR programs conducted almost 9 million screenings and treated over 365,000 precancerous lesions, making it the largest international donor of cervical cancer screening and treatment, said Jennifer Sherwood, director of research and public policy at amfAR. It funded close to 60% of all cervical cancer screening and treatment in low- and middle-income countries between 2018 and 2023. But when the U.S. government reduced its funding to PEPFAR — which was established 23 years ago under the George W. Bush administration — by 25%, or $2.1 billion, in 2025, a lot of cervical cancer prevention work became a casualty.”

PS: “… Uganda, Zambia, Kenya, Eswatini, Lesotho, and Nigeria are among the countries where PEPFAR funding propped up the screening of more than 10,000 women. Almost no organizations have been able to replace lost funding, according to amfAR’s report. “There’s just nobody that has a scale of PEPFAR,” said Mungo…”

Decolonize Global Health

Science Politics – Who Pays and Who Counts in Global Health?

Jil Molenaar; https://sciencepolitics.org/2026/09/16/who-pays-and-who-counts-in-global-health/

“Rethinking measurement priorities requires centering the people who actually produce and use health data — health workers, facility teams, and district managers, not philanthropists or donor countries.”

PS: “Some critical scholars have described the influence of the Gates Foundation as “knowledge philanthropism.” When the Foundation funds data collection while also shaping the concepts and tools used to interpret it, the Foundation deepens its indispensability in knowledge production and its influence over global health governance. …”

Habib Benzian – The Pose of Poverty

On Substack;

“Poverty porn, the foreign gaze and the rise of stunt philanthropy.”

Habib Benzian starts his weekly reflection from the news that Burkina Faso wants ‘poverty porn’ to disappear.

“On 2 July, the Burkina Faso government adopted new rules governing humanitarian work. One provision prohibits displaying images of vulnerable people beside the goods they have received. The decree also requires more funding to support recovery rather than prolonged dependence and promotes the purchase of locally produced goods. The ban has quickly been described as a prohibition of poverty porn: the use of images of deprivation to provoke pity or raise money.”

“The term captures something real. It can also make the issue appear simpler than it is….” “Poverty exists whether or not it is photographed. In Burkina Faso, conflict and displacement have produced widespread hardship that should be documented and seen. A ban on degrading imagery must not become a way of making poverty less visible, especially where governments may have their own reasons for keeping hunger or institutional failure outside the frame….”

Among others, Seye Abimbola’s ‘Foreign Gaze’ and McBeast (“stunt philanthropy”) then come up.

Benzian concludes:

“A broader visual language is possible. Poverty can be documented without placing an exposed individual at the centre. An empty clinic, a medicine price list, or a budget document can reveal deprivation. Faces remain important. They bear witness. But people should appear as citizens, workers and organisers, not merely as containers of need. Burkina Faso’s ban will not settle this. Its importance lies in making an old bargain visible. Humanitarian aid has never involved only the movement of money, medicines and food. Images also move. They leave the places where suffering occurs and acquire value abroad. MrBeast has turned that movement into stunt philanthropy. NGOs use a quieter vocabulary, though the underlying exchange may be similar. Someone is helped. Someone is watched. Someone else gains authority over the story. The lesson is not that poverty should become invisible. It is that institutions should have to justify why a particular image is needed, where it will travel, and what control the people in it retain over the story being told. Consent is part of this, but not enough. A person can agree to a photograph and still lose control over the meaning attached to their face. Poverty should not be hidden. But neither should it be arranged into a pose for donors, platforms or states. The work ahead is not to stop looking. It is to change who gets to decide what the image is for.”

Guardian – Slave-trade wealth was embedded in Britain’s financial system, research finds

https://www.theguardian.com/uk-news/ng-interactive/2026/sep/16/slave-trade-wealth-britain-financial-system-bank-of-england-enslaved-africans

“Dozens of Bank of England directors and founding subscribers invested in trafficking of enslaved Africans.”

Social determinants of health

Nature (Editorial) – Global inequality panel is a chance for research to change lives

https://www.nature.com/articles/d41586-026-02885-8

“The scientific panel is welcomed. It must now invite all interested researchers to participate.”

NCDs

Lancet Editorial – The unmet needs of people living with severe asthma

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01904-5/fulltext

Today’s Lancet editorial.

“More than 260 million people worldwide live with asthma, and more than 400 000 die of the disease each year. 5–10% of people with asthma live with severe asthma, but it has an outsized effect—frequent disease exacerbations, poor lung function, and a widespread dependence on corticosteroids. Despite serious symptoms, asthma is often underdiagnosed and mismanaged, which—in the worst-case scenarios—can be fatal….”

“Addressing the burden of severe asthma will require a multipronged approach….”

Guardian – Women with same health conditions as men ‘less likely to be offered active treatment’

https://www.theguardian.com/science/2026/sep/16/women-with-same-health-conditions-as-men-less-likely-to-be-offered-active-treatment

“Men with heart, kidney or liver conditions more likely to be offered intervention compared with women, global analysis finds.”

“A review of global research found that for several health problems, including cardiovascular conditions, kidney disease and Parkinson’s, women were less likely to receive the same treatment as men, revealing the extent to which women have significantly unequal care.”

Re a study in Plos One, by researchers at the University of St Andrews.

SRHR

BMJ Collection – Protecting global sexual and reproductive health and rights

https://www.bmj.com/collections/SRHR

“This BMJ Collection, developed in partnership with the CUNY Graduate School of Public Health & Health Policy in New York, USA, explores how SRHR can be protected and advanced in a changing and threatened global context. From reimagining multilateral institutions and strengthening civil society advocacy to tackling the economic constraints that limit investment in SRHR and learning from successful policy responses, this Collection explores practical strategies for building more resilient, equitable, and accountable systems. Moving beyond a description of the challenges facing SRHR, it offers solutions – how advocates, researchers, health professionals, governments, and civil society can mobilise, forge new partnerships, and advance renewed forms of multilateral cooperation to safeguard SRHRs for the future.”

· Start with the Editorial – Confronting financial and political headwinds against sexual and reproductive health, rights, and justice (by Chelsea Clinton)

“Health and political leaders must seize the opportunity to build lasting systems for governance, financing, and delivery of sexual and reproductive health, rights, and justice.”

· Opinion – United Nations reform must protect sexual and reproductive health and rights (by T McGovern, re the harms of merging UNFPA and UN Women )

· Among the must-reads in this Collection: International fiscal architecture for advancing sexual and reproductive health and rights

“Delivering sexual and reproductive health justice requires a new independent and neutral global body where global rights obligations are prioritised, write Attiya Waris and colleagues (including a few of my ITM colleagues).

Excerpt: “…. What is required is a new international financial architecture, including the creation of a global fiscal institution that is human centred. This new global fiscal institution should be governed on the basis of the principle of “equal sovereignty,” which means “one country, one vote.” To be able to harmonise international rules that affect all countries’ ability to provide the full enjoyment of all human rights, particularly economic, social, and cultural rights, or to allow the making of such rules if they do not yet exist, this new global fiscal institution should be empowered to have a say in, at least, reparations (instead of development assistance), global tax justice and debt restructuring, and debt relief when needed to ensure the realisation of minimum core rights….”

HPW – When Harm Hides in Hospital: Messaging and the Medicalisation of Female Genital Mutilation

F Nkansa et al ; https://healthpolicy-watch.news/when-harm-hides-in-hospital-messaging-and-the-medicalisation-of-female-genital-mutilation/

In-depth analysis & advocacy. “There have been documented decreases in female genital mutilation (FGM) rates in West Africa – declines not granted by governments, but fought for community by community by survivors, activists, and even former practitioners. In July 2025, that fight produced a landmark ruling: the ECOWAS Court of Justice found that Sierra Leone’s failure to protect girls from FGM met the legal threshold for torture. We have just published a five-country report mapping the movements behind these victories. But we would be remiss not to point out that inside the decline, the practice is changing shape….”

“FGM is moving into clinics….”

Human Resources for Health

Devex Pro – Why community health workers could be a smart investment as aid shrinks

https://www.devex.com/news/why-community-health-workers-could-be-a-smart-investment-as-aid-shrinks-113301

(gated) “Community health workers have always been a good investment, but it has primarily been donors that have paid for them. If countries still want the benefits of CHWs, they will have to figure out how to own the programs.”

Via Devex Check-up: “African heads of state pledged in 2017 to have 2 million community health workers across the continent by 2030. But the money hasn’t followed the ambition. Many countries still lack the funding needed to fully professionalize this workforce — putting community health workers on government payrolls and giving them the training, equipment, and support they need.”

“…But my colleague Andrew Green writes that investing in programs for community health workers could be one of the best investments countries can make. Why? Community health workers have long been recognized for their high-value impact on health systems. They are the bridge between clinics and remote communities. They can provide a suite of services, from HIV testing to, increasingly, prevention and diagnosis of noncommunicable diseases. And they are cost-effective, with health leaders long recognizing that for every $1 spent on a community health worker, countries can get up to $10 in return in the form of a healthier, more productive workforce….”

PS: “Now, throw some AI into the mix, and could they do even more?….”

Planetary Health

World Health Organization urged to declare climate change a Public Health Emergency of International Concern

Rob Butler; https://www.croakey.org/world-health-organization-urged-to-declare-climate-change-a-public-health-emergency-of-international-concern/

The case has only gotten stronger indeed in recent months.

Climate Change News – Türkiye says it has “final decision” at COP31 despite Australia running negotiations

https://www.climatechangenews.com/2026/09/11/turkiye-says-it-has-final-decision-at-cop31-despite-australia-running-negotiations/

(gated) “COP31 President-Designate Murat Kurum told journalists that, while the two countries have been working well together, Türkiye has the final say over the Antalya summit.”

“Uncertainty persists over how COP31 will be managed, after Türkiye’s environment minister told journalists this week his country will have the final say at the UN climate conference despite a deal that gave Australia the role of chairing the negotiations in return for withdrawing its bid for the summit.”

PS: “At COP30, the two governments resolved a deadlock by agreeing that Türkiye would host this year’s annual talks in the resort city of Antalya with its environment minister Murat Kurum serving as COP31 President, while his Australian counterpart Chris Bowen would act as COP31 President of Negotiations….”

Devex – EU delegations give fossil fuel lobbyists backdoor COP access, report says

https://www.devex.com/news/eu-delegations-give-fossil-fuel-lobbyists-backdoor-cop-access-report-says-113286

“Despite central U.N. screening, member states continue granting summit access to fossil fuel interests via party overflow badges, driving civil society demands for delegation reform ahead of COP31.”

“…… The report, compiled by Transparency International, says that at last year’s COP30 in Brazil, there were 885 nonstate players across EU delegations, 526 representing business interests. Over 95% attended via “party overflow” badges, which don’t reveal the companies that the attendees represent or their financial backing…..”

Project Syndicate – A Workable Social Contract for the Climate Transition

J Ghosh et al ; https://www.project-syndicate.org/commentary/economic-insecurity-and-distrust-threaten-to-derail-climate-action-by-jayati-ghosh-and-owen-gaffney-2026-09

“Economic insecurity and growing distrust in institutions are undermining governments’ ability to sustain support for climate action. To rebuild that support, they must show that climate policies can reduce household bills, create decent jobs, and ensure that the biggest emitters pay their fair share.”

“There is a paradox at the heart of climate politics. An overwhelming majority of people around the world want governments to tackle global warming. Yet in many of the largest economies, voters are backing parties that deny or downplay the climate crisis. The climate paradox is rooted in a profound sense of economic unfairness. Earlier this year, as Elon Musk briefly became the world’s first trillionaire, a survey conducted by Ipsos for Earth4All found that four in ten people across major global economies feared that their household would be unable to afford basic needs in the next 12 months. And in lower-income countries, economic insecurity is even more acute….”

“Behind that figure lie four decades of broken promises. The neoliberal vision of wealth trickling down has failed to materialize, while the 2008 financial crisis and subsequent global shocks laid bare a system in which profits are privatized and risks are socialized, with the poor disproportionately shouldering the costs. The result has been deepening distrust in governments. Yet those governments are now asking people to trust their assurances that the current far-reaching transformation will be fairer than the last….”

Guardian – World’s top 20 private equity firms produce more greenhouse gases a year than most countries, report finds

https://www.theguardian.com/us-news/2026/sep/15/private-equity-firms-energy-assets-greenhouse-gas

“Firms manage $7.3tn in assets and could afford to transition away from fossil fuels yet invest in natural gas and coal-fired plants to power datacenters.”

“The energy portfolios of 20 private equity firms produce 1.5bn tons of greenhouse gases a year, more than the annual emissions of any country except China, the US, India and Russia, according to a new report. Together, these firms manage $7.3tn in assets of all kinds, affording them the ability to shape the pace of the transition away from fossil fuels. However their energy investments include significant fossil fuel assets including natural gas and coal-fired power plants to provide electricity to datacenters.”

“The analysis of the top 20 private equity firms invested in global energy infrastructure was conducted by the Private Equity Climate Risks Consortium. “

Action Aid (report) – Debt Fuels the Climate Crisis: How the Finance Flows

https://actionaid.org/publications/2026/debt-fuels-climate-crisis

“The debt and climate crises are deeply interlinked, trapped in a toxic relationship in which countries and communities on the front lines of the climate crisis are paying the price. The global debt crisis is being felt acutely by the most climate-vulnerable countries, where climate disasters are taking place with increasing frequency and intensity. “

“Countries on the front lines of the climate crisis are forced to spend so much of their national budgets on sovereign debt repayments that these finance flows are driving fossil fuel expansion, preventing climate action and sustainable development, and leaving communities highly exposed to increasing climate impacts. The vicious cycle between the debt and climate crisis is getting worse year on year, causing rising emissions, accelerating climate disasters, stifling climate action and leading to ever-deepening debt crises. “

“ActionAid’s new report “Debt Fuels the Climate Crisis: How the finance flows” uncovers the data connecting the climate and debt crises. Available data shows:

93.5% of the top one-third of climate-vulnerable countries are in, or at risk of debt distress;

Climate vulnerable countries are spending nearly two thirds (65%) of national revenue on debt servicing, leaving little left to spend on climate, health, education or other public services ;

Climate-vulnerable countries are forced to spend nearly 25 times more of their national budgets on debt repayment than on climate action

Debt repayments by the Global South are nearly 225 times the grant-based climate finance received from the Global North. “

“A new report published ahead of the IMF Annual Meetings 2026 examines the contradiction at the heart of the IMF’s climate turn. On one hand, the Fund can finance resilience, forest governance and climate reforms through its newer Resilience and Sustainability Facility (RSF), while on the other hand it forces countries to expand fossil fuels and extractive industries while constraining public investment through its conventional lending programmes.”

“Five case studies in Ecuador, Egypt, the Democratic Republic of the Congo, Tanzania and Pakistan reveal this contradiction and what it means for countries, communities and climate action. Countries go to the IMF to reduce vulnerability. Stabilisation that leaves them with less public investment, greater extractive dependence and greater exposure to future shocks does the opposite.”

Guardian – Datacenter rush will create ‘tsunami’ of discarded electronics, report says

https://www.theguardian.com/world/2026/sep/16/datacenters-pollution-electronics

“Global push will triple toxic e-waste annually in 25 years, filling enough shipping containers to circle globe six times.”

“The ongoing campaign to build thousands of massive datacenters for AI will create a “tsunami” of discarded electronics, putting the world on a course to triple its annual generation of toxic e-waste in the next 25 years, a new report projects.” Report by the non-profit environmental group Basel Action Network (BAN).

Lancet – A call to humanity in the wake of Nepal’s massive Himalayan flash flood

B Acharaya et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01810-6/fulltext

Calling for climate justice more in particular.

“Scientists say global heating was a destabilising factor in collapse of 200,000 sq metre glacier in August.” Cfr new study by Imperial college London.

Lancet Planetary Health (Editorial) – Future proofing food systems

https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00108-7/fulltext

(early online editorial) “Perhaps one of the most alarming impacts of this year of climate and weather extremes has been the huge drop in food production. … … While we are still in the middle of a difficult year for global agriculture, the signs that we should be preparing for greater difficulties next year are apparent. The world is entering an El Niño cycle, a natural phenomenon where weakened Trade Winds and higher sea surface temperatures across the Pacific Ocean raise global atmospheric temperatures and shift global rainfall patterns. Agencies like the UK Met Office and the World Meteorological Organization have said there are already signs that this El Niño event is likely to be the strongest in living memory and that 2027 is increasingly likely to be the hottest year on record as a result. The United Nations World Food Programme has warned that El Niño could worsen food insecurity in already vulnerable regions and push tens of millions of people into acute hunger; WFP is ramping up its preparations accordingly.”

“These climate impacts on global agriculture of course come within the context of long-running geopolitical instability….”

The editorial concludes: “… We must learn quickly from this year’s painful harvest and recognise that building a resilient food system is a whole of society task that will require an openness to experimentation, supported by research and integrative policy design.”

Telegraph – Asia on high alert as El Niño threatens new Dengue epidemic

https://www.telegraph.co.uk/global-health/science-and-disease/asia-on-high-alert-as-el-nio-threatens-new-dengue-epidemic/

“Higher temperatures mean more mosquitoes, and with them will come a new surge in “break-bone” fever, say experts.”

Lancet (Comment) – Enhancing preparedness for the impending super El Niño

Ruby Lieber, Andy Haines et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01826-X/fulltext

“…An important question to answer is: how can we integrate adapting to long-term climate change and repeated climate shocks, while exploiting synergies between the two approaches?…”

“Adapting to climate change is costly and there is a substantial adaptation funding gap for health. Estimating the relative contributions of human-induced climate change and El Niño to health and economic outcomes would help with effectively allocating sparse resources and could also support applications to the Fund for Loss and Damage under the UN Framework Convention on Climate Change. It would also support climate litigation cases where isolating the relative roles of climate trends versus variability is essential. We suggest five steps that should be taken to advance knowledge and enhance preparedness for El Niño in the context of climate change: (1) ensure that the urgency of protecting health and preventing disease is addressed by the UN and in other international responses to official declarations of El Niño; (2) support national governments to assess the effects of El Niño and other climate shocks on the health of their populations and to implement anticipatory actions, including early-warning systems; (3) scale up collaboration between climate and health researchers to undertake climate–health attribution studies, including in the context of El Niño, and strengthen national capacity to undertake attribution analyses and use the results to influence policy and practice; (4) undertake a living review of the health effects of El Niño to ensure that evolving evidence of impacts over time is made widely available, and evidence gaps are addressed; and (5) evaluate the cost-effectiveness of climate–health interventions in the context of El Niño, including disease and extreme event early-warning systems, health-system capacity strengthening, urban flood protection, and actions for food-system resilience, and create an evidence bank of effective actions in different contexts. These steps will require concerted action between key interest holders such as research funders and WHO, the wider UN system, the World Bank, and non-governmental organisations. …”

Stockholm Resilience center – Coordinated reforms can transform Sweden and create well-being beyond growth

https://www.stockholmresilience.org/research/research-stories/2026-09-14-coordinated-reforms-can-transform-sweden-and-create-well-being-beyond-growth.html

“The climate crisis and increasing resource consumption raise questions about how high-income countries can reduce their environmental impact without simultaneously increasing unemployment and inequality. A study by Centre programme Fairtrans shows that the answer may lie in coordinated reforms that combine reduced production with greater redistribution.”

“In the study, published in Ecological Economics, Centre researchers Karel Zwetsloot, David Collste, Thomas Hahn and colleagues from the programme Fairtrans investigate how a society can function without making growth its overriding goal. They do this by using an established simulation model that has been applied to more than 40 countries. Among other things, the researchers analyse shorter working hours, a basic income, progressive taxation and a gradual scaling back of production with a high environmental impact. The results show that individual measures often lead to trade-offs. By contrast, environmental impact, poverty, inequality and unemployment all decrease when the reforms are implemented together.”

· Ecological Economics – Modelling degrowth policies with system dynamics: Towards policy coherence

Goalkeepers 2026 report & more on AI & health

Reuters – Governments worldwide are way behind AI says Bill Gates

https://www.reuters.com/world/asia-pacific/governments-worldwide-are-way-behind-ai-says-bill-gates-2026-09-15/?utm_source=twitter&utm_medium=Social

“No government in the world is ready for the changes artificial intelligence will bring to society, Bill Gates said in an interview with Reuters, as he warned of the risks ahead.”

The foundation will also spend 1 billion on equitable access to AI.

“The $1 billion pledge, announced today, comes as the foundation launches its 2026 Goalkeepers Report which focuses on expanding access to AI in the areas of health, education, agriculture, and digital equity.”

For more, see also Devex: “the foundation announced today that it is pledging $1 billion over the next two years to expand AI access across the global south in the areas of health, education, agriculture, and digital equity.”
“… Even though $1 billion certainly isn’t peanuts, I couldn’t help but ask Suzman how that sum squares with the hundreds of billions of dollars floating around in the AI ecosystem — not to mention Bill Gates’ dire warnings for our species. It’s not about competing; it’s about complementing, Suzman replied….”

“We are at an essentially existential moment for humanity in terms of the use of what is the most transformative technology of … our lifetime, and in that context, there are very real risks,” he said.
“But at the same time, the thing about transformative technologies is they can be transformative for good” — including the areas that the Gates Foundation works in. “AI has potential to close gaps and reduce inequality at a faster rate than has ever happened before, but only if very concrete actions are taken in the next 18 to 24 months,” Suzman added. “And if those actions are not taken, then the reverse is true.”…”

“So will the foundation be joining forces with some of the seemingly now-cautious AI giants to further Gates’ anti-poverty goals? Suzman was noncommittal, though he said the $1 billion is a starting point and suggested the foundation is working to build partnerships that it hopes to announce “potentially in even the next few weeks.”

· And via Devex Check-up:

“The foundation is putting in a whopping $1 billion to help expand AI use and access in areas such as health, education, and agriculture. A large chunk, or 40% of it, is meant to support healthcare, including diagnostics and clinical decision-making for frontline health workers, maternal and newborn care tools, and the discovery of new drugs and vaccines, writes Devex Managing Editor Anna Gawel….

PS: “… for AI to benefit more people, Gates said three things need to happen:

• AI tools should work across languages, not just in English.

• It needs to be grounded in local data and realities for it to be relevant.

• Investments should be made in people to build AI expertise in countries, and ensure AI tools are accessible. “

“AI could either be a great equalizer or widen global inequality — and that outcome is a “present-tense choice” being made right now, not a distant prediction. Gates argues the decisions made over the next 12–18 months about how AI is built, funded, and deployed will determine who it benefits.”

The Goalkeepers report shows the world is badly off track on reaching the SDGs by 2030, including SDG 2, zero hunger. The report calls for an expansion of AI in health, education, agriculture, and digital equity.

AI, equity, and the Choice We Can’t Delay

2026 Goalkeepers report: AI, equity & the choice we can’t delay

https://goalkeepers.gatesfoundation.org/report/2026-report/

Full report. Check out key findings & messages.

Guardian – ‘Tidal wave’ of Pfas being launched to satisfy AI industry, campaigners warn

https://www.theguardian.com/environment/2026/sep/14/pfas-firms-tidal-wave-forever-chemicals-ai-industry-demand-datacentres

“Big manufacturers planning to produce more of the forever chemicals to meet demand from datacentres.”

“Pfas companies are launching a “tidal wave” of forever chemicals production to meet demand from the AI industry, a campaign organisation has warned. Despite alarm over the chemicals, which have been linked to cancer, a survey of the 10 biggest manufacturers found most had plans to increase production. Many frame their investments around the “AI revolution”, because of the role Pfas play in semiconductor production and next-generation datacentre cooling systems…..”

“…“These companies’ expansion plans show that unless governments and regulators insist on a rapid phaseout, we will face a new tidal wave of forever chemicals,” said Anne-Sofie Bäckar, the executive director of ChemSec, the Swedish chemicals watchdog that carried out the research. ChemSec’s survey found nearly all of the 10 biggest manufacturers of Pfas had plans to increase production, at sites in Europe, Asia and North America….”

UN News – Countries must increase AI regulation to avoid ‘existential risks’: Türk

https://news.un.org/en/story/2026/09/1168326

“Voluntary self-regulation by companies developing frontier artificial intelligence (AI) is “nowhere near sufficient” to address existing harms and prevent advanced autonomous AI models from circumventing human safeguards, UN human rights chief Volker Türk wrote on Monday. “The current race towards ever more powerful AI is a step change towards greater existential risks to every aspect of our lives,” he wrote in an open letter….”

Access to Medicines, Vaccines & other health technologies

GAVI – New “blockbuster” tuberculosis vaccines could save seven million lives by 2050

https://www.gavi.org/news/media-room/new-blockbuster-tuberculosis-vaccines-could-save-seven-million-lives-2050

“Next-generation TB vaccines, expected to become available from 2029, could deliver major health and economic gains, helping to save an estimated 7.3 million lives, generate up to US$ 135 billion in economic benefits for low-and middle-income countries by 2050, and support efforts to combat antimicrobial resistance. Action must be taken now to ensure that countries with the highest disease burden are able to access vaccines in sufficient quantities.”

“Gavi CEO, Dr Sania Nishtar: “Novel TB vaccines could be the next blockbuster immunisation tool, however they will only realise their potential if we can ensure sufficient, predictable and affordable supply for those countries that need them most.”

“New tuberculosis (TB) vaccines, which are expected to become available from 2029, could help save up to an estimated 7.3 million lives between 2030 and 2050, unlocking up to US$ 135 billion in economic benefits across low- and middle-income countries, according to new analysis on their potential impact. These benefits highlight the potential for new TB vaccines to become one of the most impactful new immunisation tools in decades, representing a breakthrough technology in fighting the world’s deadliest infectious disease….” “Nevertheless, in its Early Market Shaping Roadmap for novel TB Vaccines, published today, Gavi, the Vaccine Alliance (Gavi) warns that action is required now to prepare governments and vaccine manufacturers for the vaccines’ arrival. According to the Roadmap, demand for the vaccines among low-income countries and middle-income countries could reach, on average, 86 million vaccination courses per year, with greater demand in the early years as high-burden countries seek to expand protection across multiple age groups in high-risk areas.”

UNAIDS – From vision to action: Southern Africa and China advance regional pharmaceutical manufacturing and health security

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2026/september/20260916_PR_China_SADC_health_security

“The Southern African Development Community (SADC), UNAIDS, the Government of China and the Global Health Innovation Institute (GHII) have agreed to advance collaboration on regional pharmaceutical manufacturing, following a joint visit to production facilities in Johannesburg, Durban and Cape Town, South Africa.”

“The delegation assessed existing capabilities in pharmaceutical and vaccine manufacturing, biotechnology, genomics and diagnostics, and identified priority areas to help Southern African countries expand domestic production of quality-assured medicines and health technologies. The collaboration aims to reduce reliance on imports, strengthen health security and improve more timely access to essential health products across the region. Partnering with China offers an opportunity to connect technology, expertise, investment and manufacturing capabilities with this growing regional capacity….”

Euractiv – US drug pricing could push EU prices higher, study finds

https://www.euractiv.com/news/us-drug-pricing-could-push-eu-prices-higher-study-finds/

“Policy could also prompt drugmakers to delay European medicine launches.”

“Washington’s drug-pricing policy is likely to push drugmakers to raise prices in the EU or delay launches, according to a new modelling study from The Lancet. Since last year, US President Donald Trump has signed several ‘most-favoured-nation’ (MFN) deals with drugmakers – most recently with nine midsized ones – aiming at bringing US Medicare drug prices closer to those in selected high-income countries. Parts of the pharmaceutical industry have warned that the policy could prompt companies to delay launches in European countries used as price benchmarks. Launching a medicine at a lower price in Europe could force a company to cut its US price, potentially costing it more in US revenue than it earns in the European market….”

“The study compared estimated net US prices for 195 branded drugs with prices in 19 reference countries, including several EU countries like Austria, Belgium, Czechia, Denmark and Italy. The researchers found that for three-quarters of the medicines, the estimated US revenue loss from matching a lower price in a reference country – France, for example – would exceed sales in that country. That means “manufacturers would have a strong incentive to raise prices outside the United States,” the authors explained. …. Despite rising pressure on EU countries, “this is colliding with the reality that other countries have limited budget room to give,” said lead author Thomas Hwang, a professor at Harvard Medical School.”

PS: “The authors add that Trump’s pursuit of individual deals with pharmaceutical companies could undermine his stated goal of slashing domestic prices, which are roughly three times higher than in Europe. “If manufacturers can evade participation in these models by striking side deals, most of those savings might not be realised,” Hwang explained….

· See the Lancet study: Most-favoured-nation pricing for prescription drugs in US Medicare: a cohort study (by T J Hwang et al)

“The prices of new medicines in the USA are among the highest in the world. The Centers for Medicare and Medicaid Services released mandatory most-favoured-nation payment models for prescription drugs covered under Medicare part B (GLOBE) and part D (GUARD). Under these payment models, manufacturers would be required to pay Medicare additional rebates for net drug prices exceeding the lowest international list price in a basket of 19 reference countries adjusted by gross domestic product per capita on purchasing power parity basis. In this study, we aimed to model the impact of the GLOBE and GUARD models for Medicare spending.”

“The USA pays substantially more for the same branded drug compared with other high-income nations, with estimates suggesting the USA pays three to five times the price compared with most European countries. For many, including the Trump administration, these higher prices represent an unfairness in the global pharmaceutical market. In his first term, US President Donald Trump directed the Centers for Medicare and Medicaid Innovation (CMMI) to benchmark Medicare part B drug prices to international prices as a form of international reference pricing. Courts ultimately struck this down due to procedural issues. In Trump’s second term, CMMI is launching the GLOBE and GUARD models, which will benchmark branded drugs meeting specific inclusion criteria to international reference prices for 25% of the traditional Medicare fee-for-service population….”

“In their cohort study in The Lancet, Thomas J Hwang and colleagues estimated the potential savings from the GLOBE and GUARD payment models in the USA. The authors estimated the potential savings by linking Medicare spending and prices with estimated current rebates, ex-manufacturer prices, and international sales data in 19 reference countries for GLOBE and GUARD-model-eligible brand-name drugs. They compared estimated net prices with spending under the status quo and found reductions in net Medicare spending under GLOBE of US$5·2 billion (16·1%) and of $6·4 billion (17·6%) under GUARD. The results provide an initial look at potential savings from benchmarking US prices against international prices….”

… But there will be implementation challenges, they note.

PS: “The GLOBE and GUARD models are not the only approaches the Trump administration is pursuing. It is also using US trade policy to pressure other countries to raise their drug prices, mitigating concerns about the USA bankrolling drug research and development…..”

“A new modelling study suggests that US Medicare “Most-Favored-Nation” policies on drug prices would cut Medicare spending on brand name drugs, but potentially incentivize companies to increase prices or delay new drug launches elsewhere.”

· And via Stat – Trump’s secretive pharma deals may undermine ‘most-favored nation’ pricing, an analysis suggests

“The projected savings may be reduced by as much as 80%.”

“The projected savings from a highly touted Trump administration plan to lower Medicare drug costs may be drastically reduced — by as much as 80% — thanks to secretive deals cut with more than two dozen pharmaceutical companies, according to a new analysis. At issue is an approach known as “most-favored nation” pricing, which would tie the prices paid by Medicare to what 19 other wealthy nations pay for the same medicines. The White House has maintained the effort would save Medicare $26 billion over several years and help mitigate the long-standing problem of increasingly unaffordable prescription drugs….”

Geneva Health Files – Spain’s Push For Radical Reform Of Pharma R&D: Bulk Procurement For An Aggregated Market

Rory O’Neill; Geneva Health Files;

“…. The Biotech Act, first proposed in December 2025, is the Commission’s plan to revitalise Europe’s biotechnology sector with financial support and regulatory initiatives. Among the most controversial elements of the plan is a proposed 12-month patent extension for some biotech drugs, subject to made-in-EU conditions, as a way of spurring investment in new products. …”

“ Spain’s Proposal: Spain’s proposal would instead try to incentivise the development of new medicines by forming voluntary buyer groups among EU countries, acting as a signal of demand early in the lifecycle of a drug – after it has received marketing authorisation from the Commission (based on the on recommendation of the European Medicines Agency.) ….”

Global Policy – Vaccine Hunting: Balancing Strategic Independence, Cooperation and Multilateral Obligations in Scandinavian COVID-19 Vaccine Diplomacy

Antoine de Bengy Puyvallée et al; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70237

« How do states navigate the balance between multilateral obligations, bilateral cooperation and strategic independence during global crises? This article provides an in-depth empirical analysis of the diplomatic efforts deployed by Denmark and Norway to secure vaccine access during the COVID-19 pandemic. The paper explores how these countries pursued multiple procurement pathways—bilateral negotiations, ad hoc coalitions, regional and global initiatives—and analyses how they mobilized different policy options as the crisis unfolded. Despite their institutional and economic similarities, the two countries’ different relationship with the European Union—through which they both ultimately procured vaccines—provides insight into how political alliances shape state agency in times of crisis. The paper challenges the conventional understanding of ‘vaccine diplomacy’ as the use of vaccines by great powers to advance geopolitical or diplomatic interests, demonstrating that the concept also helps understand countries’ agency to secure vaccines. For Norway and Denmark, vaccine diplomacy involved multilevel and multi-stakeholder diplomatic engagement; strategic efforts to build their international credibility; and domestic public diplomacy to project government responsiveness. In a context of crisis and uncertainty, their vaccine diplomacy was characterized by experimentation, difficult trade-offs between multilateral obligations and domestic pressures, and limited democratic oversight. »

UNAIDS – UNAIDS, WHO and Unitaid bring manufacturers and governments together in Geneva as HIV financing enters a new era

https://www.unaids.org/en/resources/presscentre/featurestories/2026/september/20260914_manufacturers_consultation

“For more than 15 years, UNAIDS and WHO have convened governments, manufacturers, financing partners, communities and technical agencies in Geneva for one purpose: making sure the medicines, diagnostics and prevention products needed for the HIV, TB and hepatitis responses are produced in sufficient quantities and reach countries at prices they can afford. From 15 to 18 September, UNAIDS jointly with WHO and Unitaid will once again convene their annual consultation with pharmaceutical and diagnostics manufacturers, partner organizations and national governments.”

“The meeting arrives at a pivotal moment for the global HIV response as international funding declines and countries take on a greater share of the cost of their own responses. In 2025, domestic sources accounted for 59% of the US$ 17.6 billion invested in the HIV response in low- and middle-income countries (LMIC). Almost 74% of antiretroviral spending is already covered by domestic spending in LMICs, and just over 52% of antiretroviral spending in Eastern and Southern Africa specifically.”

PS: “Nowhere is that shift clearer than in HIV prevention. While treatment programmes are increasingly funded from domestic budgets, many prevention interventions remain heavily dependent on external support — PrEP chief among them. Demand for oral and long-acting PrEP options is expected to rise sharply in the coming years as more countries expand access and ensuring that financing and procurement systems can keep pace with that growth is set to be a central theme of this year’s discussions.”

Global Commission on Drug Policy – Making children and young people visible in drug policy: a child rights-based agenda for reform

https://globalcommissionondrugs.org/wp-content/uploads/2026/09/GCDP_PolicyBrief2026_EN_web.pdf

Policy brief.

“This policy brief argues that the rights of children and young people should be placed at the centre of drug policy. Drawing on UNCRC, international human rights law, public health evidence, and consultations with children, young people and experts from across the world, it provides a child rights-based framework for evaluating and improving drug policies. It identifies four priority areas where reform is urgently needed….”

Some more reports of the week

HPW – Despite Funding Cuts, Global Fund Sustains Progress Against HIV, TB and Malaria

https://healthpolicy-watch.news/global-fund-sustains-progress/

(must-read) “Countries supported by the Global Fund put over a million more people on antiretroviral (ARV) treatment, sustained tuberculosis treatment and distributed 34 million more insecticide-treated mosquito nets in 2025 than the previous year. In 2025, some 26.9 million people were on ARVs (compared to 25.6 million), 7.4 million people were treated for TB, and 196 million mosquito nets were distributed (up from 162 million), according to the Global Fund’s results report released on Wednesday….”

Check out some other key messages (via Peter Sands).

“The Global Fund partnership has now helped save 72 million lives since 2002, with this year’s Results Report highlighting how country and community leadership, innovation and partnership helped protect essential services and safeguard decades of progress against HIV, tuberculosis (TB) and malaria amid unprecedented global health challenges.”

UN News – Gender equality woefully off track, new UN report reveals

https://news.un.org/en/story/2026/09/1168360

“At the current rate of progress, gender equality would take 171 years to achieve, a new UN report finds as institutions built to advance gains are being defunded and demobilised.”

“Strikingly, not a single indicator on the Sustainable Development Goal for gender equality (SDG 5) is on track to be met by 2030, the initial deadline, according to Gender Snapshot 2026. “

“These targets include ending discrimination, gender-based violence and such harmful practices as forced marriage and female genital mutilation alongside ensuring women’s full participation in leadership and securing economic and property rights.”

Miscellaneous

NUJ – Workers to strike for first time in The Lancet’s 200-year history

https://www.nuj.org.uk/resource/workers-strike-first-time-the-lancet-200-year-history.html

“NUJ members working at The Lancet, one of the world’s leading medical journals, are set to go on strike next week following a long-running dispute over pay. The strike action will take place for one day on Tuesday 22 September outside The Lancet’s London office – the first time a walkout has been staged by staff in the publication’s 200-year history….”

UN News – World fears major war more than any other global risk, UN survey finds

https://news.un.org/en/story/2026/09/1168332

“Two years ago, the idea of a large-scale war breaking out felt like a distant hypothetical to the experts who help chart the world’s dangers. Today it tops their list of fears, according to a new UN Global Risk Report.”

“…. Two years ago, environmental threats, misinformation and pandemics dominated the picture. Now geopolitical tension, war and a weakening rule of law sit at its centre.”

Reuters – Poll shows rising trust in global institutions, less comfort with US as global leader

https://www.reuters.com/world/poll-shows-rising-trust-global-institutions-less-comfort-with-us-global-leader-2026-09-16/

“Canada most trusted to lead global affairs; Most are less comfortable with US, China leading; More than 35,000 people surveyed in 34 countries.”

“A new poll of over 35,000 people worldwide shows continued support for global cooperation and rising trust in international institutions, but less comfort with the United States or China taking leadership roles. In fact, many view both as a threat. The survey, commissioned by the Rockefeller Foundation ‌and conducted in 34 countries from July 21 to August 5, reflected a grim view of economic developments and security challenges, with nearly 70% saying the world had gotten worse over the past year.”

“… Despite widespread pessimism, 57% of those surveyed said countries should cooperate to solve global challenges such as security even if it means compromising on some national interests. That’s up from 55% in last year’s survey….”

“… International institutions saw their results rise over the past year. Trust in the World Health Organization rose to 69% ⁠from 61%, while the U.N.’s score rose to 62% from 58%…. … The World Bank, International Monetary Fund and International Criminal Court, which all got failing grades in last year’s survey, saw the biggest gains. Trust in the World Bank rose to 55% from 46%, the International Monetary Fund edged to 51% from 43% and the ICC scored 54%, up from 48% ⁠last year. The World Trade Organization scored 57%, up from 50%…”

“The ⁠poll was released ahead of next week’s United Nations General Assembly in New York.”

The Collective Blog – Who Cares? Gendered Caregiving Burdens, Right-wing Populism and Neoliberal Economies

https://www.globe.uio.no/english/research/networks/the-collective-for-the-political-determinants-of-health/blog/alicia-ely-yamin/who-cares-gendered-caregiving-burdens-right-wing-p.html

“In the US and elsewhere, right-wing populism now coexists with neoliberalism’s isolation of market dynamics from state regulation, inextricably intertwining the moral and political economies of unpaid caregiving.” say Alicia Ely Yamin and Solana Yoma.”

Guardian – Fiji declares national HIV emergency as Pacific nation grapples with surge in cases

https://www.theguardian.com/world/2026/sep/17/fiji-declares-national-hiv-emergency-infections-surge-health

“Government estimates that one in 60 adults in Fiji now living with HIV, as escalating use of methamphetamine fuels ‘epidemic’.”

TWN – UN: Unilateral sanctions expand amid eroding multilateralism

K Raja; https://www.twn.my/title2/health.info/2026/hi260901.htm

“Use of unilateral coercive measures has expanded amid weakening confidence in collective multilateral mechanisms, according to Zaina Jallad, the United Nations Special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights.”

“The share of the world’s economy subject to unilateral sanctions has grown from 5.4 per cent in the 1960s to 24.7 per cent in the period 2010-2022, she said. These developments point to the normalization of sanctions and counter-sanctions across national, regional and international settings, the rights expert added. “Unilateral sanctions are creating severe humanitarian crises and punishing entire populations for political disputes they have no voice in,” the Special Rapporteur said, expressing serious concern about the expanded use of unilateral coercive measures globally, from Cuba to Iran.”

In her first report (A/HRC/63/29) to the United Nations Human Rights Council as the Special Rapporteur on the impact of unilateral coercive measures , she stressed that the latest escalation follows six decades of proliferating unilateral sanctions imposed outside the framework of the UN Security Council and applicable obligations under international law – the effects of which are often aggravated by extensive de-risking policies and over-compliance by third parties….”

Guardian – Naomi Klein: ‘Extreme wealth has a deranging effect. It turns you into a supremacist’

https://www.theguardian.com/books/2026/sep/12/naomi-klein-extreme-wealth-has-a-deranging-effect-it-turns-you-into-a-supremacist

“She’s tackled neoliberalism and the digital world, now the writer and activist is taking on tech billionaires. She explains how the super-rich are capitalising on climate and financial chaos in pursuit of power.”

“… End Times Fascism describes the world we’re in, where the components of authoritarianism are modelled everywhere you look: anarcho-libertarian economics in Argentina, the destruction of a free press in Russia, the erosion of democratic institutions in Hungary (until Viktor Orbán was deposed), “anti-immigrant neofascism” in Italy, the weaponisation of trans identity by Jair Bolsonaro in Brazil, Islamophobia in Modi’s India. But this is fascism with a difference. Its proponents are actively willing an apocalypse, or a wave of interconnected apocalypses brought forth by climate change and financial chaos, to hasten us towards a post-democratic world in which only a rich few survive to prosper….”

BMJ (Editorial) – The war on drugs is a war on women

C Stoicescu et al ; https://www.bmj.com/content/394/bmj-2026-100686

“UN policy review should promote gender responsive care, not punishment.”

“The UN’s 2026 World Drug Report yet again shows the failures of prohibition: 331 million people used drugs in 2024, up 34% in a decade, and nearly 500 000 people died from drug related causes in 2023. Concurrently, 27 UN special rapporteurs called for evidence based reforms. They were unequivocal: overcriminalisation, stigma, and discrimination are not incidental to prohibition; they are its structural logic, as The BMJ argued a decade ago. No group feels this more acutely than women, particularly in the global south….”

Global health governance & Governance of Health

Devex Check-up: drama surrounds Saima Wazed’s exit from the World Health Organization.

https://www.devex.com/news/devex-checkup-doomsday-or-better-health-gates-bets-big-on-ai-113270

For what it’s worth, the “drama”:

“Saima Wazed, the daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, has resigned as WHO’s regional director for Southeast Asia after being unable to do the job for more than a year. The World Health Organization placed her on leave in 2025, months after her mother was removed from power, and the new Bangladeshi government filed cases against her, accusing her of providing false academic credentials and financial fraud. WHO also launched its own investigation and appointed Dr. Catharina Boehme, a former assistant director-general at its Geneva headquarters, as interim head of the regional office. But for more than a year, the agency has been silent on the investigation — until last week, when Reuters reported that Wazed resigned from her position, a day after a WHO committee recommended her dismissal. She said she resigned “due to harassment and intimidation” by WHO Director-General Tedros Adhanom Ghebreyesus, and accused Tedros of trying to convince member states to terminate her before the investigation into her case was complete. She said she was placed on leave for over a year without pay.”

“According to Reuters, WHO accused Wazed of financial fraud related to a travel reimbursement worth $901 during a trip to China, misrepresenting her academic credentials, and illegally acquiring land in Bangladesh — but Wazed denied all allegations and believes they were all politically motivated. She said financial fraud allegations against her were found to be “unsubstantiated by the WHO investigation team.” “Despite being cognizant of the political vendetta against my mother and therefore me, Tedros seized upon this issue as a convenient pretext to pursue a witch hunt against me to push me out of my office,” she told another media outlet, Outlook. And now she seems bent on turning the tables. She said she has filed an appeal “against the decision not to investigate the harassment case against Tedros and the illegal decision to put me on leave without pay. I will litigate these illegal decisions to the end.” …”

“WHO insists Wazed’s case was handled “with due regard for fairness and due process, while safeguarding the interests of the Organization and its ability to fulfil its mandate.” In the interim, Dr. Nilesh ⁠Buddha will serve as officer-in-charge until the regional office elects its next director….”

Project Syndicate – The UN Cannot—and Need Not—Wait for Consensus

Helen Clark; https://www.project-syndicate.org/commentary/to-complement-un-plurilateralism-coalitions-of-willing-must-strengthen-democracy-by-helen-clark-2026-09

“Although the United Nations system remains the foundation of global governance, its capacity to drive domestic implementation of urgently needed reforms and regulations is stretched thin. Fortunately, narrower “plurilateral” arrangements can help, provided that they are explicitly designed to strengthen democracy.”

Re ‘coalitions of the willing’ (= plurilateral arrangements).

“…. often absent from discussions about our new “variable geometry,” as Carney calls it, is the question of whether plurilateral institutions strengthen or weaken democracy. …”

“Instead of leaving more positive outcomes to chance, we need to insist that plurilateral arrangements focus on three things: promoting concrete actions (such as coordinated environmental and labor regulations); encouraging participation by a wide variety of stakeholders; and establishing independent monitoring mechanisms. In each case, the core objective should be to enhance democracy. If these values are upheld, plurilateral arrangements can support the UN’s mission, rather than unwittingly undermining or substituting for it….”

Global Policy – The Persistent Fragmentation of Gulf Foreign Aid: Bilateralism and the Limits of Regional Humanitarian Coordination

K Almezaini; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70228

“This paper examines why Gulf foreign aid has remained predominantly bilateral and fragmented since its emergence in the 1960s, despite the establishment of regional institutions, recurring regional crises and repeated calls for greater coordination….”

Plos GPH – Preparing current and emerging health leaders: An innovative competency-based framework for health diplomacy

E Martinez, A Nordström et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0004974

« Health diplomacy is increasingly recognized as critical domain of practice for advancing global health equity, navigating political complexity, and fostering cooperation across sectors and borders. Yet formal training opportunities remain limited worldwide, with existing programs differing in length, depth and content, and lacking a shared core curriculum. To address these persistent gaps, the Health Diplomacy Institutional Network (HDIN) developed a globally informed, competency-based training framework that contributes to the professionalization of the field by offering a shared foundation for capacity building in health diplomacy. Co-developed by global experts and practitioners, the framework identifies five key competencies – global health knowledge, political and diplomatic acumen, strategic leadership, cross-cultural communication, and advocacy and coalition-building – each articulated across four progressive levels of mastery, from basic to expert….”

Reuters – World Bank names Nobel laureate Michael Kremer as next chief economist

https://www.reuters.com/world/world-bank-names-nobel-laureate-michael-kremer-next-chief-economist-2026-09-16/

“Kremer won Nobel Prize in 2019 for work on alleviating poverty; Current professor at University of Chicago; Kremer’s research aided farmers, children and drove vaccine development.”

“He starts his new role on October 1, shortly before the annual meetings of the World Bank and International Monetary Fund in Bangkok, Thailand.”

“Kremer, 61, won the Nobel Prize in Economic Sciences in 2019 jointly with Esther Duflo and Abhijit Banerjee for their experimental approach to alleviating ‌global poverty….”

“He and Glennerster also pioneered the ⁠use of Advance Market Commitments, binding contracts made by donors to encourage pharmaceutical companies to research, develop and produce drugs for low-income countries, aiding development of a vaccine against the main cause of pneumonia globally. Kremer’s research on de-worming school children showed a sharp drop in absenteeism, prompting governments in Africa and South Asia to provide 2 billion treatments since 2014. ⁠…”

Global health financing

ODI – What can digital PFM deliver for the health sector?

A A Naik et al ; https://odi.org/en/insights/what-can-digital-pfm-deliver-for-the-health-sector/

« Across low- and middle-income countries (LMICs), public spending on health faces multiple constraints. Aid cuts have had direct impacts on health spending. Domestic budgets have to find room for health amidst multiple competing priorities, while rising debt servicing burdens shrink fiscal space. Against this backdrop, can digital public financial management (PFM) give governments new capabilities to make health spending more efficient and effective? »

UHC & PHC

WHO and Commonwealth Secretariat renew partnership to strengthen health systems and advance universal health coverage

https://www.who.int/news/item/15-09-2026-who-and-commonwealth-secretariat-renew-partnership-to-strengthen-health-systems-and-advance-universal-health-coverage

“The World Health Organization (WHO) and the Commonwealth Secretariat today agreed to renew their Memorandum of Understanding (MoU) for four years, reaffirming their shared commitment to improving health and well-being across the Commonwealth’s 56 member countries, and strengthening collaboration to address pressing global health challenges.”

“The renewed partnership reflects a shared vision to support Commonwealth member countries to build stronger, more resilient and more equitable health systems. Under the renewed MoU, the two organisations will deepen their cooperation in four priority areas: advance primary health care and essential health system capacities for universal health coverage, including through innovation and digital health solutions; address health determinants and the root causes of ill health in key policies across sectors; improve health service coverage and financial protection to address health inequities and gender inequalities; and respond to climate change by building climate-resilient and sustainable health systems.”

WB (Governance for Development blog) – Closing Health Service Delivery Access Gaps with Geospatial Insights

K Singh et al; https://blogs.worldbank.org/en/governance/closing-health-service-delivery-access-gaps-with-geospatial-insights

“How a public infrastructure access tool helps countries measure access, find the gaps, and quantify the impact of every new facility they build.”

Health Systems & Reform – Effects, Challenges, and Preconditions for Implementing Direct Health Facility Financing and the Prime Vendor Model in Low-Resource Settings: The Experience from Tanzania

https://www.tandfonline.com/doi/full/10.1080/23288604.2026.2720979

By Peter Binyaruka et al.

Pandemic preparedness & response/ Global Health Security

Nature Health – ‘Desperate rodents’ pose hantavirus risk to humans — boosted by climate change and deforestation

T Bhobo ; https://www.nature.com/articles/s44360-026-00200-3

“Rapid urbanization and changes in rodent behaviour increase the risk of human disease outbreaks, especially in Africa, but experts fear surveillance gaps leave most zoonotic infections undetected.”

“… “At the moment, we believe that hantavirus probably is more prevalent [and] widespread than diagnosed in Africa,” says Tulio de Oliveira, Professor at Stellenbosch University, South Africa, and director of the Centre for Epidemic Response and Innovation. Such infections are mainly “self-limited transmission clusters between rodents, other animals and humans,” he tells Nature Health. … Hantaviruses pose a bigger systematic danger to Africa’s public health architecture than previously thought, argued de Oliveira and colleagues in a recent article. Limited diagnostic and testing capacity and lack of monitoring infrastructure, combined with climate change and urbanization, are leading to more zoonotic outbreaks….”

Planetary health

TGH – India’s Climate Plans Miss Those Most at Risk

https://www.thinkglobalhealth.org/article/indias-climate-plans-miss-those-most-at-risk

“Tracking caste-like hierarchies in climate and health metrics could help countries better mitigate extreme heat harms across South Asia and Africa.”

Mpox

BMJ GH – Mpox in Africa: one year continental response outcomes and way forward

M K Muteba, J Kaseya et al ; https://gh.bmj.com/content/11/9/e023050

« Following the declaration of mpox as both a global and continental public health emergency in August 2024, the Joint Incident Management Support Team (IMST), co-led by the Africa Centres for Disease Control and Prevention (Africa CDC) and the WHO, was activated in Kinshasa, DRC to coordinate the continental mpox response. This article highlights the first year’s epidemiological and operational findings….”

Infectious diseases & NTDs

Plos Med (Policy Forum) – HIV self-testing and the global diagnostic gap: Addressing a decade of missed opportunity

Reuben Granich et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005241

“In 2015, a survey-based analysis across 16 sub-Saharan African countries estimated that nearly half of people living with HIV were undiagnosed, implying ~11 million people in the region were outside the treatment cascade. However, HIV self-testing (HIVST), a technology effectively positioned to close this gap, was deployed at negligible scale for a decade following WHO recommendation in 2016. The gap has narrowed, but through conventional testing rather than HIVST, and 2.6 million people in sub-Saharan Africa and 4.9 million globally still did not know their HIV status in 2025. The decade of delay carries a likely avoidable burden of millions of illnesses, deaths and onward transmissions, though this has not been formally modelled…”

“…Four actions could improve access: 1) mandatory public reporting of HIVST commodity volumes; 2) a dedicated Africa-specific distribution target of at least 50 million kits per year within the UNAIDS 95-95-95 framework; 3) community-based distribution as the default model for the general population; and 4) explicit HIVST volume commitments in the GHSD’s 2026–2030 memoranda of understanding and work plans.”

AMR

TGH – Antimicrobial Resistance Threatens Bangladesh’s Coasts

Z H Chowdhurry; https://www.thinkglobalhealth.org/article/antimicrobial-resistance-threatens-bangladeshs-coasts

“Rising salinity in Bangladesh’s waters—which could worsen under a record-breaking El Niño—has created the perfect conditions for aquatic pathogens to multiply.”

NCDs

BMJ GH (Commentary) – Disability inclusion as a missing pillar of Africa’s non-communicable disease response

A-Aziz Seidu et al ; https://gh.bmj.com/content/11/9/e025577

« Non-communicable diseases (NCDs) are an increasing priority for African health systems, yet disability remains under-recognised in many prevention, screening, treatment, rehabilitation, and long-term care agendas. This article argues that disability inclusion is a missing pillar of Africa’s NCD response and should be treated as central to mainstream health-system design, not as a separate welfare or specialist concern. It grounds this argument in Africa-centred evidence and an explicit intersectional human rights framing. African NCD strategies should explicitly integrate disability inclusion across primary healthcare, referral systems, specialist services, rehabilitation, assistive technology, community-based care, and long-term support, supported by a defined, low-cost implementation package and disability disaggregated accountability indicators co-designed with organisations of persons with disabilities.”

Plos GPH – Implementation strategies for integrating non-communicable disease care into primary healthcare settings in sub-Saharan Africa: A systematic review

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007062

By Hubert Amu et al.

Nature Medicine – Joint impact of pathological burden and cognitive resilience on Alzheimer’s disease risk

Z Wang et al ; https://www.nature.com/articles/s41591-026-04635-9

“A 15-year cohort study shows that Alzheimer’s dementia risk is jointly shaped by Alzheimer’s pathology and cognitive resilience, with high resilience linked to lower risk, even under greater pathology.”

Social & commercial determinants of health

UNU – Meeting of Experts on Corporate Monitoring of large Food & Beverage Companies – London, April 14 2026 Meeting Report

UNU

“This report documents a meeting that was convened by ATNi and UNU-IIGH to examine methods and approaches for monitoring the activities and the health, nutrition, social and economic impacts of the largest Food & Beverage (F&B) companies. This meeting was initiated to identify gaps in corporate monitoring and accountability and bring together individuals with varied expertise and perspectives to brainstorm potential solutions to fill those gaps, and come up with concrete solutions and actions all actors can take to try to fill these gaps (see Appendix 1). … …. A particular focus of the meeting was to explore and address aspects of corporate behaviour that are currently underrepresented within the corporate monitoring landscape. These aspects included: a) corporate financial practices and conduct with respect to paying taxes; b) investor and shareholder behaviour; c) corporate political activity; d) corporate influence of science and research…”

Mental health & psycho-social wellbeing

WHO Afro – Mental health in Africa: Investment case for WHO Afro

https://iris.who.int/server/api/core/bitstreams/64220351-3bd1-4e8a-a7f7-9712c639ab49/content

20 p.

Guardian – Air pollution linked to higher suicide risk, international research suggests

https://www.theguardian.com/environment/2026/sep/15/air-pollution-linked-to-higher-suicide-risk-research-suggests

“Analysis of 29 studies highlights potentially heightened danger from small particulate matter and nitrogen dioxide.”

“Environmental pollution is known to be associated with poorer mental health but its role in suicide risk is less well understood. Scientists at Queen’s University Belfast examined whether air, noise, light, and water pollution could influence the risk of death by suicide and suicidal behaviours. Their meta analysis of 29 studies found that exposure to airborne small particulate matter and nitrogen dioxide were linked to a heightened risk of death by suicide, suicide attempts and suicidal ideation.”

Access to medicines & health technology

Lancet Oncology – Why childhood cancer medicines need market shaping led by the Global Platform: toward market transformation

S Millan et al ; https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(26)00454-7/fulltext

“The majority of children diagnosed with cancer do not have access to essential medicines. To address this reality, the Global Platform for Access to Childhood Cancer Medicines (Global Platform) was launched in February, 2025, by WHO and St Jude Children’s Research Hospital, in collaboration with UNICEF and the Pan American Health Organization (PAHO)….”

Expert Review of vaccines – Evolution of the global emergency vaccine stockpile system

https://www.tandfonline.com/doi/epdf/10.1080/14760584.2026.2715858?needAccess=true

By J A Walldorf et al.

Decolonize Global Health

Plos GPH – Building Bridges: A framework for redefining and decolonizing implementation science in low- and middle-income countries

Binod Rayamajhee et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006155

“Implementation science (IS) is gaining recognition for its role in enhancing health outcomes by connecting research evidence with practical application. However, most IS frameworks have been developed in high-income countries (HICs), raising concerns about their applicability, fairness, and sustainability in low- and middle-income countries (LMICs)….”

“This critical review underscores the urgent need to decolonize and redefine IS in LMICs or Global South. We propose the Building Bridges framework encompassing advancing equitable and decolonized IS as foundational principle and four key pillars, including localizing and adapting IS frameworks, shifting power to LMICs leadership, equitable collaboration, capacity building, reforming funding agencies, and diversifying review panels, to foster a more just and locally relevant IS agenda.”

AI & health

Nature Health – The epidemiology of artificial intelligence

Harsh Parikh et al; https://www.nature.com/articles/s44360-026-00188-w

“Artificial intelligence (AI) systems increasingly shape how people access health information, make medical decisions and receive care; yet, epidemiology lacks frameworks for measuring AI exposure or studying its health effects at the population level. Here, we argue that AI now functions as a determinant of health and propose a conceptual framework, borrowed from environmental epidemiology, for studying it. We distinguish ‘ambient AI exposure’ (algorithmic curation and AI-mediated institutional decisions that affect populations regardless of individual choice) from ‘personal AI exposure’ (direct, volitional use of AI tools). …”

Miscellaneous

Nature – People trust scientists seen to be ‘on their side’, UK study find

https://www.nature.com/articles/d41586-026-02883-w

“Politics and personal values influence people’s confidence in scientists, finds new report.”

Geneva Solutions – States are writing the first global rulebook for when disasters strike

https://genevasolutions.news/peace-humanitarian/states-are-writing-the-first-global-rulebook-for-when-disasters-strike

“After two decades of work, a treaty could see the light of day next year, sketching out the rules for how countries help each other when disaster strikes. But they still have to overcome old divides over its implications for sovereignty and human rights….”

WHO – Chile becomes first country in South America validated for eliminating dog-transmitted rabies as a public health problem

https://www.who.int/news/item/14-09-2026-chile-becomes-first-country-in-south-america-validated-for-eliminating-dog-transmitted-rabies-as-a-public-health-problem

“Chile has become the first country in South America to receive the World Health Organization (WHO) validation for eliminating dog-transmitted rabies as a public health problem. The recognition highlights more than 50 years of progress without a human case of rabies and confirms the country’s capacity to prevent transmission from re-emerging….”

Papers & reports

Lancet Public Health (Viewpoint) – Fit for the future: from siloed to integrated public health systems

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00161-1/fulltext

“Despite compelling evidence on the value of prevention, public health remains chronically underfunded and structurally deprioritised. Spending on prevention has remained stable at around 3% of total health expenditure across Organisation for Economic Co-operation and Development countries for the past two decades, and despite a temporary doubling of spending during the COVID-19 pandemic, this trend has already reversed. …“

“Three interconnected priorities stand out: (1) embedding public health in cross-sectoral governance frameworks so that prevention is assessed on equal terms with curative care; (2) strengthening data to support public health investment and budgeting, especially in a highly volatile fiscal environment for many countries; and (3) accelerating digital transformation to increase analytical ability, targeted public health intervention, and public trust…”

SSM Health Systems – How learning happens in health system responses and initiatives: a realist synthesis

K M Thu, S Abimbola et al; https://www.sciencedirect.com/science/article/pii/S2949856226001418

“We took a realist approach on the notion that learning can explain how people in the system generate, manage, and share their knowledge and make context-sensitive changes in the process of health system responses and initiatives. We identified six contextual conditions; three ‘prior’ conditions (embeddedness, curiosity, and obligation) and three ‘amid’ conditions (diversity, platform, and support) that shape how learning unfolds in a response or initiative. The identified contextual conditions – or socio-political structures in which responses and initiatives are initiated and implemented – can inform future efforts to study and facilitate learning within health system initiatives and responses….”

Editorial: Kicking off the UNGA81 High-level week (IHP News #897)

Kristof Decoster — Fri, 18 Sep 2026 04:41:27 +0000

Dear Colleagues,

Officially, the 81st UNGA High-level week (18-28 Sept) kicks off today, although the General Debate only starts next Tuesday. Later today, the annual ‘SDG moment’ is taking place. Doubt it’ll be a festive occasion, even if I largely agree with Jonathan Glennie’s take on the SDGs: they told us what matters. Sadly, though, instead of steadily getting closer to the SDGs as the deadline is approaching, mankind is increasingly flirting with ‘end times’, it appears (see eg Naomi Klein & Vance for some slightly different takes on these end times). Unlike the MDG agenda, the SDG agenda turned out a ‘universal one’ indeed. Trouble is: we collectively botched it – even if some people are obviously far more guilty than others.

And so, instead of the sustainable development we were promised, we now face three existential risks ( & counting): the climate breakdown (& more in general planetary boundaries emergency); nuclear risks/weapons of mass destruction (back from never really having gone in the first place);and AI ( the new kid on the block). In an interview from this week, UN SG Guterres also considers ‘deepening inequalities’ an existential threat, and he’s not wrong. Sometimes you get the impression this newsletter isn’t any longer about global health policies & governance but about existential risks – in the short or medium term. In case you wonder: it’s not that I particularly like it (in spite of an undeniable Schopenhauer streak on decaffeinated days). Moreover, as I don’t need to tell you, on all these accounts (ànd plenty of others), hundreds of millions of people are currently already suffering really awful consequences and real harm – with ‘swarms of tech billionaires’ behaving like ‘rogue agents’ in many of these areas : )

It’s against that rather dire (and for many even increasingly nihilist ) backdrop that the global health community continues to work towards a brighter future – while trying to avoid feeling too much like Don Quichote on a windy day.

With that in mind, this newsletter issue features updates on the Global Health reform efforts, with this week among others an important new Nature Medicine article by some heavy-hitters, ‘Rethinking the global health system for a new international order’. One of the co-authors, Wellcome’s J-A Røttingen, warned the window for global health reform is closing over the next year or so. The first author, the Alliance’s Kumanan Rasanathan reckons ‘this time could be different’ (for a number of reasons): unlike in previous decades global health reform is possible now. We tend to agree. Still on global health reform, on Monday the Accra Reset High-Level Panel releases its – highly anticipated – recommendations in New York. Do read a hard-hitting Lancet Comment by Ebere Okereke et al, ahead of next week’s launch, ‘The Accra Reset must turn sovereignty into country power’.

In the run-up to UNGA’s High-level week, as usual a number of high-profile reports were also published, among others the 2026 Gates Foundation Goalkeepers report ( this time with Bill’s ‘complicated’ view on AI and health, plus an (uncomplicated) 1 billion investment); a new BMJ Collection on protecting global SRHR in difficult times; a Rockefeller foundation global poll with some mixed messages; and the Global Fund’s annual Results report. With no doubt more reports still to come in the coming days.

In Hangzhou, China, the Global Initiative on AI for Health (GI-AI4H) (a joint WHO/ITU/WIPO body) is holding its third meeting (16-18 Sept). Among others, to push forward global AI-in-health governance standards. They have their work cut out. Interesting setting too.

We also pay quite some attention to the BRICS summit from last weekend in Delhi – rather important from a public health point of view as well. And today, September 18^th, the America First Global Health Strategy turns one year old. ( Nope, no cake …)

In the Ebola emergency in the DRC, earlier this week media reported for the first time some ‘cautious optimism’ from DRC government officials. Talk of a ‘peak’ is perhaps premature, but on Wednesday, WHO staff (including Tedros himself) also expressed some cautious optimism about the fight, while acknowledging the battle is going to take many more months. Which brings us not just to the PPPR UN High-level event in New York next week (25 Sept), but also to the resumed PABS discussions in Geneva (14-18 Sept). According to Geneva Health Files, “….both sides acknowledged that the unfolding Ebola emergency had so far failed to make an impact on these talks. “Each side is drawing their own lessons from Ebola, and is using the outbreak to serve their own narratives” (a developed country diplomat told us). …” Granted, the fact that the EU negotiator was lamenting ‘ideological polarization’ and a ‘transactional approach’ (not from the EU, mind you : ))’, as this latest round was about to start, probably didn’t help much.

But let’s hope for some ‘recursive self-improvement’ among negotiators in the coming round(s) (if necessary, with a little help from Claude)!

Enjoy your reading.

Weekly topics: IHP news 896: Highlights of the week (IHP News #896)

International Health Policies — Fri, 11 Sep 2026 05:32:41 +0000

Structure of Highlights

· Ebola Emergency DRC

· Run-up to the UN HL meeting on PPPR (Sept 25)

· Run-up to new round in the PABS negotiations (14-18 Sept)

· More on PPPR & GHS

· Global Health Reform (+ post-2030 brainstorm)

· WHO DG race

· More on Global Health Governance & Finance/Funding

· Global Tax Justice & Debt reform

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

· More on the impact of US aid cuts

· Commercial determinants of health

· Mental health

· SRHR

· Child Health

· Planetary Health

· AI & health

· Decolonize Global Health

· Access to Medicines, Vaccines & other health technologies

· Conflict/War & health

· A few more reports, Commissions… of the week

· Miscellaneous

Ebola emergency DRC

With updates & some more analysis.

Cidrap News – Ebola outbreak in DR Congo tops 6,600 cases

https://www.cidrap.umn.edu/ebola/ebola-outbreak-dr-congo-tops-6600-cases

(8 Sept) “A World Health Organization (WHO) officials says 5,000 more workers are needed in the Democratic Republic of Congo (DRC) to control the ongoing Ebola outbreak as it spreads geographically and threatens to move into bigger cities outside of the affected provinces, including Kinshasa. “

“In addition, the WHO said another 1,600 treatment beds are estimated to be needed to meet the demand of what remains the fastest-growing Ebola outbreak in world history. …”

PS: “Today the Wall Street Journal reports that frustrated, unpaid healthcare workers in the DRC are allowing families to touch dead Ebola patients before they are buried, breaking the most basic tenet of outbreak control. Funerals are a major site of Ebola transmission, as handling a dead person’s body can spread the virus….”

Lancet – Integrating responders’ mental health into the Ebola outbreak response

Jean B Nachega et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01738-1/fulltext

“… Mental health and psychosocial support should be embedded prospectively within occupational safety and organisational duty of care, rather than introduced reactively after distress becomes apparent. We propose a minimum package spanning preparation before deployment, protection and support during the response, confidential follow-up afterwards, and continuous learning….”

African Arguments – Ebola and Africa’s Preparedness Dividend: From Crisis to Capability

Ahmed Ogwell Ouma; https://africanarguments.org/2026/09/ebola-and-africas-preparedness-dividend-from-crisis-to-capability/

Former Africa CDC lead Ouma on the importance of Africa’s Preparedness dividend – and the need to properly finance it.

““The preparedness dividend”: For decades, Africa and its partners have built surveillance networks, laboratories, public health institutes, and community-based systems that make rapid containment possible. But these gains are not self-sustaining. They require stable financing, permanent institutions, and a workforce supported between crises. Surveillance is most valuable when there is nothing to detect; preparedness is most effective when it prevents an emergency from ever becoming visible.”

“The next phase of progress will depend less on emergency mobilization and more on sustained investment in the institutions that prevent outbreaks from becoming crises. That investment must increasingly come from domestic sources not because international partnerships are no longer important, but because resilient preparedness requires financing that is predictable, durable, and owned by the countries it is designed to protect.”

Global Policy – Three Months After the Ebola PHEIC in the DRC and Uganda

Nelson Aghogho Evaborhene; https://www.globalpolicyjournal.com/blog/08/09/2026/three-months-after-ebola-pheic-drc-and-uganda

“Three months after the declaration of the Bundibugyo Ebola emergency, the response reveals both the possibilities and limits of international coordination. Uganda has contained local transmission, while the DRC continues to experience extensive transmission despite a coordinated regional framework and substantial mobilisation of resources. This commentary argues that the gap lies not primarily in the absence of institutions or commitments, but in the difficulty of connecting global, regional, bilateral coordination with financing, national implementation capacity, health workers, and communities at the frontline.”

“…The declaration was important, as it established global recognition of the seriousness of the outbreak and activated a framework for cooperation. Three months later, however, the continued PHEIC alongside the sharply divergent trajectories in Uganda and the DRC suggests that international recognition and institutional coordination are only the starting point. The more difficult challenge is whether these arrangements are translating into functioning national systems, supported frontline workers, effective surveillance, and meaningful community engagement where transmission is occurring….”

PS: “… The second Emergency Committee meeting therefore comes at a different moment from the first. In May, the central task was to recognise an international emergency and establish a framework for collective action. Three months later, Uganda has contained local transmission, while the DRC continues to experience extensive transmission across multiple provinces. The updated recommendations from the second meeting call for decentralized testing, community engagement at the lowest level of response coordination, timely payment and protection of health workers, and security corridors to enable responders to reach affected communities. These recommendations reinforce a central lesson of the outbreak: global coordination has limited value unless it translates into functioning capacity where transmission is occurring….”

“This experience is directly relevant to the forthcoming UN High Level Meeting on Pandemic Prevention, Preparedness and Response in September, but its implications extend beyond the HLM. As global health architecture is being reshaped by geopolitical fragmentation, declining development assistance, and the growing prominence of regional and bilateral arrangements, broader reform efforts should focus not only on strengthening individual institutions and commitments, but also on connecting the capacities that already exist across global, regional, national, and bilateral levels.”

Lancet World Report – ALIMA: the NGO doing things differently

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01857-X/fulltext

“Founded only in 2009 but central to the Ebola response in DR Congo, ALIMA brings local leadership to humanitarian action. Andrei Popoviciu reports.”

“The Alliance for International Medical Action (ALIMA) is not a household name in the humanitarian sector but it has become one of the operational and scientific backbones of the Ebola response in DR Congo. The non-governmental organisation (NGO) runs roughly 200 Ebola treatment beds across four centres in Ituri, alongside four rapid-response teams. It was central to the Pamoja Tulinde Maisha (PALM) trial, which identified the two monoclonal antibody treatments now used to treat Ebola, and it is currently co-running EBO-PEP (the first trial of post-exposure prophylaxis for Ebola contacts) with DR Congo’s National Institute for Biomedical Research and France’s National Institute of Health and Medical Research (Inserm), among other partners.”

“Founded in Niger in 2009, during a severe child malnutrition crisis and in the wake of mass expulsions of international NGOs from the country, ALIMA was built by a group that included several Doctors Without Borders (Médecins Sans Frontières) alumni who wanted a structurally different model, namely an alliance linking national NGOs, local clinicians, and international research institutions as genuine partners, not subcontractors. Today, ALIMA works in more than a dozen countries, with its operational headquarters in Dakar, rather than Paris or Geneva like most humanitarian organisations, with roughly 95% of field staff drawn from the countries where it operates….”

JAMA Forum – Ebola and the Catastrophic Cost of Public Health Infrastructure Disinvestment

JAMA;

by L Gostin.

UN News – Ebola response in eastern DR Congo must include food assistance, WFP says

https://news.un.org/en/story/2026/09/1168295

“As Ebola sweeps across the eastern Democratic Republic of the Congo (DRC), ensuring families meet their basic food needs is crucial to halt the spread of the deadly disease. That’s the message from the World Food Programme (WFP), which is calling for greater international support for the population, particularly hungry people in remote areas far from lifesaving Ebola treatment centres….”

Devex (Opinion) – This outbreak is unprecedented. The flawed financing response isn’t

C Stefan; https://www.devex.com/news/this-outbreak-is-unprecedented-the-flawed-financing-response-isn-t-113253

“The DRC’s Ebola outbreak is the deadliest on record. The paths to financing and hurdles behind the response look almost exactly as they did seven years ago.”

· Recalling the Ebola outbreak in 2018-19 in the DRC. “The outbreak in the Democratic Republic of Congo had been running since late 2018, and donors were losing confidence. They had already committed millions of dollars, the epidemic was growing, and they were being asked for more money. The World Bank was asked to lead on the financial management of the response. So, a small group of the World Bank’s global health team flew to the DRC. The response ended up costing over $1 billion when it was declared over in 2020. Roughly 10 times the total amount of funds received from donors.

Prearranged financing is meant to reduce disaster impact in two ways: set money aside before a crisis and establish rules that let the funds move the moment they are needed. In 2019, we had neither. The only prearranged finance instrument in existence, the Pandemic Emergency Facility, released $20 million after a donor committee judged the situation grave enough. But what we saw was the money sitting in an account for months while the government worked out how to spend it….

· 7 years later: ‘More money, still no coordinated response’: “Two current appeals, the United Nations’ humanitarian plan and Africa Centres for Disease Control and Prevention’s continental plan — at $518 million — already total more than $2.5 billion. The good news is that $1.9 billion has been disbursed. However, nobody seems to know how much is new money rather than reallocated from existing health programs. Having two major funding appeals adds to the confusion around who does what, and where gaps remain. Africa CDC’s own financial tracking mechanism, under the continental plan, was built to improve transparency, but is yet to deliver on its promise. On top of the lack of mapping between donor and response activity and duplication risk (the same financing counted twice), an independent review found that how much remains unfunded, and where the gaps fall, still can’t be answered. All of this means responders are improvising, activity by activity, while donors hesitate over a shortfall no one can size….”

Stefan then suggests a way forward.

And a few links:

· The Conversation – DRC’s Ebola outbreak has the potential to become a global pandemic. How to make sure it doesn’t

· Ebola tracker: https://ebola-tracker.org/

Run-up to UN HL meeting on PPPR ( New York, 25 Sept)

Lancet GH – From commitment to governance: what should the 2026 UN high-level meeting on pandemic preparedness deliver?

Nelson Aghogho Evaborhene et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00232-9/fulltext

« … the credibility of the high-level meeting should not be measured on the basis of yet another ambitious political declaration, but instead, on the basis of whether the meeting delivers a credible governance framework that aligns ongoing reforms, strengthens their coherence, and translates political commitments into sustained preparedness. We outline three priorities….”

“First, institutional coherence across the expanding pandemic preparedness architecture must be strengthened. ….The high-level meeting should reinforce political momentum towards concluding the PABS negotiations and commit member states to a shared pathway on their implementation.

“… Second, securing sustainable and responsive financing, which remains a central challenge, should be prioritised, given that inadequate and unpredictable investment continues to undermine PPPR efforts more than 6 years after COVID-19. … The high-level meeting should, therefore, prioritise financing models that are predictable, rapidly deployable, and capable of supporting health systems, communities, research, local manufacturing, and equitable access across a wide range of pathogens….”

“Third, accountability must be strengthened through regional leadership and domestic political ownership…. … the GPMB has proposed an independent monitoring mechanism reporting to the World Health Assembly through a federated model that integrates national, regional, and global monitoring systems….”

Run-up to new round in the PABS negotiations (14-18 Sept)

Another formal round is starting next week, after a few informal sessions (3-4 Sept): see https://www.who.int/news-room/events/detail/2026/09/14/default-calendar/eighth-meeting-of-the-intergovernmental-working-group-(igwg)-on-the-who-pandemic-agreement

GHF – The View from Brussels: European Parliamentarians on the Pathogen Access Benefit Sharing (PABS) System; PABS Primer

P Patnaik; https://newsletter.genevahealthfiles.com/the-view-from-brussels-european-parliamentarians-on-the-pathogen-access-benefit-sharing-pabs-system-pabs-primer/?ref=geneva-health-files-newsletter

(must-read) “Ahead of the resumption of the negotiations on the WHO’s Pathogen Access Benefit Sharing, in Geneva next week, we bring you a brief update on what to expect.”

“Also find below, a recent discussion at the European Parliament on the PABS talks. During the briefing, lead European negotiator explains the challenges in the negotiations including polarisation, and conceptual differences between countries. We found this to be illuminating on how the European Union sees these negotiations…”

Quote from the first part (Primer): “Barring a few countries who have expressed their disinterest in these negotiations privately, our assessment is for the majority of WHO member states, concluding these negotiations remain a priority…”

Re the second part: European Union negotiator, Americo Beviglia Zampetti, outlined the scope of the WHO Pandemic Agreement’s Pathogen Access and Benefit Sharing (PABS) Annex, during a meeting of the Committee on Public Health at the European Parliament on September 7, 2026.

Quote: “…the common denominator we see is that WHO needs to be better equipped in case of a future pandemic…..”

By the way, ‘interesting’ that the EU now seems to blame LMICs (or the African group) for their ‘transactional approach’ re PABS in the negotiations …

All in all, the EU negotiator’s watchword seemed to be ‘we need to be pragmatic’.

KEI (Briefing Note) – WHO PABS Annex Negotiations

James Love; https://www.keionline.org/41414

“This is a note for negotiators at IGWG 8, beginning September 14, 2026…

Negotiations over the Annex to Article 12 of the WHO Pandemic Agreement are stalled, with no obvious consensus emerging. A quid pro quo, linking access to the pathogen samples and digital sequences to equity provisions, has known flaws. A different approach should be taken, one that provides greater certainty and leverage for realizing the equity provisions, and also enables more liberal access to samples and digital sequences. States should take responsibility for ensuring that manufacturers obtain contracts with the WHO, not as a condition of having access to PABS materials and digital sequences, but as a condition of registering and selling products, in an appropriate field of use — as countermeasures for a pandemic emergency or a PHEIC, where the obligation does not extend to the registration or sale of products for other uses or indications of the same products.”

A summary of what Love argues & suggests:

“Point 1: Relying on a link between access to PABS materials and data and equity provisions does not create reliable leverage (due to non-exclusive sharing, alternate pathogen sources).

Point 2: Linking equity to access to information actively impedes scientific collaborative work important for rapid development of useful countermeasures.

Point 3: Use-based tracking may be technically impractical. Provenance is a substantially less reliable enforcement mechanism than market authorization and sale.

Point 4: A more direct approach is available, that provides more reliable leverage for access obligations and that does not create unwanted restrictions on scientific inquiry and collaborations. Benefit sharing can be enforced at the point where governments have reliable leverage over manufacturers, the authorization and sale of relevant pandemic products, rather than depend exclusively on proving that a manufacturer obtained or used a particular PABS material or sequence.”

More on PPPR

NYT – Pentagon Agreement With N.I.H. on Biodefense Draws Alarm From Democrats

https://www.nytimes.com/2026/09/04/us/politics/pentagon-nih-biodefense-agreement.html

“Under a new partnership, the Defense Department would play a larger role in biodefense and pandemic preparedness. Democrats warned it could allow a Pentagon cash grab.”

“The Pentagon and the National Institutes of Health have signed an agreement to collaborate on biodefense and pandemic preparedness, drawing criticism from Democrats on Capitol Hill who warned that the plan could allow the Defense Department to go around Congress and gain access to billions of dollars meant for infectious disease research. The agreement, a copy of which was obtained by The New York Times, is focused on chemical and biological defense research. It does not specify a dollar figure for the partnership or which research projects would be included, but people familiar with it who spoke on the condition of anonymity said it could involve as much as $2 billion from the National Institute of Allergy and Infectious Diseases, about a third of the agency’s budget…..”

“An agreement paves the way for hundreds of millions of dollars’ worth of projects to be transferred from the NIH’s institute for infectious diseases to the Department of Defense.”

Telegraph – The world has a new weapon to fight mpox

S Nishtar; https://www.telegraph.co.uk/global-health/science-and-disease/the-world-has-a-new-weapon-to-fight-mpox/

“The first ever strategic stockpile of mpox vaccines is a decisive step towards keeping the threat in check.”

Nishtar comes back on last week’s launch, and also makes the link with the UN HL meeting on PPPR.

“… Surge financing and strategic readiness through vaccine stockpiles go hand in hand to create a global mechanism for emergency vaccine deployment that strengthens the defences of every country. These tools are essential parts of an effective global health emergency architecture, and I would argue that the establishment of similar tools for therapeutics and diagnostics is long overdue. This would mean giving serious thought to whether new models of financing are needed to maintain stockpiles as a global public health insurance policy. And the question of whether the world needs a pandemic-sized surge-financing tool to complement the FRF (i.e. Gavi’s surge financing mechanism – the First Response Fund (FRF) ) will also loom large as we approach the UN General Assembly, during which pandemic preparedness will be a major focus….”

Devex Pro – Can the world really develop a vaccine in 100 days?

https://www.devex.com/news/can-the-world-really-develop-a-vaccine-in-100-days-113251

(gated) “Scientists are racing to develop vaccines within 100 days of a pandemic threat. The current Ebola outbreak is putting that ambition to the test — and showing that faster science is only part of the equation.”

“…To be fair, a lot of groundwork has been laid. The Coalition for Epidemic Preparedness Innovations is doing critical work to advance vaccine candidates for the Bundibugyo species that’s causing the outbreak in the DRC and supporting research into licensed Ebola vaccines for the more common Zaire species. And before this outbreak began, it had already struck partnerships with several vaccine manufacturers, giving it production capacity to tap into when an outbreak hits….”

“The problem is that some of the other pieces needed to move at speed weren’t ready. It takes time to set up clinical trials, and regulators need to be familiar with the technologies and the trial designs if approvals are going to move quickly. Contracts and licensing agreements need to be negotiated. Ideally, much of that work happens before an emergency, not during one….”

“CEPI has been working on a platform for pandemic preparedness that could help researchers use artificial intelligence in vaccine development, but the organization tells Devex contributor Paul Adepoju that the platform is not yet operational. Money is also in short supply, with CEPI already facing a funding gap of $128 million for this outbreak….”

“Experts say the current outbreak needs to serve as a wake-up call for governments not to sleep on pandemic preparedness investments….”

WMHP – Health Security: A Concept in Search of a Purpose

D Akhavein & S Abimbola; https://onlinelibrary.wiley.com/doi/10.1002/wmh3.70089

“Although the term “health security” is continuously gaining prominence and there are increasing calls to “strengthen” it, the term remains conceptually ambiguous. … Extending existing scholarship on health security, this article draws on insights from the authors’ long-term engagement across various countries, their participation in global discussions and forums, and their study on health securitisation in Nigeria and the Philippines, to explore how health actors understand “health security” and critically analyse the implications of this conceptual pluralism. Our analysis reveals four main interpretations of health security: as (1) state protection and national security, (2) preparedness for infectious disease outbreaks, (3) a political or geopolitical framework, and (4) public health and population protection. These interpretations are not mutually exclusive; rather, they represent meanings that coexist and sometimes compete in practice. We argue that this conceptual plurality enables “health security” to function as a flexible framing that accommodates diverse objectives, with uneven consequences across actors, populations, and health systems. Rather than resolving the definition of health security, this commentary interrogates its utility as a guiding concept.”

Global Health Reform

Lancet (Comment) – Global health reform is missing a generation

Brian Li Han Wong, Shakira Choonara et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01753-8/fulltext

Piece by “…. mid-career professionals working in and around the current global health architecture (the combination of actors, frameworks, and processes that guide, coordinate, finance, and implement efforts to improve and protect health globally). ….”

“Reform processes have multiplied in response, including WHO’s Joint Task Force on Global Health Architecture Reform, the UN80 Initiative, the Lusaka Agenda, the Accra Reset Initiative, the Africa Centres for Disease Control and Prevention’s High-Level Ministerial Committee, and Wellcome Trust’s cross-regional dialogues. These dialogues ask what should change in global health and how, but almost none ask who should design it. However, these processes are steered largely by the same leaders who built the current global health system more than two decades ago. If that same cohort is still leading the reform conversation a generation later, can the architecture that emerges be expected to be fit for the future?…”

The authors argue “Three actions would begin to close this gap…”

“First, measure and set standards. … Second, share power across generations … Third, finance succession….”

Lancet Offline – The tragic fallacy of global health reform

R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01853-2/fulltext

Starting from a short story of J L Borges.

“… In the shadow of Borges, and similarly enchanted by dreams of symmetry and order, global health leaders have constructed a labyrinth of initiatives they label “global health reform”. …” Horton then lists the two main efforts.

“A report on what this reform might look like is being prepared for the 2027 World Health Assembly by WHO’s Director-General. These twin processes have established between them an array of subgroups: a Presidential Council, a Circle of Guardians, a High-Level Panel on Reform of the Global Health Architecture and Governance, and a 25-member Joint Task Force. These are ambitious and well-meaning schemes. … And all are destined to fail. The objective of constructing an orderly new global health architecture, as if those leading this reform process are drawing their glittering new structure on a perfectly blank page, ignores the long-standing competitiveness and enmity between existing institutions that, once born, make it their overriding priority to live on indefinitely. Self-preservation is only part of the reason why reforms will stall and wither. There are too many vested interests among those who would prefer the status quo to continue. And, anyway, what of other regions of the world? Where are the diverse voices from Latin America? Or Asia? Or the Middle East? Where are civil society organisations? Would countries and their peoples even trust a new architecture once it was built? What is sometimes forgotten is that global health is about power—and the rich world, despite its kindly reassurances, will not loosen the ties that keep countries constrained and dependent….”

And concludes: “… The task of global health reform will undoubtedly continue, motivated by illusions of order and symmetry. Councils, panels, and task forces will thrive and reproduce. And this vast displacement activity will likely contribute not one trace of benefit to the health of peoples.”

HPW – Controversy Over Merger Between UN Women and UNFPA Continues

https://healthpolicy-watch.news/controversy-over-merger-of-un-women-and-unfpa-continues/

“Women’s organisations are anxious that Secretary-General António Guterres will push the controversial proposed merger of the UN Population Fund (UNFPA) and UN Women at the UN General Assembly later this month. Guterres proposed the merger as part of his UN80 initiative, aimed at streamlining and cutting costs as the global body tries to recover from the United States’ funding withdrawal.”

“Briefing the UN General Assembly on the merger on Thursday, Guterres said that the proposal had undergone a strategic assessment, and the two bodies’ executive directors had also presented detailed analysis to their respective boards. “We will carefully consider the next steps, taking into account the results obtained by the boards,” he told the Assembly….”

“However, the Feminist Cross-Coalition UN80 Working Group, made up of key women’s organisations opposed to the merger, raised the possibility that Guterres may push the merger without considering alternatives as he has already pronounced that it is “the best way”. They also assert that the merger “lacks the confidence” of the two entities’ boards.”

“… The signatories call on Guterres to withdraw the merger proposal and consider “non-structural alternatives to ensure the UN delivers for gender equality and the human rights of women and girls”….”

PS: “However, Guterres told the briefing on Thursday: “The principle is simple: Where we perform essentially the same function, we should ask whether we truly need separate systems, separate platforms, and separate infrastructure — and we should act accordingly.”…”

IISD – UN80 Reform Initiative Moves From “Diagnosis to Design”

https://sdg.iisd.org/news/un80-reform-initiative-moves-from-diagnosis-to-design/

“The UNGA approved the merger of the UN System Staff College and the UN Institute for Training and Research into a new entity – the UN Institute for Capability and Learning Innovation. The Secretary-General provided updates on efforts to integrate the UN Research Institute for Social Development into the UN University – and the UN Interregional Crime and Justice Research Institute into the UN Office on Drugs and Crime. He also briefed UN Member States on discussions around a potential merger between UNDP and the UN Office for Project Services, as well as on bringing together the complementary capacities of the UN Population Fund and UN-Women.”

Partnership for International Politics and Diplomacy for Health – Insights on global health reform discussions, trends and perspectives: September 2026

https://globalhealthdiplomacy.se/insights-on-global-health-reform-discussions-trends-and-perspectives-september-2026

September update.

“Since its launch on the margins of the 80th United Nations General Assembly in September 2025, the Accra Reset, with its High-Level Panel on Reform of the Global Health Architecture and Governance, has become one of the most closely watched initiatives in the reform landscape. The Panel’s recommendations will be presented this September at UNGA81, and their success will be judged by whether they live up to expectations, secure political uptake, and translate into sustained action. This timing also means they can serve as a thought-provoking input as the WHO’s Joint Task Force on reforms begins its work….”

“There are no quick fixes for the structural challenges that global health reform seeks to address. The present ‘set’ of global health institutions, functions and paradigms took decades to establish; the future reset will also inevitably take time. Coalitions will be needed to build and sustain political momentum, drive the reform agenda, and ensure that it survives electoral cycles that are far shorter than reforms themselves. Impact should therefore be judged over years, not weeks or months.”

“As reform processes unfold, low- and middle-income countries are expected to continue to set the priorities and increasingly put resources behind them, as their fiscal capacity allows. At the same time, country ownership and fiscal independence should not turn into isolation.”

“Reform of the international system for health should not be interpreted as a vendetta against institutions or the individuals working within them. The debate at hand is not whether global institutions have contributed, and continue to contribute, to improvements in health. The more relevant question is whether even better outcomes could be achieved if global functions for health were organised differently.”

KFF – Mapping the Global Health Landscape: Analysis of Fourteen International Organizations

J Kates et al; https://www.kff.org/global-health-policy/mapping-the-global-health-landscape-analysis-of-fourteen-international-organizations/

“… As reform efforts intensify, the global health community has identified the importance of developing a more structured mapping across institutions (and efforts are underway to do so, including by the Multilateral Organization Performance Assessment Network (MOPAN) ). As another input into these processes, KFF has developed a descriptive mapping of 14 key global health and related international institutions, with a focus on their work to address health challenges in low- and middle-income countries (LMICs). By looking across a range of variables, it is intended to inform discussions about synergies and coordination, duplication, comparative advantage, shared challenges, and architectural reform, although it is not meant to represent an assessment of organizational performance or effectiveness. More broadly, any mapping of the global health institutional ecosystem, including this one, offers only a snapshot within what is a rapidly changing environment….”

Global Cooperation Institute – Naturally together

Ben Philipps; https://globalcooperation.institute/naturally-together/

“Guiding principles for a post-2030 international cooperation framework with nature as the foundation of a resilient, equitable and prosperous future.”

WHO DG race

HPW – BREAKING: Germany Declines to Nominate Candidate for Upcoming WHO Director-General Election

https://healthpolicy-watch.news/germany-no-nomination-who-director-general/

“Germany has declined to put forward a candidate for the election of the next WHO Director-General. With Spain also reportedly ruling out a bid, the global field of candidates has only four official nominees just a few weeks before the deadline. “

“Germany will not nominate a candidate for the post of WHO Director-General, Health Policy Watch has learned from the Federal Foreign Office….”

“…The move comes as a surprise, given that Germany has become the largest state contributor to the WHO following the withdrawal of the United States. Leading German health policymakers had called for the Federal Republic to play a stronger role on the global stage…..”

People’s Health Dispatch – Indonesia’s intern doctors are being pushed to the brink under health minister and WHO hopeful

https://breakthroughnews.org/2026/09/01/indonesias-intern-doctors-are-being-pushed-to-the-brink-under-health-minister-and-who-hopeful/?ref=peoples-health-dispatch.ghost.io

“A new generation of health workers in Indonesia is bearing the brunt of a healthcare system oriented towards financial efficiency and commercialization. One of the drivers of this policy today now vies for a position at WHO.”

More on Global Health Governance & Finance/Funding

Lancet GH – Why the health community should care about the next UN Secretary-General

Kent Buse & Sarah Hawkes; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00255-X/fulltext

“The selection of the next UN Secretary-General, due to conclude in 2026, will shape the multilateral system on which global health depends for a decade or more. The health community has a direct stake in what the incoming leader commits to deliver, including progress towards gender equality.”

“… most of what determines health and wellbeing sits outside the health sector, driven by systems and structures such as economic policy, food, conflict, and climate, which themselves are deeply gendered. Gender and health are therefore the responsibility of every UN entity and not just the ones focused on health.”

“An open letter coordinated by Global 50/50, now signed by more than 300 individuals and 60 organisations, including the Third World Network, the European Association of Science Editors, and the 1 for 8 Billion Campaign, asks the next Secretary-General to make five commitments: (1) to report sex-disaggregated data as standard across every UN agency, (2) to analyse gender implications before initiatives launch, (3) to centre feminist expertise in designing UN processes, (4) to allocate dedicated resources to gender in every UN budget, and (5) to institutionalise gender equality as a condition of leadership across the UN system….”

Reuters – Hasina’s daughter resigns as WHO regional head after fraud allegations

https://www.reuters.com/world/asia-pacific/hasinas-daughter-resigns-who-regional-head-after-fraud-allegations-2026-09-09/

“Wazed began as WHO Southeast Asia head in 2024 for five-year term; WHO sent her on unpaid administrative leave in late 2025; Wazed resigned on Wednesday, effective immediately;

WHO to begin election process for replacement next month, source says.”

“Saima Wazed, the World Health Organization’s Southeast Asia head and daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, resigned on Wednesday, according ‌to her resignation letter seen by Reuters, following fraud investigations by the U.N. agency and Bangladeshi authorities….”

“Two sources said earlier the U.N. agency was planning to formally remove Wazed. One of them said the WHO would announce nominations for the role on October 12, vet applications in December and hold elections on January 24.”

“Saima Wazed, WHO’s Regional Director (RD) for South-East Asia (SEARO) and daughter of ousted Bangladeshi Prime Minister Sheikh Hasina, resigned Wednesday, just a day after South-East Asian member states recommended her termination, WHO confirmed to Health Policy Watch.”

PS: “… According to a diplomatic official involved in exchanges between Dhaka and WHO headquarters, who requested anonymity, representatives of Bangladesh’s interim government warned the WHO Director-General as early as 2025 that inaction on Wazed could prompt Bangladesh to reconsider its position within WHO’s South-East Asia Region, and consider a move into the Eastern Mediterranean Region. “The Regional Committee cannot afford another country leaving SEARO, noted one observer, citing Indonesia’s decision to affiliate with the West Pacific Region,” last year. Currently there are ten WHO member states affiliated with the SEARO region, including: Bangladesh; Bhutan; Democratic People’s Republic of Korea; India; Maldives; Myanmar; Nepal; Sri Lanka; Thailand; and Timor-Leste. …”

Lancet Public Health – Public health in a fracturing world: the erosion of the international rules-based order

Martin McKee;

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00164-7/fulltext

“….One of the greatest threats to public health today is not any single disease, environmental hazard, or conflict, but the erosion of the international rules-based order that enables countries to cooperate in addressing shared risks. Over the past decade, public health has faced increasingly interconnected challenges, including climate change, conflict, pollution, emerging infectious diseases, food and water insecurity, mass displacement, and misinformation. These threats are amplified by fragile governance, growing inequality, and declining trust in institutions. Public health depends fundamentally on international cooperation. Surveillance systems, outbreak reporting, vaccine supply chains, environmental regulation, and climate adaptation all require shared rules, transparency, and trust between states. As these mechanisms weaken, risks become harder to manage and their effects more unequal. Public health should adapt by strengthening collaborative infrastructure, treating misinformation as a major health threat, investing in shared preparedness, and engaging more actively with trade, finance, climate, and security policies. Rebuilding effective international cooperation is essential to protecting health in an increasingly fragmented world.”

With some more detail on what McKee suggests:

“Almost a decade ago, reviews of lessons from the Ebola virus outbreak and Vienna Declaration, which updated the earlier Ottawa Charter, recognised that public health practice would have to evolve in a more unstable world. Since then, political support for public health policy has weakened with a speed and scale that has considerable strategic implications for the public health community, giving rise to four proposals….”

“First, core public health infrastructure—which relies on cooperation, surveillance, laboratory networks, early-warning systems, and data platforms—should be actively protected. Current progress on a pandemic agreement is welcome, but insufficient. Until disagreements are resolved, core functions might need to be sustained through regional arrangements, professional networks, and coalitions of willing participants that preserve transparency and common standards even in a more fragmented world. Second, preparedness should shift from national stockpiling towards shared capacity. The COVID-19 pandemic demonstrated that uncoordinated competition for supplies increases costs and delays access without improving overall security. Investments in workforce development, manufacturing capacity, and health system resilience are more effective when undertaken collectively. Third, misinformation should be viewed as a core public health threat, which requires coordinated engagement with digital platforms, education systems, and regulatory authorities. Trust in public institutions and scientific expertise should be seen as a public good and protected accordingly….” “Fourth, those who work in public health institutions should engage more deeply with policy domains traditionally seen as external, including trade, finance, climate policy, and security. The determinants of population health increasingly lie in decisions taken far beyond ministries of health. Effective advocacy now requires fluency in these interconnected arenas, with diplomacy becoming part of the core public health curriculum….”

GHF –The Geoeconomic Turn in Global Health: Pathogen Access & Benefit Sharing As a Chokepoint [Guest Essay]

I Kickbusch; https://newsletter.genevahealthfiles.com/the-geoeconomic-turn-in-global-health-pathogen-access-benefit-sharing-as-a-chokepoint-guest-essay/

Must-read. “In today’s guest essay, leading global health scholar, Ilona Kickbusch examines the opportunities afforded by the negotiations on the Pathogen Access & Benefit Sharing at the WHO, while also reading this in the context of unilateral tariff wars affecting the pharmaceutical sector. She argues that both of these are “chokepoints”, albeit at opposite ends. She follows up this piece from her earlier contribution for us: Health as a Strategic Leverage: Navigating Chokepoints with Diplomacy.”

“Global health is at the intersection of economic statecraft and political opportunism. Kickbusch says, health is no longer the humanitarian exception unaffected by power politics. It is moving to the “centre of this logic”. …”

A few excerpts: “Two dates should be at the forefront of global health strategists this September: on 14 September the Intergovernmental Working Group returns to Geneva for its eighth round, resuming the attempt to finish the Pathogen Access and Benefit-Sharing annex that is the last lock on the door of the Pandemic Agreement. On 29 September the broad tranche of the United States’ Section 232 tariffs on patented pharmaceuticals — a default rate of 100% — takes effect for every company not already inside the door. (Section 232 Pharmaceutical Tariffs 2026: The Complete Guide for Importers Before September 29 – Carra Globe). A group of seventeen firms have been under the regime since the end of July (Trump Pharma Tariffs: 100% Now in Effect, July 31, 2026.)

“One process is a painstaking multilateral negotiation over how the world will share the biological raw material of pandemic response. The other is a unilateral act of economic statecraft reshaping where the world’s medicines are permitted to be made. They must be seen together as two moves in the evermore important game of geoeconomics…..”

“The concept of geoeconomics is not new in international relations, but only now starting to be considered in global health. Edward Luttwak argued a generation ago that after the Cold War states would increasingly pursue strategic advantage through economic instruments rather than military ones. Henry Farrell and Abraham Newman later showed how states positioned at the center of global networks can convert those structural positions into coercive leverage, weaponizing the very interdependence — in finance, information, production — that globalization was meant to generate. What we are experiencing is that health, long treated as a humanitarian exception outside of power politics, has moved into the centre of this logic. The pandemic taught every country the same lesson: the capacity to make, transport, and withhold health goods is a form of power, and must be met with new strategies of health sovereignty…..”

PMNCH – Global Funding Crisis Deepens as 7 in 10 Organizations Working for WCAH Report Program Cuts, Suspensions or Closures

https://www.linkedin.com/pulse/global-funding-crisis-deepens-7-10-organizations-working-wcah-report-ddlif/

“New survey covering at least 67 countries finds nearly 80% of organizations working for Women’s, Children’s and Adolescents’ Health and well-being facing reduced or uncertain funding, as pressure increasingly translates into disruptions to programs for women, children and adolescents.”

“… The findings suggest that what began as a funding crisis is increasingly becoming a program and service delivery crisis, with organizations being forced to make difficult choices about what they can continue to provide and who they can continue to reach.”

““This survey tells us that the global health financing crisis has moved from balance sheets to the front lines. Organizations are not simply facing tighter budgets. They are reducing services, suspending programs and, in some cases, closing them altogether. Women, children and adolescents, whose health and rights were already under enormous pressure, risk paying the highest price,” said Rajat Khosla, Executive Director, PMNCH.”

Devex – Scoop: Global Fund evaluation chief exits as team’s future in limbo

https://www.devex.com/news/scoop-global-fund-evaluation-chief-exits-as-team-s-future-in-limbo-113267

“With John Grove’s exit, the evaluation and learning office will be down to just four people.”

“The future of independent evaluations at The Global Fund to Fight AIDS, Tuberculosis and Malaria was already up in the air. Now, the official leading the team is leaving….”

PS: “…. But that whole evaluation function is at risk of being dismantled. Devex reported in July on a Global Fund Secretariat proposal to dissolve its independent evaluation function, after a review by the fund’s Office of the Inspector General found it to be ineffective in promoting learning and informing decision-making, and questioned its cost-effectiveness. Under the proposal, the secretariat would be responsible for synthesizing evidence and data, with external evaluations conducted only “when there are gaps in other available evidence, capacity constraints or unmitigable conflicts of interest.”

“… A source privy to the discussions said no decision has been made yet on the proposal, and it’s unclear what happens next. The Global Fund’s strategy committee will be meeting in early October, and the board is also set to meet later that same month. But it’s unclear whether the proposal will be on either agenda. “Things seem to be in limbo,” the source said, while stating that future discussions by the committee and the board will be critical to give clarity on the future of the fund’s independent evaluation. The October board meeting will include the appointment of the fund’s next executive director, as well as a transition in board leadership, with Erna Solberg, former prime minister of Norway, taking over as chair.”

Devex Pro – Gavi’s vaccine transition was never about RFK’s fixation on mercury

https://www.devex.com/news/gavi-s-vaccine-transition-was-never-about-rfk-s-fixation-on-mercury-113213

(gated) “When reinstating Gavi funding, the U.S. said the organization committed to mercury-free vaccines, though Gavi was already transitioning to newer vaccines for their public health benefits — not because older ones contain mercury.”

Nature Communications – System-wide investments generate health and enhance HIV, TB and malaria control in Malawi

Tara D. Mangal et al; https://www.nature.com/articles/s41467-026-77306-5

« …. Here, using a dynamic microsimulation model of Malawi’s health system, we show that health system strengthening investments alone could avert 11.4% of disability-adjusted life years between 2025 and 2035, delivering a return of $26.1 per dollar invested. Combining system strengthening with HIV, tuberculosis, and malaria programme expansion produces three times greater health impact than disease-focused investment alone, delivering a return of $11.7 per dollar invested compared with $5.4 for disease-focused expansion alone. These findings support a shift toward integrated global health financing strategies that combine health system strengthening with disease-targeted programmes. »

Lancet Comment – Can wealth redistribution offset the collapse of aid?

K Z Ahsan; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01814-3/fulltext

Comment related to a new Lancet Study.

“Official development assistance (ODA) is being cut faster than at any point in history. The USA, the UK, Japan, Germany, France, and the Netherlands have all reduced aid between 2024 and 2025, and forecasts point to further large declines up to and after 2026. These cuts are occurring within the backdrop of extreme and rising wealth concentration: the richest 10% of the world’s population own 75% of global personal wealth, whereas the poorest 50% own just 2%. Considering this fact, in The Lancet Gonzalo Barreix Sibils and colleagues ask a largely unexamined question: could redistributing even a small share of that wealth offset the health damage caused by the humanitarian and development aid crisis?…” “ In an integrated retrospective impact evaluation and forecasting analysis of 59 low-income and lower-middle-income countries, Barreix Sibils and colleagues answer this question with a cautious yes…”

“… The key strength of this study is connecting two literatures that have run in parallel until now. There has been a growing body of research assessing the impact of aid withdrawal on mortality and separate literature on estimating the revenue potential of wealth taxes and related financial instruments. To our knowledge, Barreix Sibils and colleagues are the first to link these two ideas directly, translating wealth redistribution into lives saved rather than revenue raised. The reframing matters because debates about wealth taxation are typically framed in fiscal or moral terms, whereas this study introduces a health dimension which is harder to dismiss….”

· The Lancet study: Wealth redistribution policies to mitigate the impact of development assistance defunding: a retrospective evaluation and forecasting analysis up to 2030

With some of the findings & interpretation: … Forecasting analyses showed that, in comparison with the current ODA funding reductions in the 59 selected low-income and lower-middle-income countries, all ten wealth redistribution policies were associated with millions of averted deaths by 2030: overall, the lowest number of averted deaths was 6 591 984 … for a 3% crypto tax applied to the top 10 000 holders, while the highest number of averted deaths was 29 509 934 … for a 3% wealth tax on ultra-high-net-worth individuals; in children younger than 5 years, the corresponding numbers of averted deaths were 1 312 912 … for a 3% crypto tax applied to the top 10 000 holders and 3 464 607 … for a 3% wealth tax on ultra-high-net-worth individuals.”

“The implementation of wealth redistribution policies proposed in recent high-level international agreements could mitigate the health consequences of the current ODA defunding crisis, avert millions of deaths, and support the achievement of the UN Sustainable Development Goals, particularly those related to health.”

Nature (Comment) – Why we need an International Panel on Inequality

J Stiglitz, W Byanyima et al;

https://www.nature.com/articles/d41586-026-02806-9

“Disparities in income and wealth are growing. A scientific assessment process can give governments the information they need to tackle them.”

“…In 2025, we were asked by President Cyril Ramaphosa of South Africa to participate in the G20 Extraordinary Committee of Independent Experts on Global Inequality (chaired by J.E.S.). We presented a report³ to the G20 countries, in which our main recommendation was for their governments to establish an International Panel on Inequality (IPI). Since then, a founding committee, of which we are also members, has begun to develop the proposal under the leadership of South Africa, Brazil, Spain and Norway. United Nations secretary-general António Guterres has endorsed the initiative, the African Union unanimously supports it and so do more than 600 economists and inequality experts. Here we outline that case….”

“The IPI would address four areas: the measurement of inequality; its drivers; its consequences; and the policies that are available to address it….”

Global Health Advocates (Policy Analysis) – Analysing the Council’s position on the Global Europe Instrument: a Global Health perspective

https://www.ghadvocates.eu/app/uploads/2026.09-GHA-Council-GPA-GEI-analysis-2.pdf

3-pager. “In May 2026, EU Member States reached a Partial General Approach (PGA) on the Global Europe Instrument (GEI), laying down their negotiating position ahead of discussions with the European Parliament. The approach is deemed ‘partial’ because it excludes financial allocations and horizontal issues that are currently being discussed as part of the MFF regulation negotiations. GHA analysed the PGA to assess where Council made the most relevant modifications, from a Global Health lens. While we celebrate the addition of some positive elements, which have improved the European Commission’s original proposal, some key aspects are still undecided, while others could be further improved to ensure that the EU truly equips itself to fulfil its ambition of being a Global Health leader as expressed by President von der Leyen in her 2025 State of the Union speech….”

Among the positives: “Explicit inclusion of global health as an objective of the GEI. We strongly support the Council’s explicit inclusion of ‘global health and equitable access to health care services’ among the global challenges the EU should address in the Regulation. The Council also includes pandemic threats as unforeseen global challenges that require a rapid response from the EU, via the emerging challenges and priority cushion. SRHR language has also been further strengthened in the Regulation. We also welcome changes made in Annex II, including the elevation of human development as the first specific objective for the Sub-Saharan Africa pillar, as well as stronger language on health and equitable access in other pillars’ specific objectives…”

Global Health Advocates – EU Health ODA Figures Confirm Stagnating Ambition

https://www.ghadvocates.eu/eu-health-oda-figures-confirm-stagnating-ambition/

Factsheet.

“Global Health Advocates is proud to publish an updated analysis of key figures in the EU’s Official Development Assistance (ODA) dedicated to health in 2024, highlighting the most recent trends in EU health ODA contributions. These analyses seek to inform discussions on whether current EU Financing trajectories align with their stated global health ambitions.”

“…While the EU has reaffirmed its leadership through the Global Health Strategy and the new Global Health Resilience Initiative, EU health ODA actually declined in 2023 and stagnated in 2024….”

Devex – Why the CEO of a massive hedge fund is helping to lead Global Citizen

https://www.devex.com/news/why-the-ceo-of-a-massive-hedge-fund-is-helping-to-lead-global-citizen-113280

“This week, Nir Bar Dea, CEO of Bridgewater Associates, was appointed co-chair of Global Citizen. Here’s what he had to say about the state of the world and how to solve pressing global challenges.”

Quote: “…Evans, Global Citizen’s CEO, also criticized the rush to see private capital as a silver bullet for shrinking public funds, calling it “brilliant, useless phraseology” and buzzwords that miss an understanding of the need for returns from private investment. It also seems to be an excuse for the fact that many recently completed replenishments saw less public funding than in the past.”

“Global Citizen sees its role moving forward as helping eradicate poverty through public-private partnerships, such as a campaign last year to scale up renewables in Africa….”

Devex – Why health is drawing Asia’s philanthropic funding

https://www.devex.com/news/why-health-is-drawing-asia-s-philanthropic-funding-113256

“A new report found that of the more than 100 Asian family philanthropists sampled, 87% support health causes, second only to education.”

“A large number of wealthy families in Asia prioritize giving to health, according to a new report by The Bridgespan Group, a nonprofit that advises philanthropic organizations. The report examines the giving practices of nearly 200 of the world’s wealthiest individuals and families. Of the more than 100 Asian family philanthropists sampled, 87% support health causes, second only to education.”

“Gwendolyn Lim, partner and head of Bridgespan’s Southeast Asia office, told Devex that many of these families are interested in giving to maternal and child health and nutrition, as well as climate and health….”

ODI (Insight) – Do ministries of health need a stronger budget and finance function?

https://odi.org/en/insights/do-ministries-of-health-need-a-stronger-budget-and-finance-function/

“Half the world’s population lacks access to basic healthcare services, and health budgets in many countries are poorly prioritised and underspent. With fiscal pressures and aid cuts biting – especially in Africa – these challenges urgently need to be addressed. Finance ministries will need to provide more generous budgets to support the transition from donor aid. But it is also critical that the ministry of health makes good use of the resources available and does not simply push budget problems back to a finance ministry that has limited health expertise and numerous other priorities to manage. For this, the ministry of health will need a strong budget and finance function.”

“… The budget and finance function comprises the teams in the ministry of health responsible for coordinating budget planning, preparation, execution and reporting. Curiously, it is a function that receives scant attention in international standards guiding budget reforms….”

With also some ‘Implications for African governments and their partners: Today, many African countries are facing real risks of debt distress, and contending with declining aid flows, particularly in the health sector. Addressing the pressures on the health sector will need to be a joint enterprise between the ministry of finance and the ministry of health – one that would benefit from addressing gaps in the capabilities for health financing analysis and financial management.

Ministries of health in several countries, including Ethiopia and Ghana, are already investing in their capacity to prioritise health interventions, including through creation of health economics or financing teams. A key challenge, however, is to integrate this analysis into budget preparation and execution, and to ensure that prioritisation exercises are financially constrained.

Finance ministries need to ensure that the health ministry’s budget and finance function has the information, capacity and status needed to respond proactively to fiscal pressures and the aid transition. A simple first step that all finance ministries can take is to set up regular meetings with the heads of the budget and finance function in spending ministries to improve communication and guide reform priorities. …”

Devex – Jeremy Farrar lands new role at global nonprofit PATH, after WHO exit

https://www.devex.com/news/jeremy-farrar-lands-new-role-at-global-nonprofit-path-after-who-exit-113260

“The renowned British scientist will oversee PATH’s work in Asia, the Middle East, and Europe.”

Starting Oct. 1, the renowned British scientist will join PATH — the global nonprofit headquartered in Seattle known for its work in advancing science and health innovation — as chief of its Asia, Middle East, and Europe division. He will remain based in Geneva.”

WHO – Dr Vanessa Kerry appointed to new role as WHO Director-General’s Special Envoy for Health Resilience

https://hq_who_departmentofcommunications.createsend1.com/t/d-e-wjltyul-ikudkhluul-d/

“The World Health Organization has appointed Dr Vanessa Kerry as the WHO Director-General’s Special Envoy for Health Resilience. Building on her previous role as WHO’s first Director-General Special Envoy for Climate Change and Health, Dr Kerry will help advance a broader agenda focused on building resilient, integrated and sustainably-financed health systems capable of responding to day-to-day challenges and emerging threats from climate change, health emergencies and other complex global challenges. In her new role, Dr Kerry will engage with governments, development partners, multilateral institutions, civil society and the private sector to advocate for stronger health systems, more sustainable financing approaches, and stronger coordination and alignment of partners and resources behind national priorities….”

FT – Rival cities vie to ‘poach’ international organisations from Geneva

https://www.ft.com/content/1d2449b3-bd85-477a-87ec-a5a12a9128c4?syn-25a6b1a6=1

“A UN funding crisis triggered by Donald Trump’s foreign aid cuts has set off a battle for diplomatic influence, with EU capitals and Gulf states competing to lure international organisations and staff away from Geneva, Swiss officials have warned…. …Swiss officials say about 20 countries are trying to use the financial turmoil engulfing the multilateral system to bolster their own ambitions as diplomatic hubs. They identified Austria, France, Germany, Italy and Spain as well as Qatar and the United Arab Emirates as among those seeking to attract UN agencies or parts of Geneva’s international ecosystem….”

“A lot of European countries have host-state ambitions and they want to use this moment of stress to strengthen their own position,” said one Swiss official with direct knowledge of the situation. “It is blatant poaching.” “ … The WHO has proposed moving some headquarters functions to Lyon, France, as part of its restructuring. Unicef is relocating hundreds of posts to lower-cost cities including Rome, while the International Labour Organization has said it will shift some staff and functions to its existing training centre in Turin. The Swiss official said: “We’ve seen some member states offer a certain amount of money for every person they can move from Geneva to their city.”

… Another Geneva-based politician said governments were increasingly carving out specialist roles rather than trying to replicate the city wholesale. Spain wants Valencia to become a centre for digitalisation and data, France is strengthening Lyon as a hub for international health governance and Paris’s education profile, Germany is building on Bonn’s environmental institutions and Berlin’s international role, while Vienna is seeking to expand its presence as a UN hub.

“They all want different parts of the ecosystem,” the politician said.”

“Among the Gulf states, Swiss officials see Qatar as the strongest challenger because it has established itself as a diplomatic broker. They pointed to Doha’s growing role in mediation, including over Gaza and in recent diplomacy involving Iran, and said it was combining that political influence with “very attractive financial offers” as it sought to become a bigger humanitarian hub….”

PS: But “not… every government (is) pulling back. Swiss officials said countries including China have stepped up their engagement with Geneva’s multilateral institutions, seeing an opportunity to wield greater influence as the US retreats. Ferrari said six new countries had opened permanent missions in the past two years, including Belize and some Pacific island countries….”

CGD – DAC Chair: We’re Getting There

https://www.cgdev.org/blog/dac-chair-we-are-getting-there

Carsten Staur (DAC Chair) reacts to Charles Kenny’s blog from last week.

Excerpt:

“.. For the DAC and its members, these developments mean two things. First, that the global discussion on the future of international development cooperation—on the “architecture”, the emerging paradigm shift and the ensuing narratives—clearly must be wide-ranging, open and inclusive: engaging all partners and stakeholders in the broader international development cooperation community. The DAC is part of this community—and an important part, we think—but our role is different from what it was thirty years ago. Don’t expect the DAC to tell others what to do. Expect the DAC to provide evidence, lessons learned, best practices, reflections on what works, where and how—and what does not. And expect the DAC and its members to engage with partners on equal terms and to jointly shepherd the changes needed.”

“Second, the DAC has initiated a review of its own role and functions in the changing international environment. We look at our data work, moving to complement our retrospective approach, based on past data and statistics, while also delivering forward looking projections. We look at how we may complement and contextualize the focus on ODA within the totality of flows, also at country level, to provide even more relevant information to all stakeholders. And we aim to build our normative and standard-setting work on more open and inclusive involvement of others, as we have done with the new Guidance on Poverty and Inequality, which the OECD will launch in October. We also look at the graduation criteria, which Mr. Kenny finds will weaken the ODA standard. It will not—and let me explain: At present, countries which reach high-income country (HIC) status (14,375 USD in GNI/cap) will leave the DAC list of ODA recipients. At that point, most of these countries will only receive very limited ODA and graduation will be manageable. Some countries, including small island developing states (SIDS), however, may still depend significantly on ODA, when they approach HIC status. These countries often face serious vulnerabilities, which call for a careful approach to graduation. The DAC has already taken steps to ensure more sustainable graduation processes, and the ongoing discussions are a continuation of this work.”

The tale of the fellow struggler

Virginia Mucchi; https://intercomms.substack.com/p/the-tale-of-the-fellow-struggler

Very cool analysis. “China sells geopolitics as development. Europe tries to sell development as geopolitics.”

Global Tax Justice & Debt reform

Report (Save the Children UK & Debt Justice UK) – Now is The Time to Act: Six Reforms for the G20 Common Framework for Debt Treatments

L Darby et al; https://resourcecentre.savethechildren.net/document/now-is-the-time-to-act-six-reforms-for-the-g20-common-framework-for-debt-treatments

“In this report Save the Children UK and Debt Justice UK outline the six reforms needed for the G20 Common Framework for Debt Treatments, the main international mechanism for restructuring unsustainable sovereign debt. The report is endorsed by 11 organisations and coalitions… … The Common Framework has failed to deliver timely and adequate debt relief. The countries that have applied have faced lengthy negotiations and uncertainty. Expanding on the African Union Common Position on Debt, the report sets out the six practical reforms needed to make the Common Framework faster, fairer and more effective. It includes significant evidence on support for these reforms, including specifically on UK legislation. Fixing the G20 Common Framework is a collective action problem. The recommendation of this report is that G20 Finance Ministers endorse it, and that unilateral and collective action is taken by G20 members, especially the UK, as well as the IMF and the World Bank to implement the proposals. With growing consensus amongst members, international institutions and civil society, the time for action on this is now and the G20 is the right place to start. …”

Check out the six reforms they suggest.

Trump 2.0, US Global Health strategy, bilateral health agreements…

Devex Newswire: Trump’s new foreign aid gatekeeper could tighten the tap

https://www.devex.com/news/devex-newswire-trump-s-new-foreign-aid-gatekeeper-could-tighten-the-tap-113235

“Immigration hard-liner Andrew Veprek takes over leadership of the foreign assistance bureau at the U.S. State Department. “

“U.S. foreign aid has a new gatekeeper — and the big question is: Will he tighten the purse strings? Andrew Veprek took over the State Department’s foreign assistance bureau on Aug. 28, replacing Jeremy Lewin, who has moved into the coveted role of director of policy planning directly beneath Secretary of State Marco Rubio. And the contrast between the two men is already getting attention. “Andrew Veprek is no Jeremy Lewin,” says Keifer Buckingham, a former senior adviser at the State Department and current managing director of the Council for Global Equality. “He is a true believer [in the Trump administration’s approach to foreign aid].” “

“Why does that matter? Because despite presiding over the dismantling of much of USAID’s development portfolio, Lewin also oversaw billions of dollars flowing to the United Nations Office for the Coordination of Humanitarian Affairs, or OCHA, the World Food Programme, UNICEF, and faith-based organizations. Not everyone in Trumpworld was thrilled about that — particularly the money going to the U.N. Enter Veprek. As assistant secretary of state for the Population, Refugee and Migration Bureau, he boasted of transforming it from “a humanitarian assistance bureau … focused on bringing people to the United States,” into one centered on “implementing the president’s immigration agenda.” He has railed against “forever aid” and the “open-ended, blank-check approach” he says can prolong humanitarian crises. That has people wondering whether the foreign aid spigot is about to tighten again. “Speculation is that Lewin got sideways with [the Office of Management and Budget] for allowing too much foreign assistance out the door,” says a former senior official at both USAID and the State Department. “Veprek might close that door.” A Trump administration official similarly tells Devex there is “an expectation that Andrew will get that under control and align future funding with administration priorities.”…”

“… Veprek has said foreign assistance should have a “clear and direct connection” with U.S. foreign policy goals. We may now be about to find out just how narrow that connection becomes….”

HPW – US to Phase Out HIV Support for Namibia After Data-Sharing Impasse

https://healthpolicy-watch.news/us-to-phase-out-hiv-support/

“The United States will no longer fund Namibia’s HIV programme after 2027, following an impasse over data- and information-sharing terms required by the US for a longer aid package.”

“The joint US-Namibia announcement frames the one-year aid phase-out as “recognition of Namibia’s historic achievement in reaching HIV epidemic control and surpassing global targets”. The US will provide $45 million for the 2027 fiscal year to enable the transition to technical support, and thereafter Namibia will fund its own response, according to the statement released last Friday.”

PS: “… However, it emerged earlier that Namibia had rejected the United States’ demands for sharing health data and pathogen information during negotiations for renewed US support for its health and HIV programme.”

“Over the past 22 years, Namibia has received some $1.1 billion in support from the US President’s Emergency Plan for AIDS Relief (PEPFAR)….”

PS: and re the link with PABS: “… the US bilateral health agreements demand that countries provide it with full access to information about dangerous pathogens within 10 days of an outbreak. In addition, the US wants to be able to share this information with companies and groups of its choice without any restrictions. This is a direct challenge to a WHO PABS system….” “…Meanwhile, the Namibian government is concerned that the data- and pathogen-sharing demands do not comply with its laws, infringing both constitutional privacy rights and national sovereignty over biological resources, according to The Namibian newspaper.”

And a link:

· Emily Bass– Cryptic Congressional Notification is Short on Details about Government-to-Government Health Grants

“The State Department’s brief Congressional Notification for three government-to-government awards funded under the America First Global Health Strategy omits all details about milestones, activities, expected outcomes and results of mandated risk and eligibility assessments. Instead, the communication effectively asks appropriating lawmakers to take it on faith that USD$176 million will be well spent in Malawi, Kenya and Uganda, which failed a 2026 US government assessment of “control of corruption and accountability.”….”

More on the impact of US aid cuts

HPW – LGBTIQ Groups in Repressive Countries Are Worst Affected by US Funding Cuts

https://healthpolicy-watch.news/lgbtiq-groups-in-repressive-countries-worst-are-affected-by-us-funding-cuts/?feed_id=1055&_unique_id=6aa3009912a05

“HIV services, mental health and harm reduction programmes have been severely affected by the huge funding cuts to organisations providing services for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people over the past 18 months. Perversely, organisations in countries with the most repressive conditions for LGBTIQ people have been worst affected by cuts, according to a report released on Thursday by Outright, the international LGBTIQ human rights group. “Organisations in countries with the harshest living conditions, the least impartial justice systems, the most widespread discrimination, and the deepest divisions between social groups were roughly two to three times more likely to have been affected by the cuts than those in countries at the other end of each measure,” according to the report.”

“In Ghana and Uganda, the cuts have coincided with draconian laws increasing punishment for same-sex activity – resulting in a spike in attacks on LGBTIQ people and a greater need for support services….”

“Of the 229 LGBTIQ organisations from 94 countries that responded to Outright, 203 lost funding after Donald Trump became president of the United States in January 2025. The funding cuts have been fast and dramatic, with almost half of the affected organisations losing 50% of their budget, and three-quarters losing at least a quarter.”

Commercial Determinants of health

WHO – Tobacco smoking may be harming your chances of having a baby

https://www.who.int/news/item/08-09-2026-tobacco-smoking-may-be-harming-your-chances-of-having-a-baby

“Smoking may reduce the chances of conceiving for many people worldwide, according to a new World Health Organization knowledge summary.”

“The publication highlights evidence that tobacco use is associated with infertility in women, harmful effects on sperm and sexual function in men, and potentially lower chances of success of some fertility treatments. It also warns that second-hand smoke can affect fertility, meaning people do not have to smoke themselves to face possible reproductive risks. “

“Globally, one in six people of reproductive age will experience infertility at some point in their lifetime. Infertility is defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sex. … The publication cites decades of evidence showing that smoking can harm women’s reproductive health…

· Coverage via HPW: More Evidence of Link Between Smoking and Infertility

“The risk of infertility is 1.4 times higher in women who smoke, according to a systematic review of studies conducted between 2000 and 2026, according to a World Health Organization (WHO) report released on Tuesday. “This means that if the risk of infertility is 15% for women who do not smoke, then 21% will experience infertility if they smoke,” the report explains. “

“Women who smoke while trying to conceive have a higher risk of infertility or will take longer to conceive, according to the report. Meanwhile, women exposed to second-hand smoke had a 1.2 times higher risk of infertility….”

· And via UN News – Tobacco use can undermine fertility, UN health agency warns

“Smoking very likely makes it harder to have a baby, the UN World Health Organization (WHO) warned in a new publication issued on Tuesday, highlighting that women who smoke have a 40 per cent higher risk of infertility compared to non-smokers. “

BMJ Opinion – From tobacco to TikTok, continued: What the $18bn Meta settlement really means

I Kickbusch; https://www.bmj.com/content/394/bmj-2026-100800

“Meta’s $18bn settlement with 51 US states, announced in August, is already being called social media’s tobacco moment. It warrants this comparison, but not for the reason that the headlines suggest… “

“… Whether it becomes the industry reshaping moment that tobacco litigation produced in the 1990s, or a well publicised one-off that the rest of the industry quietly waits out, will depend on three things: the fact that this is a settlement rather than a verdict; what actually changes on the ground, not only in the US but also in other parts of the world; and whether it impacts on the actions of other tech companies….”

Kickbusch concludes: “”…the settlement still helps. Regulators facing the standard industry defence—that these design changes are not commercially or technically workable—now have a company that has agreed to build exactly that, under legal pressure, and at scale. Two entirely different legal traditions, US tort litigation and EU precautionary administrative regulation, are now converging on the same list of design fixes. That convergence is the strongest evidence yet that platform design could become a genuinely global regulatory category. Many of us are looking to the WHO to apply its norms and standard setting role in relation to the digital determinants of health based on this development.”

Lancet Planetary Health – Special Economic Zones, Casinos and the Threat of Zoonotic Diseases

Georgina Kenyon; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00106-3/fulltext

“Hundreds of millions of wild plants and animals are taken each year for food, medicine, crafts, and as collectables. Unfortunately, this includes a large illicit trade in critically-endangered species, such as Pangolins – sought across Asia and Africa as food and to use their scales in traditional medicine – which have become the most trafficked mammal in the world, according to anti-smuggling NGO, TRAFFIC. …. The trafficking of animals is backed by serious and organised crime linked to money laundering through casinos around the world, according to Geneva-based think tank, The Global Initiative Against Transnational Organized Crime (GiTOC). “Australian casinos have been heavily used for money laundering, particularly with junket operators facilitating money laundering for VIP gamblers,” says John Langdale, an expert in criminology from Macquarie University in Sydney, Australia.”

“The Australian government asserts it has improved anti money laundering measures in the last few years. However, Langdale says the Australian government has “tightened the rules on casinos, but rather belatedly.” He also warns of significant money laundering and animal trafficking activities within Special Economic Zones, such as the Thai-Myanmar border: “Money laundering in Southeast Asia is through both physical and online casinos — especially through Kings Romans casino in the SEZ.” The Kings Romans Casino is located at the heart of the Golden Triangle, where the borders of Thailand, Laos, and Myanmar converge. It attracts hundreds of visitors each week from mainland China. Kings Romans casino also seems to operate its own river ports that bypass standard immigration and customs checkpoints. Online casinos are also connected to scamming centres in Cambodia, Myanmar and Laos, operating without regulation and managed frequently by the same criminal groups….”

Mental health

World Suicide Prevention Day 2026

Every year on 10 September.

“Suicide is a major public health challenge, claiming the lives of more than 720 000 people every year. Each life lost has profound social, emotional, and economic consequences, deeply affecting families, friends, workplaces, and entire communities around the world. … 2026 marks the third and final year of the triennial theme for World Suicide Prevention Day (2024–2026), Changing the Narrative on Suicide, with the call to action: Start the Conversation.”

TGH – The Rise of Social Media Bans: Can Regulation Improve Teen Mental Health?

https://www.thinkglobalhealth.org/article/the-rise-of-social-media-bans-can-regulation-improve-teen-mental-health

“Social media bans are gaining global traction, yet youth stress that they should be involved in the decision-making process.”

“… Will banning kids from social media reverse this trend? The answer is unclear, but efforts to limit young people’s access to these forms of technology to protect their mental health are on the rise; eight countries have passed or implemented age-based restrictions on social media, and lawsuits against technology companies are multiplying.”

“Think Global Health spoke with experts and youth advocates to monitor the emerging response to young people’s social media use and to understand the potential effects of regulating or restricting use on youth mental health….”

SRHR

Lancet Regional Health Africa (Health Policy) – Sexual and reproductive health and rights post-ICPD: promises, implementation gaps, and lessons from Cameroon for Francophone sub-Saharan Africa—an integrative review

S A Ojong et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00110-0/fulltext

“Three decades after the 1994 International Conference on Population and Development, Cameroon’s experience reflects Africa’s broader struggle to turn global sexual and reproductive health and rights commitments into effective laws, policies and practices. … … We identified a pattern of selective domestication, where trackable SRHR domains receiving sustained political attention and donor investment such as maternal health, HIV, and family planning, showed greater progress compared to politically contested domains. This systems-first, rights-second trajectory is sustained by constrained domestic financing, policy resistance from conservative religious actors, fragmented advocacy, and male-dominated governance structures in which institutionalised norms of masculinity systematically limit women’s agency and control over their reproductive lives. …”

Guardian – $15m fund launched to create ‘unstoppable momentum’ to end FGM worldwide

https://www.theguardian.com/global-development/2026/sep/11/15m-fund-launched-to-create-unstoppable-momentum-to-end-fgm-worldwide

“Her Horizon Fund seeks $100m to stop practice harming 230m women and girls globally.”

“Frontline activists and leaders in the fight against female genital mutilation, which has affected more than 230 million women and girls worldwide, have welcomed an unprecedented $15.5m (£11.4m) fund aimed at creating “unstoppable momentum” to finally end the practice. The launch of the fund comes as women’s rights are increasingly under attack and donor funding is in sharp decline, particularly for work led by FGM survivors in local communities. It is thought to be the largest single philanthropic contribution to ending the practice of FGM.”

“The Her Horizon Fund has been seeded with $14m from the Wallace Global Fund, plus an additional $1.5m contribution from an anonymous donor, making $15.5m in total. The aim of Her Horizon Fund, set up by the US-based Wallace Global Fund, is to pool $100m from donors to reach a “tipping point” towards ending FGM within a generation.”

Child health

Guardian – Babies born to anaemic mothers have smaller brains, study finds

https://www.theguardian.com/global-development/2026/sep/09/babies-born-to-anaemic-mothers-have-smaller-brains-study-finds

“Key regions of the brain linked to movement, learning and emotions were affected and may lead to cognitive problems.”

“Babies born to mothers with anaemia have smaller brains, particularly in key regions linked to movement, learning and the regulation of emotion, according to a study. Researchers said the differences, first detected at the age of one, could lead to cognitive problems when children started school….”

“More than a third of pregnant women worldwide have anaemia – a condition typically caused by iron deficiency in which the number of red blood cells in the body is lower than normal. Symptoms include fatigue, shortness of breath and dizziness. Rates are highest in sub-Saharan Africa and south Asia. Researchers from King’s College London in the UK, and the University of Cape Town in South Africa, followed more than 300 mothers and their babies in Cape Town, scanning the brains of the infants several times between the ages of three months and two years….”

Planetary Health

Devex Pro – The pre-COP31 finance meeting no one is talking about

https://www.devex.com/news/the-pre-cop31-finance-meeting-no-one-is-talking-about-113227

(gated) “Turkey’s pre-COP31 finance summit may sidestep the stalled public finance debate, focusing on instruments and national priorities instead.”

“The Turkish presidency of the 31st United Nations Climate Change Conference is holding a climate finance summit this week in Istanbul in the lead-up to COP31. …”

“Today, during the first day of the Istanbul Climate Finance Summit, COP31 President-Designate Murat Kurum said that world leaders must close the climate finance “chasm” and called climate finance a “strategic security priority,” according to a press release. “After all, defence spending is considered an investment made today to protect against the threats of tomorrow. Climate investment must be viewed through precisely the same strategic lens,” he said….”

Global Climate & Health Alliance – Health Groups Launch Plan to Expose PR Agencies Playing Both Sides of the Climate and Health Crisis

https://mailchi.mp/95ce5a23a80b/health-groups-launch-plan-to-expose-pr-agencies-playing-both-sides-of-the-climate-and-health-crisis?e=3289726e8a

“New “Fossil PR Toolkit” reveals how agencies trusted to promote health and wellbeing also work for fossil fuel companies that drive pollution, climate change, and health harms.”

“A new online toolkit exposes how communications agencies hired by the health sector to promote health, wellbeing and sustainability are also aiding fossil fuel companies to green their public profile, thus maintaining public support for continued coal, oil and gas production. The “Fossil Public Relations Toolkit”, launched today by the Global Climate and Health Alliance (GCHA) and Clean Creatives, features PR companies such as Edelman, Publicis, Hawker Britton and VML that work with the health sector to promote human health, while also serving fossil fuel companies like Shell, ConocoPhillips and Saudi Aramco, in order to demonstrate the relationships and between health organisations, communications agencies and fossil fuel clients. …”

Climate Change News – As science comes under attack at UN talks, climate movement splits over how to respond

https://www.climatechangenews.com/2026/09/09/as-science-comes-under-attack-at-un-talks-climate-movement-splits-over-how-to-respond/

(gated) “A rift over how IPCC messages are produced and turned into policy is creating tensions in the world’s most influential coalition of climate NGOs.”

“With June’s UN climate talks inching towards gridlock, a group of diplomats calling themselves “Friends of Science” issued a stark warning: climate science was under attack in Bonn. The coalition, spanning the world’s richest to its most vulnerable nations, pointed the finger primarily at those who think “science threatens their economic prospects” – a thinly-veiled reference to fossil fuel-dependent states accused of casting doubt on long-held scientific tenets in the UN climate process….”

Guardian – Climate solutions most likely to reach ‘positive tipping points’ revealed by scientists

https://www.theguardian.com/environment/2026/sep/10/climate-crisis-tipping-points-energy-environment-report

“Global shift towards clean electricity could trigger ‘cascade’ of progress, helping reduce air pollution, cut waste and revive oceans.”

“A rapid global shift to clean electricity could trigger a “cascade” of progress towards repairing the damage to the planet by the climate crisis, according to a report identifying the environmental solutions most likely to bring about change. The analysis focuses on “positive tipping points” – thresholds beyond which a sustainable technology or practice becomes increasingly cheap, widespread or politically popular, allowing progress to become self-propelling. It identifies clean electricity as the “highest-leverage” transition, because cheaper solar and wind power can accelerate change far beyond the energy sector…”

“…The report builds on the work of Prof Tim Lenton, the founding director of the University of Exeter’s Global Systems Institute, who has studied climate tipping points since the 1990s….”

“… The report, produced by the University of Exeter with the Earthshot prize, applies tipping point science to 51 priority areas across five environmental goals: protecting nature, cleaning the air, reviving oceans, eliminating waste and tackling the climate crisis….”

Guardian – Climate ‘feedback loops’ could worsen global warming by 30%, study finds

https://www.theguardian.com/environment/2026/sep/10/climate-feedback-loops-global-warming-study

“Emissions of planet-heating methane and CO2 from natural sources are worsening the climate crisis, paper says.”

“Rising global temperatures caused by the burning of fossil fuels are transforming the world’s forests, wetlands and tundra to the point they are releasing emissions that could further worsen global heating by as much as 30%, a new study has found…. “

“… While scientists have long known of these “feedback loops” that amplify the impact of direct pollution from burning coal, oil and gas, the emissions from natural sources are largely unaccounted for in climate projections. This additional heating is however significant, researchers found, with emissions from natural sources set to amplify global heating by 20% to 30% by the end of this century. This would add an estimated 0.2C to 0.4C to the global average temperature by this time, depending on the overall action taken by countries to combat the climate crisis.”

PS: “The United Nations last week conceded the international pact to constraint the global temperature rise to 1.5C above pre-industrial levels will be breached in the next few years, causing climate impacts such as this summer’s record heatwaves and wildfires to “strike faster, hit harder and last longer.” Yet the increase in the world’s fever will likely be even larger than most projections currently account for, the new research warns, as they do not factor in the methane and CO2 that will spew from permafrost, wetlands, freshwaters and wildfires – the four areas the paper analyzed. …. “

“This hidden multiplier is missing from the models guiding climate policy, so those models are likely underestimating how much warming is coming – and overestimating how much carbon we can still afford to emit,” said Sam Abernethy, a scientist at Spark Climate Solutions Research who led the research, published in Environmental Research Letters.”

PS: “Current policies put in place by governments are likely to see the global temperature rise to 2.6C above pre-industrial times, according to Climate Action Tracker. ….”

And related quote Bill Ripple: “…. This does not mean that a Hothouse Earth trajectory is inevitable, but it provides another warning about the possibility of reinforcing feedbacks that can amplify the warming humans initiate”…

Afrobarometer – African insights 2026: Beyond borders: Citizen perspectives on a shifting global order

https://www.afrobarometer.org/publication/african-insights-2026-beyond-borders-citizen-perspectives-on-a-shifting-global-order/

“Citizen perspectives on a shifting global order. “

There’s a lot more in this report, but the increased focus on climate justice certainly struck me:

“… There has also been a significant shift in whom citizens hold accountable. Between 2021/2023 and 2024/2025, the proportion of climate-change-aware Africans who believe wealthy nations bear the primary responsibility for limiting climate change increased by an average of 14 percentage points across 35 countries – a dramatic shift in expectations. Most say developed countries have a duty to assist poorer nations in adapting to climate change (85%) and should take immediate action to limit future impacts (83%). Strong majorities also support domestic climate action, including government investment in climate-resilient infrastructure (81%), pressure on wealthy countries for climate finance (78%), and renewable energy investment (69%)…

The Conversation – Africa gets only 23% of the climate finance it needs – and pays too much for it

C Lopes; https://theconversation.com/africa-gets-only-23-of-the-climate-finance-it-needs-and-pays-too-much-for-it-291103

“African countries have committed themselves to cutting greenhouse gas emissions and protecting their people from the worsening effects of climate change. These commitments form part of the Paris Agreement, an international climate treaty adopted in 2015 in which countries agreed to take steps to limit global warming. Doing this requires billions of dollars in climate finance for clean energy and for making agriculture, water systems and infrastructure resilient to climate change. But the finance reaching Africa falls far short. The continent received an average of US$43.7 billion a year in 2021 and 2022 – only about 23% of what is needed. Africa needs roughly four dollars for every dollar it currently receives.”

“The money is also distributed unevenly. The ten African countries most vulnerable to climate change receive only 11% of the continent’s climate finance, while another ten attract 76% of private climate investment. African countries need financing for mitigation (reducing the emissions causing climate change) and adaptation (preparing people, economies and infrastructure for unavoidable droughts, floods and extreme heat). Current finance covers only 18% of planned mitigation projects and 20% of adaptation costs….”

PS: Lopes: “I am unconvinced that “climate finance” is the right organising concept for Africa. It separates what is fundamentally one development challenge. Africa needs energy systems, electricity grids, transport, resilient cities, irrigation, digital infrastructure, manufacturing capabilities and human capital. Together, these investments determine the continent’s development, resilience, productivity, industrialisation and future emissions. Calling some “climate” and others “development” may make sense to international funding institutions. It makes much less sense from the perspective of Africa’s structural transformation. Africa received only 23% of the climate finance it needs and attracts less than 3% of global energy investment, despite having about a fifth of the world’s population. This points to something larger than a climate-finance gap.”

UNEP & Climate and Clean Air Coalition – Hidden assets: The economic and health case for climate and clean air action

https://wedocs.unep.org/items/7199c3ce-6bb2-4bbb-a579-305b804c4922

“… Climate change and air pollution share many of the same sources, yet are almost always assessed separately. This Assessment corrects that. It evaluates 25 proven solutions across energy, industry, transport, agriculture, cooking and waste, and finds that integrated action delivers more than acting on either alone. Every dollar invested returns around 15 dollars, an internal rate of return of 60 per cent, with market returns exceeding costs within ten years. By 2050 the solutions could avoid 144 million premature deaths and hundreds of millions of cases of chronic disease. The chief obstacles are often neither technical nor economic but institutional. Investment in enabling conditions can bring full implementation forward by up to a decade, worth up to US$10 trillion in savings by 2040. Every region benefits. Benefit-cost ratios range from three in high-income regions to 26 in Southern Africa. Every year of delay forgoes more than US$1.5 trillion.”

Guardian – Heatwaves and wildfires are setting back air quality improvements, UN finds

https://www.theguardian.com/environment/2026/sep/07/heatwaves-wildfires-setting-back-air-quality-improvements-un-finds

“WMO report details extreme weather events causing climatic feedback loop with serious health consequences.”

“Meeting the World Health Organization (WHO) air quality guidelines will become progressively more difficult, as fires are expected to increase in the future, according to a new report from the World Meteorological Organization (WMO). The report also draws attention to the complex relationship between air quality and climate change, showing how poor air quality – driven by vehicular emissions, wildfires and heatwaves – is contributing to climate change….”

Guardian – Global move away from oil could lead to conflict and migration, experts say

https://www.theguardian.com/environment/2026/sep/08/global-move-away-from-oil-could-lead-to-conflict-and-migration-experts-say

“Researchers urge governments to help worst afflicted countries, such as Nigeria and Algeria, which rely on oil revenues for public services.”

PS: “… Many will try to hang on to their resource revenues as long as possible, according to research from the E3G thinktank published on Tuesday, but the cheapest producers with abundant resources – such as Saudi Arabia and the United Arab Emirates – are likely to win against those with less advanced infrastructure….”

Nature Comment -How countries can grow without impoverishing future generations

Eoin McLaughlin ; https://www.nature.com/articles/d41586-026-02807-8

(recommended read) « Governments should invest to develop all types of capital, and not just income, to improve the lives of future citizens and to protect the planet.”

CGD (blog) – Not Fit for Purpose: Why Climate Classifications of Developed and Developing Countries Have to Change

J Beynon et al ; https://www.cgdev.org/blog/not-fit-purpose-why-climate-classifications-developed-and-developing-countries-have-change

“In a new CGD working paper, published today, we find that the 23 developed countries that are obliged to provide climate finance (under the 1992 UN Framework Convention on Climate Change) have, in fact, produced under 40 percent of all greenhouse gas emissions since 1850. Our paper presents a comparative analysis of historical emissions from numerous datasets using different measures of emissions, different classifications of developed and developing countries, and covering different time periods. To our knowledge this has not been done before. We also find that nine major emerging economies—currently classified as “developing” under the UN system—have produced at least 30 percent. While over 100 low-income, lower-middle-income, least-developed countries and small island developing states collectively account for just 15 percent of all emissions. Adjusting for colonial, consumption and per capita emissions makes surprisingly little difference. It is nonsensical therefore not to distinguish major emerging economies from poorer, low-emitting countries—but this is currently what happens under the UN climate system….”

· For the full CGD working paper, see A Comparative Analysis of Greenhouse Gas Emissions by Developed and Developing Countries Since 1850

“This paper aims to inform discussions on historical responsibility for climate change by presenting a comparative analysis of historical emissions from numerous datasets, using different measures of emissions, different classifications of developed and developing countries, and covering different time periods. We find that while the various datasets give significantly different estimates of total emissions, they are reasonably consistent in their estimates of developed country shares; that developed countries using the UNFCCC’s Annex I classification are responsible for about half of all GHG emissions since 1850, and less than 40 percent if limited to the 23 Annex II countries with a formal obligation to provide climate finance. These shares are lower if we consider contributions to global warming rather than GHG emissions, much lower if we only consider emissions since 1990, but higher if we restrict analysis to just CO2. We also find that taking account of colonial or consumption emissions makes relatively little difference to our results, and that developed country shares of cumulative per capita emissions (not that we think this is an appropriate measure) are even lower than for cumulative emissions.”

AI & health

UN News – AI: Türk urges action before it becomes an ‘existential risk to humanity’

https://news.un.org/en/story/2026/09/1168288

“UN human rights chief Volker Türk added his voice on Monday to growing calls for greater AI controls, warning that the revolutionary technology could become an “existential risk to humanity” if left unchecked.”

“Without binding rules, independent oversight and clear limits, the technology could become impossible to control, the High Commissioner told the Human Rights Council in Geneva. Mr. Türk raised the prospect of AI systems becoming so powerful that their developers could no longer control them….”

NYT – Anthropic Says It Blocked Possible Efforts to Build Biological Weapons

https://www.nytimes.com/2026/09/10/us/politics/anthropic-ai-biological-weapons.html?smid=nytcore-ios-share

“In a new report, the A.I. start-up added that it could not determine if the research was legitimate or nefarious, leading the company to shut down the work.”

Nature (News) – AI model predicts which breast-cancer drugs work best

https://www.nature.com/articles/d41586-026-02845-2

Just one example of one of the positives of AI (& health) .“Model trained on millions of protein measurements can gauge drug effectiveness in tissue samples taken from people with triple-negative breast cancer.”

Decolonize Global Health

Review of African Political Economy – ‘Wisdom, solidarity and investment from within’: medical manufacturing as an expression of sovereignty and solidarity in post-independence Africa

L Paremoer et al; https://www.scienceopen.com/hosted-document?doi=10.62191/ROAPE-2026-0021

“Sovereignty and solidarity are at stake in efforts to establish local medical manufacturing on the African continent. Drawing on archival and published materials as well as key informant interviews, this article contrasts articulations from the immediate post-independence period with those of the post-Covid period. After laying out the shifting context from the New International Economic Order to neoliberalism, two key contrasts between the periods are explored. First, medical manufacturing has gained prominence relative to broader industrialisation imperatives, rooted in an economistic logic that nonetheless manages to have a progressive bent. Second, the orientation of medical manufacturing has shifted from social transformation to health security, affecting the meaning and significance of solidarity and sovereignty in the post-Covid conjuncture. It is argued that although contemporary articulations of medical manufacturing in and for Africa are not as radical in their vision, they are catalysing tangible transformations, reshaping Africa’s place in the global political economy.”

Access to medicines, vaccines & other health technologies

Devex – As NCDs rise in Africa, generic drugmakers see a growing market

https://www.devex.com/news/as-ncds-rise-in-africa-generic-drugmakers-see-a-growing-market-113259

“The generic pharmaceutical industry is starting to take notice of an improved operating environment in Africa, alongside a growing demand for NCD care and treatment.”

“For years, public health officials have been warning about rising rates of noncommunicable diseases, or NCDs, in Africa, including diabetes and cardiovascular disease. NCDs are set to become the leading cause of mortality in sub-Saharan Africa by 2030. Generic drugmakers in Africa are starting to take notice…”

“A new report out today from the Access to Medicine Foundation tracks how some continental manufacturers are adapting to meet these emerging health challenges, thanks in part to developments that are making it easier for generic providers working across all areas of health. “This is a rising demand and we’re going to actually need supplies in the continent, itself, in some shape and form to ensure availability,” Jayasree Iyer, the CEO of Access to Medicine Foundation, told Devex. “I think that recognition is a signal from this that we found out in this paper.”…”

· Check out the Access to Medicine Foundation’s press release: Foundation’s new report reveals opportunities for generic medicine manufacturers to bridge access gaps in Africa

“Africa’s healthcare landscape is evolving rapidly, with rising demand for medicines alongside growing investment and regional integration reshaping the market. This new report examines how eight generic medicine manufacturers are responding to the continent’s shifting healthcare needs and seizing new opportunities to improve medicine availability. It also identifies the structural barriers that continue to constrain access – and the actions needed to build a more resilient and equitable pharmaceutical ecosystem across the continent. “

“The rising burden of non-communicable diseases – including cardiovascular diseases, diabetes and cancer – alongside longstanding health challenges is reshaping Africa’s pharmaceutical landscape. Generic manufacturers are working to boost medicine supply through local manufacturing, supply chain diversification, portfolio expansion and new partnership models – but fragmented procurement, uneven financing and disparate regulatory systems continue to constrain progress. The report highlights practical opportunities for manufacturers, governments and global health partners to build more resilient medicine supply across Africa, emphasising the importance of coordinated action across stakeholders. “

Geneva Health Files – The Illustrative Case of Lenacapavir: The Gatekeepers of Prevention, Access & Financing

S Thakur; https://newsletter.genevahealthfiles.com/the-illustrative-case-of-lenacapavir-the-gatekeepers-of-prevention-access-financing/?ref=geneva-health-files-newsletter

(must-read) “In today’s story, my colleague Shubhangi Thakur brings you the evolving the picture around the HIV preventive drug Lenacapavir. This expansive edition (4,000 words +), discusses how HIV prevention strategy is being shaped by the mechanics of voluntary licensing. The story in unfolding in this era of transition: what does it mean for countries to decide on their own prevention strategies. The cast is diverse and powerful, captures the layered interests in global health….”

On the economics of voluntary licensing, the gap between generic enabling generic production and the terms on which that competition is allowed to operate, MSF criticism of Gilead’s Lenacapivir access model, South Africa as a case study, The Global Fund and lenacapavir, India as Licensee and Contestant, A Second Case: Merck’s Alimatravir (another HIV-prevention drug testing the limits of voluntary licensing), and much more.

Quote: “There are more fundamental questions that experts are raising. In the broader context of greater autonomy, and push towards self-financing, should countries be making their own decisions on their preventive strategies? Meaning, what kind of reforms are needed that would create policy space for countries to determine the drugs they want to buy, the procurement mechanisms they want to use, and the money they want to spend within constrained budgets at their disposal.”

Thakur concludes: “… the lenacapavir implications extend well beyond HIV prevention. The rollout, as MSF told us, shows that some of the barriers that accompanied the arrival of antiretroviral medicines three decades ago remain: decisions over where a new medicine is supplied, in what quantities, through which channels and at what price can still depend heavily on the originator. The question for future breakthroughs, MSF argues, is whether affordability, equitable licensing, transparent pricing and timely availability can be built into the access model from the outset, rather than negotiated after a product has been developed. Lenacapavir is not the last high-value medicine to cruise along this architecture. Long-acting prevention and treatment technologies are emerging across HIV and other infectious diseases, and their rollout will keep running through some version of this same architecture: patents, voluntary licenses, negotiated procurement, and donor bridges standing in for an open market that doesn’t yet exist.”

“Voluntary licensing has altered the economics of the access to medicines, however it has not resolved the politics of who gets to decide where access begins, where it ends, and what recourse exists for those left outside it.””

Aspen opts not to make HIV prevention jab lenacapavir

https://www.businessday.co.za/news/health/2026-09-04-exclusive-aspen-ditches-plans-to-make-hiv-prevention-jab-lenacapavir/

“Drugmaker cites lack of government commitments as it bets on Merck’s experimental pill instead.”

Gavi welcomes prequalification of multi-dose RSV maternal vaccine to protect infants

https://www.gavi.org/news/media-room/gavi-welcomes-prequalification-multi-dose-rsv-maternal-vaccine-protect-infants

“WHO prequalification of a multi-dose RSV maternal vaccine marks a major step towards protecting newborns and infants from one of the leading causes of severe respiratory illness, hospitalisation and death worldwide. The new vaccine is expected to reach women during pregnancy through routine maternal immunisation programmes in lower-income countries, where more than 97% of RSV-related child deaths occur. The milestone strengthens the pathway towards Gavi-supported introduction, helping bring equitable access to life-saving RSV prevention closer for millions of families and children most at risk.”

Lancet – Gold standard vaccine policy as a global health signal

Mauer Alexandre da Ascensão Gonçalves et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01698-3/fulltext

« The US Executive Order of Aug 10, 2026, establishing “Gold Standard Childhood Vaccine Recommendations”, should be considered not only a domestic policy change but also a potential global health signal. By redefining what childhood vaccines should be routinely recommended, encouraging separation of the combined measles, mumps, and rubella vaccine, and advocating separate medical visits for different childhood immunisations, the policy risks conflating parental choice with the optimisation of evidence-based vaccination delivery. In an interconnected world, vaccine policy is not only a domestic clinical decision but also a global signal that can shape trust in immunisation…. »

· And a link: Kenya Announces Major Reduction in Cancer Treatment Costs Through Pfizer Partnership

“The arrangement brings together Pfizer and the Kenya Medical Supplies Authority (KEMSA) under Pfizer’s Accord for a Healthier World, a global initiative through which the company provides medicines to lower-income countries on a not-for-profit basis. Kenya joined the Accord in June 2025….”

Conflict/War & health

Lancet Regional Health (September issue)

https://www.thelancet.com/issue/S3050-5011(26)X2007-7

· Editorial: The intersection of conflict, displacement, health, and human rights in Africa

“ The International Committee of the Red Cross recently reported that 40% of global conflict is taking place in Africa, and there are currently more than 50 armed conflict situations. Approximately 23 million people are forcibly displaced in eastern and southern Africa, and just over 16 million in western and central Africa. The impact of conflict and forced displacement on health systems, and consequently the health and human rights of these populations, is well documented. Although only certain countries within the continent are affected, we cannot consider the health of our region without considering conflict, and the resultant displacement of populations. As a journal serving the African region, The Lancet Regional Health – Africa is committed to keeping these issues on the agenda. Accordingly, in our September issue, we bring together nine pieces on these topics to draw attention to the intersection of conflict, displacement, health, gender, racism, and human rights in Africa….”

A few more reports, Commissions, … of the week

Lancet Comment –The WHS Academic Alliance–Lancet Commission on academic responsibility for trust in science and societal change

Axel Pries, I Kickbusch et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01777-0/fulltext

“…. In this changing environment a radical transformative process is needed to encourage academic institutions to proactively reimagine their core responsibilities. Accordingly, the World Health Summit (WHS) Academic Alliance, as part of the global health scientific community, and The Lancet have initiated the WHS Academic Alliance–Lancet Commission on academic responsibility for trust in science and societal change. …”

“…The WHS Academic Alliance–Lancet Commission consists of a diverse group of 30 interdisciplinary experts based across 22 countries and territories. Four working groups will analyse the foundation and implications of academic responsibility in historical, local, and contemporary contexts; outline requirements for the design of responsible institutions of the future; and define responsible and practice-based approaches for the interaction of academic institutions with societies (figure)….”

PS: “… A special focus will be given to drivers of transformation, including the privatisation and commercialisation of academia, challenges to legitimacy and trust, the disruptive potential of digitalisation and AI, and the requirement for participation and representation in a time of growing inequity. … The cross-cutting theme is the relation between academia and society. The social role of universities is widely accepted, but how can greater synergies between academia and societies be achieved? The academic ecosystem needs to explore new forms of interaction with societal actors that are not only more inclusive, fair, and engaging but also strengthen a sense of ownership within communities…”

“Over the next two years, the Commission will translate this work into concrete recommendations, with a final report expected in 2028.”

Guardian – Tens of millions of people fail to get humanitarian aid as global system crumbles

https://www.theguardian.com/global-development/2026/sep/10/global-humanitarian-aid-crisis-64m-fewer-people-received-help-report

“Funding cuts in 2025 left women, children, older and displaced people hard hit, with 64m fewer people receiving aid.”

“The humanitarian aid system is crumbling as funding shrinks, pressures increase and governments not only fail to protect civilians but are increasingly responsible for endangering them, a new report warned on Thursday as figures revealed 64 million fewer people received aid last year.”

“With aid contributions cut by 30% between 2022 and 2025 and thousands of aid workers losing their jobs, the humanitarian system has suffered one of its biggest contractions since being formed in the post-second world war era, according to the State of the Humanitarian System 2026 report.”

“In 2025, only those whose lives were in immediate danger became the focus, while support for longer-term issues and the ability to recover from crises was drastically scaled back….”

“The report also highlighted the growing pressure from governments on how aid could be spent, such as the US spending freeze on programmes considered driven by diversity, equity and inclusion (DEI) policies….”

Miscellaneous

Telegraph – Global hunger is a threat to Britain’s national security, report says

https://www.telegraph.co.uk/global-health/climate-and-people/global-hunger-is-a-threat-to-britains-national-security/?s=09

“Researchers warn that food shortages are a driver of mass migration, extreme violence and war – events that threaten serious repercussions.”

“Global hunger poses a direct threat to Britain’s national security, and tackling it should be a government priority, a new report from the London School of Economics has warned. It says hunger is a major driver of mass migration, extreme violence and war – events that threaten significant repercussions for Britain and Europe’s national security….”

Peer Review in Crisis: The Ethics of Unpaid Academic Labour Behind Paywalls

L Engelbert Bain; https://www.linkedin.com/pulse/peer-review-crisis-ethics-unpaid-academic-labour-engelbert-bain-urhle/

“Peer review is one of science’s most important forms of invisible labor. If researchers are expected to donate that labor, what does the publishing system owe them—and the public—in return?”

Bain concludes: “Saving peer review is no longer an editorial concern; it is a global science-policy imperative.”

Devex Pro – The supersonic rise of Operation End Starvation

https://www.devex.com/news/the-supersonic-rise-of-operation-end-starvation-113090

(gated) “A billionaire’s heir spent a decade building influence in Washington. Now, his network is betting on a new idea: that a combination of public and private cash — and a laser focus on cost-effectiveness — can remake the world’s malnutrition supply chain.”

Re “ the Eleanor Crook Foundation, or ECF, a Texas-based philanthropy focused on ending child hunger. “…. The goal can be traced back to his family’s philanthropic mission, one built by his grandmother, Eleanor Crook, the heiress to a Texas supermarket fortune. It’s also at the core of the most ambitious thing Moore has built to date: Operation End Starvation, a fledgling U.S. nonprofit launched in July. The new outfit is hoping to overhaul how the world funds, distributes, and prioritizes ready-to-use therapeutic foods, or RUTFs, a lifesaving treatment for severely malnourished children. In large part, that will be done through a razor-sharp focus on cost-effectiveness, which Moore refers to as OES’ “North Star.”…”

“The idea is to build something similar to the Global Fund, which leverages a combination of public and private financing to sustain funding for RUTFs across the production and delivery chain. That would include partnerships with both local and American RUTF manufacturers. The backbone for OES was in place by January, and in June it received a $100 million grant from the U.S. State Department. But the process has not been without debate. While OES is focused on cost-effectiveness, some U.S. lawmakers would like to see more prioritization of American RUTF producers, even if it comes with a higher price tag. And within the nutrition sector, there is concern about the laser focus on RUTFs at the expense of other aspects of a response to malnutrition….”

Global health events

18th World Congress on Public Health (6-9 Sept, Cape Town) – Health Without Borders: Equity, Inclusion, and Sustainability

https://www.wcph.org/

Check out the Conference statement.

Global health governance & Governance of Health

European Public Health Alliance – Together for EU Health Civil Society – 187 organisations call for sustainable EU support

https://epha.org/together-for-eu-health-civil-society-187-organisations-call-for-sustainable-eu-support/

“The European Public Health Alliance (EPHA), as co-chair of the EU4Health Civil Society Alliance, has joined 186 civil society organisations from across Europe and across sectors in calling for meaningful, adequate and predictable operating support for health civil society under the EU4Health Programme and beyond. The statement highlights the important role of health and patient organisations in representing communities, contributing independent expertise and participating in European policy …”

“The call comes amid continued uncertainty over the future of EU4Health operating grants. Following their exclusion from the 2025 EU4Health Work Programme, a revised proposal for 2026 reintroduced only €1.3 million in funding for 2027, an amount considered insufficient by Member States. The signatories are therefore calling on the European Commission to ensure sustainable support for health civil society and to put into practice its commitments to adequate, sustainable and transparent funding for civil society.”

Book – Global Health: Swedish perspectives on key debates, politics, and practice

Rachel Irwin; https://nordicacademicpress.se/product/global-health/

« Although Sweden has traditionally been one of the most significant donors in global health and development, it is barely mentioned in international scholarship on the history and politics of global health. In Global Health Rachel Irwin addresses this gap by examining global health from Swedish perspectives, both historical and contemporary, with a focus on how Swedish actors have driven, taken part in or reacted to many of the key debates and challenges in the field. By using Sweden as a case study, the author traces and untangles the relationships between domestic norms and values, international engagement, and national identity….”

Development Today – A very Norwegian debate about aid reform takes place on its own lonely planet

A very Norwegian debate about aid reform takes place on its own lonely planet

(gated) “Norway, which remains the world’s most generous donor, is in the thralls of a process of recalibrating its aid policy to make it more fit for a changing world. While the government wants to sharpen priorities and reduce the number of aid jobs at home, Norwegian NGOs recoil from suggesting where cuts should be made. Politically prestigious initiatives are, meanwhile, notably absent from the discussion.”

CGD (Note) – Beyond Belt and Road: Responding to the Evolution of China’s Financing for Infrastructure

C Kenny; https://www.cgdev.org/publication/beyond-belt-and-road-responding-evolution-chinas-financing-infrastructure

“China has pretty much given up on finance for publicly owned infrastructure….”

· Summary of this Note: Beyond Belt and Road: China’s Great Infrastructure Retreat

“China financed a lot of public infrastructure in developing countries. That era appears to have come to a close. That’s bad news for developing countries but an opportunity for traditional donors.”

Global health financing

Habib Benzian – What Took Germany So Long?

https://habibbenzian.substack.com/p/what-took-germany-so-long

“How Germany turned voluntary action into a decade of delay on sugar regulation.”

“The wider global health lesson is simple: evidence makes policy defensible, but power determines when it becomes possible.”

UHC & PHC

Lancet Primary Care (Editorial) – Primary and community care for a changing climate

https://www.thelancet.com/journals/lanprc/article/PIIS3050-5143(26)00109-3/fulltext

“Worldwide, primary care systems are working to implement climate resilience and improved service delivery in this era of increasing climate effects. … …Unfortunately, funding and infrastructure fall short of what is needed to support climate-resilient primary and community care.”

The Editorial concludes: “… We have moved from preparing for a future affected by climate change to trying to handle a present affected by climate change. Wildfires rage throughout the world, including in countries that have rarely, if ever, seen them before. Risk of flooding is higher than ever, yet water supply shortfalls in coming years are estimated to be billions of litres. These climate-related effects and disasters will affect the health of billions of people worldwide. Primary and community care are the first point of contact for identifying, managing, and preventing health effects resulting from climate change. Systematic, national-level investment and strong, climate-resilient infrastructure are required to ensure that primary care can withstand future climate effects.”

Pandemic preparedness & response/ Global Health Security

Book – Pandemics: Anthropological Insights

P Dawne; https://utppublishing.com/doi/abs/10.3138/9781487541323

“This book offers an anthropological analysis of pandemics, highlighting how disease outbreaks are shaped by structural inequality, political dynamics, cultural interpretations, and systems of care. It integrates ethnographic research with global case studies to examine how pandemics are experienced and managed across diverse contexts….”

Science Daily – Bats carry dangerous viruses without getting sick. This may be why

https://www.sciencedaily.com/releases/2026/09/260901010713.htm

“Scientists discovered that more than 500 species of vesper bats possess two separate sets of antibody genes, an immune arrangement never before found in mammals. The surprising system could help explain how bats tolerate so many viruses without becoming seriously ill.”

Planetary health

Lancet Planetary Health – July issue

https://www.thelancet.com/issue/S2542-5196(26)X2007-1

Most articles already appeared ‘early online’ before.

Carbon brief – How extreme heat is ‘creeping’ from summer into autumn and spring

Casey Ivanovich; https://www.carbonbrief.org/guest-post-how-extreme-heat-is-creeping-from-summer-into-autumn-and-spring

“Extreme heat is one of the deadliest climate hazards, but no two heatwaves are the same. Heat extremes that happen outside of the peak summer months are often more dangerous because they can catch people off guard. Heatwaves that hit during the spring or the first heatwave of the summer are riskier because people’s bodies are not yet accustomed to the heat and cooling strategies, such as air conditioning or public cooling centres, might not be available. On the other hand, heatwaves that happen in the autumn, after a long summer season of heat exposure, can place further strain on bodies and local infrastructure that are already under stress.”

“… Our study, published in AGU Advances, is the first to measure whether the timing of extreme heat during the calendar year is changing around the world. We find that, in more than half of the world, extreme heat events are spreading into the “shoulder seasons”, but doing so unevenly – in other words, they tend to creep more into autumn or spring, depending on the location….”

Lancet World Report – Fears over longer term health impacts of Nepal floods

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01859-3/fulltext

“Experts warn of a risk of communicable diseases, malnutrition, and mental health conditions following catastrophic flooding that has killed thousands. Sophie Cousins reports.”

Lancet – Wildfire smoke and health: current evidence, mechanisms, and future challenges

Gongbo Chen et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01601-6/fulltext

Review.

« This Review synthesises global evidence on the trends, health effects, and physical and chemical characteristics of wildfire smoke, exploring potential biological mechanisms and challenges in health risk assessment. Acknowledging the global impact of wildfires and their health effects is essential for mitigating environmental, social, and economic challenges. Safeguarding public health requires an interdisciplinary approach to comprehensively address the public health burden from wildfires. This integrated strategy is essential to systematically assess and mitigate the substantial public health burden posed by wildfires, as well as promoting resilience and sustainable solutions for affected communities.”

Lancet Public Health –Heat-health interventions for people experiencing homelessness

Alexander Moses et al; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00160-X/fulltext

Review. Based on studies mainly from HICs.

International Health –Navigating the climate–health nexus: an interest-holder analysis of the public health gaps in Uganda’s climate response

https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihag090/8787995?searchresult=1

By Reagan Daniel Emoru et al.

Guardian – Drinking very hot drinks could triple risk of oesophageal cancer, study finds

https://www.theguardian.com/society/2026/sep/09/hot-drinks-triples-risk-oesophageal-cancer-study

“Research finds temperature and amount of hot drinks consumed heightens possibility of developing disease.”

Infectious diseases & NTDs

Lancet Infectious Diseases – Is a tiered classification framework needed for sexually transmitted infections?

Prof Ismaël Maatouk et al; https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00379-8/abstract

“Working definitions of a sexually transmitted infection (STI) exist, but no universally agreed operational classification links those definitions to programme, funding, and surveillance decisions. The boundary of the STI category determines which infections enter surveillance, receive programme funding, and are included in testing and screening. Yet, the fields of microbiology, clinical medicine, and public health each define this boundary differently. Contested conditions, including bacterial vaginosis, vulvovaginal candidiasis, scabies, mpox, and sexually transmissible enteric pathogens, expose the inadequacy of the current binary classification. In this Personal View, we propose a three-tiered classification framework: core STIs, sexually associated infections, and incidental sexually transmissible infections, anchored on four explicit classification dimensions. The framework is intended to guide programme mandates and funding, clinical and diagnostic service delivery, and disease surveillance, while accommodating conditions that might shift between tiers as evidence evolves and as local epidemiology dictates.”

NCDs

Lancet Regional Health Africa – Africa’s ageing gap: from measurement to action

Leon Geffen et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00133-1/fulltext

“Africa’s health systems were mainly built for the young and the acutely ill, not for the growing millions surviving into older age with multiple interacting conditions. With the population aged 60 years and older projected to quadruple in sub-Saharan Africa by 2050, this transition is already underway. Using the ATHLOS Healthy Ageing Score across five sites in The Gambia, Zimbabwe, and South Africa, Manyara and colleagues document that women, people with multimorbidity, and those affected by obesity, physical inactivity, or tobacco use consistently had poorer healthy ageing profiles. Yet older people in sub-Saharan Africa living longer with interacting medical, functional, psychological, and social problems face systems still organised around single conditions; those with coexisting hypertension, arthritis, depression, and reduced mobility need coordinated care, not four disconnected programmes….”

“… Three areas should be prioritised….”

They conclude: “… The Manyara and colleagues’ study should be read as a call to reorganise policy, services, education, and research around functional ability, because measuring healthy ageing is valuable only when measurement triggers actions. Governments in sub-Saharan Africa should integrate multidomain assessment into primary care, redesign services for multimorbidity, invest in rehabilitation and workforce development, and monitor whether these changes narrow inequalities. Financing these actions does not require entirely new budgets; universal health coverage expansion, primary healthcare investment, integration with existing NCD programmes, and social protection frameworks for older adults and their caregivers offer practical and feasible pathways…”

Lancet Regional Health Africa – Barriers of diabetic foot rehabilitation in Africa: a scoping review of two decades of evidence

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00129-X/fulltext

By Raidah R. Gangji et al.

Social & commercial determinants of health

Lancet Public Health – Global, regional, and national prevalence of second-hand smoke and attributable disease burden in 204 countries and territories, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

GBD 2023 Second-hand smoke Collaborators; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00168-4/fulltext

Some key messages via Global Health Now: “2.7 billion+ people were exposed to secondhand smoke globally in 2023—contributing to nearly 1.7 million deaths… the authors note that women and children are disproportionately exposed and call on governments to implement stronger tobacco controls in public places and homes to better protect non-smokers…”

Lancet Public Health (Comment) – Healthy checkout policies: a new front in food regulation

Adam D Koon; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00193-3/fulltext

Comment linked to a new study in the Lancet Public Health.

“Prominent placement of junk food at store checkouts can prompt impulse purchasing, and checkout displays are encountered by nearly every shopper. Restrictions on the placement of less healthy products have rightly become a recognised part of the policy repertoire recommended to improve population diets, alongside taxation, marketing restrictions, and front-of-pack labelling. Evidence on their effects, however, comes largely from voluntary initiatives, single retail chains, or short observation periods. In this issue, Justin S White and colleagues report the first evaluation of a mandatory healthy checkout policy using retail sales data…”

Lancet Public Health (Viewpoint) – Beyond individual-level approaches to dementia prevention: a socioecological reappraisal

J Dunne et al; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00171-4/fulltext

« Dementia prevention has largely focused on modifying individual behavioural and clinical risk factors. Although this approach has advanced understanding of dementia risk, it could under-recognise the broad social, environmental, and structural conditions that shape brain health across the life course. In this Viewpoint, we apply the socioecological model, a well established public health framework, to map 61 modifiable dementia risk and protective factors identified in the published population-attributable fraction literature across four levels of influence: individual, interpersonal, community, and societal. Most mapped factors (49/61 [80%]) were at the individual level, with few at interpersonal (2/61 [3%]), community (3/61 [5%]), or societal (7/61 [11%]) levels. This pattern suggests that the published evidence base remains predominantly organised around individual-level factors despite growing recognition of upstream influences. We argue that effective dementia prevention requires coordinated action across sectors, including education, urban planning, environmental policy, and health care.”

Access to medicines & health technology

Lancet Regional Health Africa – Africa’s immunisation journey from recovery to sustained acceleration: insights from the 2025 WHO and UNICEF Estimates of National Immunisation Coverage

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00128-8/fulltext

By Charles Shey Wiysonge et al.

Plos Med – The widening medication adherence gap

Zachary A. Marcum; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005237

“The gap between medication efficacy in trials and real-world effectiveness is widening, and with it the opportunity cost of medication nonadherence. Closing this gap requires more than individual behavior change; it requires system-level solutions, including coverage and funding design, pharmacist-led programs, and health information technology.”

Globalization & Health – Quantitative assessment of national essential medicines lists processes: a descriptive study of 143 countries

https://link.springer.com/article/10.1186/s12992-026-01237-5

By E Saxena et al.

Human resources for health

Globalization & Health – Nursing as a systems profession in One Health: opportunities across the Quadripartite action tracks

J B Fernandes; https://link.springer.com/article/10.1186/s12992-026-01238-4

« The One Health agenda has progressed from a conceptual acknowledgement of human–animal–environment interdependence to a global framework for coordinated action, exemplified by the Quadripartite One Health Joint Plan of Action (2022–2026). The Joint Plan sets out high-level objectives across six action tracks, while the 2023 national implementation guide supports countries in adopting and adapting those objectives to their own contexts. This paper examines nursing as a systems profession within One Health, using the six action tracks as an analytic framework. »

HRH – Addressing the global health workforce crisis: from numerical shortages to skills quality

S Kanwar et al. https://link.springer.com/article/10.1186/s12960-026-01101-y

“… This commentary argues that existing migration frameworks and qualification recognition processes may not do enough in the absence of structured competency benchmarking and measurable skills standards. Although WHO initiatives such as the Global Code of Practice, Bilateral Framework Agreements, and the Global Competency Framework for Universal Health Coverage provide important policy foundations, significant implementation gaps remain in the assessment and comparison of competencies across borders. Competency-based education offers a potential pathway toward more measurable, transparent, and outcome-focused workforce development…”

Decolonize Global Health

The American Journal of Bioethics – How “America First” Abandoned Global Health: The Case for an African Model

Nancy S. Jecker et al;

https://www.tandfonline.com/doi/full/10.1080/15265161.2026.2692312#d1e250

“This editorial puts forth an alternative to the America First vision for global health. It looks beyond Western approaches to engage with values prevalent among African people, values we believe are compatible with many Western values. We focus on Africa for two reasons. First, the African region is among the most heavily impacted by America First (Oum et al. Citation2025). Second, ideas from Africa, and the Global South more broadly, are frequently missing from bioethics discourse (Pratt and De Vries Citation2023). This reflects profoundly unfair patterns of disadvantage and power that arose during colonialism and continue today (Santos Citation2015, Fayemi et al. Citation2025). Foregrounding non-Western approaches comprise part of a larger effort to decolonize global health….”

Lancet Letter – Inverting power must begin with authorship

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01509-6/fulltext

By Q Khraisha.

Conflict/War & Health

BBC – Sudan’s healthcare system on brink of collapse after cuts, medical charity warns

https://www.bbc.com/news/articles/c62m8247yleo

“Sudan’s fragile health system is on the brink of collapse as global funding cuts have led to the closure of healthcare facilities across the country, Médecins Sans Frontières (MSF) has warned. Dozens of organisations were unable to find alternative funding after the US – the largest donor to Sudan – closed USAID, its body for delivering foreign aid, last year, the medical charity said. MSF urged world leaders gathering at the UN General Assembly in New York to take action….”

“… MSF said while the US was still the largest donor to Sudan, existing grants to many USAID-funded organisations ran out in June – as European governments were also reducing international assistance.”

IJHPM – Pathways to Universal Health Coverage: A Qualitative Comparative Analysis of Effective Development Cooperation Principles in Fragile and Conflict‑Affected States

https://www.ijhpm.com/article_4923.html

By H Aweesha et al.

AI & health

NYT – A.I. Boom Poses Growing Public Health Threat, Former E.P.A. Officials Warn

https://www.nytimes.com/2026/09/10/climate/ai-data-centers-air-pollution-health.html

“Air pollution from gas-fired power plants to run data centers is expected to add at least $20 billion in annual health care costs by 2028, the group warns.”

“A group representing more than 800 former employees of the Environmental Protection Agency on Thursday sounded the alarm over the health consequences of data centers. It warned that Trump administration policies to weaken pollution safeguards and speed up approvals of the facilities threatened to exacerbate those health harms. In a report set to publish Thursday, the nonprofit Environmental Protection Network examined pollution from power plants, gas turbines and diesel generators needed to meet data centers’ surging electricity demand. And it listed 30 federal actions taken by the Trump administration that it warned would increase pollution-related health risks as more data centers open across the country. …”

Miscellaneous

Lancet Perspective – Tim Baker: bringing systems change to acute health-care provision

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01823-4/fulltext

“…. In Tanzania, Baker and his team developed the concept of Essential Emergency and Critical Care (EECC), a low-cost, low-resource systems innovation focused on effective life-saving interventions. To Baker, “critical illness is a massive and neglected problem, and we’ve developed a solution that is cost-effective and feasible for all hospitals in the world. Currently, this care is often not being provided and there are so many preventable deaths in all resource levels globally.”…

Papers & reports

JCPH (Editorial) – The (inevitable) politics of public health research

Judith Green; https://journalhosting.ucalgary.ca/index.php/jcph/article/view/84663

“Recent moves by the US government to increase political control over federal research funding include having political appointees make decisions on what gets funded and withdrawn, and severe constraints on ability to fund international collaborations. They have rightly incurred condemnation and protest from across the medical community. The Editors of the ‘New England Journal of Medicine’ have likened the scale of the threat to the Soviet-era political promotion of Trofim Lysenko’s anti-Mendelian genetics, which had decades-long devastating consequences for agriculture and the development of biological sciences in the Soviet Union. Science, they argued, should not be politicized. Yet public health, as a research discipline as well as a practice, is inherently and inevitably political. The challenge is one of combining a political sensibility with a commitment to methodologically sound, open and critical science.”

HP&P – Multi-sectoral governance for health: a scoping review and typology development

Matthew Aviso et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag106/8786738?searchresult=1

“Multi-sectoral governance is widely recognised as necessary to address health challenges, but approaches vary in different settings. We aimed to examine the representation and attributes of multi-sectoral governance for health in the peer-reviewed literature and develop a descriptive typology. … …. Multi-sectoral governance for health was assessed to be either single-lead (i.e. when one sector leads) or distributed (i.e. when all sectors share in governance). Single-lead multi-sectoral governance for health was further classified as: (1) deliberate, when the lead sector is clearly tasked with governing collaboration from the outset; or (2) organic, when the lead sector emerges as the sector naturally responsible for governing collaboration. Distributed multi-sectoral governance for health can be further classified as: (1) committed, when all sectors have sustained interest in contributing to collaboration; (2) flexible, when the involvement of sectors shifts depending on changing priorities and available resources; or (3) fragile, when sectors do not commit sufficiently, resulting in sub-optimal collaboration. Our findings can advance thinking on what multi-sectoral governance for health looks like, guide policymakers and other stakeholders to explicitly consider governance arrangements when planning and implementing multi-sectoral governance for health and recommend future research to explore how variations in types of multi-sectoral governance for health relate to its effectiveness.”

Policy Brief – How can we better prepare health systems to resist corruption?

https://eurohealthobservatory.who.int/publications/i/how-can-we-better-prepare-health-systems-to-resist-corruption

By D Balabanova, M McKee et al.

Plos Med – Country- and individual-level factors associated with healthy working life expectancy: A multinational longitudinal study

J Zhu et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004676

“This study provides a comprehensive estimate of HWLE at age 50, and identifies national economic indicators, governance quality and employment-related conditions as contextual factors associated with HWLE, beyond individual factors like chronic diseases and lifestyle.”

Podcasts

Global Health Matters podcast – Behind the scenes of the pandemic agreement

https://www.buzzsprout.com/1632040/episodes/19731801-behind-the-scenes-of-the-pandemic-agreement

“In May 2025, the world adopted a landmark agreement to prepare for future pandemics. It was the product of three years of negotiation across deep political divisions, including the withdrawal of the United States from the World Health Organization. How did the countries with the smallest delegations build real influence at the table? How do health leaders keep people’s health at the center of a deeply political process? And what does this achievement signal about cooperation in a divided world? In this episode, host Garry Aslanyan explores these questions with two guests who bring complementary perspectives. Anne-Claire Amprou is the French Ambassador for Global Health and co-chaired the intergovernmental negotiations that delivered the pandemic agreement. And joining her is Lia Tadesse Gebremedhin, Executive Director of the Harvard Ministerial Leadership Program at the Harvard T.H. Chan School of Public Health and former Minister of Health of Ethiopia, who helped build one African voice — 47 countries speaking together — during the negotiations.”

Editorial: “Fit for the future” (IHP News #896)

Kristof Decoster — Fri, 11 Sep 2026 05:32:40 +0000

Dear Colleagues,

It’s still a month but nevertheless, the World Health Summit (11-13 October) in Berlin is approaching – I’ll normally be there, at least if the Deutsche Bahn has mercy on me. And so, early this week, the WHS posted the following quote from IHME’s Chris Murray on social media: “The World Health Summit 2026 comes at a decisive moment for global health. Health financing is contracting, progress on mortality is slowing, and the threats to health ahead of us are shifting faster than our institutions are adapting. The health of the next generation will be defined not by one crisis but by a series of catastrophic threats. Yet each remains amenable to action. The future is not determined, and what we do now will change its trajectory.”

I’m not sure the ‘next generation’ is thrilled by this wonderful prospect, but am certainly looking forward to the related WHS Keynote Session, ‘Launch of the Findings from the Lancet Commission on 21st Century Global Threats to Health’ , co-hosted by IHME and The Lancet Group, which will examine potentially catastrophic threats ranging from pandemics, antimicrobial resistance, and conflict to the malicious use of AI, non-communicable diseases, and mental health. Not being American, I’m somewhat less hopeful than Murray on the ‘strategic action’ mankind is presumably going to take in the coming decades to ‘change the trajectory’ and avert some of the worst scenarios. Add to that Martin McKee’s excellent analysis in the Lancet Public Health, in which he argues that the “erosion of the rules-based international order has become one of the most substantial threats to public health in the 21st century” (yet another amplifier of public health risks in the coming decades), and the fact that I’m still wondering whether we’re now in a ‘polycrisis’, ‘permacrisis’ or ‘metacrisis’ ( or all of them together), and you will understand that I have some trouble these days to read about global health reform efforts aiming for a ‘fit for purpose’ or ‘fit for the future’ architecture. The term feels a bit – how shall I put this politely – ‘misaligned’ in the current dire circumstances. We can aim at most for ‘damage control’ in the coming decades, I’m afraid. In more politically palatable terms, perhaps: ‘Resilience and Stability for All’. Or as we like to say in bad English over here: “…we’d better hold on to the branches of the trees.” The mantra ‘Resilience for All’ which seems to have replaced ‘Health for All’, is still anything but ‘truth’ (and let’s not get into ‘resilience for whom’ etc), but at least less naïve than dreaming of a ‘fit for purpose’ Global health architecture in the current circumstances. Just ask the Romans towards the end of the 5^th century.

I’m not as gloomy on global health reform as Horton in today’s Offline, but let’s nevertheless keep in mind that we somehow went from dreamy ‘cosmopolitan moment & other Global Health Convergence ’ discourses to the current ‘chokepoints’ analysis in less than a decade. The latter brings me to the PABS negotiations in Geneva, about to start again next week (14-18 September). After listening in to a couple of interesting (TWN, Grad institute) webinars this week (admittedly, while multitasking), my non-expert view ( or rather hunch) is increasingly that if this is to land somewhere by the next WHA, James Love (KEI)’s briefing note for negotiators is probably one to look carefully into.

The WHO DG race also continues to get some attention in this newsletter, and it could turn out a nasty race this time. If so, that would be much in line with the overall geopolitical environment, I hear you think. ( ps: I checked with Claude: “”Nasty” is maybe too strong for now — it’s tense and high-stakes, but not openly ugly so far”; I agree, Claude! )

Last but not least, being from Western Europe, I guess I also have to say something about the very worrying AfD victory in regional elections in Germany. Obviously, I don’t like the radical-right to have more than 40 % of the votes (and in Germany it’s actually an extreme-right party), but as others have noted, France is still the main worry in the short term. Also, call me naïve, but I have enough faith in human beings to believe that no more than 10 % of human beings (well, maybe 15 % in ‘exceptional’ countries like the US …) are hardcore racist – at least in our times. Anything beyond that requires other explanations – even if I acknowledge the migration issue is a difficult one.

With respect to some of these ‘other explanations’, I would like to ask the following question: why have leaders like Macron, Starmer (before) and Merz so easily become ‘lightning rods’? Well, from where I sit, it’s a mix of them being perceived as being ‘aloof’ and ‘not really running for the public good of the country (but instead for some vested interests, mostly wealthy ones and captains of industry, with austerity in store for the many others)’. And let’s cut the crap, it’s not just a perception – I bet many of us who aren’t stupid enough to vote for radical-right parties (among others, because we know our history) would agree with that assessment.

I’m aware that in some public health (and EU establishment) circles, the ‘Musk/X’ factor is also fairly popular (together with Russian disinformation), and I’m not going to deny those might make a few percent difference (as well as that tougher regulation is absolutely necessary for most social media platforms for many reasons), but in my opinion, the double standards in our late-capitalist western societies are far more corrosive for society. Just one example: many ordinary people are trying their best for the climate, while Musk and other tech billionaires are basically doing whatever, not caring at all about their climate footprint (and worse, are even proud of it). And common citizens witness this on their tv-screens and amplified by social media on a daily basis. And that’s just one example of the ‘double standards’ allowed by Merz and ‘likeminded’ ‘centrist’ leaders, which in my opinion totally destroy our western societies and social contracts. There are plenty of others – see for example the French fashion industry’s pathetic take on (a bit more) tax justice.

And so, global health reformers from these and other countries in ‘likeminded’ trouble, should perhaps dare to think out of the box. A new Lancet study (and relatedComment ) on wealth redistribution policies has part of the answer – while acknowledging it’s going to be anything but politically easy. But there’s no other way. At least if we still want end up at some point at an architecture and world ‘fit for the future’. The alternative is dystopian, I don’t need to tell you.

Coming back on the upcoming World Health Summit, I hope the just launched WHS Academic Alliance-Lancet Commission on academic responsibility for trust in science and societal change, which focuses more on the role of academic institutions, arrives at a similar conclusion. And that an IPCC-style International Panel on Inequality is putin placesooner rather than later. As if we fail to deal with blatant inequality, between and within countries, we’re toast in this century. Ps: from another angle, the 18^th World Congress on Public Health in Cape Town, themed ‘Health Without Borders: Equity, Inclusion, and Sustainability’ (6-9 September), seemed to ‘align’.

Enjoy the read.

Kristof Decoster

Editorial: “Global Health” restarts in September & a new quarterly column (IHP News #895)

Kristof Decoster — Fri, 04 Sep 2026 04:10:36 +0000

Dear Colleagues,

With the summer now behind us, we start this newsletter issue with an announcement on a brand new column. Deccan Dispatches” will be a quarterly column offering a practitioner’s perspective from southern India on global health issues. Each edition will take a current theme and examine it through the lens of someone embedded in local realities but with a global gaze.

Check out today’s first Dispatch by Prashanth NS (Institute of Public Health Bengaluru) in the Feat article below. His work over the last decade has focused largely on health inequities and social determinants of health of people living in southern India in the biodiverse forested landscapes of the Western Ghats and large expansive Deccan plateau. Both regions face their own ecological mayhem. Prashanth: “Being a community health practitioner at heart, a passion for the general and a scholarship that seeks as much breadth as it seeks depth fascinates me, and hence my work is much more at the intersections of biomedical, social and ecological than pursuit of core expertise in one subject.”

You find Prashanth’s first column below in full – ‘Global Health’s great derangement’.

Over to the news of the global health week then – ‘deranged’ and other news : )

In addition to the inevitable new start of the ‘webinar season’ and a flurry of new journal issues, September will feature among others a new PABS negotiations’ iteration in Geneva (14-18 September) and the annual UNGA meeting in New York. The UN High-level Meeting on Pandemic Prevention, Preparedness and Response isscheduled on the 25^th of this month. In Geneva, the States Parties Committee for the Implementation of the IHR (2005) (SPCIHR) came together for the first time this week (31 August-2 September). And in other GHS related news, last week (27 August), a new Global initiative to improve access to mpox vaccines was launched. At last, I hear you say.

The Ebola emergency in the DRC continues to provide the worrying backdrop for many of these PPPR related discussions. On Ebola, I wonder whether, in addition to the many other factors playing a role in the current dire situation, maybe we also see the impact of the “polycrisis” (for lack of a better word) at work here, compared to the Ebola outbreak from the mid-2010s. These days, there are so many urgent crises needing attention from policy makers that perhaps, unlike at the time of the Ebola outbreak in West-Africa, ‘all hands on deck’ is less straightforward than a decade ago, PHEIC or not? I know, it’s just one factor – and by no means the most important one for why the outbreak continues to outpace the response. But it’s one we’ll increasingly see playing out, I’m afraid – the factor ‘one among many urgent crises’. Call it ‘crisis brain fog’ if you want.

Speaking of another one of these other urgent crises (and still the most important one as far as I am concerned), a new UNEP report, ‘Limiting Overshoot’ warned this week that “Global heating will hit at least 1.8C”, adding “…the best hope for humanity to limit damage is to adopt an “overshoot, peak and decline” pathway that requires immediate and sustained greenhouse gas emissions cuts combined with steps to remove carbon dioxide from the atmosphere.” Given the rapidly increasing militarization in many our societies, and more in general Sapiens’ top-notch shooting skills, I guess we have at least the ‘overshoot’ part of the pathway covered.

Obviously, the WHO DG race is going to be a fixture in the newsletter in the coming months ( on LinkedIn, we spotted a nice video from a jogging Kluge this week in Maputo), and the same is true for global health reform – with the Accra Reset and the WHO-convened GHA reform process as the main ones to track. While we’re waiting for the Accra Reset High-Level panel recommendations, the Joint Task force on GHA reform set up its first in-person meeting this week (3-4 Sept) in Geneva. At the same time, BRICS countries’ health cooperation is also becoming more concrete (Next week, a BRICS leaders’ summit takes place in Delhi). Still on global health reform, we hope that the people involved in these high-level discussions have a good look at the following IHP blog: ‘Gen Z Rage Tests Global Health’s Reform Theatre’. They might not be ‘Gen Z’ themselves, but I bet many have Gen Z offspring.

Meanwhile, far away, in Stellenbosch, South Africa, the second World Sexual Health Assembly takes place. Every year, World Sexual Health day is celebrated on 4 September. This week was also the Global week for action on NCDs (31 August-4 Sept).

Among the key reports of this week, Devex and others flagged: “Public Citizen and Partners In Health found that the Trump administration is planning a 59% reduction in health spending in 18 countries by 2030 — about $2 billion.” And make sure you check out the inaugural Alcohol Tax Scoreboard, launched just yesterday.

Finally, this week Bhutan hosted the first Global Conscious Food Systems Summit. If it wasn’t for my carbon footprint, I would have loved to attend that one, even if I’m not exactly known for a spiritual relationship with food.

Still on food, we also came across a neat quote in a Devex article on Kenyan civil society providing a blueprint for civil society in the ‘America First’ era. The backdrop for the quote: “…Civil society, which once had external funding from the U.S., may now have to seek partnerships with governments receiving funds directly from the U.S. That could complicate the role civil society plays as watchdogs. “ “A phrase that stood out during these meetings was someone describing it as: “When you have food in your mouth, you don’t talk.”“

Based on personal experience (eg at lavish World Health Summit breaks), I can relate to that

Enjoy your reading.

Kristof Decoster

Weekly topics: IHP news 894: Highlights of the week (IHP News #894)

International Health Policies — Fri, 28 Aug 2026 07:57:17 +0000

Structure of Highlights

· A few must-reads of the past two weeks

· WHO Afro regional meeting in Addis (24-28 August)

· Ebola emergency DRC: 100 days and counting

· Mpox outbreak Guinea

· AMR

· More on PPPR

· Global health reform (& post-2030 brainstorm)

· WHO DG race speeds up

· More on Global Health Governance & Financing/Funding

· Global Tax justice: Analysis of latest UN Framework Convention round in New York

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

· SRHR

· Decolonize Global Health

· UHC & PHC

· Human Resources for Health

· Social Determinants of health

· Planetary health

· Environmental determinants of health

· WASH

· Access to Medicines, Vaccines & other health technologies

· AI & health

· Conflict/War & health

· Miscellaneous

A few must-reads of the past few weeks

Health Politics (Perspective) – Neoliberalism: The politics of health writ large

Clare Bambra, Ted Schrecker; https://hpolitics.org/journal/view.php?doi=10.66534/hp.2026.0007

We want to draw your attention to this article in a rather new journal (second issue by now), Health Politics.

“Drawing on our book Neoliberal Epidemics: How politics makes us sick (2nd edition, 2025), this article sets out how neoliberalism – the hegemonic political–economy of the last 50 years – has operated as a powerful upstream determinant of population health acting through four interlocking and mutually reinforcing pathways: widening socioeconomic inequality, chronic psychosocial stress, pervasive economic and social insecurity, and the growing power of the commercial determinants of health. Together, these pathways explain how political and economic choices translate into biologically embodied health outcomes over the life course. We illustrate our argument with a case study of austerity. Following Virchow’s insight that politics is medicine “on a large scale”, we conclude that under neoliberalism, health inequalities are inevitable. Addressing them therefore requires public health to confront the political and economic structures that systematically generate stress, insecurity, inequality and commercial harm, rather than relying on downstream or individual‑level interventions.”

· Related: some more background info on the new journal Health Politics – Introducing Health Politics (by Haejoo Chung & Carles Muntaner) (from the first issue).

“With this inaugural issue, Health Politics opens a new scholarly home for research that explains how power, institutions, and political conflict shape health and equity. The journal emerges at a moment when the post–World War II institutional order that has structured international cooperation, social protection, and public health governance are under sustained strain—and when political decisions made over the coming decade will shape health outcomes for generations. We believe the field needs a dedicated platform where political science, political sociology, political economy, and public health converge on these questions with the theoretical depth and methodological rigour they demand…

“… We begin with our inaugural editorial, “Why Health Politics?” (Chung & Muntaner, 2026), which sets out the journal’s intellectual foundations. That essay argues that politics is not the only determinant of health among many. It is the arena in which all other determinants are organized and contested. The editorial situates the journal within the tradition of political economy of health. It also bridges that tradition with political science theory. These include historical institutionalism, power resources theory, comparative federalism, and regulatory governance. It articulates the journal’s commitment to methodological pluralism with a quantitative edge. The essay also identifies six research priority domains. These span labour and welfare states, health systems, corporate power, geopolitics, misinformation, and methods for studying power…..”

Lancet Editorial – Attacks on LGBTQ+ health are a threat to all

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01704-6/fulltext

Last week’s Lancet editorial. Must-read. A few excerpts:

“The health of LGBTQ+ people has long been an indicator of wider advances in human rights and health equity. Modern LGBTQ+ liberation movements have achieved substantial progress towards the decriminalisation and depathologisation of LGBTQ+ identities. Yet hard-won gains are easily lost, and many parts of the world see no such gains at all, with LGBTQ+ people denied even the most basic human rights…..”

The editorial concludes: “… Health equity for LGBTQ+ people is not a utopian vision, but it is only achievable when LGBTQ+ people are able to access services when they need them, free from discrimination, and realise their full potential towards health, happiness, and self-expression. There are reasons for hope: there is progress in Asia and, in Europe, Spain ranks first for LGBTQ+ rights owing to robust legal protections against discrimination, the creation of an independent equality authority, new national LGBTQ+ inclusion strategies, and a depathologising model of transgender care that permits legal self-determination without requiring psychiatric diagnosis or hormone therapy—despite campaigns against women’s and LGBTQ+ freedoms by the far-right populist party Vox. The rollback of LGBTQ+ rights is a warning: movements that seek to undermine LGBTQ+ people are those that seek to control all of us—our freedom of expression, our personal medical decisions, and our privacy. We must resist the othering of the LGBTQ+ community, in pursuit of health, human rights, and dignity for all.”

Habib Benzian – What Health Research Calls Curiosity

On Substack;

“The hidden hierarchy behind scientific freedom.”

“In February this year, a Nature editorial defended “curiosity-driven research” against governments seeking clearer alignment between public research funding and political priorities. Its warning was reasonable: if science is required to promise immediate economic or social returns, it risks losing the freedom that makes unexpected discovery possible. Fair enough. But the phrase “curiosity-driven research” deserves some curiosity of its own….”

Benzian concludes: “…. That is why the language of “curiosity-driven research” can become protective. It places certain forms of inquiry beyond the need to explain why their questions became central while others remained peripheral. And once those hierarchies are established, defending curiosity can inadvertently become a defence of the accumulated choices that produced them. The challenge is to widen our understanding of where intellectual seriousness resides. Curiosity can interrogate molecules. It can also interrogate markets, institutions, professional power and inequality. It can ask how disease works inside a cell and why its consequences are distributed so predictably across society. The future of health research is not a choice between freedom and mission. It is a question of whose questions we have decided are worthy of being called curiosity at all. And that is a question curiosity itself should be asking.”

Regional meeting WHO Afro (24-28 August, Addis)

African health ministers convene to shape region’s health priorities

https://www.afro.who.int/news/african-health-ministers-convene-shape-regions-health-priorities

(25 August) – Primer.

“… Key agenda items include a strategy to strengthen sustainable health financing; the Africa Health Workforce Agenda 2026–2035 to help countries educate, employ and retain more health workers; and a regional strategy to give every child the best start in life through greater investment in early childhood development. Ministers will also consider proposals to strengthen regulation of medical products, and reinforce health security and emergency preparedness, in a region that experiences more public health emergencies than any other globally. As the Democratic Republic of the Congo responds to its largest Ebola outbreak, ministers will review a regional framework to strengthen national emergency medical teams so that countries can respond more rapidly and effectively to outbreaks, disasters and other public health emergencies. They will also consider a framework to safeguard Africa’s hard-won gains against polio by preserving the surveillance systems, laboratories, skilled workforce and emergency response capacities built through decades of eradication efforts. The Committee will consider how better data can improve people’s health through a new Regional Health Data Hub, designed to help countries detect health threats earlier, target resources more effectively and make better-informed decisions. Ministers will also consider A New Era of Health for Africa: United Action for Vision 2035, a long-term strategic framework to guide African-led health transformation through stronger primary health care, resilient health systems, sustainable financing, digital transformation and greater country ownership….”

Annual Report of the Regional Director – Delivering Results, Driving Reform, Securing Africa’s Health Future

https://www.afro.who.int/about-us/regional-director/annual-report-2025

Check it out.

AU Chairperson Urges African Countries to Pursue Self-reliance in Health

https://www.ena.et/web/eng/w/eng_9451866

“African Union Chairperson Mahmoud Ali Youssouf called on African countries to pursue self-reliance in health through stronger domestic financing, local production, research and innovation.

Speaking at the 76th session of World Health Organization Regional Committee for Africa (RC76), which opened in Addis Ababa today, the Chairperson said that health remains central to Africa’s priorities. Health sovereignty on the continent is no longer optional, he emphasized….”

WHO Afro – African countries commit to train and retain 3 million more health workers by 2035

https://www.afro.who.int/news/african-countries-commit-train-and-retain-3-million-more-health-workers-2035

“Ministers of health from Africa today endorsed the Africa Health Workforce Agenda 2026–2035, committing to plan, educate, employ and retain 3 million additional health workers by 2035 in a landmark effort to strengthen health systems and ensure more people across the continent have access to quality health services when and where they need them.”

“Facing a projected shortage of more than six million health professionals by 2035, African countries are stepping up efforts to strengthen their workforce, with a new decade-long plan announced on Wednesday during a meeting of health ministers in Addis Ababa, Ethiopia….”

“The new plan calls for coordinated investment to ensure countries have a skilled, motivated and adequately supported workforce capable of meeting Africa’s rapidly growing health needs. The agenda marks a shift from simply training more health workers to building sustainable, well-planned and equitably distributed health systems …

PS: “The new programme provides countries with a roadmap to improve workforce planning, expand quality training, create more employment opportunities and retain skilled professionals in the areas where they are most needed.”

“WHO also highlights the economic case for investing in health workers. Closing Africa’s workforce gap would require an additional $4 to $6 per person each year. The potential returns, however, are substantial. Every dollar invested in health workers could generate up to $10 in economic benefits and roughly 30 times that amount in broader social returns, through better health, higher productivity and stronger economies.”

African health ministers, partners agree to accelerate multi-disease elimination

https://www.linkedin.com/pulse/african-health-ministers-partners-agree-y1qee/

“African health ministers, development partners, heads of African Union and regional health institutions today agreed on a renewed continental agenda to accelerate the elimination of multiple diseases in the region, committing to ensuring that disease elimination remains a priority within broader health and development agenda. Meeting during a high-level ministerial side event held on the margins of the Seventy-sixth session of the WHO Regional Committee for Africa, the health leaders also endorsed the Addis Ababa Call to Action on Protecting and Accelerating Multi-Disease Elimination in Africa which aims to boost country ownership, domestic investment in health and improve resilient health systems that are capable of responding to multiple public health challenges….”

“… The Addis Ababa Call to Action emphasized the need to move beyond disease-specific interventions towards integrated approaches that strengthen primary health care and deliver results across multiple disease programmes….”

WHO Afro – Securing the future of health in Africa through sustainable financing

https://www.afro.who.int/news/securing-future-health-africa-through-sustainable-financing

“Around 385 million people in the African region are pushed into or deeper into poverty each year due to out-of-pocket expenditure on health. At the same time, governments are facing growing national financial pressures as public spending stagnates, debt burden increases and external assistance declines. Health ministers gathering in Addis Ababa for the Seventy-sixth session of the World Health Organization (WHO) Regional Committee for Africa today endorsed a new strategy that sets out a roadmap for sustainable health financing over the next decade to help countries build more resilient and self-reliant health systems.”

“The Strategy for Financing the Future of Health in the WHO African Region (2026–2035) responds to one of the Region’s most pressing challenges: ensuring that everyone can continue to access quality health services without financial hardship, even as countries navigate changing economic realities. The strategy promotes stronger domestic resource mobilization, more efficient use of available resources and financing systems that are better prepared to withstand future shocks.”

“… The strategy outlines seven priority areas for action, including strengthening health financing governance, increasing domestic resource mobilization, improving the pooling of health funds, making purchasing of health services more strategic, modernizing public financial management and strengthening financing for essential public health functions. Together, these reforms aim to improve efficiency, expand financial protection and ensure that limited resources generate greater health impact.”

“By 2035, the strategy aims for 56% of Member States to demonstrate sustained increases in government spending on health, 56% to improve financial protection for their populations, and 75% to have up-to-date national health financing strategies that support effective resource mobilization and use. It also seeks sustained regional progress in reducing the number of people pushed into poverty because of health spending….”

And some links:

· WHO Afro – African countries commit to giving every child the best start in life

· WHO Afro – African health ministers adopt new strategy to bolster medical regulatory systems re The Regional Strategy on Regulation of Medical Products in the African Region (2026–2035).

· WHO Afro – Health ministers adopt framework to safeguard Africa’s polio gains

Ebola emergency DRC: 100 days and counting

After an update on yesterday’s Africa CDC briefing, this subsection focuses on key updates related to ‘100 days of the Ebola outbreak’. Then some more reads (including from earlier this month).

HPW – Four DRC Health Zones Mark 42 Days With No New Ebola Infections

https://healthpolicy-watch.news/four-drc-health-zones-mark-42-days-with-no-new-ebola-infections/?feed_id=1029&_unique_id=6a905e1001142

(27 August) “Four of the 58 health zones in the Democratic Republic of Congo (DRC) affected by the Ebola Bundibugyo outbreak have had no new cases in the past 42 days, while five others have been case-free for at least three weeks. “The message is that it is definitely possible in that environment to break the transmission,” said Professor Yap Boum, Africa CDC’s head of Emergency Preparedness and Response, at a media briefing on Thursday….

“… Boum also revealed details of the village-based approach recently adopted by the DRC government and partners. It will be built from clusters of households to villages, health areas, health zones and finally, specialised teams to deal with a range of issues from dignified burials to vaccinations. This decentralised community approach “will improve the trust, the access, but more critically, the mobilisation”, said Boum….”

“… The outbreak has disrupted essential health services, particularly maternal health and immunisation services….”

“… Boum said that the ongoing strikes by health workers over non-payment of salaries are being addressed “health zone by health zone”. A “major challenge” has been to ensure that all the health workers working on the outbreak are registered on the government payroll, as some had been recruited by different partners. “Implementing that registration and payment has been quite tedious,” said Boum. “But I can confirm that, as we speak now, 2,800 of those health workers have been paid by the government and some by partners.”… Community healthcare workers are to be paid $150 per month, which Boum described as a positive development that will “fast-track the deployment of community healthcare workers within the village-centred approach”….”

UN News – UN chief condemns “indifference” as Ebola cases mount in DR Congo

https://news.un.org/en/story/2026/08/1168217

(27 August) “The Ebola Bundibugyo outbreak in the Democratic Republic of the Congo (DRC) requires “urgent” action and funding to rein in its alarming spread, the UN Secretary-General told reporters at UN Headquarters on Thursday.”

““Without additional funding, vital operations will run out of money at the very moment they need to ramp up,” Guterres warned, calling for an additional $1.1 billion. Money, however, is only part of the problem….”

UN News – 100 days of Ebola and the race to stop the spread

https://news.un.org/en/story/2026/08/1168195

(24 August)

“A hundred days after the Bundibugyo Ebola outbreak was declared, the Democratic Republic of the Congo (DRC) is facing an epidemic of an unprecedented scale and efforts must grow to contain the spread in the eastern region and across borders, UN agencies warned on Monday.”

“The World Health Organisation (WHO) reports an average of nearly 90 confirmed cases were recorded daily in during the first three months, a rate higher than the 2018-2020 outbreak in the DRC. The latest figures indicate 5,515 cases and 2,642 deaths, meaning the mortality rate is almost 48 per cent. The outbreak now affects six provinces, with Ituri remaining the epicentre, accounting for around 85 per cent of cases and 79 per cent of deaths.”

(25 August) (recommended read)

“The Democratic Republic of Congo (DRC)’s Ebola outbreak passed the 100-day mark on Monday with over 5,515 confirmed cases and 2,642 deaths – and health experts warn that the response needs to be accelerated to bring the world’s fastest Ebola outbreak under control.e

“While the case fatality rate is almost 48%, the DRC’s Ministry of Health reported that 1,200 people have been cured and that hospital stays are now between five and 10 days compared with the 18 to 21 days earlier in the outbreak, thanks to “improvements in technical equipment and diagnostics”. “Laboratory capacity has expanded from one testing site to 19 laboratories capable of processing more than 3,000 samples a day,” according to the World Health Organization (WHO) Africa region. Meanwhile, over 1,300 beds are available and over 900 health facilities have received infection prevention and control support.”

“The WHO issued a raft of new and modified recommendations on Monday to address the outbreak, following last week’s meeting of the Emergency Committee on the International Health Regulations (IHR). ….”

PS: “Dramatic scale-up needed: “One hundred days ago the world was warned of the Ebola Bundibugyo emergency. One hundred days later it is the fastest-growing Ebola outbreak ever recorded. Ending this emergency requires a dramatic increase in the scale and speed of the response and follow-through to put the necessary resources and tools in the hands of those on the front lines,” said Helen Clark, Co-Chair of The Independent Panel for Pandemic Preparedness and Response.”

WHO – Second meeting of the IHR Emergency Committee on the epidemic of Ebola Bundibugyo virus disease in the Democratic Republic of the Congo – Temporary recommendations

(24 August) WHO;

For the detail on the updated recommendations.

PS: Following its second Emergency Committee meeting on 18 Aug, WHO kept DRC’s risk assessment at ‘very high’.

Independent Panel for Pandemic Preparedness and Response – We Are Losing the Fight Against the Bundibugyo Ebola Outbreak.
https://mailchi.mp/independentpanel.org/bundibugyostatements-17465784

(25 August) “The World Must Take Urgent and Bold Action to Turn the Tide and End the Suffering.”

“One hundred days after the emergency declarations, the Bundibugyo outbreak risks becoming the deadliest Ebola outbreak in history. The Independent Panel for Pandemic Preparedness and Response calls for a major acceleration of effort on public health measures, including community engagement and ownership, on financing, access to outbreak tools, and coordination of effort. With the right action now, the next hundred days could turn the tide on this catastrophic outbreak.”

“This will take coordinated efforts from the Democratic Republic of the Congo (DRC) and neighbouring countries, community organisations and INGOs, UN and regional organisations including WHO, Africa CDC, and the African Union, international donors, and the medical countermeasures industries….”

· Also with a neat overview of “At 100 Days – where do financing and outbreak countermeasures stand?” See below (in full):

Financing: “As of 23 August, the WHO—Africa CDC finance tracker shows pledges of US$1.3 billion and disbursements of US$333.3 million against a continental plan costed at US$518 million to the end of November. The tracker shows disbursement flows from financing partners to receiving governments or institutions and the geographical target for the funding. On 20 August, Africa CDC reported some US$758 million released, and it is unclear why this differs from the joint tracker. “

“The “research, knowledge management and access to MCMs” estimated budget of US$67.7 million attracted US$213.6 million in pledges, and as per the data on the tracker as of 23 August, US$80.2 million of that has been disbursed. Risk communication and community engagement require US$46.6 million and has received US$24.2 million. The IPC, WASH and Safe and Dignified Burials pillar has seen US$23.3 million disbursed against a budget of US$49.1 million. Case Management and Clinical Care is the lowest funded pillar, with only US$753,200 disbursed against an estimated requirement of US$66.5 million. “
“The United States has announced more than US$512 million and says publicly that it is the largest donor to this response, but that funding is not tracked on the WHO–Africa CDC platform and cannot be reconciled with published figures. As with much other donor funding, it is unclear how much is new and how much is reprogrammed, and how much is directly available for the response in the DRC.”

Vaccines
“CEPI is supporting four vaccine candidates. Two have entered first-in-human trials: the University of Oxford’s ChAdOx1 BDBV, which began in Oxford on 13 July, and Moderna’s mRNA-1469, which dosed its first participant on 3 August in Canada. Two further candidates, from IAVI and Public Health Vaccines, both using the rVSV platform, remain in preclinical development.

On 31 July, WHO’s technical advisory group recommended that Ervebo – the licensed Zaire ebolavirus vaccine – be included in a Phase 3 study in this outbreak on evidence of possible cross-protection. On 20 August, WHO announced the DRC would receive 70,000 Ervebo doses including 50,000 for compassionate use for front-line health workers, and 20,000 for a Phase 3 clinical trial to understand the impact of the vaccine on the Bundibugyo virus.”

“Therapeutics
Two therapeutic trials are also enrolling. The PARTNERS trial, sponsored by WHO with the DRC Ministry of Public Health, ALIMA and MSF, is testing the monoclonal antibody MBP134 (Mapp Biopharmaceutical) and the antiviral remdesivir (Gilead) in confirmed patients, and had enrolled 100 people by 12 August. EBO-PEP, led by INRB Kinshasa with ANRS/Inserm and ALIMA, is testing the oral antiviral obeldesivir as post-exposure prophylaxis in contacts of confirmed cases.”

Diagnostics
“On 2 July, the first Bundibugyo-specific diagnostic received WHO Emergency Use Listing. A platform to validate the performance of laboratory-based, near-point-of-care and antigen rapid diagnostic tests now exists, led by WHO and Africa CDC, with PATH, FIND and CHAI and support from Unitaid.”

“Published access commitments
Moderna has committed to 500,000 vaccine doses for low- and middle-income countries at access pricing, and Oxford has committed to “affordable supply”. Gavi has committed up to US$50 million, with US$10 million for outbreak response and protection of routine immunisation and US$40 million for accelerating access to investigational doses and any future approved vaccines. An additional US$7 million has been committed for the Ervebo vaccines. Unitaid has also announced US$3.4 million to support rapid access to diagnostics and therapeutics.”

IPPS (International Pandemic Preparedness Secretariat) tracker – Ebola (Bundibugyo) Day 100 – Tracking Progress on Medical Countermeasures

https://ippsecretariat.org/news/ebola-bundibugyo-day-100-tracking-progress-on-medical-countermeasures/

“Today marks Day 100 since WHO declared the Ebola outbreak caused by Bundibugyo virus (BDBV) in the Democratic Republic of Congo and Uganda a public health emergency of international concern (PHEIC) on 17 May 2026. Africa CDC declared a Public Health Emergency of Continental Security (PHECS) the following day. This update provides a review of progress achieved in diagnostic, therapeutic, and vaccine (DTV) availability over the past 100 days.”

“This analysis supports ongoing work by 100 Days Mission partners and has been developed in consultation with implementing organisations. …”

Devex – CEPI faces huge Ebola vaccine funding shortfall

https://www.devex.com/news/cepi-faces-huge-ebola-vaccine-funding-shortfall-113176

“CEPI’s Dr. Richard Hatchett says the organization already borrowed $100 million from its existing programs to advance the research and development of several potential Ebola vaccine candidates. But they are still short of cash.”

“… He said CEPI will need somewhere between $350 million and $500 million, but it only has around $200 million at the moment, and it can no longer borrow funding from its other programs.

“The $100 million is actually funds that we have in the bank that are allocated to uses within existing projects and programs, but that won’t be needed until 2028 … so we actually are going to have holes in existing projects and programs unless that funding is restored,” he said. He’s hoping global funders, sovereign donors and philanthropic institutions would recognize the urgency of the situation and step up their funding …”

HPW – Ebola Outbreak May be Three Times the Officially Reported Size

https://healthpolicy-watch.news/ebola-outbreak-may-be-three-times-the-official-size/

(21 August) Update from earlier this month. (based on Africa CDC media briefing)

“Over 5,000 people have been infected with the Ebola Bundibugyo virus in the Democratic Republic of Congo (DRC), but the outbreak may be three times the officially reported size, warned the Africa Centre for Disease Control and Prevention has said. Speaking at a press briefing, Africa CDC’s Prof Yap Boum said the estimation of various experts and academics, is that “only 30-40% of cases” are in fact being detected and reported.”

“… Boum also noted that the vast majority of deaths – 97% in the past week – were still taking place in the “community” – although he clarified that the definition includes health facilities that were not Ebola treatment centres. Once again, the Africa CDC highlighted the weakness in contact tracing, with only around 16% of contacts with confirmed Ebola cases having been traced….”

PS: “Spread to DRC regions near Central African Republic an emerging concern: Boum also sounded the alarm about new cases detected in the DRC provinces of Haut-Uélé and Bas-Uélé, which border the Central African Republic (CAR). Two cases have now been detected in the Bas-Uélé capital of Buta, about 200km from the CAR border….”

PS: “… Ervebo vaccines to be trialled in DRC against Bundibugyo virus strain: Meanwhile, the DRC and international partners as preparing to conduct a clinical trial testing the efficacy of the Ervebo vaccine against the Zaire ebolavirus strain against Bundibugyo in amongst groups of health workers deemed to be at highest risk, WHO said on Thursday. This followed an agreement with the International Coordinating Group on Vaccine Provision (ICG) to send 70,000 doses of Ervebo vaccines to the DRC, at the government’s. The ICG manages the vaccine stockpile in partnership with WHO, the International Federation of the Red Cross and Red Crescent, Médecins Sans Frontières and UNICEF. Gavi, the Vaccine Alliance, provides funding for the stockpile….”

Devex (Opinion) – Africa is leading the Ebola response. Financing must keep up

By Dr. Jean Kaseya, Évariste Ndayishimiye, Félix Antoine Tshisekedi Tshilombo, Faustin-Archange Touadéra, Yoweri Kaguta Museveni; https://www.devex.com/news/sponsored/africa-is-leading-the-ebola-response-financing-must-keep-up-113162

“Africa’s Ebola response needs financing that moves at outbreak speed. Country leadership, regional coordination, and transparent disbursement are essential to turning pledges into protection.” (ps: especially the World Bank seems to get some good marks)

· Related: Guardian op-ed (by J Kaseya & Tedros) After 100 days of the deadliest Ebola outbreak, it can be stopped. Here’s how

FT – Ebola outbreak becomes DR Congo’s deadliest

https://www.ft.com/content/9472e6dd-7b51-48e9-91fa-1f59412e0093?syn-25a6b1a6=1

(17 August) “World Health Organization warns country has entered ‘intense transmission’ phase of the virus.”

“The DR Congo National Institute of Public Health on Sunday confirmed the total fatalities from the outbreak, which started about six months ago, at 2,325. That is still far short of the epidemic from 2014 to 2016 in west Africa which killed 11,310 people. The number of reported cases and deaths hit a record during the most recent reporting week, according to the WHO. “The broader geographic spread and continued high mortality demonstrate the rapidly changing scope of this public health emergency,” it said. … …. London health analytics company Airfinity estimates infections during this outbreak to be five times above the officially reported figures. “The 2014-16 west Africa outbreak remains the only meaningful comparator for where this could go if the trajectory is not reversed within weeks,” Airfinity said on Monday.”

Reuters – WHO says Congo Ebola outbreak can still be brought under control within three months

Reuters;

(18 August). Maybe a bit optimistic, this.

“WHO has raised about 60% of $115 million sought for Ebola response; … WHO Emergency Committee to meet on Ebola on Tuesday.”

“A World Health Organization official said on Tuesday it was still possible to bring under control an Ebola outbreak that is outpacing containment efforts and has become the second-deadliest on record. … … “About ⁠the next plan for the three months, yes, if you have the necessary resources, I think it will be possible to do that,” Thierno Balde, WHO incident manager, told reporters in Geneva from Bunia, in the Democratic Republic of Congo….”

Lancet – Communities and civil society as essential partners in Ebola response

Umberto Pellecchia et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01606-5/fulltext

“A persistent challenge is that many community engagement activities continue to be conceived as instruments for increasing the cultural acceptability of biomedical interventions, rather than as processes through which affected populations can meaningfully shape the response itself. Social science research has consistently shown that effective outbreak response requires moving beyond a purely cultural framing of engagement. Community attitudes and responses to public health interventions during outbreaks are shaped not only by cultural norms and values but by histories of marginalisation, political exclusion, unequal access to care, and relationships with state authorities and humanitarian actors. Interpreting resistance or challenges to response primarily through a cultural lens can overlook the wider social and political factors that influence trust, participation, and acceptance of public health interventions, while potentially reinforcing existing power inequalities.

Previous Ebola epidemics clearly showed that outbreak control depends not only on biomedical interventions but also on meaningful collaboration with affected populations.

…. … Although community engagement is far more prominent in contemporary outbreak responses than in previous epidemics, the need remains to move beyond approaches centred on the acceptability of biomedical interventions towards more meaningful forms of collaboration with affected communities. Several actions could help to shift outbreak response from an approach that works for communities to one that works with them….”

They conclude: “The persistence of community resistance across successive Ebola outbreaks is not evidence that lessons have failed to identify the right priorities. Rather, it suggests that these lessons have not been fully translated into operational practice. The most important lesson from Ebola is not simply that communities matter; it is that sustainable outbreak control depends on citizens and civil society being recognised as legitimate partners in the production of health security. As Ebola outbreaks continue to emerge, institutionalising this principle could prove as important as any biomedical or technological innovation.”

Lancet Infectious Diseases (Newsdesk) – The Global Fund supports malaria response in DR Congo

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00477-9/abstract

“In July, The Global Fund granted DR Congo US$4·6 million in emergency malaria funding—support expected to also bolster its Ebola outbreak response. Manjulika Das reports.”

Lancet Letter – Redefining the end of Uganda’s Ebola virus crisis

Serge Tonen-Wolyec et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01614-4/fulltext

“The declaration on July 28, 2026, that the Bundibugyo virus outbreak in Uganda had ended marks a crucial milestone in outbreak control. WHO considers an Ebola outbreak resolved 42 consecutive days after the second negative PCR test result of the last patient, or their safe burial. Although this threshold effectively captures the interruption of transmission, it remains strictly epidemiological. In reality, the true end of an epidemic is not a singular event but a complex clinical, health system, and social transition that extends far beyond the final detected case….”

“… current outbreak metrics capture only one dimension of epidemic recovery; we therefore propose a four-stage framework to define the complete recovery from an Ebola epidemic. The epidemiological end of an outbreak corresponds to interruption of transmission according to established surveillance criteria. The clinical end is associated with clinical stabilisation of survivors, resolution of post-epidemic excess mortality, and structured management of long-term sequelae. The health system end is characterised by the restoration of routine health care, the resumption of essential services, and the enhancement of public health capacity. Finally, the footprint end is achieved through substantial resolution of indirect systemic consequences, including therapeutic distortions, antimicrobial resistance, behavioural shifts, psychosocial trauma, and economic strain. Because epidemics reshape therapeutic practices and health behaviours long after transmission ceases, recovery should also encompass the resolution of these indirect effects.

Future outbreak declarations should therefore distinguish between the end of transmission and the end of epidemic recovery. Adopting a comprehensive framework that integrates epidemiological, clinical, health system, and societal recovery will align outbreak metrics with the lived realities of survivors, health systems, and affected communities.”

· Related: WHO AFRO – Uganda ends Ebola outbreak following completion of 42-day countdown (27 August)

Lancet GH (Comment) – Operational bottlenecks in the response to Bundibugyo virus disease outbreak in the Democratic Republic of the Congo: a call to action

Justin J Devine et al;

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00228-7/fulltext

« The current outbreak has exposed a crucial gap: despite the availability of scientific tools, major barriers to implementing outbreak research findings are now predominantly operational rather than scientific. Here, we define operational preparedness as the regulatory, logistics, commercial, and governance systems required to translate scientific advances into effective outbreak research and public health interventions. The BVD outbreak illustrates a widening gap between scientific preparedness and operational readiness….”

“… We argue that alongside surveillance, diagnostics, clinical research, and medical countermeasures development, operational preparedness should be recognised as a core pillar of epidemic preparedness….”

Nature Medicine – Overcrowded Ebola treatment centers are fueling transmission in the Democratic Republic of the Congo

https://www.nature.com/articles/s41591-026-04649-3

By J Kambale Kahingi et al.

Nature Medicine – Beyond Ebola: armed conflict and humanitarian funding cuts threaten control of malaria, TB and HIV in eastern DRC

Roland Muhindo Muyisa et al; https://www.nature.com/articles/s41591-026-04592-3

“The ongoing Ebola virus outbreak in the eastern part of the Democratic Republic of the Congo (DRC), declared a Public Health Emergency by the World Health Organization (WHO) on 17 May 2026, is set against a broader humanitarian crisis. Armed conflict, mass displacement and reduced humanitarian funding are undermining disease surveillance, prevention and treatment not only for Ebola but also for malaria, tuberculosis (TB) and HIV, creating a syndemic that threatens years of progress in disease control…..”

“… the current Ebola outbreak should be viewed as part of a larger syndemic driven by conflict and humanitarian retrenchment. Effective epidemic preparedness in eastern DRC requires integrated strategies to strengthen health-system resilience while maintaining critical programs for malaria, TB and HIV. Without sustained investment, the vulnerabilities of one of the world’s most fragile health systems will remain exposed and exacerbated….”

HPW – Violence Against Ebola Responders Mounts in DRC as Red Cross Condemns Attacks

https://healthpolicy-watch.news/violence-against-ebola-health-workers-mounts-in-drc-as-red-cross-condemns-attacks/

(24 August) “Twelve Red Cross volunteers have been injured and an ambulance set on fire in 11 violent incidents during the 100 days since the Democratic Republic of Congo (DRC) declared its Ebola outbreak, the International Red Cross and Red Crescent Movement said Monday….”

And some links:

· (14 August) – Africa CDC Welcomes Emergency Consultative Group Recommendations on Ebola Bundibugyo Response

“Africa CDC welcomes the recommendations of the Emergency Consultative Group (ECG), which will guide the organisation in providing the best possible scientific advice to the Democratic Republic of the Congo and other African countries as they respond to the Ebola Bundibugyo outbreak. …” “We extend our profound appreciation to the members of the ECG, our distinguished African scientists, many of whom serve in leading African and global scientific and advisory bodies for making their expertise, independence and experience available to our continent. …”

· UN News – Ebola: Motorbike riders carrying the sick may hold key to response boost

(18 August) “ From the frontlines of the deadliest-ever Ebola outbreak in Democratic Republic of the Congo (DRC), the UN World Health Organization (WHO) shared details on Tuesday of a massive push for community engagement, a day after yet another ambulance attack.”

“Ambulance attack highlights dangers facing responders; Motorbike riders are key to tracking infections; Surveillance and treatment capacity reinforced.”

Mpox outbreak in Guinea

Guardian – Mpox is back – and in new countries. How can this outbreak be contained?

https://www.theguardian.com/global-development/2026/aug/26/global-health-mpox-outbreak-explainer-children

“The public health emergencies in 2022 and 2024 saw the virus reported in 145 countries, but in the new cases children appear particularly affected….”

“ A fresh outbreak of mpox in Guinea Bissau – the country’s first – means the virus formerly known as monkey pox is back in the headlines. So what has changed?…”

“… Cases had not been reported in Guinea Bissau before this outbreak. Unicef said it was concerned that of 46 suspected cases, 23 were children aged under 15 and most of those were aged under four. “The concern about children is that they are at the highest risk of severe disease and death from mpox,” said Dr Aula Abbara, a senior lecturer at Imperial College London and adviser to Médecins Sans Frontières UK. “Young children can become much sicker than healthy adults.” …… However, she cautioned that the apparent over-representation of children in the outbreak data should be interpreted carefully. She said: “There may also be some bias in the data. Families are often more likely to seek healthcare for a sick child than for an adult, particularly in a resource-constrained setting with a fragile health system, such as Guinea-Bissau.” …”

“… Are there vaccines and treatments? The WHO recommends two vaccines, which can be given to people at high risk or offered to people who have been in contact with a known case to prevent further spread. The question is where they are available….”

“Marks said: “The major challenge remains that supplies of vaccines are best in high-income countries but worst in low-income settings, where the need and conditions for mpox transmission are highest.”

“A new global stockpile is due to be launched within weeks, which should mean vaccines can be deployed more rapidly to quell outbreaks. Officials also hope it will allow manufacturers to plan ahead and produce more of the jabs by providing a clear, concrete demand…..”

AMR

Cidrap News – Study highlights ‘substantial’ burden of drug-resistant hospital infections in Asia

https://www.cidrap.umn.edu/antimicrobial-stewardship/study-highlights-substantial-burden-drug-resistant-hospital-infections

“A large multinational study suggests the burden of drug-resistant hospital infections in Asia is “substantial and likely underestimated,” particularly in the region’s low- and middle-income countries (LMICs).”

“The study, published late last week in The Lancet Infectious Diseases, found that deaths from ventilator-associated pneumonia and bloodstream infections, which are two of the most severe types of healthcare-associated infection (HAI), are significantly higher than previously reported—roughly twice as high as previous estimates….”

“For the prospective study, a team led by researchers with the National University of Singapore analyzed data on nearly 10,000 patients treated for ventilator-associated pneumonia and hospital-acquired bloodstream infections at 41 hospitals in 19 Asian countries and regions. Their aim was to characterize resistance profiles, clinical outcomes, and mortality attributable to antimicrobial resistance (AMR). …”

· The study in the Lancet Infectious Diseases – Severe health-care-associated infections and antimicrobial resistance in an Asian Surveillance Network (ACORN-HAI): a multicentre, prospective cohort study

More on PPPR

HPW – Political Declaration on Pandemics is Modified Ahead of UN Meeting

https://healthpolicy-watch.news/political-declaration-on-pandemics-is-modified-ahead-of-un-meeting/

(19 August) “The Political Declaration to be adopted at the United Nations High-Level Meeting on Pandemic Prevention, Preparedness and Response (PPPR) on 25 September has been modified since being placed under the “silence procedure” in late July. This is according to those close to the process, who told Health Policy Watch that most changes are relatively minor – bar the removal of reference to tuberculosis as one of the world’s leading infectious diseases. A welcome addition is a timeline change, with progress on pandemic preparedness to be reviewed in three years instead of five. The reference to “sexual and reproductive health” has so far survived, opening the door for the United States and allies to contest this on the day, as has become their custom….

“Armenia and Rwanda, the co-facilitators of the declaration negotiations, put the “final” text of the declaration for the High-Level Meeting (HLM) on PPPR in September under the silence procedure on 28 July….”

Statement from Friends of the PPPR High-Level Meeting – UN Member States: Commit to a political declaration that upholds the promise of ‘never again’

https://theindependentpanel.org/news/un-member-states-commit-to-a-political-declaration-that-upholds-the-promise-of-never-again/

(17 August) Neat summary via Arush Lal (on LinkedIn):

“As UN Member States consider next drafts of the Pandemic Political Declaration, they must ask themselves: will the text make the pledge of ‘never again’ a reality? Is it upholding the principles of multilateralism, solidarity and equity?” Rt. Hon. Helen Clark, on behalf of the Friends of the UN High-Level Meeting on Pandemic Prevention, Preparedness, and Response.
…
Over the past year, the Friends of the UN High-Level Meeting on PPPR has worked to turn these questions into political action — building a coalition of unified voices to secure strong commitments during September’s UN General Assembly High-Level Week, including for the 2026 Political Declaration on Pandemics.

As Member States enter the final stretch of negotiations, we are urging them to:

– Uphold past pledges — including the G20’s 2021 Rome Declaration commitments to collective action on global health security

– Deliver on financing — including strengthening domestic investments and securing a sustained $15 billion annual increase in international PPR funding

– Expand equitable access — including protecting TRIPS flexibilities and strengthening local and regional manufacturing capacity for vaccines, diagnostics, and therapeutics

– Hold the line on existing commitments on multilateralism, solidarity, and equity in the 2026 Political Declaration on PPPR…”

Lancet Letter – Pandemic prevention: UN must link spillover and human rights

A Phelan, L Gostin et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01476-5/fulltext

“In September, 2026, UN member states are expected to adopt a Political Declaration at the UN General Assembly’s second High-Level Meeting on pandemic prevention, preparedness, and response. This is a vital opportunity to bolster commitments and resources to address the upstream drivers of spillovers of the next epidemic or pandemic. To advance these goals and solidify its own standing, the declaration must affirm recent legal milestones connecting human rights with spillover and pandemic prevention…..”

Lancet Editorial – Biosecurity in a rapidly changing world

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01758-7/fulltext

Today’s Lancet editorial.

“….backward-looking focus on COVID-19 conspiracy theories has made it difficult to have balanced, evidence-led discussions about post-COVID-19 biosecurity and biosafety. In fact, there is an urgent need to direct political attention instead towards rapid scientific advances in AI, synthetic biology, biotechnology, and research that are reshaping global biosecurity risks.”

The editorial lists five of these.

And concludes: “Advances in biotechnology offer huge opportunities for early disease detection and therapy and vaccine development. At the same time, inadvertent or deliberate misuse carries catastrophic health risks. How do we balance the two? Scientists must have a central role in governance discussions because many of the key questions are highly technical and require scientific expertise to interpret accurately. But effective governance must also find a way to involve broader societal engagement. Public trust in scientists has eroded through anti-science movements pursued by populist governments, the politicisation of science, and misinformation. Safely navigating this latest era of biosecurity requires a new social contract to be forged. The public cannot be passive subjects in this new world; they must be active partners.”

Lancet GH – Energy chokepoints and diagnostic resilience in global health

Xiang Li; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00194-4/fulltext

“Geopolitical tensions that expose the fragility of maritime energy corridors should concern global health not only because of fuel prices, but also because of diagnostic capacity. The Strait of Hormuz carries around a quarter of global seaborne oil trade and substantial liquefied natural gas flows. For health systems, disruption of such a chokepoint could affect care through both visible and less visible pathways. Modern health care depends on petroleum-derived supply chains, including those for plastics, syringes, catheters, infusion systems, pharmaceutical packaging, and cold-chain logistics. A second, under-recognised dependency is helium…”

“… Critical-resource dependency should, therefore, be incorporated into health-system resilience planning. Ministries of health and hospital systems should map essential diagnostics to upstream commodities, transport routes, and maintenance requirements; prioritise helium stewardship and recovery; diversify supply and service contracts; consider low-helium or helium-free MRI technologies wherever feasible; and develop imaging triage plans for shortage periods. International procurement programmes should also account for lifetime consumables, service continuity, and geopolitical exposure, rather than focusing only on equipment acquisition….”

“Energy transition will not eliminate all critical-resource dependencies. Global health preparedness needs to recognise that chokepoints in trade, energy, and rare-resource supply are also chokepoints in care. For disadvantaged health systems, the difference between resilient and disrupted supply chains might become the difference between timely diagnosis and no diagnosis at all.”

FT – Spend more on vet services to curb pandemic threat, says animal health body

https://www.ft.com/content/4deb626f-df26-4ea3-a654-540855fef0b0?syn-25a6b1a6=1

“Head of global organisation says billions of dollars needed to curb risks of mass culls. “

“Countries need to spend billions of dollars more on veterinary and other animal health services to curb the threat of catastrophes such as mass livestock culls or even a human pandemic, the head of the World Organisation for Animal Health (Woah) has recommended. Public and private sectors need to raise investment, while governments should beware the false economy of cutting animal health spending to divert resources to security budgets, Emmanuelle Soubeyran said in an interview….”

“… Woah estimates that spending on public animal health systems needs to rise by an estimated $2.3bn a year to improve surveillance and meet international standards. The money is needed for vets, workforce capacity, laboratory systems, surveillance, medicines, regulatory and inspection functions, and service delivery to farmers, it says. International development assistance for veterinary services is at present less than $1bn a year, Woah estimates, pointing out that this shows the scale of the investment gap….”

“… While it was “understandable” governments were reallocating money towards security and defence, it would be a mistake to cut animal health funding to help achieve this, Soubeyran warned. Diseases of animal origin could be spread deliberately and used as bioweapons, she added. “Strengthening veterinary services is also a part of strengthening global and national security,” she said. “It really has an impact on food security, on public health, on the economy, on livelihood, trade — and also biodiversity.””

“Animals are estimated by Woah to account for only 0.6 per cent of global health spending, even though the majority of established and emerging human infectious diseases have animal origins. A fifth or more of global livestock production is lost to preventable diseases each year, the organisation says…..”

Project Syndicate – Ebola is Back-and the IMF’s Relief Fund Is Empty

Marina Zucker-Marques (Global Economic Governance Initiative, Boston University Global Development Policy Center & Commissioner for the Jubilee Report on Addressing the Debt and Development Crises.); https://www.project-syndicate.org/commentary/imf-needs-resources-for-poor-countries-in-crisis-by-marina-zucker-marques-2026-08

“Once again, the International Monetary Fund finds itself begging for resources to support poor countries facing a public-health emergency. It is an old problem, but one for which there is a remarkably simple solution.”

“In November 2014, then-US Treasury Secretary Jack Lew called on the IMF to cancel approximately $100 million in debt owed by the three Ebola-stricken countries, and then-Managing Director Christine Lagarde proposed an additional financing package to the G20 heads of state. Within three months, the PCDR Trust was transformed. A new public-health window was added to its mandate, and existing resources were combined with leftover funds from the earlier Multilateral Debt Relief Initiative, resulting in the Catastrophe Containment and Relief Trust, a dedicated mechanism allowing the poorest countries to redirect fiscal resources from debt repayment to protecting lives. The global fiscal strain of the COVID-19 pandemic, however, nearly exhausted the CCRT’s resources, leaving the trust running dry just as another Ebola crisis has erupted. …”

“…The DRC was among the countries that borrowed heavily from the IMF during the COVID-19 pandemic to support its economy. It now carries more than $3 billion in outstanding IMF debt. While the country has not yet maxed out its borrowing capacity at the Fund, it will likely require additional financing as it confronts a combination of oil-price shocks, slowing growth, and now Ebola. It will need not just liquidity, but also relief from existing obligations. The CCRT exists precisely for this purpose. Yet its available resources total only $120 million, whereas the DRC alone must pay the IMF almost $300 million in debt service in 2027. The Fund’s primary instrument for disaster relief does not have sufficient funds to cover even one country facing a disaster, let alone the 30 others that could potentially apply for assistance….”

“ Every time a major health crisis erupts, the IMF must again ask its shareholders to replenish an instrument specifically designed to respond to recurring shocks, causing political delays in delivering what should be an automatic, rapid stabilizer. There is a better way…”

“… The proposal is straightforward: sell a small portion of IMF gold, say 10%, and place the proceeds in a permanent endowment account. At a modest 3% annual return, consistent with the yield assumptions underpinning other IMF instruments, a $35.8 billion endowment would generate over $1 billion per year in perpetuity. That would be sufficient not only to fund the CCRT fully but also to subsidize the IMF’s entire concessional lending architecture—the Poverty Reduction and Growth Trust, the Resilience and Sustainability Trust, and any successor instruments—without ever again requiring the institution to solicit donor contributions….”

· And finally, via RANI’s newsletter, re the upcoming new PABS iteration (14-18 Sept) & timeline:

“Dates to watch: Ahead of IGWG 8, two informal sessions will address the (1) scope of pandemic-potential pathogens and (2) the two conceptual models running 3–4 Sept. IGWG 8 will run 14–18 Sept., followed by IGWG 9 on 2–13 Nov., with informal meetings in October and additional time on 30 Nov. – 4 Dec., if needed. A possible two-day World Health Assembly Special Session is pencilled in for the week of 14 Dec., contingent on Member States calling it by 10 Nov. See the full timeline.”

Global Health Reform (& post-2030 brainstorm)

Nature Health – Solidarity is essential in a more transactional global health era

C Atuire et al; https://www.nature.com/articles/s44360-026-00191-1

« As geopolitical interests increasingly shape global health funding and partnerships, there is a growing need to build solidarity in guiding how resources are shared, decisions are made and health equity is advanced. »

“…Recent empirical work from the Global Health Solidarity Project, which draws on research and engagement across five continents, has sought to address this gap by articulating solidarity as a set of relational and institutional commitments. Focusing on the global-health funding ecosystem, the project has articulated a nine-article framework (‘3–3–3’) for embedding solidarity in global health (Fig. 1). The framework is a practical starting point to embed solidarity in funding decisions. … They characterize what solidarity is, how it is enacted and the ends towards which genuine solidaristic practices in global health aspire: the achievement of health equity, fairness and justice. At its core, solidarity is expressed through action: standing with and for others in ways that carry cost and are oriented towards measurable improvements in health and reductions in inequity. It is embodied and enacted, and not merely proclaimed….”

HPW – The next global health architecture must deliver more than reform

David Reddy (IFPMA); https://healthpolicy-watch.news/the-next-global-health-architecture-must-deliver-more-than-reform/

“As governments consider the future of the global health architecture, three principles should guide reform….”: (IFPMA view, so you know what to expect…):

Foster an environment where innovation can thrive; Strengthen health systems so innovations reach those who need them; Forge partnerships to advance health globally (including with ‘industry’).

Lancet Comment – Advancing women’s, children’s, and adolescents’ health in the post-2030 era

P Allotey, H Fogstadt, J Bunting, R Khosla et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01607-7/fulltext

“The health and wellbeing of women, newborns, children, and adolescents are a fundamental human right and a cornerstone of global socioeconomic development. The 2030 Sustainable Development Goal (SDG) era is approaching its conclusion, with progress towards several targets still elusive and the geopolitical landscape highly fragmented. Against this background, we, as three UN agencies with a primary focus on health, together with the Partnership for Maternal, Newborn and Child Health, are beginning to review the evidence on what it will take to protect and advance sexual, reproductive, maternal, newborn, child, and adolescent health and wellbeing beyond 2030. This groundwork aims to synthesise global evidence and emerging megatrends. It is intended to help ensure that a post-2030 agenda is anchored in robust data, and that the health of women, newborns, children, and adolescents remains a global priority….”

“…Over the next 2 years, our organisations with many partners will undertake evidence reviews to assess post-2030 challenges and opportunities in promoting women’s, children’s, and adolescents’ health and wellbeing. This process is exploratory and analytical and intended to support future discussions led by member states and existing intergovernmental processes. It does not aim to draft, negotiate, or endorse any future strategies or approaches for advancing women’s, children’s, and adolescents’ health in the post-2030 era….”

“… A first concrete step is an open call for suggestions on priority topics and for contributors to the background analyses. We welcome proposals across women’s, children’s, and adolescents’ health and wellbeing, including sexual, reproductive, maternal, newborn, child, and adolescent health and stillbirths. We also welcome attention to their social, economic, environmental, nutritional, legal, political, and commercial determinants, and to cross-cutting life-course perspectives. Contributors are invited to propose priority topics, identify potential lead authors or institutions, and outline the rationale and indicative scope of proposed analyses. Suggestions can be submitted and further information can be found on the websites for WHO, UNICEF, the UN Population Fund, and the Partnership for Maternal, Newborn and Child Health….”

SSM Health Systems –Towards global health governance in the post SDG world

Gerald Bloom & Kalypso Chalkidou; https://www.sciencedirect.com/science/article/pii/S2949856226001364

“We are approaching a turning point in global health due to reductions in development assistance, rapid technological change and the growing influence of countries in the global south, several of which have become important producers of drugs and diagnostic equipment. The global health system faces a period of rapid change in a context of geopolitical contestation that is affecting the governance of every sector. Since there is agreement on key global health objectives, health could be an arena in which to build more inclusive global governance. Governments and other stakeholders in the global north and south will need to participate in building a consensus, which includes a variety of initiatives to address priority problems. The WHO can play an important role in supporting change by providing a platform for evidence-based consultations on specific issues, exchanges about how different ways to address a challenge have worked and ensuring that all affected groups have a voice. The focus should be on convening, supporting evidence-based learning and building consensus, rather than prescribing.”

Lancet GH – Global health and its crises: laugh, but then what?

Pablo Villalobos Dintrans et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00210-X/fulltext

A Latin-American view. One of a number of letters in response to a hard-hitting Comment by Afifah Rahman-Shepherd and colleagues from May. (see also below)

“We recently attended a meeting set to discuss the current problems of the global health architecture. … Surprisingly, we found that the global health debate was both replicating the same problems that were meant to be solved and reinforcing the current framework of global health as global aid. We had the epiphany that we—coming from Latin America—were outside this debate that, by nature, occurs between donors and recipients (with a natural hierarchy between participants). Thus, we were not only trying to play a game to which we were not invited but also trying to change its rules. Honestly, the resultant feeling of despair and disappointment is strong, and laughter appears a reasonable response. But then what?…”

“The solution comes from realising the existence of not just one but several global health crises. As much as global health has been defined in the last decades by multilateralism and development assistance for health, these are not the only issues in global health. Key discussions need to be held, for which a more inclusive participation in the definition of problems and solutions is required. Discussions such as those about climate change risks, the use of evidence-based information for decision making, preparedness for global emergencies, or regulations regarding artificial intelligence in health would benefit from a different approach. Changing the dynamics of the debate, including increasing participation (vs restricting actors in discussions), empowerment of countries (instead of the emergence of power groups), and building coalitions (as opposed to imposing decisions based on hierarchies) is fundamental for a new global health debate. This new global health does not represent just a different field, but instead, a different game—one that we are all required to play.”

Lancet GH – Structural silencing and the elephant in the room in global health

Wei-Hsiang Liao; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00211-1/fulltext

“The recent Comment by Afifah Rahman-Shepherd and colleagues (May 2, 2026) incisively unmasks performative inclusivity at global health conferences. However, this tokenism on conference panels reflects a more profound, institutionalised contradiction: the substantive geopolitical exclusion and structural silencing of entire populations from international health governance.”

“If omitting marginalised voices from an academic panel constitutes an ethical failure, systematically silencing a population of 23 million in Taiwan represents a severe form of global epistemic injustice and testimonial domination, ensuring that valuable experiential knowledge is continuously excluded from the global hermeneutical resource….”

Lancet GH (Letter) How to find panellists for a global health conference

Madeleine Ballard et al;

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00212-3/fulltext

“In their Comment, Afifah Rahman-Shepherd and colleagues (May 2, 2026) describe the exclusion and tokenism that has existed on global health panels most of us have sat through (or more uncomfortably, helped stage). We want to share how the community health field has made avoiding such issues easier for organisers.”

“Community Health Impact Coalition members who are not themselves community health workers (CHWs) have made a pledge: nothing about CHWs without CHWs. We do not sit on panels, join convenings, or hold meetings on community health where CHW leaders are not in the room. Moreover, we have built a mechanism that lets any organiser hold the same line: the CHW Speaker Bureau…..

WHO DG race speeds up

More or less chronologically – since mid-August.

Devex CheckUp: Changing of the guard

https://www.devex.com/news/devex-checkup-changing-of-the-guard-113104

(18 August)

“There have been some shake-ups in global health leadership. I recently wrote about Dr. Yukiko Nakatani, assistant director-general for health systems, leaving the World Health Organization. Now there’s another impending departure at the agency. Dr. Jeremy Farrar, who first joined WHO as chief scientist and now serves as assistant director-general for health promotion and disease prevention and control, is leaving by the end of September. There have been reports he resigned, although WHO Director-General Tedros Adhanom Ghebreyesus stated in an internal announcement that he is retiring.”

“Dr. Bruce Aylward, who was previously on Tedros’ senior leadership team before the 2025 restructuring, will take over Farrar’s job….”

“WHO has also published the first two candidates in the running to replace the agency’s leadership: WHO’s Dr. Hanan Balkhy and Dr. Hanan Mohamed Al Kuwari from Qatar — the two “Hanans” as health insiders often tell me….”

· Related: Devex – Dr. Jeremy Farrar to leave WHO

HPW – High-Profile Departures Shake Up WHO Leadership, Tedros ‘Confidant’ Returns

https://healthpolicy-watch.news/high-profile-departures-who-leadership/?feed_id=1010&_unique_id=6a848938a7635

(18 August) Great analysis (and a bit of spin) : )

“A major leadership shake-up is rocking the WHO, with two assistant directors-general, Dr Jeremy Farrar and Dr Yukiko Nakatani, leaving the organisation in quick succession.” (recommended read)

“…For now, Dr Bruce Aylward will take over Farrar’s role while Dr Sylvie Briand will step in for Nakatani. Moreover, following allegations of corruption against Saima Wazed, the regional director for South-East Asia, Dr Nilesh Buddha has taken over as Officer-in-Charge…

“… While the internal email from Tedros announced Farrar’s departure as a retirement, insiders and media reports characterised the sudden exit as a resignation. When asked by Health Policy Watch about the circumstances of Farrar’s departure at a press briefing on Tuesday, the WHO described it as a usual proceeding. “Dr Farrar is reaching WHO retirement age at the end of next month. So that’s why he is retiring at the end of September,” a WHO spokesperson said. However, experts maintain that there has been flexibility regarding the retirement of ADGs in the past. “Retirement age as the reason makes no sense,” said one source on the condition of anonymity. “The reasons could also be political.”…”

“… Insiders attribute the departures of Farrar and Nakatani to deep frustration over Tedros’s leadership. According to these sources, both had recently voiced sharp internal criticism of the WHO’s technical work and data policy…..”

· Related: Lancet World Report – Jeremy Farrar to leave WHO

“The unexpected departure of the Assistant Director-General of Health Promotion, Disease Prevention and Care has prompted concerns over leadership at WHO. Faith McLellan reports.”

With a number of reactions (to his departure) by observers.

Devex – Another WHO official joins the director-general race

https://www.devex.com/news/another-who-official-joins-the-director-general-race-113157

(20 August) “Dr. Hans Kluge, the World Health Organization’s regional director for Europe, is taking leave from his WHO functions effective this Friday, Aug. 21.”

Kluge already published a manifesto – Rebuilding the World Health Organisation together

PS: on a side note, Kluge is from my own province in Belgium, West-Vlaanderen (and has some lovely English) : )

HPW – Indonesian Health Minister Budi Sadikin Becomes Fourth Candidate to Run for WHO Director-General

https://healthpolicy-watch.news/indonesian-health-minister-budi-sadikin/

“Indonesia has officially nominated its Health Minister, Budi Gunadi Sadikin, for the WHO Director-General election – in what is also an unconventional candidacy for the global health agency that has traditionally been led by medical or public health professionals. Sadikin was posted as an official nominee on the WHO election website over the weekend.”

“A nuclear physicist and banker by training, Sadikin took over the Indonesian Ministry of Health in December 2020, leading the country through the COVID-19 pandemic without any formal medical or public health background. … Sadikin’s lack of medical or public health training is seen as a disadvantage by some observers. By contrast, all previous Director-Generals – with the sole exception of Dr Tedros Adhanom Ghebreyesus – were qualified medical doctors. Tedros holds an MSc in infectious diseases from the University of London. However, Sadikin’s strong background in finance could arguably be a decisive advantage in the current climate. … As a key diplomatic credential, he is also one of the architects of the World Bank-hosted Pandemic Fund, launched in Bali in 2022….”

PS: “While Tedros has not openly endorsed any DG candidate, he posted a flattering thanks to Sadikin on LinkedIn last month after Indonesia contributed some $30 million to WHO in voluntary funding to help close the outstanding funding gap in the agency’s 2026-27 $4.2 billion base programme budget….”

“… The declared candidates so far, also are informally regarded as the current “frontrunners” in the election, scheduled for May 2027 in Geneva. Just one month remains for new contenders or dark horses to emerge before nominations close on 24 September. “

Geneva Health Files – In & Out At the WHO: Nominations for the Next Director-General; Departure of Two Top Officials

https://newsletter.genevahealthfiles.com/in-out-at-the-who-nominations-for-the-next-director-general-departure-of-two-top-officials/?ref=geneva-health-files-newsletter

(25 August) “This edition has two parts. First, we discuss recent announcements about departures at the WHO and what this means. Second, we present a few early nominations for the next Director-General of the organization. In this edition, we try to contextualize these developments…..”

Quote: “Apart from the news of these two departures, observers raised broader questions on on how Assistant Directors-General are appointed. “There is so much scrutiny, interest and accountability in the process of the election of the Director-General. And nearly none of that applies to the way ADGs are appointed,” an insider long at the institution said. …. The appointments of ADGs is often seen as quid pro quo during an election process, and this might sometimes result in honoring political commitments instead of getting the best person suited for the function in question, the insider added…..”

· And via Devex Check-up (25 August) : A detour to Addis

“One of the high-profile names expected at (the AVPN conference in Delhi) is Indonesia’s health minister, Budi Gunadi Sadikin — who you should all know by now has officially entered the race to become the next director-general of the World Health Organization. … But a WHO DG candidate’s diary can get rather busy. What I’m hearing? Sadikin has been “diverted” to Addis Ababa today, where the 76th session of the WHO Regional Committee for Africa is underway. And it’s not just Sadikin. Other WHO DG candidates are there too. The gathering gives candidates vying for the DG job an opportunity to make their case to WHO’s African member states — seven of which have seats on the agency’s executive board….”

More on Global Health Governance & Financing/Funding

Science Insider – Worldwide study of diseases gets historic funding influx

https://www.science.org/content/article/worldwide-study-diseases-gets-historic-funding-influx

See also a previous IHP newsletter issue. “Gates Foundation pledges $540 million to a project (i.e. IHME) often criticized for its opacity.” Must-read.

Neat & nuanced analysis, with views from Lincoln Chen, Tim Evans, Prabat Jha, Lucia D’Ambruoso.

CEPI Board appoints Ibrahim Abubakar as new Chief Executive Officer

https://cepi.net/cepi-board-appoints-ibrahim-abubakar-new-chief-executive-officer

(14 August) “The Board of CEPI has appointed Professor Ibrahim Abubakar as its next Chief Executive Officer. Professor Abubakar, currently Vice-Provost (Health) and Professor of Infectious Disease Epidemiology at University College London (UCL), will take up the role in April 2027.”

“The Board of CEPI, the Coalition for Epidemic Preparedness Innovations, has appointed Professor Ibrahim Abubakar as the organisation’s next Chief Executive Officer following a rigorous open recruitment process. Professor Abubakar will join CEPI in March 2027 and Dr Richard Hatchett, who has led CEPI since its founding in 2017, will remain as CEO until the end of his full term in April 2027, ensuring a smooth transition.”

HPW – Germany to Further Slash Global Health Funding in 2027, But Policymakers Push Back on Draft Budget

https://healthpolicy-watch.news/germany-slash-global-health-funding/

Recommended. “Under Germany’s tightly constrained draft budget proposal for 2027, the government is set to reduce global health funding substantially. While mandatory assessed contributions to the World Health Organization (WHO) will rise slightly, flexible budgets for pandemic preparedness are planned to be cut by 15.3%. Leading global health policymakers warn of the risks.”

Devex – Does aid pay off at home? A new study claims more aid means more exports

https://www.devex.com/news/does-aid-pay-off-at-home-a-new-study-claims-more-aid-means-more-exports-113175

“A bank-backed study linking every €1 of German development aid to €2.50 in donor export returns gives politicians a convenient budget defense — but critics warn it treats partner countries’ growth as an afterthought.”

Very cool analysis, this Devex article (of pros, cons & caveats). With also the view of Bodo Ellmers.

WHO – WHO appoints 21 leading scientists to Science Council to help shape future health breakthroughs

https://www.who.int/news/item/27-08-2026-who-appoints-21-leading-scientists-to-science-council-to-help-shape-future-health-breakthroughs

“The World Health Organization (WHO) has renewed its Science Council with new members as part of its regular process for renewing the advisory body’s membership. The renewed Council brings together 21 leading scientists and experts from across disciplines, regions and generations, including specialists in public health, epidemiology, biomedical research, health systems, ageing, engineering, precision medicine and emerging technologies. The Council includes representation from all WHO regions, as well as two youth members….”

· For more, see https://www.who.int/groups/science-council (for the members, scroll to the bottom)

Devex Check-up – Following Asia’s health money

https://www.devex.com/news/devex-checkup-following-asia-s-health-money-113158

An account from AVPN’s global conference in Delhi – AVPN is Asia’s largest platform for social impact.

“There are several health and finance announcements on the agenda this week. One is Nexa Lighthouse, the next iteration of a climate and health solutions fund previously launched by AVPN, with Grand Challenges Canada now coming on board as a partner. Another is a new global mental health consortium, which Dhun Davar, deputy CEO at AVPN, told me is intended to unlock — and attract — more money for mental health programs and services….”

“… Diaspora dirhams: …. Batra also said AVPN has a new program with the Gates Foundation focused on diaspora giving. Many wealthy members of the Asian diaspora are looking for ways to give back to their countries of origin, and the program aims to tap into that, she said. This isn’t strictly a health initiative. But bear with me, because some of that money could eventually find its way into health too. The program is still in its infancy, launching only a couple of months ago, and is initially looking at how the Indian diaspora in Singapore and the United Arab Emirates gives. …. . And Asia isn’t the only place where there’s potential for diaspora giving. For example the Gates Foundation is also looking at Africa….”

Devex Check-up: ADB’s health push

https://www.devex.com/news/devex-checkup-changing-of-the-guard-113104

“…. Speaking of new resources, an evolution of sorts is underway at the Asian Development Bank, aimed at unlocking more support for health. The multilateral bank played a major role in supporting its member countries during the COVID-19 pandemic. The bank’s health spending shot up in the range of 14% to 32%, as it helped countries respond to the health emergency, including in purchasing vaccines — a significant jump from its pre-pandemic health spending of about 2-4%. But after the pandemic, health spending went back down to 5% in 2024.”

“Does that mean ADB will go back to seeing health on the margins? That’s not the plan, Dr. Eduardo Banzon, the bank’s health director, tells me. In fact, the opposite. “I want us to become the go-to guy [in] Asia for health,” he says. Banzon’s ambition is to raise ADB’s health spending to at least 10% of the overall bank portfolio by 2030, which could amount to $3.6 billion a year if ADB’s annual financing grows to $36 billion by 2034….”

“Where will the money go? The team is working on a new health strategy that aims to “level up” universal health coverage in Asia, drive investments in regional public goods, and help countries go digital on health…..”

Coefficient Giving’s Largest Grant Ever: $276 Million, Co-Funded With GiveWell, to the Against Malaria Foundation

https://coefficientgiving.org/research/coefficient-givings-largest-grant-ever-276-million-co-funded-with-givewell-to-the-against-malaria-foundation/

(24 August) “The combined $276 million grant — $212 million from Coefficient Giving and $64 million from GiveWell — will pay for bed nets in the Democratic Republic of the Congo, where malaria remains one of the leading causes of death for young children.”

(San Francisco) “… Coefficient Giving announced its largest grant ever: $276 million, co-funded with GiveWell, to support the Against Malaria Foundation’s (AMF) net campaigns in the Democratic Republic of the Congo. Coefficient Giving is providing $212 million, funded by Good Ventures, the foundation of Cari Tuna and Dustin Moskovitz. GiveWell, which researched and recommended the grant, is contributing the remaining $64 million.”

“A portion of this grant draws from Coefficient Giving’s 2026 allocation to GiveWell’s recommendations, which it recently raised from $175 million to $1 billion — nearly double what it has directed to GiveWell’s recommendations over the previous decade combined. Coefficient Giving described the increase as a “one-off surge rather than a new steady state, driven most notably by our growing expectations of future giving from Good Ventures and other funders.”

HP&P – What is success in global health diplomacy? A qualitative analysis of gendered and global perspectives on success and failure

Victoria Haldane, A Nordström, C Wenham et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag097/8766084?searchresult=1

“Global health diplomacy is central to shaping the international response to health challenges, yet what counts as “success” or “failure” remains contested. This study explores how gender and geopolitical identity influence perceptions of success and failure among global health diplomacy practitioners. Drawing on qualitative analysis of free-text responses from 136 professionals worldwide, we identify distinct narrative patterns. Women and Global South respondents emphasized normative goals: equity, justice, and structural reform, framing success in terms of inclusion, voice, and redistribution. In contrast, men and Global North respondents often framed success through processes: institutional innovation, efficiency, and procedural legitimacy. Failures were similarly divergent, seen as systemic exclusion and dependency by some, and as governance breakdowns or missed diplomatic opportunities by others. Our findings highlight the plurality of diplomatic worldviews and call for a more reflexive, inclusive approach to evaluating and practicing global health diplomacy that recognizes diverse epistemologies and power dynamics shaping the field.”

BBC – ‘Ghana was the crime scene’: The country leading the demand for slavery reparations

BBC;

(16 August) “This year has seen a dramatic change in tone in the global conversation about the transatlantic slave trade. The demand for formal apologies, debt relief and financial compensation from nations and institutions that benefited from slavery has become increasingly forceful. In March, a resolution was passed at the United Nations recognising slavery as “the greatest crime against humanity” – though the United States voted against the resolution and every European nation abstained from the vote.”

“The UK, which alongside Portugal dominated the transatlantic slave trade, has consistently rejected the idea of paying reparations, which is perhaps unsurprising given estimates of what Britain “owes” in damages to nations affected run into many trillions of pounds. This resistance has not deterred the country that has become the leading voice on reparations: Ghana. … … The foreign minister has called for a system of reparatory justice that funds educational grants, venture capital for young African entrepreneurs and research into enduring health issues that some argue may trace their roots back to the severe malnutrition and inhumane conditions of enslavement. And though he insists that this is not about direct financial gain for African leaders, one of the demands laid out at the recent summit on reparations clearly talked of debt relief and debt cancellation…..”

Devex – Why Unitaid’s incoming chief says global health must keep innovating

https://www.devex.com/news/why-unitaid-s-incoming-chief-says-global-health-must-keep-innovating-113095

“Drugs and diagnostics may exist for the likes of HIV, malaria, and tuberculosis, but that doesn’t mean innovation needs to stop, Dr. Luis Pizarro says.”

“As global health funding shifts and new health challenges emerge, incoming Unitaid Executive Director Dr. Luis Pizarro says the agency must continue to support the creation of the next generation of health technologies, not just expand access to existing ones. “Sometimes people think all the innovation is already there… I think we have shown that’s not true,” he said, referencing recent developments from his current organization, nonprofit drug R & D organization Drugs for Neglected Diseases Initiative, or DNDi, of which he is Executive Director….”

PS: “One opportunity for further success for both DNDi and Unitaid is to capitalize on the political interest in pandemic preparedness and create synergies between it and other disease areas.”

“…Sitting down with Devex on the sidelines of the 26th International AIDS Conference in Rio de Janeiro, Pizarro outlined his vision for Unitaid at a time of profound change for global health financing, shared the lessons he’ll be taking from his four years at DNDi, and explained why now isn’t necessarily a time for pessimism….”

Nature Medicine (News) – Can traditional medicines go mainstream?

https://www.nature.com/articles/s41591-026-04588-z

“Traditional medicine is already used by billions worldwide. Researchers, regulators and the World Health Organization (WHO) are now working to generate acceptable evidence, win regulatory acceptance, and integrate traditional medicines into modern clinical care.”

Guardian – Around the world, people are rejecting divisive and dangerous politics. We can – and must – build on that

Gordon Brown; https://www.devex.com/news/why-unitaid-s-incoming-chief-says-global-health-must-keep-innovating-113095

“The vast majority of the global public wants international cooperation on human rights, climate and AI. Like-minded countries must stand together to deliver.”

“… what should give us a measure of hope, is that people’s rising fears of conflict are now matched by a clear demand that the world come together to counter this collapse into chaos. This has been revealed in a survey covering more than 36,000 people in 34 countries, conducted for my new book by Focaldata, on behalf of the Rockefeller Foundation (for whom I am a trustee).

“We asked a most demanding question: whether people would support “international cooperation”, even if it meant some compromise of their “country’s national interest”. The 55% who said yes, with only 20% saying no, were clearly signalling their rejection of the “America first”, “Russia first”, “China first”, “my country first” dogmas that view life as no more than an endless struggle between an “us” and a “them”. Clear majorities in every continent oppose those populist nationalist leaders, who would pull up the drawbridge and see geopolitics as a zero-sum game in which their country can only do well if other countries do badly.”

“Indeed, more than 70% of the global public want their governments to uphold human rights and the rule of law, take action on the climate crisis, AI and cyber security and fund humanitarian aid. Follow-up research shows that an even larger group – 80% worldwide – now believe there should be a global system to ensure the existence of policies that not only engender peace and stability but also promote the dignity of all, requiring action against poverty, disease, hunger and illiteracy….”

Global Tax Justice: Analysis of latest UN Framework Convention round in New York

Devex: Tax talks gather steam

Devex

(19 August) “Negotiators wrapped the fifth round of talks on a U.N. Framework Convention on International Tax Cooperation in New York last week, capping 10 days that pushed forward one of the most ambitious efforts yet to rewrite global tax rules. The negotiations, launched by the Africa group and backed by other low- and middle-income countries, aim to replace a fragmented patchwork of bilateral tax treaties with a unified framework, potentially unlocking hundreds of billions in revenue for development, climate, and public services.”

“The first week centered on a newly released zero draft of the framework convention, while the second focused on two early protocols — one on taxing cross-border digital services, the other on preventing and resolving tax disputes.”

“Civil society groups tracking the process said the discussions showed genuine momentum on long-stuck issues such as how countries share taxing rights over multinationals and how to tax wealthy individuals more effectively. … “Countries are pushing us towards a more fair and equitable international tax system,” said Dereje Alemayehu, executive coordinator of the Global Alliance for Tax Justice, at the close of the fifth session. However, he also noted that global south countries drove most of the ambition while many global north delegations held back — despite what could be a beneficial deal for them.”

“Talks now move to a written-comments phase, with governments and stakeholders submitting feedback on the draft texts before an updated version is released ahead of the next negotiating session set for Nov. 30-Dec. 11 in Nairobi. The full process is expected to run through mid-2027.”

CESR – From principles to plumbing: what the fifth session of the UN tax negotiations revealed

Juan Auz (Fiscal Justice Lead);

https://www.cesr.org/from-principles-to-plumbing-what-the-fifth-session-of-the-un-tax-negotiations-revealed/

With takeaways from week 1 and 2.

PS: “… If we look at other multilateral negotiation processes for comparison, the binding treaty on business and human rights has held 11 sessions since 2015 without an agreed text, largely because the home states of the corporations concerned disengaged. The plastics negotiations have collapsed twice over the consensus rule, prompting researchers to call in Nature for majority-fallback voting when a minority blocks broad support, precisely the question raised by Article 13. The tax process has so far avoided both fates: it has a General Assembly mandate, Terms of Reference adopted by vote and a fixed 2027 deadline, and it has proceeded despite the United States’ withdrawal from the talks. Its risk is not collapse but attrition and lack of ambition. …”

Africa Brief – UN Tax Talks Advance Push for Fairer Global Taxation

https://africabrief.substack.com/p/un-tax-talks-advance-push-for-fairer

“The conclusion of the New York session marks a shift from broad conceptual discussions towards detailed negotiations over the rules that could eventually govern international tax cooperation.”

Global Alliance for Tax Justice – Global Tax Treaty Negotiations Take Major Step Forward During Discussions on Draft Text

https://globaltaxjustice.org/news/global-tax-treaty-negotiations-take-major-step-forward-during-discussions-on-draft-text/

“The first week of the session covered the newly released zero draft Framework Convention, marking an important step towards addressing the core issues of the international tax system. The second week of negotiations covered the first and second early protocols, on taxation of digital services and dispute prevention and resolution, respectively. “

And a link:

· Greenpeace International – UN tax talks: Global South push for fairer rules as rich nations drag their feet on properly taxing wealthiest polluters

“Key takeaways from INC-5 include……” (nice short overview)

Trump 2.0, US Global Health Strategy & bilateral health agreements

Science – NIH lifts ban on funding research in South Africa

https://www.science.org/content/article/nih-lifts-ban-funding-research-south-africa

(18 August) Great news. “Researchers who study HIV, tuberculosis, and other infectious disease in the country welcome policy change.”

“In a major policy shift, the U.S. National Institutes of Health (NIH) has ended a far-reaching ban imposed last year on funding new research projects in South Africa. …

In an internal staff memo sent yesterday and obtained by Science, NIH Director Jay Bhattacharya explained that the agency decided it was exempt from a February 2025 executive order issued by President Donald Trump that halted “foreign aid or assistance” to South Africa because of supposed “egregious actions” its government had taken against white farmers and Israel. NIH grants, Bhattacharya wrote, “are distinguished from ‘foreign aid or assistance.’” He cited the Public Health Service Act that dates back to 1944 and intends to “foster global scientific exchange,” and noted that the Foreign Assistance Act of 1961 does not govern NIH funding….”

PS: “ The new availability of funding is limited to what Bhattacharya described as “meritorious research projects located in South Africa,” and any proposal is subject to Department of State review. In accordance with new requirements for all NIH-funded international collaborations announced in August 2025, the research must also “have a clear scientific rationale to be conducted in a foreign country rather than in the United States and should have direct potential to generate knowledge applicable to understanding, improving, or protecting the health of Americans.”

The memo has some bad news for South African scientists, too: As of 5 December, they no longer will be able to receive training grants designed for scientists in poor nations from NIH’s Fogarty International Center, because the country is upper middle-income and part of the G20, Bhattacharya wrote….”

Devex – Money Matters: Who can tap the US State Department’s new global health funding?

https://www.devex.com/news/money-matters-who-can-tap-the-us-state-department-s-new-global-health-funding-113160

(24 August) “The U.S. State Department is turning on the taps for global health, with a new channel of funding set to award $4.5 billion over the next five years. That money will come in the form of up to 100 grants, all of which will be awarded through a new umbrella platform the State Department is referring to as the Annual Program Statement, or APS. We took a look at the pipeline so far….”

“… Opening the floodgates: The Trump administration’s America First Global Health Strategy, which was unveiled last September, focuses mostly on bilateral health deals between the U.S. and partner nations. But alongside that, there’s another pot of funding — the Annual Program Statement, which is meant to supplement those agreements….” “ The APS matters for aid organizations seeking funds, because unlike most Trump administration money, it’s open to competitive bids. In theory, awards can be anything from $500,000 to $250 million each. APS awards are highly variable and country-specific. The State Department has indicated that its preference would be for new partners — faith-based organizations, local NGOs, and the private sector — rather than INGOs. It has also indicated that it wants to avoid creating parallel systems to those already in place in the global south. However, it remains to be seen whether it will play out this way in practice. …”

“To date, about $1.4 billion of the total APS funding is open for applications or is already in the final stages of being awarded. … Today, there is up to $5.4 million available for projects in Cameroon, $50 million reserved for Côte d’Ivoire, and $180 million slated for Mozambique. There is also another $80 million reserved for population-based surveys and disease surveillance, and $115 million for nutrition programs across a dozen African nations, among other funding opportunities….”

“Roughly $1.4 billion of U.S. health funding is currently either open for applications or in the final stages of being awarded. “

· And see also a very neat overview graph via Devex Check-up – Details on the $1.4 billion U.S. health funding

PS: “The award calls that have already been issued so far offer some insights into exactly what Washington is looking to fund and how INGOs — and others — might need to position themselves if they want to compete for the money that is available. Cameroon’s open call includes a focus on stopping the spillover of pathogens from animals to humans; in Côte d’Ivoire there is a call to help build the health sector capacity of faith-based groups; and Mozambique is looking to improve digital health….”

Devex – Scoop: UNICEF lays out plans for $218 million State Department award

https://www.devex.com/news/scoop-unicef-lays-out-plans-for-218-million-state-department-award-113135

(20 August) “In an unsigned planning document, UNICEF’s vision for its recent U.S. government-funded “macro award” begins to come into focus.”

“UNICEF has laid out a proposed plan for its $218 million humanitarian grant from the U.S. State Department, shedding the first light on one of several so-called macro awards the Trump administration has given to large aid agencies this year. In early internal documents shared with Devex, the United Nations agency splits its award into four separate pillars: rapid response to natural disasters, complex emergency response, rapid response within complex emergencies, and integrated nutrition response for women and children….”

“… “In partnership with the United States Government and the State Department’s Bureau of Disaster and Humanitarian Response (DHR), UNICEF aims to save lives and protect the wellbeing of crisis-affected children, women, and families,” reads the document, which is dated June 2026. “This will be achieved by enabling rapid deployment of assistance within 72–96 hours.” This echoes the approach the State Department has prioritized through a string of what it calls macro awards — large, uncontested grants for humanitarian activity, which have so far been granted to Catholic Relief Services, UNICEF, the World Food Programme, and Operation End Starvation, a new public-private partnership dedicated to ending child malnutrition….”

Emily Bass – Parallel Systems, CDC Office Closures, and New Offers to Fund Work Others Are Already Doing

on Substack;

(15 August) “Parallel Systems 2.0”: How the America First Global Health Strategy is developing the duplicative, disparate reporting systems it claims to hate.””

“Groups funded under the America First Global Health Strategy will collect data on metrics different from those in the Memoranda of Understanding and report that data separately from country governments in order to get paid—creating exactly the kind of incoherent, duplicative reporting environment the strategy’s architects say they set out to destroy….

“Two More CDC Global Offices To Shut Down by the End of September: Angola and South Sudan join Zimbabwe in closing without consideration of global health security risks due to State Budgetary Control…”

J Ratevosian – The post-PEPFAR playbook is already being written

J Ratevosian; On Substack;

“What Sierra Leone, Malawi, Cambodia, Zimbabwe and Zambia reveal about the future of the HIV response.”

With 4 themes: Integration as a sequence; efficiency & its risks; the prevention warning; data should govern the transition.

Geneva Solutions – Trump aid creeps back, setting the sector to a new tune

https://genevasolutions.news/peace-humanitarian/trump-aid-creeps-back-setting-the-sector-to-a-new-tune

“After steep aid cuts in 2025, the US has resumed funding to the UN and other organisations responding to mounting humanitarian crises. But conditions attached reveal a selective approach, and there is concern that other donors are not filling the gaps.”

Analysis with focus on humanitarian aid.

Stat – New CDC director tells staff she is prepared to speak ‘truth to power’

https://www.statnews.com/2026/08/19/cdc-director-erica-schwartz-staff-meeting-truth-to-power/

(19 August) “In an all-hands meeting, Erica Schwartz confronted concerns about her independence.”

“ Erica Schwartz, the new director of the Centers for Disease Control and Prevention, told agency staff on Wednesday that she was prepared to disagree with administration leaders and sought to empower others to do the same, according to a recording of the meeting obtained by STAT. During her first all-hands address on Wednesday, Schwartz identified three priorities: preserving trust through radical transparency and scientific rigor; strengthening the CDC’s ability to respond to disease threats; and building up the agency’s relationship with state and local partners.”

Devex – Scoop: $7.5B in US funding for international affairs at risk of expiring

https://www.devex.com/news/scoop-7-5b-in-us-funding-for-international-affairs-at-risk-of-expiring-113185

(26 August) (gated) “In a letter signed by over 100 American lawmakers, Democratic senators and representatives warn that billions of dollars in foreign aid are slated for expiry by the end of next month — including more $3 billion in global health assistance.”

Devex – Jeremy Lewin departs the State Department’s foreign aid bureau

https://www.devex.com/news/jeremy-lewin-departs-the-state-department-s-foreign-aid-bureau-113188

(26 August) “The former Department of Government Efficiency staffer is now serving as the State Department’s director of policy planning, where he is a special adviser and operator for Rubio on “key foreign policy matters.” “

“Jeremy Lewin has officially left the helm of the State Department’s foreign assistance bureau, shifting to a new role under Secretary of State Marco Rubio that began Aug. 24. Lewin — who was once a staffer at Elon Musk’s budget-slashing Department of Government Efficiency — now holds two hats: director of policy planning at the State Department, where he serves as a special adviser and operator for Rubio on “key foreign policy matters;” and overseer of the Bureau of Economic, Energy and Business Affairs, according to his newly minted State Department biography. Lewin is also the U.S. “development minister” for the Group of Seven and Group of 20 development tracks, the forums where members of both groups coordinate policies on foreign assistance….”

· And via AVAC’s newsletter:

“Lewin’s departure is yet another leadership transition for US foreign assistance. This happens as the State Department works to implement a redesigned aid and global health system, while being unable to obligate billions in congressionally- appropriated funding. The big question for global health now is who will lead implementation of the new foreign assistance architecture that Lewin helped design, including the bilateral agreements intended to reshape PEPFAR and other US global health programs. …”

Global Policy – Rethinking U.S.- Africa Development Cooperation in an Era of African Health Sovereignty

Nelson Aghogho Evaborhene

https://www.globalpolicyjournal.com/blog/26/08/2026/rethinking-us-africa-development-cooperation-era-african-health-sovereignty

(must-read) “The future of U.S.–Africa cooperation will be determined less by whether previous aid models are restored than by whether new partnerships support Africa’s long-term development agenda. This commentary argues for a shift from aid-centred engagement towards cooperation that strengthens regional institutions, local production, and strategic autonomy.”

Excerpts: “…. Africa itself has changed. The central question is no longer whether the United States should return to its previous development model, but whether that model remains suited to a continent whose political, economic, and institutional priorities have fundamentally evolved. Over the past decade, African governments have progressively shifted from a development model centred on external assistance towards one focused on regional integration, local production and institutional resilience. COVID-19 accelerated this transition by exposing the risks dependence on external financing, manufacturing, and supply chains.”

“…Africa’s pursuit of health sovereignty has not diminished engagement with the United States. Rather than representing a contradiction, the expansion of bilateral partnerships reflects the pragmatic strategies that African governments are adopting in an increasingly fragmented geopolitical environment. As competition among major powers intensifies and development assistance declines, governments must respond to immediate financing and health security needs while continuing to invest in long-term regional capabilities. Bilateral partnerships therefore coexist with continental institution building, not because African governments have abandoned regionalism, but because they are pursuing both immediate national interests and long-term collective resilience. Thus, the critical policy question is not whether bilateral partnerships should exist, but whether they reinforce Africa’s long-term development agenda. Recent developments suggest that the foundations of such an approach may already be emerging….

“… An Emerging Foundation for a New Partnership: One indication of this shift is the establishment of the U.S.–African Union Commission Strategic Infrastructure and Investment Working Group (SIWG). Launched in January 2026, the SIWG seeks to strengthen cooperation by advancing opportunities for U.S. private sector investment and engagement in areas aligned with the African Union Agenda 2063, the Programme for Infrastructure Development in Africa, AfCFTA, and African Regional Economic Communities. The initiative has been described as a potential shift from traditional development cooperation towards investment led engagement, with the possibility of reshaping the economic relationship between the United States and the African continent….”

Evaborhene sees “Three Priorities for the Next Phase”:

“First, strengthen regional institutions…. Second, invest in productive capacity…. Third, institutionalise strategic dialogue. Geopolitical competition is likely to remain a defining feature of international relations, and future U.S.–Africa cooperation will inevitably reflect broader strategic interests. Rather than allowing these interests to be pursued through fragmented bilateral initiatives alone, the SIWG should evolve into a permanent platform for dialogue on health security, regional manufacturing, regulatory cooperation, and resilient supply chains.”

SRHR

Devex: A different kind of Geneva declaration

Devex;

(14 August) “The United States has taken over as secretariat of the controversial Geneva Consensus Declaration, placing the 6-year-old political coalition — which asserts there is no international right to abortion — inside the U.S. Department of Health and Human Services.

“The Declaration has four main objectives: to secure meaningful health and development gains for women; to protect life at all stages; to defend the family as the fundamental unit of society; and to work together across the UN system to realize these values,” the State Department wrote in a press release on Aug. 12. Created during the first Trump administration, the Geneva Consensus Declaration has been signed by 42 nations, half of which are from Africa. It’s a nonbinding declaration with eight main pillars, from reaffirming the role of the family to rejecting abortion as a method of family planning….”

“After U.S. President Joe Biden took office, the U.S. withdrew its sponsorship of the declaration, and Hungary took over the secretariat — but throughout Hungary’s presidency, former U.S. Special Representative for Global Women’s Health Valerie Huber continued the charge through the Institute for Women’s Health, an organization based in Washington, D.C. Now the U.S. is back center stage, with the Trump administration stating the country will carry its work forward “through a whole-of-government” approach led by the Department of Health and Human Services and the State Department.”

“The GCD affirms what should never have been controversial: that there is no international right to abortion, that every woman deserves the highest attainable standard of health, and that the family is the fundamental unit of society,” Huber said in a statement on Wednesday, adding that “with 42 nations behind it, this coalition is positioned to do more than defend those values. It is positioned to accelerate their advance.”

“The United States has assumed the secretariat of the Geneva Consensus Declaration (GCD), a global anti-abortion initiative launched by Donald Trump’s administration weeks before he was voted out of office in 2020.”

“Late last week, the US announced that it had taken over the secretariat again, and this is being housed in the US Department of Health and Human Services’ Office of Global Affairs (OGA). OGA director Bethany Kozma has been driving GCD since its formation and is a longstanding anti-abortion campaigner….”

“Argentina joins despite allowing abortion: Last week, she travelled to Argentina to welcome it as the latest signatory of the GCD, which is now supported by 42 countries.Argentina’s President Javier Milei is a key Trump ally….”

Nature Medicine – A multi-faceted hospital-based intervention for intrapartum care in sub-Saharan Africa: a stepped-wedge cluster-randomized trial

C Hanson et al; A multi-faceted hospital-based intervention for intrapartum care in sub-Saharan Africa: a stepped-wedge cluster-randomized trial

“A stepped-wedge cluster-randomized trial showed that implementation of a multi-faceted ALERT intervention that promoted essential practices of intrapartum childbirth reduced the odds of early perinatal mortality but not stillbirth across 16 hospitals in Benin, Malawi, Tanzania and Uganda.”

Decolonize Global Health

Graduate Institute – Reshaping the Future of Global Health Governance: A Forward-Looking Exploration and Analysis of Global Health after the 2025 US ODA Cuts

Awa Suso et al; https://www.graduateinstitute.ch/sites/internet/files/2026-08/ARP10-Reshaping-Global-Health-Governance—copy-ARP-repository—Natasha-Rosenberg.pdf

“Drawing on 27 semi-structured expert interviews conducted across Switzerland, the US, and Sub-Saharan Africa, this research triangulates institutional and country-level perspectives through a decolonial lens to ask how the withdrawal has reshaped global health governance—financially, structurally, and politically—and whether the adaptations underway constitute the decolonising shift the field has rhetorically promised for decades. The findings cut against the rhetoric of rupture. Donor concentration, disease silos, and partnership discourse that obscures structural asymmetries had been the system’s operating logic long before January 2025; the shock has ended the consensus that allowed them to persist. The substitutes hold less than advertised: innovative finance cannot match ODA’s volume, and philanthropy faces financial, strategic, and legitimacy limits that prevent wholesale substitution. Most critically, bilateral instruments such as the Kenya–US Cooperation Framework trade away fiscal autonomy in exchange for the knowledge systems that autonomy requires. Nevertheless, African leadership is consolidating where the architecture’s crisis has opened space: initiatives such as Africa CDC, the Accra Reset, and the Lusaka Agenda show that the decolonising agenda is no longer purely rhetorical.”

Habib Benzian – What Global Health Chooses to Cool

https://habibbenzian.substack.com/p/what-global-health-chooses-to-cool?r=ap2ly&utm_campaign=post&utm_medium=web&triedRedirect=true

“Cold chains, exposed bodies and the politics of temperature.”

On the politics of cooling & much more.

More Co-Financing Does Not Necessarily Mean More Sustainability: Rethinking Co-Financing as a Sustainability Tool

E Sabine Koum-Besson; https://www.linkedin.com/pulse/more-co-financing-does-necessarily-mean-rethinking-tool-koum-besson-mfxzc/

“Co-financing should track dependencies — and aim to reduce them.”

Excerpt towards the end of the LinkedIn post: “…The implication is not that we need a new category of “PHC co-financing.” It is that co-financing commitments should become more specific about the dependency they are intended to reduce. Rather than treating co-financing primarily as a question of how much government contributes alongside an external programme, we should start from the full financing architecture: what the domestic system already finances, what external financing adds, which functions remain dependent on that external financing, and what would need to change for those functions to be sustained over time….”

“That changes the unit of analysis. A financing gap is no longer simply the difference between programme needs and available resources. It can be located in a specific function, at a specific level of the health system, with a specific financing dependency. A clearer PHC financing baseline and function-level strategies would allow us to distinguish disease-specific financing risks from PHC sustainability risks…”

“… Health sovereignty is also about whether countries can identify, govern and progressively sustain the systems through which those inputs become services. If co-financing is intended as a sustainability tool, it should be designed to tell us whether sustainability is improving, not simply whether domestic contributions to a programme are increasing. It should be designed around which dependency needs to decline, which function needs to become sustainably financed, and whether the proposed domestic contribution actually changes that trajectory….” “ Otherwise, a country may finance the medicines and still depend on someone else for the system that delivers them.”

“Co-financing should not only measure how much domestic financing increases. It should tell us whether the health system is becoming more sustainable. More co-financing should ultimately mean less critical dependency. If it does not, we should be careful about calling it progress towards sustainability…..”

Plos GPH – Reciprocity in global health: How successes from the global south can inform global health interventions in Canada and the U.S

Tsitsi B Masvawure et al ; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007208

“Global health has traditionally functioned as a project of high-income countries (HICs) addressing health challenges in low- and middle-income countries (LMICs). This “outward facing” orientation has created conceptual and operational boundaries that obscure the persistence of health inequities within HICs and perpetuates the false assumption that resource-rich nations have resolved fundamental health equity challenges in their own countries. In this essay we argue that HICs have global health problems of their own and should be considered legitimate sites for global health intervention. We propose an approach to doing global health in the global north that is based on reciprocal learning and where solutions to global health problems can also be found outside the borders of HICs. Complementing the extant scholarship on the need to decolonize global health, this essay highlights LMIC-led successes that can inform global health practice in the U.S. and Canada thus positioning global health as a truly egalitarian project.”

UHC & PHC

Devex – Will healthcare in the global south repeat the mistakes of the north?

https://www.devex.com/news/will-healthcare-in-the-global-south-repeat-the-mistakes-of-the-north-113120

“Several analyses over the years have revealed wasteful spending on health. But health systems too have become unsustainable, reacting to diseases instead of focusing on prevention. »

“High-income countries are known to spend more on health, but they’re not exactly the best model for health systems. And countries in the global south may be in danger of copying the same mistakes, instead of learning from them. That’s the view of Ricardo Baptista Leite, a medical doctor and CEO of nonprofit organization HealthAI. He served for four terms as a member of Parliament in Portugal, and was involved in both health and foreign affairs. He is also the founder and president of the UNITE Parliamentarians Network for Global Health, which involves more than 500 policymakers from over 110 countries. The network’s recent summit in Manila, Philippines, focused, among other things, on helping decision makers prioritize health and address the widening gaps in access….”

“Leite was critical of some of the ways that health systems in the global north operate. “Although they’re called health systems, in reality they are disease systems that simply react when people get sick,” he told Devex on the sidelines of the summit. “We’re typically reacting when diseases are already present and many times in a late stage with much worse prognosis and typically at a higher cost.” He was concerned that such health systems have become the blueprint in some low- and middle-income countries, which he argued “is a mistake because we know the global north model is broken” and “should not be replicated.”…”

Human Resources for Health

Lancet Public Health – Measuring the composition and availability of human resources for health by sex in 204 countries and territories, 1990–2023, and workforce gaps for universal health coverage: a systematic analysis for the Global Burden of Disease Study 2023

GBD 2023 Human Resources for Health Collaborators ; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00145-3/fulltext

“To reach 80 out of 100 on the UHC index, an additional 7·1 million (6·6–7·5) doctors, 23·9 million (21·8–26·1) nurses and midwives, 1·8 million (1·6–1·9) dentists, and 1·6 million (1·4–1·9) pharmacists are required globally….”

“The global health workforce has expanded substantially since 1990, largely due to women entering the formal health workforce. However, this expansion has been uneven across regions and persistent shortfalls remain in doctors, nurses and midwives, dentists, and pharmacists relative to moderate UHC attainment. Addressing these gaps will require expansion of training capacity, retention and remuneration policies for early-career workers, and gender-responsive workforce arrangements….”

“… This study provides the first global, sex-disaggregated estimates of 20 health worker cadres across 204 countries and territories from 1990 to 2023, including the first global quantification of community health workers (CHWs) and offering the most comprehensive assessment of the global health workforce to date. … …. These updated estimates were analysed with an improved stochastic frontier meta-analysis approach, a frontier estimation methodology used to evaluate the minimum HRH density observed in countries attaining a given level of the universal health coverage (UHC) effective coverage index for the cadres identified in Sustainable Development Goal indicator 3.c.1. The use of minimum thresholds recognises that performance can be attained with different cadre mixes while also offering guidance on minimum health workforce needs. These innovations produce new findings that were not possible with previously available estimates, including the quantification of sex-specific HRH growth, information on the global feminisation of health cadres, and new cadre-specific thresholds for UHC. Overall, these findings provide new insights into gender dynamics, cadre composition, and global workforce shortages, with direct relevance for national and international health workforce planning.”

Lancet Public Health (Comment) – Beyond global counts: making health workforce estimates actionable and equitable

Mathieu Boniol et al; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00167-2/fulltext

The related Comment.

« In The Lancet Public Health, the GBD 2023 Human Resources for Health Collaborators present an updated description of global health workforce numbers and distribution for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The analysis of sex distribution is striking, with female health workers representing 69% of the health workforce and contributing to around three-quarters of its growth. The study also shows substantial differences across occupations, with 44% of medical doctors but 81% of nursing personnel being female, with wide country and regional differences. Even within a particular field such as pharmacy or dentistry, female workers tend to occupy lower-skilled positions. With nursing representing the largest estimated shortage, the study implies that addressing shortages would require a massive employment of women in the health sector. Although this approach could create important opportunities for women, nursing education seems less attractive to young people than medical education. Indeed, in countries in the Organisation for Economic Co-operation and Development, the 2022 Programme for International Student Assessment (PISA) survey showed that only around 2% of 15-year-olds expected to become nurses, compared with four times more expecting to become doctors. The PISA survey also showed a decline in attractiveness of health professions since 2018—particularly nursing, for which interest decreased in half of countries. This declining interest, compounded by persistent shortages projected to 2030, particularly in the WHO African and Eastern Mediterranean regions, creates major challenges for achieving the Sustainable Development Goals….”

“… The study also attempted to estimate the global health workforce shortage, producing a value of 34·4 million health workers in 2023, more than twice as high as WHO’s estimate of 14·7 million because of different assumptions and thresholds….”

“… Beyond trends and distribution, research in this area should also focus on longer-term and realistic policy implications. With a projected global shortage of 11 million health workers by 2030, increasing inequities, and difficult financial situations, how should countries respond? Although often excluded from global shortage estimations, high-income countries should act on their triple challenge: an ageing workforce, population ageing, and declining interest in health occupations. They should also reduce excessive reliance on international recruitment, which exacerbates shortages in low-income countries. Countries with the largest current shortages should strengthen their capacity to plan, train, and retain health and care workers. They also require support to alleviate existing fiscal space constraints. For all countries, the current economic environment increases the importance of optimising the current health workforce….”

Social determinants of health

Lancet Global Health – Beyond land tenure and titling: legal recognition as a pivotal determinant of health in urban informal settlements

Alice Sverdlik et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00214-7/fulltext

“Over 1 billion people across low-income and middle-income countries live in urban informal settlements, where these residents face severe health disparities. In this Viewpoint, we argue that the absence of legal recognition in informal settlements is a foundational cause of the causes of ill health, as the absence of recognition contributes to unsafe housing and inadequate access to water, sanitation, and other life-sustaining basic services. Despite the importance of legal recognition, few public health researchers have explored how legal barriers influence health outcomes in these communities. Based on the evidence identified through a systematic search, we argue that previous research focused on how tenure or titling can improve living conditions but overlooked other legal interventions that might better enhance health equity by expanding basic service access. We propose an innovative research agenda aimed at characterising the global landscape and underlying mechanisms of a wider spectrum of legal interventions—beyond tenure or titling alone—that could improve health in informal settlements.”

Planetary Health

We start this subsection with an update on COP 31 (via Arthur Wyns, on LinkedIn):

“Following a summer of climate disasters, the Turkish COP31 Presidency has shared a 3rd letter with governments, laying out its plans for the UN climate conference this November.

In it, Turkey has now confirmed the ten priority themes of the COP31 Action Agenda:
(1) Clean Energy Transition and Electrification
(2) Zero Waste and Methane Reduction
(3) Climate-Resilient Cities
(4) Green Industrialization
(5) Youth and Education
(6) Food Security
(7) Oceans and Seas
(8) Dynamic and Resilient Health Systems
(9) Rio Synergies
(10) Climate Implementation Bridge.

“Each of these ten themes will bring together large coalitions of the willing – countries and partners who are already implementing the solutions we needing accross these critical areas.
Each of the themes will also have a thematic day, focusing on key initiatives and events….”

Guardian – Spotlight on UN desertification summit as it mulls how to spend $12bn war chest

https://www.theguardian.com/environment/2026/aug/17/spotlight-on-un-cop17-desertification-summit-mongolia

(17 August) “Extreme weather has raised the significance of Cop17 talks starting this week on tackling drought and land degradation.”

“The UN’s bi-annual talks on desertification have assumed much greater importance – and have started attracting more money. Work will begin this week on allocating more than $12bn (£8.9bn) to vulnerable countries to help them deal with drought and land degradation, when scores of countries gather in Mongolia for Cop17. The key aim is to put pledges of billions of dollars made two years ago into action through projects in the developing world….”

“… The UNCCD was signed in 1992, one of a trio of environmental treaties launched at the Earth summit in Rio de Janeiro, alongside the better known UN Framework Convention on Climate Change (UNFCCC), which is parent treaty to the Paris agreement of 2015; and the Convention on Biological Diversity, which includes targets on protecting species. Over the last three decades, the desertification treaty has been the “poor relation”, garnering the least attention of the three and producing scant progress. But that is changing…”

“… At the core of the Cop17 talks, which will run until 28 August, will be the “operationalisation” of the Riyadh Global Drought Resilience Partnership, forged in 2024 under the leadership of Saudi Arabia. Under this fund and related initiatives, countries and institutions pledged $12bn over seven years to help 74 countries stricken by drought and the accompanying problem of land degradation….”

ORF -Why Health Remains Underfunded in Global Climate Finance

R Kha Jha; https://www.orfonline.org/expert-speak/why-health-remains-underfunded-in-global-climate-finance

“Global climate finance directs only a small share of adaptation funding to health, reflecting a structural bias towards discrete, measurable projects rather than the sustained investment needed to make health systems climate-resilient”.

Lancet Letter – Health should be key to transitioning away from fossil fuels

Robbie M Parks et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01538-2/fulltext

« The first conference on Transitioning Away from Fossil Fuels (Santa Marta, Colombia; April, 2026), co-hosted by Colombia and the Netherlands, convened representatives from 57 nations to advance a just, orderly, and equitable transition. The final report from the conference makes a powerful argument for the rapid global phase-out of fossil fuels. Regrettably, the report overlooks the extraordinary health and health–economic benefits of doing so. Fossil fuels harm health across their full lifecycle—ie, from extraction to processing, transport, combustion, and waste—and disproportionately burden the most vulnerable communities, widening global inequities. Many low-income and middle-income countries face overlapping burdens of energy poverty, climate vulnerability, debt, and price volatility. In 2022, 2·52 million deaths were attributable to outdoor air pollution due to fossil fuels. Phase-out offers a quintuple win: healthier populations, enhanced energy security, cleaner environments, more resilient and affordable health systems, and more effective climate mitigation. Communicating these gains can strengthen public support for climate action. “

“We—as members of the health community—offer three recommendations, which emerged from the conference’s Health Benefits Workstream and were submitted through the academic dialogue…”

Carbon Brief – Climate change exposes 580 million children to 20 extra ‘heat-stress days’ every year

https://www.carbonbrief.org/climate-change-exposes-580-million-children-to-20-extra-heat-stress-days-every-year

“More than 40% of children under the age of 10 globally are already experiencing at least 20 additional “heat-stress days” due to climate change.”

“This is according to a new attribution study, published in Science Advances, which combines climate models with demographic data to assess the age groups and regions that are exposed to the most hot, humid days. The study finds that children up to the age of nine already face more additional heat-stress days globally as a result of climate change than any other age group. It adds that south Asia and west Africa are recording the greatest childhood exposure to dangerous levels of humid heat – largely because these regions have a rapidly growing population with the highest proportion of young children. As the climate warms, children will continue to be more exposed to heat stress than any other age group, the paper warns….”

“The lead author of the study tells Carbon Brief that the findings should inform discussions about climate justice, noting that children in developing countries “have contributed the least to historical greenhouse gas emissions”. …”

Environmental determinants of health

HPW – Eighty Years Strong and Still Forgetting Water: How WHO’s Anniversary Story Erases a Century of Environmental Health

W Kreisel; https://healthpolicy-watch.news/eighty-years-strong-and-still-forgetting-water-how-whos-anniversary-story-erases-a-century-of-environmental-health/

“Twice in three years – at its 75th anniversary and again this July at the Constitution’s 80th – the World Health Oganization (WHO) has told the official story of what it has achieved. Twice, water, sanitation, air, chemicals and climate have been left out. The former head of WHO’s environmental health programme argues this is not a curatorial slip but institutional amnesia – and that the organization must correct the record.”

“…Why do anniversary webpages matter this much? Because they are the organization telling member states, donors, young staff and itself what it believes it is for. Budgets follow stories; careers follow stories. When WHO’s official self-portrait contains 70 milestones and no water, no sanitation, no air, no chemicals and no climate – and when the 80th-anniversary tribute renews the omission – every health minister weighing an environmental investment, every foundation officer drafting a strategy, and every young engineer deciding whether WHO is a place for her receives the same message: this is not what WHO considers memorable. That message is false, and it is costly. It is also economically illiterate…

“… What the new WHO DG needs to correct : WHO’s member states will soon choose the organization’s next Director-General – a leader who will govern in the century of climate disruption, polluted air, water insecurity and chemical proliferation, when the environmental determinants of health will not be one programme among many but the terrain on which all health outcomes are won or lost. Let the correction begin simply. Amend the milestones timeline publicly to include what this article has named – from the League’s rural hygiene programme to the Green Climate Fund. Protect and fund the normative crown jewels – the drinking-water and air quality guidelines, and the monitoring programmes – as core functions, not discretionary extras. Place the environmental determinants of health at the heart of the next General Programme of Work, where the Constitution’s drafters put them in 1946….”

WASH

WHO/UNICEF report highlights gaps in health facility sanitation

(18 August) https://www.who.int/news/item/18-08-2026-who-unicef-report-highlights-gaps-in-health-facility-sanitation

“A new WHO and UNICEF report reveals significant gaps in essential water, sanitation, hygiene and environmental health services in health-care facilities worldwide. Despite notable gains since 2015, only four in ten facilities meet basic sanitation standards and fewer than six in ten achieve basic environmental cleaning standards such patient rooms and wards, operating theatres, examination and treatment areas, toilets and sanitation facilities, leaving patients and health workers exposed to preventable health risks….”

“Progress on water, sanitation, hygiene, environmental cleaning and waste management in health-care facilities 2015–2025, published today by the World Health Organization (WHO) and UNICEF, through the Joint Monitoring Programme on for Water Supply, Sanitation and Hygiene (JMP), provides the clearest global picture yet of these essential services in health-care facilities. For the first time, global estimates are available for all five basic service areas, including the first estimates for basic sanitation and environmental cleaning….”

“In 2025, an estimated 85% of health-care facilities had a basic water service, 72% had basic hygiene services and 71% had basic health-care waste management services. However, only 59% met the basic standard for environmental cleaning and 40% met the requirements for a basic sanitation service….”

Devex – Special edition on World Water Week

Devex

Account from Stockholm. Re “World Water Week, the annual conference of government officials, financial institutions, businesses, researchers, and civil society to talk about all things WASH — or water, sanitation, and hygiene — along with water security….”

“… Many are calling 2026 the “Year of Water” — and the sector is riding a wave of global attention. First and foremost, there’s a race to accelerate action on Sustainable Development Goal 6 — clean water and sanitation for all — ahead of the United Nations Water Conference to be cohosted by the United Arab Emirates and Senegal in Abu Dhabi in December. Stockholm this week is seen as a pivotal moment where various players can meet, compare notes, and hone their projects and pledges ahead of December.”

“….Top of mind is a groundbreaking U.N. report in January showing that we have entered an era of “global water bankruptcy” in which water use in many basins and aquifers worldwide has exceeded renewable inflows and safe depletion limits — in some cases, beyond the chance for recovery. Nearly three-quarters of the world’s population lives in countries classified as water-insecure….”

“… A report last week by UNICEF and the World Health Organization on WASH in healthcare facilities worldwide found that while there has been progress since 2015, only 4 in 10 meet basic sanitation standards, and fewer than 6 in 10 meet basic environmental cleaning standards in patient wards, operating rooms, treatment areas, and toilets and sanitation facilities — potentially exposing patients and health workers to health risks….. (see above)

“… A drop of hope: There’s one thing putting wind in everybody’s sails: Water Forward, an ambitious World Bank-led initiative that aims to improve water access for 1 billion people by 2030. Multiple experts have described it to me as the most promising initiative in decades for attracting finance to the WASH sector and galvanizing political will around it. In Stockholm, it’s on everybody’s lips…. … … Water Forward launched in April during the World Bank and International Monetary Fund Spring Meetings. It frames water as an economic asset — not merely a social service expenditure. The bank’s own goal is to reach 400 million people….”

“There’s over 4 billion people who lack water security. So 400 million is just a drop,” says Sarah Nedolast, program manager of the Global Water Security and Sanitation Partnership at the World Bank. “So the only way that we can really make a big dent, we can make real progress, is working with others.” The bank has partnered with eight other MDBs, along with three other financial institutions: GCF, the OPEC Fund for International Development, and the International Fund for Agricultural Development….”

“Central to the initiative are country “compacts,” in which governments analyze their own water resources and vulnerabilities, then decide their own priorities and how to allocate their capital. The initiative launched with 14 compacts and a goal to reach around 40 by the U.N. Water Conference in December, Nedolast says.”

“The water sector requires a cumulative investment to the tune of $6.7 trillion by 2030. The majority of its funding comes from governments, while official development assistance, or ODA, accounts for about 6% and the private sector provides around 2%….”

Access to Medicines, vaccines & other health technologies

TGH – Trump’s Executive Order on Vaccines Could Be Contagious

P Yadav; https://www.thinkglobalhealth.org/article/trumps-executive-order-on-vaccines-could-be-contagious

“The push to split the measles-mumps-rubella vaccine into separate shots could have a ripple effect on global markets.”

“… even if the recommendations never fully take hold in the United States, they could have important contagion effects on demand and supply for measles-mumps-rubella (MMR), measles-rubella (MR), and measles-only vaccines globally. It has taken the World Health Organization (WHO), the UN Children’s Fund (UNICEF), and Gavi decades to encourage countries to move from measles-only vaccines to MR and MMR vaccines. Combination vaccines offer many benefits: fewer injections, fewer clinic or immunization site visits, simpler schedules, and a lower cold-chain, procurement, and logistical burden. A move toward separating MMR would run opposite to the broader overall direction of using combination vaccines in global immunization programs for uptake, cost effectiveness, and logistical efficiency.”

“These advantages are particularly important in resource-constrained health systems, where clinician time, syringe availability, cold-chain capacity, and access to immunization services are much more limited than in the United States. MR has been an important part of this transition to combination vaccines, allowing low-income countries to address two priority elimination diseases in a single vaccine in a cost-effective manner….”

“Exclusive use of measles-only vaccine has declined globally as more countries introduce rubella vaccines as a combination. Some high-income countries have moved even further toward combination products. Israel, Luxembourg, and San Marino, for example, routinely use a combination of measles, mumps, rubella, and varicella (MMRV) in a single vaccine. A move toward separating MMR would run opposite to the broader overall direction of using combination vaccines in global immunization programs for uptake, cost effectiveness, and logistical efficiency…”

HPW – New TB vaccines are moving closer. Is Africa ready?

S M Mule (Kenyan Member of Parliament and the Vice-Chair of the Global TB Caucus) https://healthpolicy-watch.news/new-tb-vaccines-are-moving-closer-is-africa-ready/

“African scientists, institutions and communities are helping advance the development of new TB vaccines. Governments must now work together to prepare national systems, secure fair pricing and ensure scientific progress leads to timely and equitable access.”

Devex – Making matches

https://www.devex.com/news/devex-checkup-washington-hasn-t-completely-cut-ngos-out-of-global-health-113172

Lenacapavir was the star of the show at the recent International AIDS Conference in Rio de Janeiro. But one of the repeated concerns I heard there about the twice-yearly form of injectable HIV prevention is that no matter how effective it is, it’s not particularly useful if it’s not reaching the people who would benefit from it the most. In many settings, that includes members of marginalized communities, such as men who have sex with men and transgender people. They are often most at risk of acquiring HIV. But they are also increasingly criminalized and fearful of seeking out services from government facilities, even if those are the only places offering lenacapavir.”

“To help mitigate those concerns, Freddie — a telehealth platform geared to the 2SLGBTQ+ community in North America and a leading provider of HIV preexposure prophylaxis — is partnering with the Clinton Health Access Initiative to get lenacapavir to communities in Africa that need it. The plan is that for every Freddie client who starts lenacapavir in North America, CHAI will procure and deliver a dose of generic lenacapavir to someone in sub-Saharan Africa, up to the first 14,500 people. And the priority is to get those doses to key populations, including LGBTQ+ communities, with rollout set to start at the beginning of 2027…”

TWN – Expert Committee recommends local clinical trial waivers for generic lenacapavir

C Rao; https://www.twn.my/title2/health.info/2026/hi260801.htm

(22 August) “India has moved closer to the availability of generic lenacapavir for HIV prevention after a Subject Expert Committee (SEC) of the Central Drugs Standard Control Organisation (CDSCO) recommended the waiver of local clinical trial for Dr. Reddy’s Laboratories Limited and Emcure Pharmaceuticals Limited. This recommendation could accelerate access in India, subject to final marketing authorisation and mandatory post-marketing Phase IV efficacy studies….”

Geneva Health Files – The GLP-1 Patent Split: A Contrast of How Major Markets Deal With The Loss of Exclusivity [Analysis]

Anne Jomard; Geneva Health Files;

“Anne Jomard sinks her teeth into examining the moat of intellectual property protection for weight loss drugs in some jurisdictions.”

“Generic semaglutide in India is now available for a fraction of the branded price, around $15 for the lowest dose, compared to over US $1,000 in the U.S. Analysts have noted this as one of the fastest generic rollouts in recent pharmaceutical history. Jomard, a scientist who writes on health policy says, “The divergence is not a market accident. It is the deliberate outcome of a patent system that allows the same molecule to be public property in one jurisdiction and a protected monopoly in another.” In her analysis she presents a picture of “stark contrasts in how major markets handle the loss of exclusivity”, as some experts have described the situation….”

Excerpts: “…. The countries where patent expiry has brought generic competition — India, Brazil, China — achieved access through their domestic patent law architecture, not through multilateral health governance. For countries that lack that architecture, and lack manufacturing capacity, the multilateral system has not yet been mobilized to help….

“… Who will pay the price? For the majority of people living with type 2 diabetes and obesity in low- and middle-income countries, GLP-1 prices are prohibitive. The India model demonstrates that affordable GLP-1 access is technically and economically feasible. Indian manufacturers were ready to launch the day the patent expired; generic prices fell sharply within weeks. What does not yet exist is the multilateral will — or the mechanism — to move that supply to the patients who need it most, in the countries where patents still hold or where no local generic industry can fill the gap. The EML listing, the WHO guidelines, the prequalification call: these are necessary steps, but they are not sufficient ones….”

“Even with Novo Nordisk’s announced US price cut, the fracture between markets where GLP-1s cost less than $10 a month and markets where they cost several hundred remains an order of wide magnitude. …”

FT – Big Pharma steps up fight against counterfeit weight-loss drugs

https://www.ft.com/content/094467c8-6154-4fd2-8b64-a334d83bd772?syn-25a6b1a6=1

(gated) “Novo Nordisk and Eli Lilly use court orders and public campaigns to tackle unlicensed medicines.”

AI & health

Nature (World view) – Why we must stop talking about artificial general intelligence — and instead build ‘pro-worker’ AI

Daron Acemoglu; Nature ;

“Studies of the US labour market suggest that automation has played a crucial part in increasing inequality — and this dynamic is likely to intensify with the adoption of AI, argues economist Daron Acemoglu. Acemoglu has joined thousands of economists and AI researchers in signing We Must Act Now, a statement urging policymakers and technology leaders to steer AI towards complementing, rather than replacing, human labour. “What is at stake is not only shared prosperity, but also our democratic system,” he writes. “Societies cannot remain stable if large numbers of people are excluded from economic opportunity.”

· Related: Bill Gates (via the Guardian) – Bill Gates calls for ‘human-reserved’ jobs in face of AI takeover (yeah, right, that’s going to work)

Conflict/War & health

UN News – An attack on healthcare every six hours, and no one held to account

https://news.un.org/en/story/2026/08/1168144

(14 August) “Across the world, healthcare has suffered more than 10,000 attacks in the past eight years, including during the brutal conflict in Ukraine and efforts to contain the current Ebola outbreak spreading rapidly in the eastern Democratic Republic of the Congo (DRC). That information comes from the World Health Organization (WHO) which on Friday reiterated that the critical sector must not be targeted. “

“The UN agency maintains a surveillance system for attacks on healthcare, which includes hospitals and other facilities, personnel and patients, ambulances and other transport, as well as warehouses and supplies. Since 2018, more than 10,400 attacks have been reported across 29 countries and territories, resulting in approximately 5,700 deaths and over 8,000 injuries. To date, no one has been held accountable. …”

· Related link: Lancet World Report – Report says attacks on health care in Ethiopia are systematic

HPW – Most Gaza Palestinians Living in Dangerous, Unsanitary and Unhealthy Shelters

https://healthpolicy-watch.news/94-of-gazan-palestinians-live-in-dangerous-unsanitary-and-unhealthy-shelters/

“Nearly a year after Israel and Hamas agreed to a US-brokered cease-fire, some 94% of Gaza’s 2.1 million Palestinian residents lack adequate shelters with 84% facing severe constraints in heating, cooling, cooking, lighting and hygiene and nearly 60% facing “critical” or “catastrophic” shelter needs. This according to a new analysis by the Global Shelter Cluster, a coalition led by the Norwegian Refugee Council and the UN’s Geneva-based International Organization for Migration (IOM)….”

“The prolonged housing crisis means that most Gazans are being exposed to growing environmental health risks as a result of the delays in reconstruction following the two-year war. These range from poor access to hygiene and sanitation to rodent infestations; extreme heat in the summer and wintertime flooding, unsafe conditions for food and water storage; as well as toxic exposures from burning plastics and debris for cooking, the report concludes….”

Lancet Global Health (Letter) – Life expectancy is a late signal of sanctions-related harm

Reza Majdzadeh; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00208-1/fulltext

“Cross-national evidence reports lower life expectancy and higher mortality in countries exposed to economic sanctions. Gutmann and colleagues reported that UN sanctions were associated, on average, with a 1·2–1·4-year reduction in life expectancy. Furthermore, in their Article in The Lancet Global Health, Francisco Rodríguez and colleagues estimated that unilateral sanctions were associated with more than 560 000 annual deaths. Iran, however, complicates this picture. Iran has experienced one of the most extensive and prolonged periods of economic sanctions globally. Yet, no clear break or trend shift in national life expectancy aligned with major changes in sanctions is apparent from the life-expectancy trajectory reported by the GBD 2023 Iran Collaborators (May, 2026). Although the study was not designed to estimate effects of sanctions directly, this observation warrants careful consideration as the current evidence does not support a large, immediate, or independent sanctions-attributable fall in Iran’s national life expectancy….”

“… Sanctions operate through intermediate pathways before becoming visible in registered causes of death and age-specific mortality. Evidence from Iran is consistent with this interpretation. A 20-year mixed-methods study of 28 national and subnational indicators found no clear, stable, and attributable sanctions-related signal for many major mortality outcomes but did find recurrent pressure on access, affordability, medicine availability, treatment continuity, and household coping. The Iranian case might therefore illustrate buffered, displaced, diluted, or pathway-specific harm rather than the absence of harm.”

“The implication for monitoring is direct. Life expectancy and overall mortality remain important final outcomes, but they are insufficiently sensitive starting points for early detection. Sanctions-related health monitoring should move upstream to address medicine availability, stock-outs, procurement delays, overcompliance events, health inflation, out-of-pocket payments, treatment interruptions, chronic care continuity, and vulnerable-group inequalities…”

Miscellaneous

HPW – As Taliban Rule Enters Sixth Year, Healthcare for Afghan Women Is Being Dismantled

https://healthpolicy-watch.news/as-taliban-rule-enters-sixth-year-afghan-womens-healthcare-is-being-dismantled/

“Five years after the Taliban returned to power, Afghanistan’s health system is being squeezed from two directions: shrinking healthcare services and restrictions that are making it increasingly difficult for women to reach them. The consequences are particularly acute for Afghan women. Taliban-imposed restrictions on their movement, employment and education have narrowed access to healthcare, while the December 2024 ban on women training in health and medicine has prevented new female doctors, nurses and midwives….”

Bump and Beyond (Women’s Health through an African lens) – Exclusion by Classification

https://xsquared.substack.com/p/exclusion-by-classification

“Time to retire the 15-49 age grouping for women.”

“For most of global health, an African woman officially exists between her 15th and her 49th birthday. Before 15, she is a child, mostly invisible in the surveys that drive policy. After 49, she falls off the dashboard. The Demographic and Health Surveys that anchor most national women’s health data only interview women aged 15 to 49. SDG indicator 3.7.1 for sexual and reproductive health uses 15 to 49, and so do most indicators on anaemia, contraception, gender-based violence, HIV in women, and maternal mortality. The category is so deeply embedded that for many programmes, “women” simply means “women of reproductive age,” and “women of reproductive age” simply means 15 to 49….”

TGH – As Malaria Spreads, Africa Needs Data on Gene-Edited Mosquitos

F Okumu; https://www.thinkglobalhealth.org/article/as-malaria-spreads-africa-needs-data-on-gene-edited-mosquitos

“Gene drives could be transformational for the malaria response, but countries need evidence to weigh the benefits over the risks.” (recommended article)

“… Gene drives cannot be tested by their developers alone. Instead, Africa needs a trusted public-interest architecture to evaluate gene drives. The institutions building gene-drive mosquitoes should provide mosquito strains, safety data, and labels identifying what their product is expected to achieve. But they should not also be the main sponsors, public advocates, risk communicators, and judges of the technology readiness.

Each trial should remain nationally authorized and publicly owned, with ministries of health, biosafety authorities, and other competent national bodies defining the public health question and approving the work. The evaluations should be run by independent African-led consortia of research institutions and public health agencies, working with regulators, ethicists, and community representatives. The foundations for this architecture already exist. …”

“…WHO, the WHO Africa regional office, Africa Centres for Disease Control and Prevention, UDA-NEPAD, and regional bodies should play a more proactive role in generating badly needed data on gene drives: they should help countries prepare for and organize the trials to generate the evidence necessary for countries to decide…. …. Developers and funders would still have an essential role in the evaluation process, but neither should control the trial, own the evidence, or lead the public message. …”

Global health governance & Governance of Health

Devex – US rebukes UN General Assembly president’s handling of election of UN chief

https://www.devex.com/news/us-rebukes-un-general-assembly-president-s-handling-of-election-of-un-chief-113145

(19 August) “The Trump administration accuses United Nations General Assembly President Annalena Baerbock of interfering in the U.N. Security Council’s role in selecting the new U.N. secretary-general.”

· For a more recent update, see Geneva Solutions – Deep rifts and secrecy cloud race to pick next UN chief (28 August)

“The contest to find the next UN secretary general is well underway, with no clear favourite emerging yet. The impasse has laid bare rifts within the UN Security Council, stoked concerns of closed-door horse-trading and raised the prospect of more mystery candidates entering the fray in the months ahead.”

Global Policy – The future Global Development Agenda will have to be shouldered by Middle Powers

https://www.globalpolicyjournal.com/blog/25/08/2026/future-global-development-agenda-will-have-be-shouldered-middle-powers

“Niels Keijzer, Hyeyoung Woo & Jee Hee Yoon outline the potential ways middle powers may best organise to shoulder the global development agenda and the (quasi-) multilateral institutions could support them in this regard.

Re the “…. third annual seminar organised by the Korea Development Institute and the German Institute of Development and Sustainability (IDOS), and was held on 25 June in South-Korea’s administrative capital city Sejong-Si. The seminar brought together researchers from both organisations, as well as from JICA Ogata Research Institute. The participants explored the overall topic of middle powers and global development from various actor-specific angles and in relation to a number of specific themes. Rather than seeking to represent a comprehensive summary, this contribution highlights a number of issues as selected and phrased by the authors of this piece. …”

Future of Development Cooperation Coalition Newsletter #7

Future of Development Cooperation coalition;

“The Coalition is pleased to welcome its newest supporting country, Norway. And just as welcome, this marks 20 countries now supporting the Future of Development Cooperation Coalition.

The 20 supporting countries are: Barbados, Belgium, Canada, France, Germany, Ghana, Ireland, Malawi, Mexico, Nepal, the Netherlands, Norway, the Republic of Korea, Senegal, Singapore, Somalia, South Africa, Spain, the United Kingdom, and Zambia….”

PS: “The Coalition’s second report, Driving Change: Purposes and Principles for Effective Development Cooperation is scheduled for a September release. The report identifies four main purposes of development cooperation and presents a targeted suite of five principles that, taken together, underpin the enduring logic of a reimagined approach to development cooperation. (The Coalition’s third, and final, report, scheduled for release by year-end, will offer a series of actionable recommendations. “

As a reminder: “…. the Coalition’s first report—The Development Balance Sheet: Rethinking Development Cooperation from the Ground Up—… made the case that any discussion of development cooperation must have the ambitions, capacities, and needs of low- and middle-income countries front and center. ….”

Global Health Diplomacy role of Islamic organizations in shaping international health policy

Saeed Anwar; https://fimaweb.net/wp-content/uploads/2026/08/FIMAYearbook2025_web.pdf#page=115

“Global health diplomacy (GHD) increasingly demands ethical legitimacy, cultural credibility, and trust across political and civilizational divides. Islamic organizations such as the Organization of Islamic Cooperation (OIC), the Federation of Islamic Medical Associations (FIMA), and allied institutions could contribute to international health policy through an ethical framework that is universal rather than aligned to geopolitical blocs. This reflective scientific article examines how Islamic ethical universality grounded in justice, human dignity, stewardship, and collective responsibility enables engagement across diverse systems and communities. Drawing on selected Qur’anic guidance and Prophetic traditions, the paper illustrates how health equity in Islam is framed as a shared human obligation rather than charity or mere regional aligning. Through state-level coordination, professional diplomacy, and humanitarian engagement, Islamic organizations can function as moral bridge-builders in global health governance.”

Nature World View – China is changing the shape of global health. The terms are still up for negotiation

Ruby Wang; https://www.nature.com/articles/d41586-026-02622-1

“Health-care partnerships (cfr China’s approach) can provide other nations with cheap diagnostics, medicines and more — but global institutions should help to ensure that they also strengthen local capacity and preserve sovereignty.”

“During the COVID-19 pandemic, Chinese companies supplied vaccines to Indonesia and Mexico. Chinese firms have since begun to finance medical equipment in Kenya and Côte d’Ivoire, pharmaceutical and vaccine production in Zambia and digital-health solutions across the world. These partnerships differ from old models of multilateral aid, budgets for which are dwindling worldwide. Other nations, notably the United States, are moving towards bilateral partnerships, but China has been making these agreements for longer, and is doing so on a bigger scale. And because many of China’s health products were developed while the country was facing pressures similar to those that LMICs contend with — shortages of specialists, regional inequality, tight budgets — they appeal to countries that cannot copy the expensive, hospital-heavy systems of richer nations….”

“Three areas deserve particular attention….”

China Review – Embedding Traditional Chinese Medicine in the United Arab Emirates: Healthcare Landscapes, State–Market Dynamics, and Soft Power

Yuting Wang; https://muse.jhu.edu/pub/250/article/998691

“This article examines how Traditional Chinese Medicine (TCM) has been institutionalized in the United Arab Emirates (UAE) since the 1980s by situating its development within the intersecting logics of urban branding, market-driven cosmopolitanism, and global health diplomacy. Rather than treating TCM as a simple export of Chinese culture under the “Health Silk Road” initiative, the article argues that TCM in the UAE, a prominent regional node in the global healthcare market, is co-produced through the interplay of Chinese state promotion, local regulatory regimes, urban development strategies, and consumer markets…”

Project Syndicate – Is China Really a Champion of the Global South?

A Adebajo; https://www.project-syndicate.org/commentary/china-not-leader-of-global-south-wants-to-preserve-status-quo-by-adekeye-adebajo-2026-08

“The United States is an overextended hegemon, and its decline will continue slowly, as other powers like China assume more global responsibilities. Against this backdrop, China’s efforts to lead the Global South are more about consolidating its power in the current international system than creating a new one that benefits all.”

Global Policy – Book Review – Making Global Norms: Politics versus Science in International Organizations

https://www.globalpolicyjournal.com/blog/19/08/2026/book-review-making-global-norms-politics-versus-science-international-organizations

Book review of “Making Global Norms: Politics versus Science in International Organizations”, by Alexandros Kentikelenis and Leonard Seabrooke.

“International organisations are often portrayed as either technocratic bodies guided by expertise or political arenas shaped by competing national interests. Making Global Norms: Politics versus Science in International Organisations demonstrates that this dichotomy is too simplistic. Alexandros Kentikelenis and Leonard Seabrooke draw on a decade of collaborative research to show that global norm making is fundamentally a human process, driven by individuals whose dual identities, garnered through professional training and national affiliations, jointly shape how they interpret evidence, argue over policy, and ultimately influence international norms.”

“The book makes two major contributions. First, it develops a micro-foundational account of norm change by conceptualising how individuals’ training and nationalities can, collectively, help explain norm formation and change. Second, the book provides an impressive empirical foundation for this claim through an original dataset that combines biographical information on 727 International Monetary Fund (IMF) Executive Board members between 1980 and 2009, with extensive analysis of what these individuals say across Executive Board minutes….”

“… The book shows that IMF board members possess what the authors describe as dual loyalties: to their national constituencies and to their professional communities. Their behaviour reflects the interaction between these identities rather than the dominance of either one alone. This offers a refreshing alternative to accounts that reduce IMF decision-making either to state interests or to technocratic expertise….”

Global Health Advocates – Aligning EU health innovation with public interest: insights from the new CEPS Report

https://www.ghadvocates.eu/aligning-eu-health-innovation-with-public-interest-insights-from-the-new-ceps-report/

“A common narrative in European policy circles suggests a tension between two major priorities: boosting Europe’s industrial competitiveness on one hand, and advancing equitable global health access on the other. However, the latest CEPS R&D Perspectives report ‘Equitable and resilient R&D ecosystems for health innovation and access’, authored by Dr. Luis Pizarro and Rachel Cohen, demonstrates that this is a false dichotomy. In reality, addressing global health challenges, improving health security, promoting scientific excellence, and fostering European competitiveness are mutually reinforcing priorities.”

“They highlight how Product Development Partnerships (PDPs) provide strong evidence of this complementarity. … … Rather than representing a single institutional model, their experience offers practical lessons on how EU biomedical R&D can be structured to maximise public return on public investment while preparing for future health crises. The report outlines three key recommendations that echo GHA’s long-standing advocacy for a public interest-driven European health innovation ecosystem: 1 – Set up predictable, multi-year financing mechanism(s) for public interest-driven and geographically distributed R&D and manufacturing; 2 – Mainstream access strategies in EU-funded biomedical R&D; 3 – Invest in the enabling infrastructure for open and collaborative science…”

Global health financing

Devex – To prepare for AI philanthropy, do what we know works

C Elizabeth Orth et al; https://www.devex.com/news/to-prepare-for-ai-philanthropy-do-what-we-know-works-113131

“Given the uncertainty about upcoming AI-wealth donations and the precarious post-ODA reality, this is the time for global health philanthropy to double down on key best practices.”

Honestly, who writes these things? : )

UHC & PHC

BMJ GH – Assessing the quality of care in low- and middle-income countries: a rapid review of the landscape of assessment tools

N D L Togbenon, JP Dossou, Kefi Belloh et al ; https://gh.bmj.com/content/11/8/e019738

“This study sought to review the landscape of tools used to assess each component of quality of care—according to Donabedian’s model—in low- and middle-income countries (LMICs), and to evaluate their reported validity and applicability in routine health system settings.”

“… This review highlights the need for context-appropriate, validated and cost-effective tools for assessing quality of care in LMICs. Tools should be user-friendly and embedded within routine monitoring systems to better support continuous quality improvement.”

Plos GPH – Health insurance in Nigeria: Findings from the People’s Voice Survey

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006948

By Kevin Croke et al.

Yale School of Public Health – Universal Health Coverage Could Save $1 Trillion and 114,000 Lives Every Year, Yale Study Projects

https://ysph.yale.edu/news-article/universal-health-coverage-could-save-one-trillion-dollars-and-114000-lives-every-year/

“A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace, according to a new preprint study led by researchers at the Yale School of Public Health.”

“For the study, which has not yet been peer reviewed, the researchers modeled what would happen if the United States adopted a national public insurance program like the one proposed in the Medicare for All Act. Using 2024 spending, insurance coverage, and mortality data, they estimate that the universal coverage would reduce annual health expenditures by $1.04 trillion, or nearly 20% — even after accounting for the additional care that uninsured and underinsured people would receive….”

Pandemic preparedness & response/ Global Health Security

TWN – book: The road to IHR reform

https://mailchi.mp/twnetwork/new-book-the-road-to-ihr-reform?e=2016d72837

“How the International Health Regulations were amended to fortify the response to health emergencies. “

Journal of Global Health Law – Beyond the WHO Pandemic Agreement: mandatory pathogen sharing as the foundation for reimagining Global Health Commons

Edeze Chidimma Augustina; https://www.elgaronline.com/view/journals/jghl/aop/article-10.4337-jghl.2026.0001/article-10.4337-jghl.2026.0001.xml

“The WHO Pandemic Agreement, adopted in May 2025, is a significant step toward global pandemic preparedness but does not sufficiently address the fundamental disparities exposed during COVID-19. This paper argues that pandemic pathogens and essential countermeasures constitute a Global Health Commons requiring mandatory sharing obligations enforced through binding international law mechanisms. The study analyzes the Agreement’s key provisions on pathogen sharing, technology transfer, and compliance mechanisms through global commons theory. The research finds that the Agreement’s reliance on voluntary cooperation and deferred enforcement mechanisms maintains the same power imbalances that enabled vaccine inequity during COVID-19. The paper proposes a mandatory pathogen-sharing framework with three core elements: automatic legal obligations triggered by Public Health Emergency declarations, binding technology transfer requirements linked to pathogen access, and graduated sanction mechanisms.”

Plos GPH – The ‘Other’ face of health security: Reimagining epistemic attachments in global health

Max D. López Toledano et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007105

« The ‘health security’ paradigm has reshaped global health since Covid-19, framing infectious diseases as existential threats and targeting marginalised populations as risky ‘others’ to surveil and contain. However, its exclusionary consequences for those ‘othered’ remain underexamined, particularly from the perspective of lived experience. Drawing on ethnographic and archival case studies in Lebanon, Nepal, Serbia, and Syria (2021–2025), we examine health security’s ‘other’ face, the systematic exclusion of migrant, rural, and displaced populations from protection, ranging from vaccine apartheid to medicalised border controls. We argue that these are not abstract harms but embodied burdens, and that ethnographic perspectives are essential to reveal them. Rejecting the premise that securitisation as the only available logic, we propose five cooperative mechanisms, including demilitarised financing, a binding vaccine convention, and data sovereignty, to shift global health toward equity and care. »

BMJ Opinion – Developments in AI designed viruses demonstrate why such research must be done in the open

https://www.bmj.com/content/394/bmj-2026-100572

“A recent breakthrough in generative biology is exciting but it raises important ethical and safety concerns, says Simon Clarke.”

Planetary health

ODI Global – A fair share of climate finance

https://odi.org/en/insights/a-fair-share-of-climate-finance/

“Every year, ODI Global reports on which developed countries are providing their ‘fair share’ of international climate finance, and which aren’t. Our ‘fair share’ work is used extensively by advocacy NGOs campaigning for more and better climate finance, and by developed country governments in setting their own climate finance targets and in their diplomatic outreach.”

“…By introducing the idea of ‘fair shares’ into climate finance debates, alongside an accessible and transparent method for benchmarking, ODI Global has changed the conversation. From Brussels to Wellington, developed countries now use the language of ‘fair share’ to benchmark their contributions. There is now much greater recognition that the shortfall in the $100 billion goal is down to a handful of large economies: the US accounts for the largest gap in absolute terms, but Australia, Canada, Italy and Spain also have work to do. There is also much greater awareness that many developed countries have long met and exceeded their fair share of the climate finance goal, particularly Denmark, France, Germany, the Netherlands, Norway and Sweden, enabling engagement in good faith across the developed–developing country divide….”

Nature Climate Change – Failure to track a stable AMOC state under rapid climate change

https://www.nature.com/articles/s41558-026-02730-w

via Ian Hall (on Bluesky):

“A striking climate-model result suggests AMOC may have a rate-induced tipping point. Slow CO₂ increase: AMOC stable to +5.5°C ; Faster increase: collapse around +2°C Same climate system. Very different outcome. The rate of warming matters.”

Guardian – Extreme heat more dangerous for people 60 and over than previously thought

https://www.theguardian.com/society/2026/aug/17/extreme-heat-more-dangerous-for-people-60-and-over-than-previously-thought

“Study finds older adults could face harmful heat stress at just 1.5C of warming above preindustrial levels.”

“People aged 60 and over face dangers to their health from exposure to heat at much lower temperatures than previously thought, research has found. Older adults will bear the brunt of increasingly frequent sustained spells of extreme heat globally as the world continues to warm up, according to a study in The Lancet Public Health.”

“Heatwaves will leave huge and growing numbers of people worldwide of all ages suffering from uncompensable heat stress (UHS) – where the body loses the ability to cool itself – and thus at risk of serious damage to their health, including death….”

“… A combination of rising global temperatures and the projected doubling in the world’s population of those aged 60 and over to 2.1bn by 2050 means more people in that age bracket will suffer heat-related health problems, especially in low- and middle-income countries such as India and Pakistan….”

Guardian – The threatening thaw: climate professor on heatwave risks to tipping point of permafrost

https://www.theguardian.com/environment/2026/aug/20/tipping-points-heatwaves-wildfires-permafrost-climate-crisis

“Prof Gustaf Hugelius warns wildfires could accelerate release of methane and carbon as vast regions approach irreversible thresholds.”

“Heatwaves and wildfires are not just scorching forests, they are adding to the tipping point risks in the world’s vast permafrost regions, which contain three times more carbon than all the living vegetation on Earth. This is a major concern for Gustaf Hugelius, a professor at the Bolin Centre of Climate Research at Stockholm University, Sweden, and a leading authority on the risks from thawing tundra and peatlands. In this Q&A, he explains why the world should pay attention.”

Nature (Comment) – Too hot to sleep? How heatwaves at night affect our health

P Gong et al; https://www.nature.com/articles/d41586-026-02532-2

“As climate change ramps up, scientists must urgently understand how night-time heat makes it harder for our bodies to rest and recover.”

Climate Change News – “Dangerous consequences” – how AI’s climate framing lets Big Tech off the hook

https://www.climatechangenews.com/2026/08/17/dangerous-consequences-how-ais-climate-framing-lets-big-tech-off-the-hook/

“Former Microsoft manager Holly Alpine explains why AI’s climate danger isn’t just data centres but also its unchecked use across the fossil fuel industry.”

“As tech giants race to build out AI and the sprawling infrastructure it depends on, climate concerns have tended to focus on one thing: power-hungry data centres. Their electricity use is growing so fast that by 2030, it’s projected to be nearly three times more than the combined annual consumption of Pakistan, Bangladesh and Nigeria. With the explosion in the construction of data centres driving new investment in fossil fuels, especially in the US, greenhouse gas emissions generated by data centres – now standing at less than 1% of the global total – are set to soar.

But this narrow focus on electricity has let AI’s supporters and the International Energy Agency (IEA) make a convenient case: that rising emissions can be more than offset by the technology’s green applications, like optimising renewables or boosting efficiency. That story conceals how AI’s real climate danger lies elsewhere: in the oil fields, where it’s helping fossil fuel companies extract planet-heating oil and gas faster and more cheaply….”

Lancet Planetary Health (Feature) – Indigenous Peoples’ Health: Reflections from the 25^th annual meeting of the UN Permanent Forum on Indigenous Issues

L Willetts; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00093-8/fulltext

“The UN Permanent Forum on Indigenous Issues (UNPFII) is a unique space that works differently than other UN bodies. As a knowledge and communication hub of Indigenous Peoples from 7 sociocultural regions of the world, collective views arising out of UNPFII can be understood as not just geographically universal but intragenerational. Despite its importance, UNPFII has limited visibility in and beyond the UN and in turn the application of its guidance is underappreciated in global decision making and poorly understood. This article discusses UNPFII’s purpose and function, zooms in and highlights on the 2026 theme (health), and zooms out to consider UNPFII in the context of the wider UN system and planetary health governance. This piece is a narrative woven by the words of Indigenous Peoples threaded from interventions at UNPFII25, an event that took place in New York City, April 20 – May 1, 2026.”

TGH – Improving Kenya’s Carbon Market to Support Health and Climate

J Chimbi; https://www.thinkglobalhealth.org/article/improving-kenyas-carbon-market-to-support-health-and-climate

“Building on the success of projects like Mikoko Pamoja, Kenya is working to regulate its carbon market to address past controversy and secure community gains.”

“In a bid to secure financing for climate projects and improve community health, Kenya is developing one of Africa’s most robust carbon markets, which places a price on greenhouse gas emissions by turning pollution into a cost, incentivizing emission reductions and low-carbon investments. In such a market, one credit represents one ton of (carbon dioxide (CO₂) either prevented from entering the atmosphere or removed. In recent years, Kenya has worked to strengthen regulation around its carbon market, to address concerns around weak oversight and attract foreign investment. Mikoko Pamoja, Kenya’s pioneering blue carbon project—one that captures carbon dioxide in marine environments—proves that when properly designed, carbon-trading initiatives can have significant public health and socioeconomic benefits.”

Mpox

BMJ GH – Dynamics of global mpox epidemics, 1970–2025: a systematic review and meta-analysis of evolving transmissibility and intervention effects

Y-Chien Lin et al ; https://gh.bmj.com/content/11/8/e022252

« Behaviour change and vaccination likely played important roles in the decline of the 2022 mpox epidemic in many studied settings; empirical modelling studies estimated substantial case reductions, although effect sizes varied across settings according to vaccine rollout timing, coverage, and the extent of behaviour change….”

Infectious diseases & NTDs

Lancet HIV – Global, regional, and national burden of HIV/AIDS, 1990–2023, with the estimated burden attributable to intimate partner violence and forecasted impacts of funding cuts through 2030

https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(26)00147-5/fulltext

This “study aimed to quantify recent trends in the HIV burden, the magnitude of the HIV burden associated with IPV, and the potential impact of declining financial support globally….”

Check out the findings.

Lancet Regional Health Africa – The global HIV metabolome cannot be defined without Africa

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00123-9/fulltext

By Levanco K. Asia et al.

Cidrap News – New study sheds light on why tuberculosis disproportionately affects men

https://www.cidrap.umn.edu/tuberculosis/new-study-sheds-light-why-tuberculosis-disproportionately-affects-men

“Across the globe, men develop tuberculosis (TB) at substantially higher rates than women. New research suggests that this disparity may have more to do with men’s greater risk of becoming infected in the first place than with a greater likelihood of the infection progressing to disease.”

“An estimated 10.7 million people worldwide developed TB in 2024—5.8 million men and 3.7 million women. Researchers have long wondered about the precise mechanisms behind the higher prevalence in men: Does the disparity reflect differences in exposure to Mycobacterium tuberculosis, biological differences in susceptibility to disease after infection, or a combination of the two? The findings, published last week in eClinicalMedicine, are drawn from 11 prospective cohort studies conducted in sub-Saharan Africa, Europe, Asia, and South America. Together, the studies tracked more than 22,000 participants for 12 years. …”

Telegraph – Ten years after Brazil’s Zika epidemic, its children are still paying the price

https://www.telegraph.co.uk/global-health/science-and-disease/brazils-zika-epidemic-ten-years-on/

“A decade on from the outbreak, a second wave of complications is emerging in the ‘Zika babies’ born with severe defects.”

Telegraph – Rabies deaths are rising. What is going wrong?

Telegraph;

“After decades of progress, infections are increasing – and almost all cases coincide with large populations of stray dogs.”

“… the number of rabies cases and deaths rises in hotspots like Bangladesh, India, and in parts of Africa. In almost all cases, the rising cases coincide with large populations of stray dogs…”

Plos Med – Estimates of global burden of snakebite: A literature review and geostatistical modelling study

Dileepa Senajith Ediriweera et al;

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005201

17 years after the previous estimate.

“Snake envenoming (SE) remains an important public health problem, disproportionately affecting impoverished rural communities in tropical and subtropical regions. Although previous attempts have been made to quantify the global burden of SE, accurate, up-to-date data remain scarce. Here we present a comprehensive re-evaluation of the global burden of snakebite, 17 years after our initial estimate.”

“We estimate that at least 2.1 million envenomings and 274,000 deaths occur globally each year due to snakebites, and our high estimates suggest up to 7 million envenomings and 513,000 deaths annually. Low-income countries exhibit the highest incidence and mortality rates, with sub-Saharan Africa accounting for 45% of global envenomings and deaths, nearly three times the incidence observed in South Asia. These estimates suggest that previous burden estimates could substantially underestimate the scale of the problem.”

AMR

Stat Opinion – In parts of the world, antibiotic overuse isn’t the problem — underuse is

P Beyer; https://www.statnews.com/2026/08/18/antibiotic-underuse-overuse-resistance-aware/

“Low- and middle-income countries are often portrayed as the worst offenders of antibiotic underuse, but a new study upends that narrative.”

“Research published in the Lancet Public Health found that overuse is actually concentrated in high-income settings, with these countries consuming the largest volumes of antibiotics used to treat drug-resistant infections. In contrast, many lower-income countries still lack access to these drugs, despite accounting for more than 80% of the estimated global need….”

NCDs

Plos GPH – Health-system challenges, resilience strategies, and actionable priorities for non-communicable disease care in humanitarian crises: A scoping review

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006035

By Pirhossein Kolivand et al.

Nature Health – Global cancer burden associated with long-term exposure to ambient air pollution

G Zhang et al ; https://www.nature.com/articles/s44360-026-00180-4

“Using cancer incidence data on 109 million cases from 952 locations worldwide between 2000 and 2020, the authors report that long-term exposure to PM_2.5, ozone and nitrogen dioxide is associated with increased cancer risk and millions of attributable cancer cases globally.”

Lancet Regional Health Africa – Prevalence and risk factors of CKD in sub-Saharan Africa, 2015–2024: a systematic review and critical appraisal of knowledge gaps

Nikolai Carl Hodel et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00117-3/fulltext

Among the findings: “CKD prevalence in SSA approximates global estimates but remains uncertain because of methodological heterogeneity, particularly inconsistent assessment of albuminuria and limited chronicity confirmation. Reliance on single measurements may substantially overestimate CKD prevalence. Standardized, resource-adapted protocols are needed to generate reliable burden estimates and inform kidney health policy and practice….”

Plos Med (Perspective) – Stroke risk in younger age groups is increasing and requires targeted prevention

Iain J. Marshall et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005232

« While global stroke incidence has reduced considerably in recent years, a new study suggests that stroke risk may be increasing among younger age groups. Worryingly, the main drivers are well-established risk factors with effective treatments, but new risks are emerging. Development of more accurate risk algorithms and novel targeted prevention programmes are needed to reduce this risk….”

Social & commercial determinants of health

Health Politics – Applying a Health Equity Lens to the Commercial Determinants of Health: A Critical Review

Courtney McNamara & Eric Crosbie; https://hpolitics.org/journal/view.php?doi=10.66534/hp.2026.0005

“Commercial determinants of health (CDOH) are increasingly recognised as central to health inequities, yet CDOH scholarship has not consistently engaged with established health equity theories. As a result, CDOH research often invokes equity without clearly articulating the mechanisms through which commercial power translates into unequal health outcomes. This review addresses this conceptual gap by examining how health equity theories can be used to interpret and organise CDOH scholarship and clarify where theoretical engagement is strongest and where key gaps remain.”

“A theory-informed interpretive review was conducted using purposive sampling of influential conceptual papers and review literature in the CDOH field. Six established health equity explanations and theories were used as interpretive lenses: cultural-behavioural, materialist, and psychosocial perspectives; fundamental cause theory, the Diderichsen model, and life course theory….”

Check out the findings.

Global Public Health – Maiming by design: Structural harm in oral health systems globally

Habib Benzian et al; https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2709658

“Tooth extraction is among the most common dental interventions, particularly in underfunded health systems where preventive, restorative, and rehabilitative dental services remain scarce. Drawing on Jasbir Puar’s concept of ‘maiming’ tooth extraction is reframed from technical/economic inevitability to care that results in structural harm. Extraction-based oral healthcare reflects a transnational logic in which injury is normalised, repair withheld, and debility managed rather than resolved. The analysis shows how tooth extraction becomes an organised response to resource constraints; absence of restoration or rehabilitation produces lasting debility; and how omission of population-level preventive strategies maintains predictable cycles of disease and loss. Stigma and narratives of personal responsibility recast this structural injury as individual failure, extending maiming into psychological dimensions that constrain civic mobilisation. A typology of structural maiming in dental care makes these dynamics explicit. Recognising the global patterns through which oral harm is produced shifts the discourse from clinical shortcomings to systemic governance, aligning with Universal Health Coverage commitments and the right to health. Extraction-based care persists across countries despite vast differences in wealth and infrastructure, calling for renewed scrutiny of the global political, economic, and institutional conditions that continue to render avoidable harm a global routine in dental healthcare.”

Lancet Regional Health Africa – Strengthening alcohol control policies in Kenya: an analysis of policy comprehensiveness and restrictiveness

Florence Jaguga et al ; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00126-4/fulltext

“This paper assesses the restrictiveness and comprehensiveness of Kenya’s alcohol policies, identifies gaps, and offers recommendations to strengthen the policy framework….”

Sexual & Reproductive health rights

BMJ GH – Scaling pleasure-based sexual and reproductive health: an impact and economic modelling study in 99 low- and middle-income countries

B Wong et al; https://gh.bmj.com/content/11/8/e024479

Re pleasure-based sexual and reproductive healthcare (PBSRH).

Authors conclude: “PBSRH is a cost-effective and high-return intervention to support global SRHR and HIV/AIDS goals for young people in LMICs.”

“… To our knowledge, this is the first study to describe the operational activities required to integrate pleasure-based sexual and reproductive healthcare into conventional programmes. We estimate that doing so across 99 LMICs would cost $1.6 billion over 10 years, avert over 92 000 deaths and return roughly $23 in benefits per $1 spent….”

Adolescent health

HPW – Historic Meta Settlement Mandates Safer Social Media for Youth

https://healthpolicy-watch.news/meta-safer-youth-social-media/

“Following a landmark agreement in the United States on Wednesday, social media giant Meta agreed to pay up to $18 billion to US states. This historic settlement, pending court approval, obliges the company to make Instagram and Facebook safer for children.”

“Scientific research – including a landmark report by an expert panel commissioned by the European Commission – shows that excessive social media use damages early childhood brain development and fuels mental health crises among young people. Meta emphasises that the settlement is not proof of harmful health effects caused by its platforms. However, the unprecedented sum is likely to increase global pressure on platform operators to take action….”

It’s a “signal to regulators worldwide”…

Lancet (Viewpoint) – Systematic reviews and the needs of the adolescent transgender health care field

D M Doyle et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00788-9/abstract

“Gender-affirming medical treatment for adolescents (defined as the start of puberty to age 18 years) has become an increasingly contested area of medicine in recent years. 13 reviews have been conducted since 2017 (with seven since 2023) to summarise studies on the potential effects of pubertal suppression and gender-affirming hormone therapy on psychosocial, cognitive, and physical outcomes in adolescents who are transgender, gender diverse, or non-binary. … In this Viewpoint, we review the conclusions of these systematic reviews regarding the efficacy and safety of pubertal suppression and gender-affirming hormone therapy for adolescents, and examine how these reviews are being misused to influence treatment options and care pathways. We affirm that the development of clinical guidelines should be underpinned by all three facets of evidence-based medicine (ie, empirical evidence, clinical expertise, and patient values), as evaluated by experts in the field.”

Access to medicines & health technology

Stat – New treatments for common cardiovascular risk factor near the market, with billions at stake

Stat;

(gated) “Unlike cholesterol, there is no approved therapy to lower levels of Lp(a).”

“Many people who face a heightened likelihood of heart disease and heart attacks can take protective measures, whether by adjusting their lifestyle or starting medication. But 1 in 5 people carry a risk factor that isn’t so easily addressed. This gap in medicine is also a potentially massive market for drugmakers, which are advancing experimental treatments for the risk factor through late-stage trials, including front-runner Novartis….”

WHO’s Alliance for HPSR – Vaccine uptake is a systems problem: what six country teams found in Enugu

https://ahpsr.who.int/newsroom/news/item/27-08-2026-vaccine-uptake-is-a-systems-problem-what-six-country-teams-found-in-enugu

“Six country teams brought their findings to the annual learning forum of the Alliance’s vaccine uptake programme. Across very different settings, they describe the same kind of problem.”

BMJ Editorial – Scaling up malaria vaccines in Africa

G Turner et al ; https://www.bmj.com/content/394/bmj-2026-100502

« While vaccine development has been a success, equitable delivery remains a barrier. »

Geneva Health Files – End The Global Double Standards in Diabetes Care [Guest Essay]

O Rafferty et al ; https://newsletter.genevahealthfiles.com/end-the-global-double-standards-in-diabetes-care-guest-essay/?ref=geneva-health-files-newsletter

“In today’s edition, activists are calling for including insulin analogue pens as a first-line treatment option in the World Health Organization’s forthcoming guidelines for type 1 diabetes.

Despite insulin being indispensable, the quality of treatment people receive still depends largely on where they live and what they can afford. They are calling for easy-to-use pens to become a part of recommended guidelines so that these treatments become the global standard of care.

In this guest essay, Canadian activists from Voices in Action (VIA) Diabetes, take a critical look at the “two-tier system of diabetes care that leaves millions without the treatment options routinely available elsewhere…”

FT – Big pharma hunts for weight-loss drugs without nasty side effects

https://www.ft.com/content/ba401de2-f60d-49fc-a862-aa491ee0dfad?syn-25a6b1a6=1

“Pharma groups seek new generation of GLP-1 medicines as some patents start to expire.”

“Weight-loss drugs such as Mounjaro and Wegovy have been blockbusters for the Big Pharma groups that developed them. But while the treatments have been hailed for transforming the often torturous process of losing weight for millions of people, the companies behind them have noted a problem: side effects. Many patients report gastrointestinal side effects of incretin-based therapies, such as Eli Lilly’s Mounjaro and Novo Nordisk’s Wegovy, including nausea, constipation, diarrhoea and vomiting….”

“… Pharma groups are now working to develop therapies that can deliver similar weight loss while addressing many of the concerns with the current market leaders. Associated benefits for new drugs could also include improving cardiovascular and liver health of patients and muscle mass preservation. …”

“… Yet reducing side effects is not the only reason pharma groups are trying to create the next generation of weight-loss drugs. For incumbents such as Novo and Lilly, patent expiries are looming, making it crucial for their business strategies to develop new therapies before the end of this decade. Novo’s semaglutide has already lost patent protection this year in Canada, India, China, Brazil and Turkey. Concerns over the state of the company’s pipeline contributed to the ousting of Novo’s chief executive last year….”

Human resources for health

Human Resources for Health – International migration of Africa-born health workers: a scoping review of drivers and policies, 2010–2024

https://link.springer.com/article/10.1186/s12960-026-01093-9

By B Wamuti, M A Pate et al.

Decolonize Global Health

Global Health: The Long Arc of Colonialism

(chapter in book – The Palgrave Handbook on Decolonizing International Affairs)

S Fukuda-Parr et al ; https://link.springer.com/chapter/10.1007/978-3-032-18958-5_27

“This chapter examines how age-old hierarchies that vest disproportionate power in the North have persisted in the field of global health, despite the mainstream narrative of promoting health equity as the principal purpose of the field. We argue that colonial logics have perpetuated older power structures into the twenty-first century, even after formal territorial decolonization. These hegemonic forms of reasoning, undergirded by a presumptive hierarchy of people, places and ideas, have persistently animated the field and its institutions, interventions, and knowledge, even as they transformed alongside the trajectories of global capitalism from Keynesianism in the 1950s–70s to neoliberalism in the 1980s–90s to finance and monopoly capitalism in the 2000s. The close correlation between the contours of the global economic system on the one hand and global health policies and priorities on the other hand has implications for an agenda of decolonization. Decolonizing global health cannot only be about epistemic politics—it must also confront the structures of capitalism that intertwine hierarchies of knowledge within a broader political economy to determine the conditions for who has power and agency.”

Economy & Society – ‘Sticky knowledge’: The political economy of global health science in Uganda

J P Allen; https://www.tandfonline.com/doi/full/10.1080/03085147.2026.2704348

“How are inequalities in scientific knowledge production in global public health and development (re)produced? Drawing on multiscalar and multisited ethnographic research in Uganda, this paper elucidates the political economies of blind spots in global health science. It shows how the establishment of research infrastructures in particular places, focusing on particular pathogens and populations, has led to gaps in knowledge that contradict global health’s commitment to reducing inequalities. These are compounded by a funding system that blinds the field to its own blind spots. This reveals what I term ‘stickiness’: path dependencies that shape the production of knowledge which emerge due to systemic difficulties in departing from existing technical arrangements, material and human infrastructures, funding rationalities, and political and scientific consensuses. I thus demonstrate how global health science repeatedly reinscribes its own priorities through the production of knowledge due to the systemic difficulty in departing from the status quo in method, location, topic or population.”

SS&M – DIY Global Health: Informality, Privilege and Ideologies that Drive Short-Term Medical Missions

Nicole S. Berry; https://www.sciencedirect.com/science/article/pii/S0277953626008476

“Defines DIY global health as distinct practices that combine informality and privilege. DIY global health presents useful framework to understand STMMs (Short-Term Medical Missions). Three ideologies sustain STMMs despite lack of evidence of positive impacts/outcomes. Addressing deficits in DIY global health model is an ideological, not technical issue.”

Development Today – Shifting power to NGOs in the Global South is easier said than done

A D Usher; Shifting power to NGOs in the Global South is easier said than done

(gated) “Efforts in Sweden and Norway to “shift power” and funding to civil society organisations in the Global South are proving difficult to put into practice. Sida’s chaotic selection process drags into its third year, and Norad’s proposal to provide direct grants to organisations in developing countries has been put on hold by the Foreign Ministry in Oslo until 2028.”

Lancet Regional Health Africa – Mentorship initiatives supporting grant acquisition and research capacity among early-career African scientists: systematic review and meta-synthesis

Olanrewaju Oladimeji et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00125-2/fulltext

“Mentorship is increasingly recognised as a key mechanism for supporting grant acquisition, research productivity, and career development. This systematic review and meta-synthesis examined mentorship initiatives designed to enhance grant success among early-career African researchers.”

Some of the findings: “… Five themes emerged: (1) structured mentorship, (2) competency development, (3) institutional support, (4) collaborative networks, and (5) research outcomes. Mentorship was associated with improved grant-writing skills, confidence in navigating funding opportunities, research productivity, and career progression. Most studies reported intermediate outcomes, including proposal development, networking, and skills acquisition, with limited direct evidence of successful grant awards. “

Conflict/War & Health

SSM Health Systems – Building resilient health systems through learning sites in fragile and shock-prone settings: Insights from Lebanon, Nepal and Sierra Leone

https://www.sciencedirect.com/science/article/pii/S2949856226001327

By S Regmi, S Witter et al.

Lancet World Report – Cuba’s health crisis deepens

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01706-X/fulltext

“Serious shortages of fuel and medical supplies have plunged the health system into chaos. Joe Parkin Daniels reports.”

UN News – Aid workers under fire as drones reshape warfare

https://news.un.org/en/story/2026/08/1168153

“The UN is warning that aid workers face a deadly and evolving threat, with armed drones reshaping battlefields worldwide – putting humanitarian teams increasingly in the line of fire.”

“In a stark new assessment, the UN aid coordination office (OCHA) marked World Humanitarian Day on Wednesday warning that 907 aid workers were victims of violence last year simply going about their lifesaving work in the face of increasing danger in conflict zones.

Fatalities fell in 2025 but remained historically high, with 350 humanitarian staff killed – the second-highest toll ever recorded….”

Health System & Reform – A Pragmatic Call to Integrate and Regulate Non-State Actors in Fragile Health Systems

Augustus Osborne et al; https://www.tandfonline.com/doi/full/10.1080/23288604.2026.2708910

“In fragile states, healthcare delivery relies on non-state actors like NGOs and private providers. Short-term donor funding has created fragmented services and weak state capacity. However, donor-driven fragmentation is not only a technical coordination problem; it is also a political economy problem shaped by earmarking, attribution pressures, fiduciary risk aversion, donor-controlled contracts, and upward accountability to funders. We propose shifting from state-as-provider to state-as-steward, not as a choice between two mutually exclusive roles, but as a move toward pluralistic health-system stewardship in which the state may continue to provide some services while stewarding a mixed delivery system. This means integrating the “shadow health system” of non-state services into national health systems through licensing, contracting, and monitoring providers, while unified standards support coordination. Pooled or jointly governed financing, independent verification, shared reporting metrics, and community accountability are needed to align donor incentives with national priorities. Evidence from Afghanistan, Cambodia, Liberia, and other fragile settings demonstrates that contracting and regulation can improve access and oversight. Where governments lack legitimacy, territorial control, or impartiality, stewardship should be adapted through subnational, regional, hybrid, or independently verified mechanisms…”

Miscellaneous

Nature Africa – Building a systems science network for Africa

https://www.nature.com/articles/d44148-026-00234-5

“Researchers are redesigning a southern African systems analysis network to help tackle challenges that cross borders, from water security and food systems to climate change and conflict.”

“ …. governments and development agencies often rely on planning models that assume complex problems can be solved with linear solutions. Those challenges brought together scientific leaders from seven South African institutions to the International Institute for Applied Systems Analysis in Laxenburg, Austria, in June. Their task was to reimagine the Southern African Systems Analysis Centre (SASAC) as a broader network connecting researchers and policymakers across sub-Saharan Africa, with the aim of bringing research and systems analysis more directly into decision-making….”

IISD – World Bank Issues Sustainable Development Bonds Worth Billions

https://sdg.iisd.org/news/world-bank-issues-sustainable-development-bonds-worth-billions/

“A USD 4 billion benchmark bond matures in August 2033, and a EUR 3 billion benchmark bond matures in September 2036. The World Bank’s sustainable development bonds support the financing of sustainable development projects and programs that aim to end extreme poverty and boost shared prosperity on a livable planet, accelerate the SDGs, and enable positive social and environmental outcomes in countries.”

Editorial: Catching up on the second half of August (IHP News #894)

Kristof Decoster — Fri, 28 Aug 2026 07:57:16 +0000

Dear Colleagues,

As promised, though a bit earlier than foreseen, here’s a catch-up issue on the past two weeks in global health. I’ve been spending among others some time in Basel (family visit), also the home of a few big pharmaceutical companies with rather flashy headquarters (you probably know what I think of pharmaceutical companies that can afford shiny ‘towers’ – and no, it’s not that the World Health Summit organizers should *really* invite their CEOs to the opening plenary/ceremony : ) ).

This issue features updates on the Ebola emergency, 100 days into the outbreak (or at least declared a PHEIC), the WHO DG race (and related staff movements – with among others Bruce Aylward still on a neverending Rolling Stones-style farewell tour : ) ), the WHO Afro regional meeting in Addis, a bunch of new journal articles, and much more.

Enjoy your reading.

Kristof Decoster

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.”

IHP - Recent newsletters, articles and topics

Weekly topics: IHP news 898: Highlights of the week (IHP News #898)

Structure of Highlights

Read of the (1st part of the ) week

Habib Benzian – The End of the UHC Financing Consensus

UNGA81 – General news, reports, …

Guardian – Global leaders urged to join initiative to fight extreme inequality

Devex Pro– UNGA is here — and here’s what’s at stake

United Nations Foundation – A Mandate for Renewal Global Public: Opinion on the United Nations and the Selection of the 10th Secretary-General

UN News – Less than 4 years from development goals deadline, progress shows what’s possible

UN News – The right to development: Why equity, not charity, is a human right

Devex – UN’s sprawling development system faces ‘existential threat’

FT – Multilateralism is not idealism, it is a necessity

Run-up to the UN High-Level meeting on PPPR (25 September)

GAVI – Global health reform and last-mile integration: the missing link in pandemic preparedness

Lancet – The NUS–Lancet PRIME Commission: transforming pandemic readiness for equity

HPW – Pandemic Agreement Negotiator Warns Against Losing Momentum

DNDi (Policy report) – Implementing article 9.5 of the WHO pandemic agreement

TGH – Five Ways to Deliver on the Pandemic Agreement’s Promises

PABS negotiations: wrap-up of the latest round

WHO (press release) – Member States advance negotiations on pathogen access and benefit-sharing ahead of UN General Assembly meeting on pandemics

Geneva Health Files – Sovereign Control Over Pathogen Information: The Design Crux of The Pathogen Access Benefit Sharing System at The WHO [IGWG8 Update]

BMJ – US plans to stop HIV support for Namibia as African country rejects “colonial” data sharing demands

More on PPPR

CEPI – Ethiopia, Norway and UK commit US$240 million to CEPI’s global plan to tackle epidemic and pandemic threats

Ebola Emergency DRC

MSF – Assuming the Ebola disease outbreak in DRC is under control would be a mistake

UN News – Ebola vaccine trial begins in DR Congo

HPW – When Ebola strikes, HIV care cannot stop

HPW – DRC’s Ebola Outbreak: The Vast Mobilisation That Doesn’t Measure Itself (Part II)

Devex Pro – WHO Africa chief: DRC Ebola outbreak could surpass West Africa crisis

Foreign Affairs – Ebola Is Only the Beginning

Run-up to the World Health Summit in Berlin

Lancet – 2026 World Health Summit Academic Alliance Declaration: health and peace in a world in turmoil

Nature Health (Comment) – Why Europe must step up on global health

WHO DG race

Geneva Solutions – Who wants to lead the WHO? Four candidates jostle for top job as deadline nears

CGTN – Hans Kluge, Belgium’s nominee for WHO director-general, calls for stronger China-Europe health cooperation

Bloomberg – Ex-Banker Eyeing Top WHO Job Says Agency Can Tap Outside Money

HPW – As Deadline Nears, Civil Society Urges Spain to Nominate María Neira in WHO DG Election

Geneva Health Files – WHO’s Next DG Should Be A Medical Doctor, Public Health Leader & Health-Systems Expert [Guest Essay]

Global Health Reform

Devex Pro – One year after Accra Reset launch, panel lays out next steps

Devex Check-up – re UNAIDS reform

Plos GPH – Who is really shaping global health reform?

Plos GPH – From Accra to America: Putting development first in global health

UCSF – After Global Health: Building the Next Era of Applied Public Health

Post-2030 brainstorm & the future of development cooperation

Brookings – Nature, People, and Sustainable Development

CGD (blog) – When Is Development Cooperation Really Mutually Beneficial?

IDOS (German institute of development and sustainability)- Global cooperation under pressure – new report on shaping reforms

More on Global Health Governance & Financing/Funding

Devex Pro – Coefficient Giving launches $130M fund to help countries navigate aid cuts

P4H- From billions to balance sheets: where will the money for health actually (not) come from – Part 2A

Results for Development – Strengthening country-led health systems through technical support partnerships and platforms

Cashin et al then list Core Functions of the Technical Support Partnerships and Platforms.

Guardian – As president of Botswana, I know how we can make malaria a memory in Africa

World Bank – What Works for Public Sector Reform in Africa? Preliminary Evidence on New Public Management Reforms in World Bank Projects

BMC Global & Public Health – Financing of adolescent health and wellbeing in Bangladesh, Ethiopia and Nigeria: a case study of the Global Financing Facility

Global Tax Justice

Economics Nobel Laureates Support letter for Proposition 40, the California billionaire tax

Trump 2.0, US Global Health Strategy & bilateral health agreements

NYT – White House Moves to Take Control of N.I.H. Grants

CGD – Impact Data Helped Saved PEPFAR. What About Everything Else?

PHC

Africa CDC – The Arusha Call for Action: Primary Health Care Transformation

SRHR

Devex – Anti-abortion groups launch coalition on Geneva Consensus Declaration

Reproductive Health (supplement) – On sustainable SRH services during Covid

Child Health

NEJM – The Epstein Files Transparency Act and the Health of Trafficked Children

Human Resources for Health

WHO – One in four doctors nearing retirement age as WHO warns of global health workforce gap

NCDs & Urban health

NCD Alliance (Policy brief) – Meeting the moment: NCD funding in a changing world – The role of private philanthropy in financing the response to NCDs

Lancet Public Health (Editorial) – The role of cities in public health

Mental health

Nature (World View) – Losing your way of life to climate change matters — and we need a way to measure it

Planetary Health

Climate Change News – Climate change and energy transition rise up national security agenda

Read of the (1^st part of the ) week

United Nations Foundation – A Mandate for Renewal Global Public: Opinion on the United Nations and the Selection of the 10^th Secretary-General