·         International Women’s Day (8 March)

·         Global Health Reform & Reimagining (+ post-2030)

·         More on Global Health Governance & Financing/Funding

·         US Global Health strategy & bilateral health agreements

·         Trump 2.0

·         UHC, PHC (& integrated care)

·         PPPR & GHS

·         AMR

·         Human Resources for Health

·         Commercial Determinants of Health & NCDs

·         Commission on the Status of Women (and other SRHR updates)

·         Planetary Health

·         Access to Medicines, Vaccines & other health technologies

·         Conflict/War/Genocide & health

·         Lancet Regional Health Africa – inaugural issue

·         Miscellaneous

International Women’s Day (8 March)

Global Policy – International Women’s Day at 115: A Moment of Reflection

https://www.globalpolicyjournal.com/blog/07/03/2026/international-womens-day-115-moment-reflection

“Helen Clark and Rajat Khosla use International Women’s Day to ask deeper questions about the structures and opportunities that shape our societies.”

PHM – This March 8 we commemorate, we resist, we reclaim, and we restore

https://phmovement.org/march-8-we-commemorate-we-resist-we-reclaim-and-we-restore

PHM statement for International Women’s day.

Economist – What people get wrong about women’s rights

Alice Evans;  Economist;  

“Elites should stop assuming that the barriers to progress are the same from Brazil to Bangladesh, writes Alice Evans.”

“Global elites frequently convene conferences on gender, but tend to gloss over the striking regional disparities in women’s status. Whether at Davos, the World Bank or Ivy League universities, attention gravitates to Western concerns, such as affordable child care, as if women are bound by the same constraints everywhere. In my forthcoming book, “The Great Gender Divergence”, I challenge this mindset by emphasising the enormous differences in gender attitudes around the world. Drawing on comparative historical analysis and thousands of interviews on all continents, I show why one-size-fits-all approaches are unhelpful.”

“… To speed up progress on gender, it would help to cast aside Western-centrism and tackle local obstacles: female seclusion in South Asia and the Middle East; poverty and conflict in sub-Saharan Africa; and homicides in Latin America…”

TGH – Women in Leadership: Global Health’s Missing Dose

S Ramarao et al; https://www.thinkglobalhealth.org/article/women-in-leadership-global-healths-missing-dose

“Women in health leadership bring essential perspectives to challenges long ignored by hierarchies dominated by men.”

The Lancet Obstetrics, Gynaecology, & Women’s Health (Editorial) – Women’s health: lessons from the past, visions for the future

https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038(26)00055-5/fulltext?dgcid=tlcom_carousel1_whod_eds26_lanogw

“International Women’s Day (March 8) is a perfect time to reflect on recent advances in women’s health while considering what the future might hold. The past decade has witnessed significant research and innovation in women’s health, leaving a lasting impact across disciplines and clear signs of progress globally. With valuable feedback from our International Advisory Board, we have compiled a list of ten advances—presented in an infographic—that we feel have altered the course of women’s health over the past 10 years…”

Global Health Reform & Reimagining (+ post-2030)

HPW – Global Health Infrastructure is Changing. Why Getting it Right Matters

M Low; https://healthpolicy-watch.news/global-health-infrastructure-is-changing-why-getting-it-right-matters/

Viewpoint with focus on a country like South-Africa. “Funding cuts over the past year have created a crisis for multilateral health institutions. Which institutions emerge from this crisis, and in what form, will have real consequences for the health of people in countries like South Africa.” 

A few excerpts:

“In recent weeks, there has been a glut of articles from global health big-hitters, all concerned with how multilateral health institutions should, or should not be redesigned.  These include articles from Philippe Duneton, Executive Director of UNITAID, Sania Nishtar, CEO of GAVI, and one co-authored by, among others, Anders Nordström, a former acting Director-General of the WHO, Helen Clark, a former New Zealand Prime Minister, and Peter Piot, the driving force behind UNAIDS from the mid-90s to 2008….”

“… The reality is that multilateral health institutions have often been at their most effective when people were driven by the need to address urgent health needs, as in the early days of UNAIDS, for example.  The belief that people’s health matters, no matter who they are, or where they live – essentially a belief in human rights – can make the difference between an ineffectual bureaucracy and a vital health movement…. Our current crisis is not only one of technical capacity, but also one where the animating power of human rights-based thinking is being challenged….”

PS: “…. All of these shifts [in multilateral health] are now occurring within the broader geopolitical context of what Canadian Prime Minister Mark Carney recently described as a “rupture in the world order”. … … Maybe a first harsh reality to come to terms with, then is that the rupture that is taking place in global geopolitics is also occurring in the world of global health….. To think that we can go back to the way the WHO or UNAIDS were 20 years ago is wishful thinking. The “rupture” might take time to propagate, but it will extend all the way…..”

“As outlined above, countries like South Africa benefited in very concrete ways from multi-lateral forums, but somehow those benefits were never widely appreciated. Ultimately, it is telling that so many national governments have failed to put up the money the WHO requires to do its work – even before the current US withdrawal.  Maybe then, to make a reset of multilateral health institutions a success, will require that governments reassess and newly appreciate why it is that we need multilateral health institutions in the first place.  This will require a thorough and honest assessment of what we have gained from these institutions in recent decades. Things like market-shaping, patent pooling, pooled procurement, sharing of genomics and other data, regulatory harmonisation, guideline development, research cooperation, and multilateral fund-raising have all been important and will continue to be so….” “ We must make sure that, whatever emerges in the next few years, we have multilateral mechanisms that can deliver in all these areas.  But we will have to accept that those entities might look quite different from what we’ve come to know in recent decades. There will certainly be areas in which we still need global institutions like the WHO, but for some issues, we might get more done by working with coalitions of the willing, or collaborating at a regional level – as we’re already seeing with the African Medicines Agency (although South Africa rather inexplicably hasn’t yet ratified the related treaty)….”

Low concludes: “… In many respects, this has been a disaster for our common good, but it is also an opportunity to craft new and more fit-for-purpose multilateral health institutions that are animated by a shared commitment to human rights. This is an opportunity that countries like South Africa must grasp.”

S Nishtar – Our global health architecture needs urgent reform: the Pandemic Agreement could be the catalyst

https://www.gavi.org/vaccineswork/our-global-health-architecture-needs-urgent-reform-pandemic-agreement-catalyst

In Sania’s words: “on the importance of avoiding duplication and ensuring the speed, predictability and flexibility required to respond effectively to a pandemic threat.”

“There are few public goods more vital than an effective plan for pandemic response. The Pandemic Agreement could pay dividends for future generations, but must draw on the strengths, experience and comparative advantages of the current global health ecosystem.”

“… My concern is that, as negotiations on the Pathogen Access and Benefit Sharing (PABS) system of the Pandemic Agreement move towards their conclusion, the direction of travel on key operational aspects of PABS may appear to be at odds with the principle of clear and focused mandates, and may run counter to the spirit of collaboration, coherence and complementarity that must be at the heart of the Pandemic Agreement’s implementation. Necessarily, an effective Pandemic Agreement needs to draw on the comparative advantages of many different stakeholders, including key implementing partners.  Many of these partners, such as Gavi, CEPI and UNICEF, are already stewards of tried and tested operational capabilities and financial instruments that could and should be fully integrated as foundational elements of both a Coordinating Financial Mechanism (CFM) and a Global Supply Chain and Logistics Network (GSCL) for pandemic prevention, preparedness and response. Many of these capabilities and instruments have been built in collaboration with countries and donors, and have been designed based on the lessons learned during and after the COVID-19 pandemic. …”

“A case in point is Gavi’s establishment and inauguration of the First Response Fund in 2024, which ensured that mpox vaccines were procured at scale within days of an mpox vaccine receiving WHO prequalification. …”

“… … Discussions are ongoing with multiple partners to build on the liquidity arrangements that backstop the First Response Fund to create a truly “pandemic-scale” financing facility, with a potential role for multilateral development banks. The First Response Fund was a capability Gavi developed to fill an essential niche in the emergency response ecosystem…”

“…Gavi supported the creation of a Coordinating Financial Mechanism (CFM) during the initial Pandemic Agreement negotiations, but it is crucial that any CFM is designed to reinforce and enhance proven financial instruments, rather than create parallel structures or crowd out existing mechanisms….”

Devex (Opinion) – The next UN chief must architect a new era of multilateralism

Qahir Dhanani, Jim Larson  (both from the Boston Consulting group); https://www.devex.com/news/the-next-un-chief-must-architect-a-new-era-of-multilateralism-112027

“From rebuilding trust and delivering reforms to setting the post-2030 agenda, here are five priorities for the next United Nations secretary-general.”

Including:  “ Deliver on global public goods and actively define the post-2030 agenda….;  Navigate a fragmented and multistakeholder world; Reassert the core mandate enshrined in the U.N. Charter…”

Re the latter (core mandate): “Above all, the United Nations exists to maintain international peace and security and to create the conditions of stability and well-being necessary for peace and human dignity. Peace and development are thus not one priority among many — they are the institution’s founding purpose.”

Sustainable Development – Prescriptive Positivism: Discourse on Sustainable Development Goal Interactions and Perspectives for a Post-2030 World

Gin Dupont et al ; https://onlinelibrary.wiley.com/doi/10.1002/sd.70905

“The Sustainable Development Goals (SDGs) are unlikely to be achieved by 2030, prompting debate about what should follow. Beyond revision, there is a need to critically examine what values and assumptions have shaped how the SDGs are conceptualised and operationalised. Much of the academic discussion about the SDGs has centred around their interactions. Using an inductive, latent thematic analysis of 35 papers, we analysed the discourse on SDG interactions and identified a prescriptive positivist discourse that promotes management as the solution, puts faith in research and demonstrates transactionality and internalised fragmentation. Authors frequently adopt directive language and advocate technical or managerial fixes; solving trade-offs with adequate financial resources, proper governance, and science. Equity is treated as instrumental, only what is measurable is acknowledged, and calls for integration rarely go beyond coordination. The paper highlights overlooked perspectives of stewardship that considers pluralism and treats equity, justice and nature as intrinsic.”

More on Global Health Governance & Finance/Funding

BMJ Editorial – Peace, come closer

Jocalyn Clark; https://www.bmj.com/content/392/bmj.s480

“… Whether you believe the war with Iran is a diversionary tactic to distract from the Epstein files or not, the abuse scandal must not go away—not least because the sheer scale of Epstein’s cabal and harm demands more action to protect women and girls from sexual violence. And the Epstein files should no longer be ignored by those of us in the global health community. Although he is not accused of any illegal activity, Bill Gates has emerged as an associate of the convicted sex offender Jeffrey Epstein, including having discussions about philanthropy for global health. Gates has been the main influencer of the global health agenda for the past two decades, a champion of gender equality, and his Gates Foundation the largest donor to WHO. The foundation plans to double its overall funding to $200bn for the next two decades until it sunsets, cementing its enormous impact on global health governance. The foundation has stated that it had no involvement with Epstein beyond initial interactions to secure funding that never materialised and that it abhors the horrific harm he afflicted . Gates has apologised for poor judgment.  But the saga raises a broader need: for critical debate about the role and influence of powerful financiers in global health, especially now as traditional sources of support dwindle. Billionaire philanthropists are one group in need of scrutiny, but so too are the tech robber barons, petro-states, and human rights abusing regimes that will increasingly be looked to for support and patronage—and all too willing to oblige—as the fledgling global health architecture is reimagined. Climate change advocates have struggled with this moral dilemma, and their lessons are instructive. Will we allow global health to healthwash dirty money? This is a long overdue reckoning….”

Clark concludes: “… Ultimately all wars are a choice, and they hasten destruction of people and the planet. A redoubled counter movement from civil society and global health communities is needed to make health the fight of our lives. Health is a bridge to peace, and peace a prerequisite for health—come closer.”

Tim Schwab – How Epstein & Gates harmed public health and global security

https://timschwab.substack.com/p/how-epstein-and-gates-harmed-public

“As Congress compels Bill Gates to answer questions about Epstein, troubling new details of their relationship surface–including questions about how philanthropy and military intelligence overlap.”

Coming back on Epstein’s involvement in the polio eradication in Pakistan, among others.  “Journalists have uncovered documents showing that Epstein played a far more extensive role in the Gates Foundation’s signature philanthropic project, its crusade to eradicate polio, than previously known. Several media outlets in recent weeks have reported that Epstein’s work often seemed more like military-intelligence gathering than philanthropy….”

·         And a link: Project Syndicate – Epstein and the Globalization of Criminal Exploitation (by K Hyland)

“While the Jeffrey Epstein affair continues to receive global attention, the true scale of human trafficking and modern slavery remains underappreciated, and the perpetrators almost always go unpunished. G20 countries can start cracking down on this scourge immediately by focusing on six priorities….”

PS: “The exploitation of some 50 million children, women, and men generates at least $236 billion per year in criminal profit…” “G20 countries combined allocate around $1.6 billion to combating human trafficking and modern slavery. That is less than 1% of the annual illicit profits generated by this vile industry each year…”

Devex checkup– The Global Health’s boy’s club: re gender equity in global health

Devex ; 

Covering an “an event on Monday, hosted by Women in Global Health, looking at the status of women’s leadership in the sector.”

With among others examples from Magda Robalo and Precious Matsoso.

HPW – Global Fund Faces $5bn Shortfall as France Slashes Support, EU Delays Pledge

https://healthpolicy-watch.news/global-fund-shortfall/

Coming back on the Global Fund Board meeting in February, with also some more info on the (why of the) French cut, and EU delayed pledge.

“Battered by a 58% cut from France, a delayed European Union (EU) pledge, and a US pullback, the Global Fund faces a significant shortfall, securing $12.64 billion against its $18 billion target during the 8th replenishment. According to the organization, reaching the full target would have prevented roughly 400 million new AIDS, tuberculosis, and malaria infections between 2027 and 2029. Despite this compounding retreat, executive director Peter Sands praised the final tally as a “remarkable result, achieved in a challenging global context.” …”

“… Significant changes in global health financing have forced a strategic shift, introduced in late 2025, toward the poorest nations bearing the heaviest disease burdens, while placing middle-income countries on accelerated transition timelines toward national self-reliance….”

“To manage the Global Fund shortfall, the board approved $10.78 billion in core country allocations for the 2027-2029 implementation period. To maximize the impact of the remaining funds, the board also earmarked $260 million for “catalytic investments” designed to expand access to innovative health products.  … …. Executive leadership stressed the urgent need to prioritize these game-changing biomedical innovations, specifically highlighting the continued scale-up of the HIV prevention tool Lenacapavir, alongside new molecular diagnostics for tuberculosis and advanced vector control tools for malaria.”

PS: “… African states are stepping up, taking a larger financial stake in their health systems….”

Geneva Solutions -After a year of turmoil, WHO remains a pillar of global health

https://genevasolutions.news/global-health/after-a-year-of-turmoil-who-remains-a-pillar-of-global-health

“The World Health Organization just experienced one of the most challenging years in its history, following the US withdrawal and deep donor cuts. Experts however say the UN agency remains central to global health governance.”

With interesting views of Antoine Flahault, Suerie Moon, …

Geneva Solutions – WHO assistant director general Jeremy Farrar: ‘In the age of disinformation, WHO must remain a normative power

https://genevasolutions.news/global-health/who-assistant-director-general-jeremy-farrar-in-the-age-of-disinformation-who-must-remain-a-normative-power

“Responsible for health promotion and disease prevention and care at the World Health Organization, the former charity chief takes stock of the state of the UN health agency.”

Lancet – Health in Africa: the WHO African region in the next decade

B Impouma, M Janabi et al ;  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00183-2/fulltext

« The profound disruptions to the international public health ecosystem in 2025 presented both substantial threats and new opportunities. For the WHO African region, the year marked a period of rethinking, reappraisal, and strategic reorientation….”

« The region’s priorities are shifting from donor alignment to fiscal stewardship, requiring bold action from the WHO Regional Office for Africa. Institutionalised health–finance dialogues will be established at national and regional levels. Ring-fenced domestic financing—for example, through sin taxes, solidarity levies, and insurance reforms—will be promoted. Regional public goods will be prioritised over fragmented, country-specific projects. For example, regional surveillance, data collection, and analytics will be strengthened to compensate for the decline in aid-funded statistical systems. Efficiencies of scale will be achieved by pooled procurement, regulatory harmonisation, strengthened manufacturing ecosystems, and shared digital platforms—advancing progress towards regional self-sufficiency in health products and services. Population resilience across the life course is inseparable from robust non-communicable disease management, workforce retention, and climate resilience. Together, these elements shift the focus from narrow emergency preparedness to whole-system resilience—ensuring continuity of essential services, even during shocks. »

« This transformation reframes the WHO Regional Office for Africa not as a technical body but as a political broker, fiscal and policy steward, and architect of African health sovereignty. Progress requires defragmenting initiatives, sharpening institutional priorities, and making disciplined strategic choices. Concrete next steps will include developing a Regional Health Sovereignty framework, launching structured health–finance–planning dialogues in high-impact countries, consolidating disease-specific platforms in integrated delivery models, reducing internal fragmentation to focus on core regional public goods, and deploying high-visibility flagship political initiatives in partnership with heads of state….”

Sania Nishtar – A new era of country ownership: introducing Gavi’s first-ever vaccine budgets

https://www.linkedin.com/pulse/new-era-country-ownership-introducing-gavis-vaccine-budgets-nishtar-nlfre/

“Simpler, more transparent and designed to put countries in the driving seat, Gavi’s vaccine budgets signal a leap forward for global health. “

“Last week, our Gavi Leap reform programme marked an important milestone. In keeping with our aspiration to radically simplify how we work with countries, and to put greater ownership in the hands of countries themselves, we are sending letters to all 56 Gavi-supported countries outlining their vaccine budgets for the next five years.   The introduction of vaccine budgets and other elements of the Gavi Leap reform are the culmination of a 12-month process to completely redesign the way we disburse money to countries. “

“Instead of a multitude of grants for individual vaccines, each with different timeframes and application processes, countries now receive one budget, one cash grant, secured through one application process and managed by one fully digitised grant-management system. “

“Along with unprecedented long-term visibility over their financial resources for immunisation, countries also have much greater flexibility about how their available budget is allocated. Each vaccine budget includes a funding envelope that countries can use to prioritise vaccines from Gavi’s portfolio of their own choosing, in accordance with their national strategies…”

Devex Pro – Africa CDC eyes debt swaps to plug health financing gaps

https://www.devex.com/news/africa-cdc-eyes-debt-swaps-to-plug-health-financing-gaps-111940

(gated) “There’s one area considered a largely untapped resource for health finance on the African continent: converting debt into health programs. Africa CDC has hired a special adviser to guide the agency on scaling these transactions for countries.”

“The Africa Centres for Disease Control and Prevention, or Africa CDC, plans to focus heavily on matchmaking debtors and creditors to broker these deals.  “We are talking about increasing innovative domestic resources, but also bringing some funding that we didn’t explore in the past, like the debt swaps,” Dr. Jean Kaseya, director-general of Africa CDC, said. “It’s a major area of focus for Africa CDC for more sustainable financing.”…”

“The idea is straightforward, says Christoph Benn, a former executive at The Global Fund to Fight AIDS, Tuberculosis and Malaria who is now advising the agency: “[Kaseya] believed that this could be a good way for many African countries to address two big problems at the same time: You reduce the [debt] burden that many countries are suffering from, and you increase the domestic investments in health.”…”

“Benn is a leading expert on this. While working at The Global Fund to Fight AIDS, Tuberculosis and Malaria, he helped establish a mechanism known as Debt2Health. Since then, the Global Fund has executed 14 debt swap agreements, converting $470 million in debt into about $330 million in health funding.   But scaling up these deals is easier said than done. Benn tells me the negotiations can be complex and painfully time-consuming, which can be a heavy lift for already stretched government ministries.  Part of his new role with Africa CDC, he says, is to help smooth out those hurdles.  “What the intention of our collaboration is to make the mechanism as easy as possible and kind of minimize the transaction costs…”

·         Via LinkedIn: “The Africa CDC aims to unlock about $1 billion in health financing through debt-for-health swaps as part of efforts to secure sustainable funding for African health systems.”

Devex Pro – Multilateral development banks stepped up as bilateral aid dropped

https://www.devex.com/news/multilateral-development-banks-stepped-up-as-bilateral-aid-dropped-111947

(gated) “ONE Data shows that while finance from traditional donors, private investors, and China plummeted, MDBs picked up the slack — with caveats.”

“The world may be in the midst of escalating nationalism, but in development finance, multilateralism is ascendant. That’s according to ONE Data’s recently published Great Reversal report, which says that while net development finance flows to low- and middle-income countries decreased by 25% between 2010-2014 and 2020-2024, the decline would have been more severe without the increased lending of multilateral development banks.  The report maps out the withdrawal of finance to LMICs from China, from private investors, and from members of the OECD’s Development Assistance Committee. While all those sources are slashing their levels of finance, ONE Data found a 124% increase in finance from MDBs since 2010. The result is that multilateral funding now exceeds bilateral as a source of cash for these countries — with the caveat that MDB money is more likely to come in the form of loans, not grants.”

Health Security Policy Academy – PEPFAR’s Next Quarter Could Be Its Last

K J Seung & V Lin; https://globalhealthwatch.org/?blog=pepfars-next-quarter-could-be-its-last

“PEPFAR is on the brink, and almost no one seems to realize it.  The President’s Emergency Plan for AIDS Relief—one of the most successful public health programs in history—is not collapsing in a dramatic announcement or a legislative showdown. Instead, the program is being slowly starved, through budgetary choke points and administrative fiat rather than any open legislative decision.”

“Look closely at the financials and the pattern becomes unmistakable. The infrastructure that sustained PEPFAR for more than two decades is rapidly eroding. And if current funding trends continue, the CDC platform that now carries much of what remains of PEPFAR could run out of funds by June 2026—not because Congress failed to appropriate money for PEPFAR, but because the State Department is not transferring enough of it to CDC….”

“After the dismantling of USAID, CDC programs are now the last operational pillar of PEPFAR, widely considered the most successful global health program in history. Those programs provide care for more than 12 million people living with HIV across 50+ countries and regions. But CDC got only $640 million this year for PEPFAR. Normally it’s $1.3 billion….”

Guardian – UK government axes flagship global health project

https://www.theguardian.com/global-development/2026/mar/12/uk-government-axes-flagship-global-health-project

“Programme which supports schemes in six African countries was previously hailed as vital protection for Britain against future pandemics.”

“…A flagship health project in Africa, which UK ministers said would play a vital role in protecting Britain from future pandemic threats, is being axed due to aid cuts, the Guardian can reveal.

“The Global Health Workforce Programme (GHWP) which supported development and training for healthcare staff in six African countries, will close at the end of the month, the Foreign, Commonwealth and Development Office (FCDO) said. “That is a genuinely historic decision, and the UK now risks ceding ground in global health that we will struggle to recover,” said Ben Simms, chief executive of Global Health Partnerships, which ran the programme….”

TGH – Indonesia in the BRICS: What It Means for Global Health  

I M Kurnia et al ; https://www.thinkglobalhealth.org/article/indonesia-in-the-brics-what-it-means-for-global-health

“Just over a year after Indonesia joined the BRICS, the nation is still determining its place in the bloc’s health-cooperation dynamics.”

Well worth a read.

Independent – Aid cuts reducing public support for overseas help, study finds

Independent;  

“Questions mentioning government aid cuts were met with respondents being less likely to describe aid as essential and less likely to frame it as a moral duty.”

“… The study, which was produced by nonprofit network GlobalGiving, is based on interviews with 2,000 participants in the UK and Germany.”

“… According to the researchers, the results could reflect a “system justification effect”, where individuals subtly align their views with perceived government decisions.”

“The research also finds that individuals believe governments are most responsible for giving aid, rather than private individuals. Some 84 per cent and 80 per cent of respondents respectively think that governments and philanthropies are responsible for aid, versus just 31 per cent of individuals.”

Global Health Strategies – From Commitments to Action: Practical Pathways for Health Financing in Africa Position statement from the December 2025 Health Financing Experts Insight Workshop

Eberere Okereke et al; https://globalhealthstrategies.com/wp-content/uploads/2026/03/From-Commitments-to-Action-Practical-Pathways-for-Health-Financing-in-Africa.pdf

“A Health Financing Expert Insights Workshop, convened in December 2025, brought together African leaders in health financing, economists, implementers, and policy advisers. The discussion revealed strong convergence around four key realities:   Health continues to be treated primarily as a social sector cost rather than an economic and development investment; Accountability, costing, and implementation often remain weak despite repeated commitments; Practical financing mechanisms already exist across the continent, but they are inconsistently governed, unevenly scaled, and insufficiently embedded in national systems; While African expertise exists in abundance, it is underutilised in shaping financing narratives, policy choices, and political decision-making.”

“… There is no shortage of commitments on health financing in Africa. What remains scarce is disciplined execution anchored in governance, accountability, and realistic costing, with named owners and deadlines. The gap between aspiration and delivery has become a fiscal and political liability. The recommendations in this paper point to a narrower, more demanding agenda: reframe health as economic policy, make accountability visible and enforceable, scale financing mechanisms that already function, and ground decisions in locally owned, operational evidence. This agenda requires a shift in leadership, not more strategy documents…”

“This paper consolidates those points of convergence into a focused set of recommendations aimed at political leaders, including finance ministries, health ministries and regional institutions, as well as partners in African-led financing reforms- with an emphasis on what can be done inside today’s fiscal ceilings.”

Global Health Advocates – Health Taxes: The “Triple Win” to navigate the global health financing crisis

https://www.ghadvocates.eu/health-taxes-the-triple-win-to-navigate-the-global-health-financing-crisis/

“As global health financing faces unprecedented challenges, GHA is publishing a brief summarizing the key takeaways from our February 11 webinar. This document is essential reading for understanding how health taxes can transform a financing crisis into an opportunity for health sovereignty, ahead of the Africa Forward summit.”

“Taxing harmful products (tobacco, alcohol, sugary drinks) is not just a budgetary measure, it is a lever of sovereignty…..”

SS&M – Global definitions of Political determinants of health: a systematic review

P Durcic et al; https://www.sciencedirect.com/science/article/pii/S0277953626002674

“Despite growing interest in PDoH, no universally accepted definition exists. Clarifying which determinants are political and their links to others is crucial. Understanding political dynamics is key for research, advocacy, and health reform. Lessons from highly politicised societies can guide countries where health is apolitical.”

Conclusions: “…This review highlights the conceptual fragmentation of PDoH in the literature, underscoring the need for clearer, more critical conceptualisations of PDoH that incorporate power dynamics and political contexts. It also highlights the importance of broadening research beyond Western-centric perspectives to encompass diverse political systems.”

US Global Health Strategy & US bilateral health agreements

Devex – US launches $4.5B platform inviting NGO support for bilateral health deals

https://www.devex.com/news/us-launches-4-5b-platform-inviting-ngo-support-for-bilateral-health-deals-112026

“The State Department launched a funding platform that gives insight into how the Trump administration plans to engage entities around global health. INGOs, local NGOs, faith-based organizations, companies, universities, and government entities are eligible to apply. »

J Ratevosian – The State Department Is Asking the World for New Global Health Ideas

J Ratevosian (on Substack);  

“Breakdown of the State Department’s New  “Advancing Global Health”  APS Funding Opportunity.”

“A relatively quiet development in U.S. global health policy arrived this week with the launch of the State Department’s long-awaited “Advancing Global Health” Annual Program Statement (APS). It may not generate headlines like a major PEPFAR authorization or a Global Fund replenishment, but it signals something more important. At first glance, the program looks like another large federal funding opportunity. In reality, it is something more consequential. The APS creates a new mechanism for the State Department’s Bureau of Global Health Security and Diplomacy (GHSD) to fund projects that operationalize the America First Global Health Strategy.”

“… The Advancing Global Health APS is essentially a funding platform. Rather than announcing a single grant competition, it establishes a standing mechanism through which the State Department can release targeted funding opportunities over time….”  “ The program is substantial in scale. In total, it authorizes up to $4.5 billion in potential funding, with individual awards ranging from $500,000 to as much as $250 million, and projects lasting up to five years.  Organizations from around the world—including NGOs, universities, private companies, and notably, international organizations—are eligible to apply. However, applicants cannot apply directly to the overarching program. Instead, the State Department releases specific “addenda”—focused funding calls tied to particular priorities. Applicants submit proposals in response to those targeted opportunities. Two such priorities have already been announced. The first focuses on Rapid Outbreak Response, with up to $290 million available to support countries in detecting and containing infectious disease outbreaks quickly….  … The second addendum focuses on Child Development, Care, and Protection, allocating roughly $52.6 million to strengthen child protection systems, support family-based care, and improve early childhood development outcomes in vulnerable settings. … both priorities reflect a broader emphasis on health system resilience and prevention, rather than single-disease programs. …”

PS:  “it will be important to see how this new funding platform interacts with the existing global health architecture. Long-standing U.S. programs—including PEPFAR for HIV/AIDS, the President’s Malaria Initiative (PMI), tuberculosis programs supported through USAID and global partnerships, and multilateral mechanisms such as the Global Fund—already form the backbone of U.S. global health engagement….”

“… The Bigger Picture: Beyond the mechanics of the funding announcement, the APS signals a broader shift in how the United States may organize its global health efforts in the years ahead. The model links three elements: a new national strategy, bilateral health agreements with partner countries, and a flexible funding platform to support implementation. In effect, the APS creates a pipeline through which ideas from universities, NGOs, private companies, and local organizations can be aligned with country-level priorities negotiated by the U.S. government. It also reflects a growing role for the State Department in shaping global health investments….”

·         See also Emily Bass – PEPFAR Bridge Plans Extended, Possibly Without New Money

Emily Bass;   Substack;   

“America First Global Health Strategy deadlines didn’t work out.”

“PEPFAR partners can continue implementing HIV services for another three months in countries that have not signed or received funding for America First Global Health Strategy activities, according to several country-based groups. Previously, PEPFAR programs did not have permission to operate after March 31 2026, when AFGHS was supposed to be in place. The permission to keep operating comes weeks before this deadline, at a time when many countries have missed deadlines for developing AFGHS implementation plans. The go-ahead to keep operating means HIV programs reliant on US government funding can keep doing what they’ve been doing in the past six months. However, based on Office of Management and Budget (OMB) reports, it is highly likely that this permission has not come with corresponding financial resources. In this post, I explain why I think PEPFAR programs may be being asked to stretch six months of funding (plus whatever they have in reserve) over nine months of work….”

PS: “… no country met the February 27 deadline for submitting its implementation plan. As far as I know, no country has turned in their plans this week, either. … … Many signs point to the timelines slipping even more. In the last week one country (Zambia) has stayed mired in MoU negotiations; Zimbabwe has stayed firm in bowing out of its talks; Rwanda, which had a signed MoU filled with sweet potential private sector deals that also positioned the country as the cornerstone of a health security surveillance hub in the region, has severed diplomatic relations with the United States; and Kenya’s MoU is still tied up in court….”

Emily Bass – Department of State Officially Releases 5 MoUs

Emily Bass (on Substack)

“Twenty-odd to go…”

“The US Government has officially released the full text of Memoranda of Understanding from Ethiopia, Kenya, Mozambique, Nigeria and Uganda in the Freedom of Information Act Library on the Department of State website. These are the first such documents to be released by the US government, and they bring two new MoUs into circulation (Ethiopia and Nigeria) in addition supplying official versions of three other MoUs that have already slipped out by other means….”

Lancet World Report – US global health deals falter over sovereignty concerns

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00509-X/fulltext

Must-read. “Provisions around data sharing and other conditions in new bilateral deals between the USA and several African countries have drawn criticisms. Gilbert Nakweya reports.”  “Data control and sovereignty concerns are leading African countries to pull out of deals with the USA under the America First Global Health Strategy (AFGHS) as criticsm over the deals’ details mounts….”

“… African scientists and public health researchers are calling on African countries to review the deals and address data governance and sovereignty concerns….”

With the views of Nelson Evaborhene, Emilie Besson, Peter Waiswa, Jean Kaseya, …

BMJ GH – US new playbook for global health: balancing national interest and global responsibility

S O Aremu et al; https://gh.bmj.com/content/11/3/e022235

Must-read. “… While positioned as a corrective to inefficiency and dependency in past aid programmes, this shift raises profound questions about equity, solidarity and the future of multilateralism in health governance. This analysis critically examines the implications of the US first approach through four inter-related lenses. First, the strategy’s security-first framing risks privileging outbreak containment over collaboration, potentially reinforcing a fortress mentality rather than fostering collective preparedness. Second, its critique of ‘dependency’ obscures the documented contributions of US programmes such as the President’s Emergency Plan for AIDS Relief and the President’s Malaria Initiative to health system strengthening, raising concerns that abrupt transitions could dismantle fragile gains. Third, the prioritisation of US innovation in commodity procurement highlights tensions between economic diplomacy and moral legitimacy, with the risk of crowding out local innovation ecosystems. Finally, the privileging of bilateralism over multilateralism may deliver short-term accountability but risks fragmenting global health coordination and undermining shared responsibility. At its core, global health security is indivisible; no nation can insulate itself indefinitely from cross-border threats. A strategy that prioritises national interests while relegating equity to the margins risks eroding US credibility and weakening global solidarity. We argue that only by integrating equity, reciprocity and multilateral collaboration into its ‘new playbook’ can the US safeguard both its own people and global health security.”

Health beat ‘Maximum disruption, minimal clarity’: How ‘America First’ aid deals are playing out in Africa

W Herkewitz; https://www.healthbeat.org/2026/03/05/global-health-checkup-africa-aid-drunken-monkeys/

“I was able to speak with Dr. Paul Spiegel, who directs Johns Hopkins’ Center for Humanitarian Health for some much needed context. … we discussed what he’s seeing and how to make sense of these deals so far.”

“I started by asking Spiegel frankly: Are these 19 deals a sign of stabilization from the chaos of 2025? While he acknowledged some upsides (which we’ll get to) his overall assessment of the deals, and the year ahead of us, was grim. “No. I think things are going to get a lot worse before they get better,” he said.  Spiegel described “maximum disruption right now with minimal clarity,” and that reality on the ground for lifesaving aid programs is still chaotic, with supply chains disrupted and local partners unsure whether funding will continue month to month. He blames the rushed transition “from the old architecture to something so new, so quickly,” he said. “In the meantime, so many people are going to die and suffer.”  We also zeroed in on what worries us both most. The new U.S. strategy is publicly built around channeling major funding directly to governments that (at best!) lack robust oversight and, in some cases, rank among the worst globally on corruption. And the admittedly cumbersome bureaucracy that once helped curb fraud, waste, and abuse has been functionally stripped of many of its guardrails. ….”

Semafor – The challenge and opportunity of America First’s new health deals

Daniele Nyirandutiye;  Semafor;  

Well worth a read. But can’t see it (i.e. recalibration along the lines she suggests) happen with the current US government….

The Conversation – African countries are signing bilateral health deals with the US: virologist identifies the ‘red flags’

https://theconversation.com/african-countries-are-signing-bilateral-health-deals-with-the-us-virologist-identifies-the-red-flags-277862

The Conversation Africa asked virology professor Oyewale Tomori, a former World Health Organization regional virologist, how African countries should have responded to this US initiative.

Listing 4 red flags.

Also seeing a few positives.

Trump 2.0

Guardian –  Experts fear ‘unethical’ vaccine trial in Africa is ‘prototype’ for US studies under RFK Jr

https://www.theguardian.com/us-news/2026/mar/11/rfk-vaccine-trials-guinea-bissau

“New details are leading experts to fear that an “unethical” vaccine trial in Guinea-Bissau is the “prototype” for studies under Robert F Kennedy Jr, secretary of the US department of health and human services (HHS) and longtime vaccine critic.  At the center of US vaccine policy is an unlikely set of Danish researchers whose work on the health effects of vaccines has been called into question….”

“… Stand Up for Science, a science and health nonprofit in the US, sent an investigator to Guinea-Bissau to look at public records and interview experts. The organization met with members of Congress on 19 February to share these results in an unreleased report, obtained by the Guardian, that raises concerns about how deeply the Bandim Health Project is enmeshed in public health in Guinea-Bissau and the challenges to conducting ethical research in this setting – with immense repercussions for how US research will be carried out under Kennedy….”

HPW – War and Herbicide: Renewed Focus on Trump’s Support for ‘Elemental Phosphorus’

https://healthpolicy-watch.news/war-and-herbicide-renewed-focus-on-trumps-support-for-elemental-phosphorus-production/

“US President Donald Trump’s recent executive order on “elemental phosphorus and glyphosate-based herbicide” is facing renewed scrutiny for potentially shielding a controversial weapon of war.  The order promotes the domestic production of elemental phosphorus and glyphosate. Elemental phosphorus is the raw material used in white phosphorus weapons, which cause severe burns and tissue damage, and are considered deeply controversial under international humanitarian law….”

“… … Initial reaction to the order focused on Trump’s support for glyphosate, drawing condemnation from key leaders of Make America Healthy Again (MAHA), the lobby group of US Health Secretary Robert F Kennedy Jr. Controversially, Kennedy has backed Trump’s order, claiming that it “safeguards America’s national security”.  The executive order also declares that “elemental phosphorus is a scarce material that is critical to national defense and security”, and the New York Times reports that Trump’s decision “was significantly influenced by “concerns about the availability of phosphorus for defense”….”

Science  (News) – U.S. agency will devote $144 million to studies that slow aging, extend quality of life
U.S. agency will devote $144 million to studies that slow aging, extend quality of life

“ARPA-H will “build the train tracks” for first large clinical studies of aging interventions.”

UHC, PHC (& integrated care)

Lancet Primary Care –  Organisation of health services for the delivery of primary health care in the WHO African region: a future perspective

H Karamagi et al ; https://www.thelancet.com/journals/lanprc/article/PIIS3050-5143(26)00017-8/fulltext

“Despite decades of investment in health systems across the WHO African region, population health outcomes remain suboptimal. The region faces evolving challenges, including demographic shifts, emerging health threats, and persistent inequalities. Current health-service delivery models are misaligned with anticipated future health demands, necessitating a reimagined operational framework grounded in a revitalised primary health-care approach. In this Viewpoint, we draw on expert consensus from professionals across 19 countries using the nominal group technique and Delphi-style rounds. ….. Three key constructs emerged for future health-service organisation: (1) primary care units as integrated networks delivering first point-of-care interventions; (2) hospitals redefined to include training, research, and clinical governance roles; and (3) oversight structures with decentralised, participatory, and evidence-informed decision-making capacities. …The future of health-service delivery in Africa lies not in replacing existing structures, but in repurposing and realigning them to meet population health needs. Incremental reforms, supported by digital tools, essential health packages, and rationalised service-provision modalities, can enable countries to build resilient, people-centred health-care systems….”.

Health Economics, Policy & Law – Depoliticising resilience? Uncovering the political theories of health system resilience

B Ewert;  Cambridge

“This paper examines Health System Resilience (HSR) through a political science lens, arguing that the capacity of health systems to become resilient is shaped not only by technical capabilities and available resources but also by the political theories underpinning health systems and health policy. While HSR has gained prominence in health research as a concept, its integration with political theories remains limited – particularly within political science literature. Drawing on a scoping review, the paper finds that political dimensions – such as governance and leadership, institutional path dependency, and power dynamics – are rarely and unevenly addressed in the literature. Most sources adopt a fragmented view of policy and politics, infrequently identifying the Political Determinants of Health (PDoH) systematically or analysing them through robust political theory. As a result, resilience is often depoliticised and treated as a managerial issue rather than a contested political process. In light of these findings, the paper proposes new opportunities to scrutinise how HSR is shaped by the interplay of actors, ideas, and institutions. In doing so, it contributes to developing a political science of health that fosters stronger interdisciplinary engagement. “

Lancet Comment – Moving integrated care into the community in sub-Saharan Africa

M Weisser;

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00413-7/fulltext

“…In the cluster-randomised INTE-COMM trial, Francis X Kasujja and colleagues (on behalf of the RESPOND-AFRICA group) compared the delivery of the integrated community-based service model used in INTE-AFRICA4 with integrated facility-based care….”

·         Comment linked to a new Lancet study: Integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-COMM): an open-label, multicountry, cluster-randomised trial

And a link: Oxford –  Nuffield Department of Primary Care Health Sciences designated as the World Health Organization Collaborating Centre on Primary Health Care

PPPR & GHS

Geneva Health Files – New IGWG Text: Strong Obligations To Share Pathogen Information, Lists Technology Transfer & Licensing As “Optional” Benefits

P Patnaik; Geneva health files;  

“…quick update on new text proposals on the Pathogen Access Benefit Sharing (PABS) System being negotiated at the WHO. The Bureau of the Intergovernmental Working Group (IGWG) shared the latest version of the text that will be discussed in the forthcoming formal negotiations scheduled in Geneva for March 23rd-28th 2026.”  “We present key takeaways, the action in Geneva, and excerpts from the latest version that is being workshopped with countries.”

Among the takeaways: “…Both “sides” appear to remain locked-in, in their respective positions as per our reporting during this inter-sessional period. Developed countries appear to be keen on limiting benefits to the access to medical products. Traceability, and licensing, among others, continue to be priorities for developing countries. … … New language in the latest text include proposals on onward sharing, unique persistent identifiers, optional technology transfer, mandatory annual monetary contributions, among issues that could potentially be contentious for countries.”

TWN – WHO: Bureau PABS Text Only Accommodates EU’s Unreasonable Demands, Promoting Biopiracy

S Shashikant et al https://www.twn.my/title2/health.info/2026/hi260301.htm

“A new draft negotiating text dated 9th March for the Pathogen Access and Benefit Sharing (PABS) Annex to the Pandemic Agreement is strikingly aligned with the positions of the G6 countries — the European Union and other developed countries. The draft was prepared and circulated by the Bureau of the Intergovernmental Working Group (IGWG) at the World Health Organization.”

“The draft, which promotes greater legal uncertainty, is weak in benefit-sharing, and effectively normalises biopiracy, should be of serious concern to developing countries. The text barely contains the key elements needed to be consistent with the objectives of the Convention on Biological Diversity (CBD) and its Nagoya Protocol on Access and Benefit-sharing. Instead, it risks establishing the PABS system as a precedent that could undermine multilateral access and benefit-sharing frameworks globally. Ironically, the proposed PABS system — which was meant to be the core mechanism of the Pandemic Agreement to ensure predictable and meaningful benefit-sharing — has been weaponised to create a mechanism of systematic exploitation of developing countries. The draft imposes mandatory obligations on countries to share pathogen samples and genetic sequence information yet pays little attention to the repeated demands by developing countries for accountability, safeguards, and equitable benefit-sharing….”

The Elders urge progress on Pathogen Access and Benefit Sharing Annex to secure a fair pandemic deal

https://theelders.org/news/elders-urge-progress-pathogen-access-and-benefit-sharing-annex-secure-fair-pandemic-deal

(10 March)  “We urge governments to deliver a PABS Annex that is equitable and operational from day one. Both access and benefit-sharing obligations must be predictable and guaranteed, not left to goodwill or last-minute negotiations once a crisis has hit. Without binding arrangements, countries with the least bargaining power will be left without access again. The system should also include firm commitments which generate trust and incentivise broad participation. Member States should be flexible to include additional negotiating days if needed to reach consensus by the current deadline.”

“Commitments already reached in the Pandemic Agreement should be upheld and not reopened or diluted. Transparency, accountability, and inclusive governance – with full and meaningful participation of affected communities and civil society – are important for long term success. Countries should commit to sustainably financing the PABS system – not just when a crisis hits, but long before one begins. Finally, the multilateral architecture for pandemic preparedness and response must be protected as a collective endeavour. Bilateral arrangements are not a substitute for a shared mechanism supported by all countries which can be counted on in an emergency.”

Global Policy – The WHO Pandemic Agreement Negotiation: Introducing a New Database (The Pandemic Agreement Database)

Kevin Parthenay et al; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70140

“In May 2025, the Member States of the World Health Organization (WHO) adopted a historic pandemic agreement following 3 years of intensive and complex multilateral negotiations. By providing primary data on the negotiation process, the Pandemic Agreement Database supports empirical and scholarly research across multiple dimensions of global health diplomacy. This article introduces the database, presents its principal features, and demonstrates how it can be used to trace and map the multilateral negotiation process conducted within the Intergovernmental Negotiating Body (INB). Drawing on two concrete examples, we illustrate how data on actors, agreement texts, thematic issues, positions, and networks can be mobilized to analyze different aspects of the treaty-making process…..”

Africa CDC – Africa CDC and ECDC strengthen their joint commitment to global health security MoU signing deepens an intercontinental partnership

https://africacdc.org/news-item/africa-cdc-and-ecdc-strengthen-their-joint-commitment-to-global-health-security-mou-signing-deepens-an-intercontinental-partnership/

“Today, the Africa Centres for Disease Control and Prevention (Africa CDC) and the European Centre for Disease Prevention and Control (ECDC) signed their first Memorandum of Understanding to strengthen health security in Africa and Europe…. The agreement formalises more than a decade of collaboration and provides a framework for closer cooperation in surveillance, risk assessment, preparedness, and response.  It will also support joint work on antimicrobial resistance, vaccine-preventable diseases, emerging health threats, laboratory capacity, data analytics, and workforce development….”

PS: “The Memorandum builds on the successful completion in April this year of a five-year partnership project between Africa CDC and ECDC funded by the European Commission. This capacity- and partnership-building project has established a solid basis for technical collaboration in the areas of preparedness, surveillance, and workforce development.  ECDC and Africa CDC will continue their collaboration through a new five-year action starting in May 2026 under the Team Europe Initiative on Fighting Antimicrobial Resistance and Strengthening the One Health Approach in Africa, in collaboration with EFSA….”

WHS Perspectives – Actionable Intelligence: Why Geospatial Foresights are the Missing Link in Global Health Security

M Bharel; https://www.worldhealthsummit.org/whs-perspectives/monica-bharel-actionable-intelligence-why-geospatial-foresights-are-the-missing-link-in-global-health-security

“… our current global surveillance systems remain reactive and fragmented. We are fighting 21st-century biological threats with 20th-century tools, leading to preventable mortality and significant economic strain. To build true health security, we will have to pivot from passive observation to proactive intelligence, a shift made possible by the convergence of geospatial data and artificial intelligence. “

“… By integrating nontraditional data streams such as satellite imagery, mobile phone records, and search data, embeddings offer an efficient means of supplementing existing health information systems. While they cannot replace robust primary data collection, embeddings may provide a valuable tool for identifying trends, filling geographic gaps, and informing resource allocation in real time….”

“Answering complex “what if” scenarios : …However, the true revolution of geospatial insights lies beyond targeted prediction by enabling dynamic agentic reasoning. We are moving toward systems capable of answering complex “what if” scenarios. Imagine a “Geospatial Reasoning Agent” that acts as a central coordinator for disease surveillance…”

Africa CDC – Landmark Summit Elevates Fungal Diseases to a Public Health Priority in Africa

https://africacdc.org/news-item/landmark-summit-elevates-fungal-diseases-to-a-public-health-priority-in-africa/

(Addis Ababa, Ethiopia, 10 March)  “Africa’s first summit dedicated to fungal diseases concluded with a multi-stakeholder commitment to strengthen surveillance, capacity building, access to diagnostics and treatment across the continent.”

“Co-hosted by the Africa Centres for Disease Control and Prevention (Africa CDC) and the Global Action for Fungal Infections (GAFFI), the summit brought together researchers, clinicians, policymakers, health activists and funders to address what experts increasingly describe as a silent epidemic affecting millions of people worldwide, with Africa bearing a disproportionately high burden.”

“Fungal infections remain a major public health challenge across the continent. They contribute to nearly half of AIDS-related deaths and complicate diseases such as tuberculosis, chronic obstructive pulmonary disease, asthma and cancer. Fungal keratitis is also a leading cause of blindness. In addition, millions suffer from common skin infections, including zoonotic strains that are becoming more virulent, easily transmitted and increasingly resistant to treatment….”

“A 2022 survey by GAFFI and Africa CDC revealed severe gaps in the availability and accessibility of essential diagnostics for fungal diseases across 48 African Union Member States, leading to delayed diagnoses and preventable deaths. Experts also highlighted growing concerns about superficial fungal infections driven by newer drug-resistant strains, as well as the emerging threat of Candida auris, which is spreading in several regions.”

“Participants at the summit agreed to enhance collaboration in research and development (R&D), capacity building, surveillance and clinical care. They also committed to aligning continental initiatives with the forthcoming World Health Organization (WHO) Fungal Priority Pathogens List (FPPL) Blueprint, while adapting these priorities to Africa’s unique contexts to strengthen diagnosis, monitoring and treatment outcomes across the continent….”

AMR

Devex – Will antimicrobial resistance outpace research?

Andrew Green; https://www.devex.com/news/will-antimicrobial-resistance-outpace-research-112035

“The pipeline for new antimicrobial projects shrank since the Access to Medicine Foundation released its last benchmark five years ago.”

·         See also the  Guardian –  Pipeline of new drugs to fight superbugs is ‘worryingly thin’, experts warn

“The pipeline of new drugs to fight superbugs remains “worryingly thin” and has shrunk by 35% in the last five years, experts have warned….”

“The number of projects from large pharma companies has shrunk by 35% over the past five years, from 92 to 60 medicines in development, according to a report from the Access to Medicine Foundation (AMF), a Netherlands-based non-profit group, and the Wellcome Trust.”   “Overall, however, the R&D pipeline remains worryingly thin, and industry investment has lost momentum,” said Jayasree K Iyer, the chief executive of AMF. She described drug resistance as the biggest single threat to healthcare worldwide.”

… The UK’s GSK is leading the way in antimicrobial resistance research and development (R&D) with 30 projects and is one of just three big pharma companies that continue to invest in this area, the report found.  The other two big players are Japan’s Shionogi and Otsuka, while the US drugmaker Pfizer, which was joint first with GSK in 2021, has fallen back….”

·         Via  Stat :  (focusing on paediatric antimicrobials)  “… Meanwhile, only five, or 13%, of 39 antimicrobial pipeline projects targeting priority pathogens listed by the World Health Organization are being developed for children under five years old. Inequities were also uncovered. In 17 sub-Saharan African countries, none of the companies whose pipelines were assessed had registered pediatric formulations of their antimicrobials. Although regulatory challenges exist, the analysis noted that companies did register other medicines in 10 of these countries….”

·         For the report, see  Access to Medicine –  2026 AMR Benchmark

With four key findings, among others these two:

“A shrinking antimicrobial pipeline contrasts with seven late-stage projects targeting priority pathogens, with some companies strengthening product-specific access plans for LMICs. “

“With just 13% of pipeline projects developed for children under five and major registration gaps in sub-Saharan Africa, access to child-friendly antimicrobials remains limited. “

Telegraph – WHO targets new antibiotics to fight hospital ‘superbugs’

https://www.telegraph.co.uk/global-health/science-and-disease/who-targets-new-antibiotics-to-fight-hospital-superbugs/

“Drugmakers must focus on developing new antibiotics to fight hospital “superbugs” including meningitis and other infections that can resist last-line treatments, the World Health Organization (WHO) has said.”

“The agency on Wednesday released its latest guidance identifying the most urgently needed qualities that future antibiotics should have in order to curb the spread of drug-resistant infections – a rising threat to global health.  Anti-microbial resistance (AMR) – the phenomenon where bacteria develop resistance to the drugs used to kill them – already kills over a million people a year and is forecast to kill 10 million by 2050…”

“… The document highlights three critical targets for new antibiotics:  (1) Fighting hard-to-treat Gram-negative bacteria – pathogens with an outer shell that are notoriously difficult to kill. (2) Finding new drugs for critically ill patients, particularly those with infections that can no longer be treated with vancomycin, a powerful antibiotic considered a drug of last-resort. (3) Developing better treatments for bacterial meningitis, which is often caused by drug-resistant bacteria…”

Human Resources for Health

Habib Benzian – Presence, Payment, and Power

Substack; 

“How per diem payments shape participation in global health.”

“In global health and development, money does not only move through budgets and grants. It also moves through envelopes, receipts, allowances, and expectations. One of the most ordinary, least examined instruments in this economy is the per diem.”

“A per diem, Latin for “per day”, is a fixed daily allowance paid by an organisation to an individual, typically to cover food and incidental living costs while travelling on official business. It is meant to be banal. Administrative. A technical solution to the inconvenience of being away from home. In some settings, per diems are tellingly referred to as sitting fees, a colloquial term that captures, perhaps too honestly, how attendance itself can become the remunerated activity.  What is being compensated, increasingly, is not cost but presence. In much of global health and development work, however, per diems do something else. That difference, between what per diems are supposed to be and what they have become, is where the story begins. Per diems were designed as reimbursements. In practice, they have become compensatory mechanisms embedded in chronically underpaid systems….”

Do read on.

Commercial Determinants of Health & NCDs

WHO Foundation – WHO Foundation and Novo Nordisk Expand Collaboration to Provide Financial Support Towards Strengthening Health Systems for Cardio-Renal-Metabolic Diseases

WHO Foundation; 

(11 March)  “The WHO Foundation today announced an expanded collaboration with Novo Nordisk to support global efforts to strengthen health systems against the rising burden of cardio-renal-metabolic diseases, including obesity and diabetes.  Novo Nordisk has committed a total of USD 7.9 million to support this effort, with an initial gift of USD 2.9 million in 2024 followed by an additional USD 5 million in December 2025.”

“The contribution will enable the WHO Foundation to support WHO’s broader efforts to address noncommunicable diseases through prevention, early action, and strengthened primary health care, particularly in low- and middle-income countries where health systems often face capacity constraints….”

IJHPM – Engaging the Influence of Global Private Actors in Health in Sub-Saharan Africa

R Loewenson et al ;  https://www.ijhpm.com/article_4843.html

“As background to this viewpoint, we explored the pathways of PPA (Global Powerful Private Actors) influence on health in SSA through a desk review of over 219 public domain documents. The review covered five purposively selected areas of PPA activity—food, essential medicines, extractive industries, information and finance—that impact health in SSA….”

Authors concluded: “… PPAs have multiple pathways of influence in health in SSA, through narrative, agential and structural power. Yet we have found also multiple opportunities and initiatives in SSA to identify and engage the policy, legal, information and institutional levers of the power behind this influence where this is needed to promote population health. Implementing these measures calls for strengthened and strategic leadership and governance…..”

Nature Health – Low global physical activity despite two decades of policy progress

Andrea Ramírez Varela et al; https://www.nature.com/articles/s44360-025-00044-3

“A qualitative analysis of two decades of policy documents from 200 countries and interviews with 46 key informants found that adoption of policies to promote physical activity has increased since 2004, but implementation remains weak because physical activity is still a low, albeit gradually increasing, political priority in most countries.”

“Global physical inactivity has remained high and unchanged for the past two decades. We assessed global political priority for physical activity. An analysis of national policy documents from 200 countries revealed notable progress in policy adoption since 2004, but we found limited evidence of implementation. A qualitative case study design, including insights from 46 key informants, confirmed low political priority. Four key challenges emerged: (1) domination of health-centric approaches; (2) limited recognition of benefits beyond non-communicable disease prevention; (3) interest across sectors but lack of clarity defining physical activity policy and of leadership; and (4) limited multisectoral partnerships….”

“… The prevalence of physical inactivity globally has remained unchanged in most countries for the last two decades, with approximately 80% of adolescents and one in three adults worldwide not meeting the World Health Organization (WHO) physical activity guidelines. Despite advances in surveillance and research capacity, physical inactivity remains high, and the WHO’s target of a 15% relative reduction by 2030 (ref. 4) is unlikely to be met in most countries….”

·         And related policy brief – Physical activity remains under-prioritized in political agendas  (by A Ramirez Varela et al)

“Despite widespread development of national physical activity policies over the past 20 years, global levels of physical activity have been largely unchanged (with around one in three adults and four in five adolescents not meeting recommended physical activity levels since 2012). This gap between policy development and real‑world impact highlights the need for stronger political prioritization, clearer leadership and effective multisectoral implementation.”

Nature Medicine – Physical activity for public health in the 21st century

Deborah Salvo et al; https://www.nature.com/articles/s41591-026-04237-5

“With over 5 million attributed deaths per year, physical inactivity is a major global public health issue…”

“… Here we (1) used a health equity lens to describe global domain-specific physical activity inequalities through an analysis of World Health Organization STEPwise approach to NCD risk factor surveillance (WHO STEPS) data from 68 countries; (2) summarized evidence linking physical activity with health outcomes beyond cardiometabolic disease, including immunity and infectious disease, depression and cancer; and (3) developed a new model reconceptualizing physical activity to better respond to 21st-century public health challenges. Our global, intersectional analysis of gender and socioeconomic physical activity inequalities revealed a 40-percentage-point gap in active leisure—the only domain consistently driven by choice—between historically privileged groups (wealthy men in high-income countries) and historically disadvantaged ones (poor women in low-income countries)….”

·         And a link: Nature Health – Benefit of physical activity initiatives for climate change mitigation and adaptation

Lancet Editorial – Back to basics in sickle cell disease

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00506-4/fulltext

This week’s Lancet Editorial.  “Sickle cell disease—the subject of a new Seminar in The Lancet—is one of the most prevalent and fastest-growing genetic disorders worldwide. Although its true prevalence is difficult to determine owing to the absence of screening in much of the world, the Global Burden of Diseases, Injuries, and Risk Factors Study estimates that nearly 8 million people are living with sickle cell disease. Deaths from sickle cell disease rose 18·4% between 2000 and 2023, from 45 600 to 54 000. Sub-Saharan Africa is home to three-quarters of infants born with the disease, where it causes more than one in 20 deaths in children younger than 5 years; most children affected do not live into adulthood. Life expectancy is also curtailed for people with sickle cell disease in high-income countries, with multiorgan complications and complex needs common in adult patients. Yet, the global standard of care for sickle cell disease is not commensurate with these stark realities….”

The Editorial concludes: “Individuals with sickle cell disease have been let down by the false promise of new treatments, persistent structural barriers in access to essential medicines, and neglect by the health community. It is time for health systems and policy makers globally to provide a basic standard of care that would alleviate substantial morbidity and save thousands of lives every year.”

SS&M – Road Traffic Accidents and Disability: A global health concern

G N. et al;  https://www.sciencedirect.com/science/article/abs/pii/S027795362600239X

« Road traffic accidents (RTAs) are the 8th leading cause of death in LMICs. RTAs are also a leading – but rarely acknowledged – cause of disability in LMICs. The Road Traffic Safety community pays little attention to people disabled in RTAs. The Disability community rarely considers those disabled in RTAs as a discrete group. This lack of ‘joined up’ thinking is a lost opportunity to address a major global health concern.”

Commission on the status of Women (New York) (9-19 March) & other SRHR updates

With among others, the debate on the merger of UN Women & UNFPA.

First, some analysis published ahead of CSW, then the first action at CSW (including a vote where the US lost (hurray!)).

Guardian – Will UN plans to transform the way it works ‘throw equality under the bus’?

https://www.theguardian.com/global-development/2026/mar/08/un-plans-merge-women-unfpa-equality-reform

Analysis from last weekend, as CSW was about to kick off. “Many of those attending the world’s largest meeting on women’s rights in New York this week are primed to defend the two key UN agencies that protect women and girls around the world.”

“Thousands of international delegates are gathering in New York this week for the world’s largest meeting on women’s rights. The United Nation’s annual Commission on the Status of Women (CSW) is an opportunity for government ministers, UN officials, NGO representatives and activists to discuss the global state of gender equality and women’s empowerment. This year, there will be a strong focus on “ensuring and strengthening access to justice”. But as senior UN figures urge countries to intensify their efforts to achieve gender equality, many of the delegates will be asking whether the UN is at risk of diluting its own commitment to women and girls.”

“The question centres on a plan to merge UN Women, the agency dedicated to gender equality and women’s empowerment, with the UN’s sexual and reproductive health agency, the UNFPA. The aim of the merger is to improve efficiency, strengthen impact, reduce duplication and create a single body for governments and partners to work with.”   “But since it was first proposed last year as part of UN80 – an initiative to reform the entire organisation – voices expressing concern over the idea have grown louder and more urgent. Women’s rights groups and a significant number of member states fear that restructuring the two agencies at a time of multiple global crises, plummeting levels of aid and a fierce rollback of rights is a high-risk strategy….”

PS: “Both UN Women and UNFPA told the Guardian they fully supported UN80, but this was based on the assumption that their mandates – longstanding and globally agreed missions – will be preserved.  Women’s rights organisations, however, say that protecting those mandates in the current political climate is unrealistic. A merger would have to go to a vote, throwing open the opportunity for the US – which has already withdrawn financial support for UNFPA and UN Women – and other member states that are hostile to women’s rights to challenge the mandate of a new, single agency.  “My expectation, if this goes to a general assembly vote, is that the US will use its power to whip [other countries] to undermine and dismantle the architecture for gender equality and sexual and reproductive rights,” said Stern…..”

Devex – US seeks to scrap UN efforts to expand women’s rights

https://www.devex.com/news/exclusive-us-seeks-to-scrap-un-efforts-to-expand-women-s-rights-112005

Also published ahead of CSW. “Trump administration seeks to undue decades of U.N. efforts to build a protective platform for women, girls and other disadvantaged groups.”

“The Trump administration renewed its campaign to limit the global expansion of human and economic rights for women and girls, opposing United Nations proposals to create a reparations fund for female victims of violence and to regulate artificial intelligence and other emerging technologies that can potentially fuel misinformation and hate speech targeting women and girls, according to internal notes of the talks obtained by Devex.  The U.S. initiative is playing out in negotiations over an outcome document that governments will consider at the Commission on the Status of Women, or CSW, at U.N. headquarters from March 9 to March 19. The document reflects on previous gains in the pursuit of women’s rights and provides recommendations to governments on what they can do to advance the cause of women.  U.S. diplomats had initially abstained from participation in the early stages of the talks, before reentering the negotiations last week with a laundry list of more than 90 amendments and comments to the draft outcome document. The Trump administration views the process as an unwelcome intrusion of U.S. sovereignty, which maintains that the U.N. has no business imposing its values on member states….”

PS:  Meanwhile, …“ the U.S. … [is] hosting a number of events not at CSW, but at a separate gathering entirely: the Conference on the State of Women and Family. The two-day event, which takes place on March 11 and 12, is steered by conservative advocacy organizations, anti-abortion groups, and nonprofits focused on promoting “traditional family values,” a phrase typically used to describe a nuclear family with a breadwinning father, homemaking mother, and their biological children. The U.S. will be hosting events at that conference, CSWF, on gender ideology, “the protective power of parental rights,” and digital safety.”

·         See also  HPW – As Women’s Rights Falter Globally, US Moves to Weaken UN Support for Gender Equality

“The United Nations Commission on the Status of Women (CSW) began its 10-day session in New York on Monday, amid efforts by the United States to weaken women’s rights proposed in the draft outcome document.   The theme of the CSW, the world’s biggest global meeting on women’s rights, is “ensuring and strengthening access to justice for all women and girls.””

“But the US, after initially abstaining from negotiations on the outcome document to be adopted by CSW, changed tack in the past few days and urged the removal of “controversial social issues” from the document, Devex reports.   The US wants references to climate change and a gender-responsive justice sector removed, and does not support the proposed reparations fund for survivors of violence, for example.”

“However, the entire purpose of the CSW’s 70th session is to chart a path to eliminating gender discriminatory laws, policies, and practices, as well as structural barriers to justice – and the outcome document due to be adopted by the end of Monday was supposed to guide this….”

Also with some speeches from the opening day (eg. by Malala).

PS: “Merger plan?   Country delegates may also discuss the potential merger of UN Women and UNFPA, which deals with sexual and reproductive health, first mooted by the UN Secretary-General in his plan to reform the UN, UN80.  The US has withdrawn from both bodies and defunded them, sparking a serious resource crisis.”

“The global feminist organisation, Fos Feminista, and other groups have opposed the merger, stressing that the two have different functions with little overlap.  For Fos Feminista, UN Women was created to “hold the entire UN system accountable for gender equality” with a mandate to ensure “gender equality is not treated as an afterthought but as a binding obligation”.  “UNFPA, meanwhile, leads on sexual and reproductive health and rights (SRHR), population data and demographic analysis, humanitarian gender-based violence coordination and reproductive health supply chains that reach women in the most fragile settings. Its work is technical, operational and often lifesaving.”

·         For more on CSW, see   Devex – Special edition: Drawing the battle lines on women, girls, and gender at the UN    (from Tuesday)

HPW – Only US Votes Against Women’s Rights Document at UN Commission

https://healthpolicy-watch.news/us-isolated-in-opposition-to-un-womens-rights-document/

Update from later this week. “The United States was isolated in its opposition to the adoption of “agreed conclusions” at the Commission on the Status of Women (CSW) on Tuesday, recording the only “no” vote at the United Nations headquarters in New York on Monday.”

“There were 37 votes in favour and six abstentions from Côte d’Ivoire, the Democratic Republic of Congo, Egypt, Mali, Mauritania, and Saudi Arabia.”       

“Prior to the adoption, the representative of the United States first proposed that its consideration be deferred, then that the text be withdrawn and then proposed eight amendments to the text,” according to a UN media release.  The US sought the removal of “controversial social issues” from the document, Devex reports. US objections included “ambiguous language promoting gender ideology”, “vague, unqualified commitments to sexual and reproductive health that can be interpreted as implying abortion rights”, and “censorship language on regulating artificial intelligence”, according to the UN media release.  “

“… The “agreed conclusions” (the final text is not yet available) “seek to create justice systems that work for everyone equally”, according to Valverde.  The proposals focus strongly on justice for survivors of gender-based violence, including integrating gender-responsive access to justice across sectors, formally recognising community justice actors, and introducing new language on digital justice and AI governance aimed at protecting women and girls.  “ “The text also strengthens standardised systems for gender-based violence data and promotes a whole-of-society approach that recognises civil society’s role….”

·         See also Devex – UN diplomats revel in US setback at women’s rights forum

“The Trump administration’s attempt to export conservative America First values runs aground at the U.N. conference on women’s rights.”

PS: “The exchange marked the latest chapter in the U.S. effort to export the American culture wars to foreign lands, and to scale back decades of U.N. backing for progressive policies aimed at erecting a scaffolding of protections for women, girls, and other historically disadvantaged groups, including members of the LGBTQ+ community. … It also signaled Washington’s willingness to break the diplomatic china. By forcing a vote on the pact — the first time this has happened since the commission’s creation at the end of World War II — the U.S. effectively killed consensus….”

PS: “The U.S. was not entirely isolated. A group of 22 countries, including Egypt, Nigeria, Pakistan, and Saudi Arabia, backed U.S. efforts to press for a delay on the vote in an effort to secure more concessions….”

CSW70 Agrees Roadmap for More Inclusive Governance

https://sdg.iisd.org/news/csw70-agrees-roadmap-for-more-inclusive-governance/

“The Agreed Conclusions draw on a recent report of the UN Secretary-General, which finds that globally, full legal equality between women and men remains elusive.  Traditionally adopted by consensus, this year’s Agreed Conclusions were adopted by a recorded vote of 37 in favor, one against (the US), and six abstaining.”

Devex –  Document lays groundwork for UN Women–UNFPA merger

https://www.devex.com/news/document-lays-groundwork-for-un-women-unfpa-merger-112043

Must-read analysis. “A proposed merger between UN Women and UNFPA is stirring debate as a new U.N. analysis maps the agencies’ overlap and differences.”

Devex – US pulls away from family planning. What about the $600M saved for it?

https://www.devex.com/news/us-pulls-away-from-family-planning-what-about-the-600m-saved-for-it-112058

“Despite Congress approving $607.5 million for family planning, new U.S. policies are reshaping how global health funding is spent.”

Excerpt: “…“If family planning is not formally reflected in implementation frameworks, it will compete for space within health budgets that are being reshaped to meet co-financing obligations tied to named disease priorities,” wrote FP2030, a global partnership focused on family planning. All of that leaves the $607.5 million earmarked by Congress in a state of uncertainty, explained Beth Schlachter, the senior director of external relations and advocacy for MSI Reproductive Choices. The funds exist on paper, but how they will be spent on family planning and reproductive health services depends on the State Department — and whether Congress pushes the White House to spend money as they intended. “We don’t know if Congress is going to force the administration to spend that money, and if so, will it be spent separately from those global health compacts, or will it be merged in at some point? Still [to be determined],” Schlachter told Devex. “Until Congress grows a backbone, it’s very unlikely [the State Department is] going to do anything with it — and they don’t have the staff to do it anyway.”…”

HP&P – Aid Cut, Lives Lost: Estimating the Impact of USAID’s Withdrawal on Maternal Mortality in Six African Countries 

Matthew Cummins;  https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag034/8513131?searchresult=1

“In January 2025, the United States government suspended and subsequently terminated the majority of United States Agency for International Development (USAID) programs. This study estimates the impact of that decision on maternal mortality in six highly vulnerable countries in West and Central Africa: Burkina Faso, Central African Republic, Chad, Mali, Niger, and Nigeria. Using a deterministic model grounded in regional health expenditure elasticities, the analysis projects how the sudden withdrawal of foreign aid affects health spending among populations in humanitarian need, under the assumption that no immediate domestic or external financing substitutes for the lost resources, and the resulting changes in maternal mortality ratios (deaths per 100,000 live births). The results indicate that the funding cuts could cause maternal deaths to increase by 45%, on average, among populations in need. This increase is estimated relative to a baseline of approximately 2,900 maternal deaths predicted in 2025, yielding approximately 1,000 additional deaths across the countries within a single year….”

Guardian – Peruvian state responsible for mother’s death in forced sterilisation, court rules

Guardian;  

“Landmark ruling in Celia Ramos case finds 310,000 women, most Indigenous, were targeted in brutal 1990s campaign.”

“The highest human rights court in Latin America condemned Peru on Thursday over the death of its citizen Celia Ramos, who died at the age of 34 in 1997 after undergoing sterilisation “under coercion”. The landmark ruling by the inter-American court of human rights (IACHR) is the first on Peru’s forced sterilisation programme, which operated between 1996 and 2000 and was directed against poor, rural and Indigenous women.  The court held the Peruvian state “internationally responsible” for the violation of Ramos’s right to life, health, personal integrity, family, access to information and equality before the law…..”

Planetary Health

Nature (News) –  The world is getting hotter faster — its pace nearly doubled in the past decade

https://www.nature.com/articles/d41586-026-00745-z

“Earth is now warming at a rate of around 0.35 ºC per decade, fresh analysis finds.”  “The study was published today in Geophysical Research Letters….”

·         See also Carbon Brief:  Pace of global warming has nearly doubled since 2015, reveals study   

“An acceleration in human-caused global warming could see the Paris Agreement’s 1.5C limit breached before 2030, a new study suggests.  The paper, published in Geophysical Research Letters, finds that, over the past decade, the planet has been warming at its fastest rate on record.  The authors isolate the trend of human-driven warming in the long-term global temperature record, removing the influence of natural factors, such as El Niño, volcanic eruptions and solar variation. They find that the world had been warming at a rate of around 0.2C per decade since the 1970s, but has “accelerated” since 2015 to a rate of 0.35C per decade.  The study warns that if the current rate of warming persists, the 1.5C Paris threshold will be breached in the next few years…..”

HPW – UN Rapporteur Signals Legal Shift to Hold Air Polluters Accountable

https://healthpolicy-watch.news/legal-shift-burdens-air-polluters/

“While air pollution claims more than eight million lives annually, the burden of proving exactly which air polluters or tailpipes caused a specific lung cancer or child’s asthma attack has rested firmly on the shoulders of the sick. That is about to change, according to a landmark United Nations (UN) report by Astrid Puentes Riaño, Special Rapporteur on the right to a clean environment, presented to the Human Rights Council in Geneva. She signals a seismic shift in international jurisprudence: moving the burden of proof away from the victims and onto the state, ultimately targeting the polluters. This mechanism suggests that once dangerous pollution levels and health harms are established in an area, the onus shifts to holding governments accountable when they fail to prevent exposure to dangerous contamination….”

Guardian – London, San Francisco and Beijing achieve ‘remarkable reductions’ in air pollution

https://www.theguardian.com/environment/2026/mar/12/london-san-francisco-and-beijing-achieve-remarkable-reductions-in-air-pollution

“London, San Francisco and Beijing are among 19 global cities that have achieved “remarkable reductions” in air pollution, analysis has found, having slashed levels of two airway-aggravating pollutants by more than 20% since 2010. The analysis found interventions such as cycle lanes, uptake of electric cars and restrictions on polluting vehicles had helped to drive the improvements…”

“The report, shared exclusively with the Guardian, looked at air quality in cities in the C40 and Breathe Cities networks – mostly large cities, but also some smaller ones such as Heidelberg in Germany – and found “substantial reductions” can be achieved within 15 years through deliberate action….”

Yale (School of Public Health) – Forecasting the Next Pandemic

https://ysph.yale.edu/news-article/forecasting-the-next-pandemic/

“Led by scientists from Yale and the University of Oklahoma, the Verena research initiative is using AI and team science to predict viral threats.”

Excerpt: “At Yale, [Colin] Carlson’s research focuses on how climate change and global environmental disruptions heighten pandemic risk and contribute to viral emergence. “Every year, there are 5% more spillover events and 8% more deaths from these viruses,” he said. “That’s humans at work — wildlife trade, deforestation, climate change. It’s all moving animals around. It’s moving mosquitoes around. It’s creating new problems for health systems.”  The global health security architecture, Carlson said, was built in the mid-20th century for a world where pandemics were once-in-a-century events. “We didn’t build the World Health Organization for a world where pandemics are a once-in-a-decade risk.”

HPW – ‘Gulf War 3’ Threatens Progress on Climate and Air Pollution

https://healthpolicy-watch.news/gulf-war-3-threatens-progress-on-climate-and-air-pollution/

Published ahead of the conference in Bangkok. “The 12th Better Air Quality conference in Bangkok, which opens on Wednesday, is the first large climate and air quality gathering since the US and Israel attacked Iran, triggering an oil and gas-energy crisis. “

“The ‘Gulf War 3’ threatens to slow down climate action and the move to cleaner air. However, in the first major climate conference since the war began, experts are banking on market forces and the cost-benefit of countries not just sticking to the current climate and air quality ambitions but scaling these up.   “There’s no doubt it [fighting in the Gulf] will slow progress. However, the fact is that the market forces are ultimately going to drive things. There’s only so much political will can do,” Nathan Borgford-Parnell, scientific affairs lead at the UN’s Climate and Clean Air Coalition (CCAC), told Health Policy Watch.”

“The conference is being organised by Clean Air Asia, with co-organisers CCAC, the Asian Development Bank (ADB), the United Nations Environmental Programme (UNEP) and the Economic and Social Commission for Asia and the Pacific (ESCAP). “

PS: “The theme for this 12th BAQ is Together for Clear Skies. But the ‘together’ part is hard to achieve. Air pollution is a transboundary issue, which means that one region or one country is often polluted by air from outside its jurisdiction. …” “ The World Bank points out that the governance systems across nations in the most polluted region of the world – Bangladesh, Bhutan, India, Nepal, and Pakistan – remain largely “siloed, reactive, and compliance-oriented rather than preventive”.  Its report, A Breath of Change, documents the cross-border crisis in the northern belt of South Asia, across the plains and the Himalayan foothills, which is home to about one billion people…..”

HPW – Policy ‘Magic’ vs Industrial Reality in the Fight for Asia’s Breathable Air

https://healthpolicy-watch.news/policy-magic-vs-industrial-reality-in-the-fight-for-asias-breathable-air/

First update from the Bangkok conference: “The 12th Better Air Quality conference opened with a call to treat clean air as vital economic infrastructure, highlighting the large benefit-cost return – but financing clean-tech is a challenge in developing nations….”

Climate Change News – New summit in Colombia seeks to revive stalled UN talks on fossil fuel transition

https://www.climatechangenews.com/2026/03/09/new-summit-in-colombia-seeks-to-revive-stalled-un-talks-on-fossil-fuel-transition/

“Colombia will host the first conference on transitioning away from fossil fuels, after more than 80 countries pushed at COP30 for an end to coal, oil and gas.”

“A landmark conference hosted by Colombia and the Netherlands will aim to lay the foundations for renewed talks on transitioning away from fossil fuels at COP31, though organisers say it remains unclear what concrete outcomes it will deliver.  The First Conference on the Transition Away from Fossil Fuels will take place in April in the city of Santa Marta, on Colombia’s Caribbean coast, where first-moving countries, states and cities will seek to restart last year’s stalled push for a global roadmap away from coal, oil and gas….”

“Bastiaan Hassing, head of international climate policy for the Dutch government, told an online briefing last week that the “most obvious” impact of the conference would be for its hosts to report back to the UN climate summit on what was agreed in Santa Marta.  …. He noted that there are many options for how the conference can influence UN talks on implementing the global transition away from fossil fuels, but the exact possibilities would depend on the outcome of the gathering. “Rest assured that we will be looking into this,” he added….”

“… The upcoming Santa Marta conference should build momentum to plan that transition away from fossil fuels and signal that “there is no turning back”, said Peter Newell, professor of international relations at the University of Sussex and one of the main proponents of a fossil fuel non-proliferation treaty.  “Its outcomes, which might include a declaration on key principles and next steps (for the fossil fuel transition), should give renewed vigour to efforts within the UN climate negotiations to drive the agenda forward,” Newell said.  Because major fossil fuel producers have effectively “vetoed” discussions on a fossil fuel phase-out at COPs, he added, willing countries must move forward independently with initiatives like the Santa Marta conference….”

Guardian – ‘A sobering preview’: extreme heat now affects one in three people globally, study finds

https://www.theguardian.com/environment/2026/mar/10/extreme-heat-study-global-warming-physical-activity

“Rising temperatures making it hard even for young, healthy people to safely do normal physical tasks in many regions.”

“Climate breakdown is shrinking the amount of time that people can safely go about their lives, according to a study that shows a third of the world’s population now resides in areas where heat severely limits activity. … “

“Worst-affected are those in poorer countries or regions, even though they are far less responsible for climate breakdown than wealthy consumers whose lifestyles produce higher greenhouse gas emissions from the burning of gas, oil and coal. In some tropical and subtropical regions, heat restricts outdoor activity for older adults for between one-quarter and one-third of the year. The most severe challenges are found in south-west Asia (Bahrain, Qatar, Kuwait, the United Arab Emirates, Iraq, Oman), south Asia (Pakistan, Bangladesh, India) and parts of west Africa (Mauritania, Mali, Burkina Faso, Senegal, Djibouti and Niger).”

“… The study, which was led by scientists from the Nature Conservancy and published in the journal Environmental Research: Health on Tuesday, goes further than previous research on global heat risks by examining the social and physiological capacity to adapt to heat. The authors measure “liveability” in different temperatures in METs, a unit of equivalent to the average energy expenditure of a human at rest. A manageable temperature is one in which people below 65 can perform up to 3.3 METs of activity – for example, sweeping a floor or walking at a moderate pace – for an extended period without heat stress, which means they can regulate their core body temperature at a steady state. By contrast, “unliveable limitations’” are found at hot locations during hours when human activity is restricted to 1.5 METs, which are primarily sedentary activities, such as lying down or sitting….”

NEF – The climate-fiscal timebomb

https://neweconomics.org/2026/03/the-climate-fiscal-timebomb

“How climate change will impact public budgets.”  Focus on the EU here. (but doubt it’s very different in most other regions)

“By 2050, the average public debt of EU member states could be 58 percentage points (pps) higher than official forecasts unless climate risks are addressed. In 2070, that could rise to 197 pps. New modelling by the New Economics Foundation (NEF) finds that fiscal stability depends on early and coordinated climate action. Despite growing evidence of the severe economic impacts of climate change, the EU’s economic framework still treats short-term public debt as the central threat to stability, while overlooking the deeper vulnerabilities that will drive debt in the decades ahead. Integrating climate damages, adaptation, and mitigation costs into debt paths shows debt ratios that rise steeply under inaction but are materially lower under credible climate investment and supportive policy settings. Meeting these challenges requires a fiscal framework that enables rather than constrains public investment.”

“…   The conclusion is clear: climate stability is fiscal stability. Inaction drives debt onto explosive trajectories, while early, globally coordinated action means climate-related fiscal risk is averted..”

Access to Medicines, Vaccines & other health technologies

Guardian – Weight-loss jab could be made for $3 a month, study finds

Guardian;  

“Cheap semaglutide, the drug in Ozempic and Wegovy, could help millions with diabetes and obesity in 160 countries”

“Weight-loss jabs such as Wegovy and Ozempic could be made for just $3 a month, according to new analysis, potentially making the treatment available to millions in poorer countries as patents expire.  …   New research, published as a pre-print, suggests that semaglutide could be mass produced for $3 (about £2.35) for a monthly dose in its injectable form.  Newer formulations, taken as a pill rather than an injection, could be made for about $16 a month.”

“… The researchers also found that core patents on semaglutide were due to expire in 10 countries this year, including Brazil, China, India, South Africa, Turkey, Mexico and Canada from 21 March, opening the way to generic competition.  They identified another 150 countries where patents had not been filed, including most of Africa. Those 160 countries are home to 69% of people with type 2 diabetes and 84% of those living with obesity….”

HP&P – Gavi’s Zero-Dose Learning Hubs: Enhanced Approach for Evidence Generation and Use from Local to Global 

Heidi W Reynolds et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag028/8512918?searchresult=1

“Reaching and fully immunizing zero-dose (ZD) children and missed communities is at the core of the Gavi, The Vaccine Alliance 5.0/5.1 and Immunization Agenda 2030 strategies. This is critical to ensure equitable immunization coverage and access to other primary health care services and to prevent outbreaks. The diversity of settings where these children live and the complexity of vaccination barriers require a complementary set of activities embedded in national systems. Learning approaches are needed to use evidence to improve equity and reach. Gavi has helped fill this gap with the Zero-Dose Learning Hub (ZDLH) initiative, which is composed of consortia partners in four countries—Mali, Nigeria, Uganda, and Bangladesh—and a global-level consortium. This paper describes the ZDLH design, theory of change, methods, and measures of success…”

Progress in Development Studies – Global Duties in Crisis Response: A Duty to Help, and a Duty Not to Harm Global Access to COVID-19 Vaccines?

Antoine de Bengy Puyvallée et al; https://journals.sagepub.com/doi/abs/10.1177/14649934251414285

« During the COVID-19 pandemic, governments widely recognized a duty to ensure global access to vaccines. What this duty entailed, however, became highly contested. I highlight how different actors formulated this duty and the political consequences that this duty-making had during the pandemic and its aftermath. I show that wealthy countries acknowledged a duty to share vaccine doses, while activists and Global South governments formulated a duty to share the ‘vaccine recipe’. I suggest moreover that the pandemic also facilitated the emergence of a negative duty ‘not to hoard vaccines’—in addition to a duty to help. I argue that global crisis response should seek to mobilize global solidarity initiatives (duty of charity) and simultaneously limit the negative consequences of countries’ own domestic responses (duty of justice). »

PS (via LinkedIn): “This paper contributes to a broader project led by Simon Reid-Henry, which adopted a sociological approach to studying duties during the pandemic – examining how governments and citizens negotiate the formulation of duties, how people perform duties, or dealt with conflicting demands.   For a summary of the project findings, check out:
The project team’s commentary: https://lnkd.in/eAG4XT4q    What are duties good for? Lessons from the pandemic.”          (re the Co-Duties project)

Conflict/War/Genocide & health

WHO Emro – Conflict deepens health crisis across Middle East, WHO says

https://www.emro.who.int/media/news/conflict-deepens-health-crisis-across-middle-east-who-says.html

“More than ten days into the latest escalation of conflict in the Middle East, health systems across the Region are coming under strain as injuries and displacement rise, attacks on health care continue, and public health risks increase….”

UN News – UN relief chief condemns ‘$1 billion-a-day’ cost of war in Middle East

https://news.un.org/en/story/2026/03/1167116

“The UN’s emergency relief chief on Wednesday condemned the “$1 billion-a-day” cost of the war in the Middle East, at a time when humanitarian needs are soaring and aid funding is falling dangerously short.”

“… The $23 billion appeal announced last December by the UN aid coordinator to help 87 million of the world’s most vulnerable people remains around two-thirds underfunded.  Although the number of people in need of assistance globally far exceeds the 87 million identified, Mr. Fletcher explained that these were the people “in greatest need”.  “We still need over $14 billion now to deliver this plan, and this is at a time when conflict in the Middle East is costing $1 billion a day,” he said. “Even just $1 billion would allow us to save millions of lives.”…”

·         See also Reuters –  UN warns global aid at risk as war in Middle East spreads

“The United Nations aid chief warned on Wednesday that the conflict in the Middle East is straining humanitarian operations worldwide, ​disrupting supply chains and slowing the delivery of life‑saving assistance ‌to numerous crisis zones. “We are in a moment of grave peril for the Middle East and, actually I believe, for the wider world,” Tom Fletcher, the U.N. aid ​chief, told Reuters….”

Nature (News) – ‘Black rain’ in Tehran — what are the health effects?

https://www.nature.com/articles/d41586-026-00800-9

“Toxic smoke from burning oil depots has blanketed Iran’s capital following missle strikes.”

Lancet Offline – The human consequences of Epic Fury

R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00497-6/fulltext

Horton’s early take on Gulf War 3 & health ramifications.    A few excerpts:

“The health crisis in Iran and across the Middle East is “escalating rapidly”, reported Hanan Balkhy, WHO’s Regional Director for the Eastern Mediterranean. She was speaking at a WHO press conference on March 5, 2026, convened to discuss the latest developments in the war initiated on Feb 28 by the US and Israel against Iran.”

“… But do not underestimate Iran’s resilience, at least from the perspective of health. Iran has a strong primary health-care system, with an array of robust capabilities that should be able to absorb the health consequences of the current war. The government has mobilised 2 million people to boost health-care capacity. According to WHO, Iran is in a good position to meet the health needs of its population. However, those undergoing elective surgery, awaiting diagnostic investigations, depending on regular supplies of medicines, receiving antenatal care, or relying on complex services, such as dialysis, will suffer health-harming disruptions to their continuity of care….”

Horton concludes: “… as Vali Nasr points out in Iran’s Grand Strategy: A Political History (2025), the West’s “understanding of Iran’s strategic calculations is hopelessly inadequate and dangerously outdated”. So, when belligerents revel, to quote Hegseth, in the “quiet death” they are imposing “without mercy”, they fail to understand that the current Iranian regime defines itself through resistance to centuries of western interference in the country’s affairs. The room for wisdom and peace feels severely curtailed.”

Lancet World Report – Syria’s missing: rebuilding forensic identification

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00511-8/fulltext

“With hundreds of thousands of Syrians missing, doctors are working to revive the country’s long-neglected forensic medicine infrastructure. Amélie David reports.”

Lancet Regional Health Africa – inaugural issue

https://www.thelancet.com/issue/S3050-5011(26)X2001-6

·         Start with the Editorial – Amplifying African voices to lead science for better health

“Despite making up 19% of the world’s population, Africa contributes only 1–2% to global knowledge production across multiple fields of research. The terminology of Majority vs Minority World countries is especially apt to highlight this imbalance, as it challenges the notion that high-income, Westernized countries make up the majority of the world’s population because they contribute the most to global knowledge production. This imbalance is neither inevitable nor acceptable, and the assumptions that sustain it must change.  To address this imbalance, we have launched The Lancet Regional Health – Africa, a journal that will provide a platform for African voices and advocate for the best clinical practice and health policy across the region. As a journal, we stand for the decolonization of health and medical research in Africa. This means addressing “power asymmetries, and the dominance of Western-centric paradigms.” Critical to this is prioritizing African voices who have lived experience of the contextual realities of research, policy making, health systems, and community engagement in Africa. We aim to publish the best health and medical research in our region, covering a diverse range of topics that matter most for African individuals, communities and health systems….”

Do check out the full issue.

Miscellaneous

Reuters – Ghana to submit UN resolution on slavery reparations; eyes broad support

Reuters; 

“African Union and Caribbean nations support resolution”.

“Ghana ​intends to propose a United Nations resolution recognising transatlantic slavery as ‌the “gravest crime in the history of humankind” and calling for reparations, and expects broad support despite resistance in Europe. The West African nation, a prominent advocate of reparations, opens new tab on the continent, plans to ​table the proposal at the U.N. General Assembly, possibly as early ​as this month, its Foreign Ministry said in a statement to ⁠Reuters….”

UN News – New challenges bring increased risks in combating child sexual abuse, exploitation

https://news.un.org/en/story/2026/03/1167102

“Despite some progress made globally, children around the world still face serious and evolving risks of being sold, sexually exploited and abused, the UN independent human rights expert on the sale, sexual exploitation and sexual abuse of children, Mama Fatima Singhateh, warned on Monday.”

““There is a deeper understanding of the interconnectedness of these crimes,” Ms. Sinhart said. “We are also witnessing stronger international cooperation, more victim-centred approaches and deeper involvement from the private sector. However, despite these achievements, the scale and severity of abuses against children remain alarming and worrying.””

“Far too many children around the world are still being trafficked, sexually exploited and abused, Ms. Sinhart stated in her final report to the Geneva-based UN Human Rights Council, adding that these crimes are often hidden, perceived as normal or fail to receive due attention. The independent expert pointed out that in recent years, countries have made significant progress in strengthening their criminal law frameworks to align them with international standards and hold perpetrators criminally accountable for child trafficking and sexual exploitation.  However, the report’s review of the current situation reveals a rapidly evolving landscape of child sexual exploitation. As digital threats intensify and global crises emerge, the risks to children are constantly increasing. Technology-driven sexual exploitation and abuse are on the rise, while conflict and climate-related disasters continue to create environments conducive to child sexual exploitation and abuse and the expanding extractive industries often exacerbate children’s vulnerability….”

Global health events

KPMG – PMAC 2026 Rapid Brief: Equity as the Organizing Principle for a Turbulent Health Future

https://kpmg.com/jp/en/insights/2026/02/pmac2026-rapid-brief.html

“— With a Deliberate Emphasis on Intergenerational Equity — The Prince Mahidol Award Conference 2026 (PMAC 2026) was held in Bangkok. This report highlights the overview of why PMAC matters and the stance of PMAC 2026.”

HPW – Unlocking the Power of the Private Sector for Stronger Health Systems 

https://healthpolicy-watch.news/unlocking-the-power-of-the-private-sector-for-stronger-health-systems/

Under the motto, anything with ‘unlocking’ and/or ‘leveraging’ in the title, gets a mention in the extra sections (as compared to the Highlights section) : )

“As USAID programmes funding vital treatments for HIV/AIDS, malaria, maternal and child health, and other critical needs were imploding across Africa last year, a for-profit social enterprise startup geared up for its first real test.  Using medicines procurement as its lever, the Swiss-based startup Axmed called for a radical reboot of national systems — to digitize and streamline purchases, scale up pooled procurement, and drive down medicine costs.”

… … “Technology- enabled platforms, digital pooled procurement, data-driven forecasting, and new financing mechanisms are no longer theoretical concepts; they are active interventions reshaping healthcare systems. It is time we dared to imagine, and build, a world where fragmented, inefficient procurement cycles are replaced by digital platforms that match demand and supply in real-time, eliminating costly delays and unnecessary complexities.”  Over the past year, Axmed — a spinoff of the Gates Foundation — did just that.  It integrated more than 5,000 essential health products in 10 therapeutic areas into a cutting-edge business-to-business (B2B) marketplace connecting healthcare buyers in low- and middle-income countries (LMICs) directly with suppliers.  Working with more than 130 commercially active procurers and suppliers, some 4.2 million patients were reached with a 35% average savings on medicines and other health products, said Alejandro Bes, Axmed General Counsel.”

“He was speaking at a gathering of private and public sector leaders focused on “unlocking private sector engagement” to improve health systems at the Geneva AIDEX 2025 conference, an annual global conference on humanitarian aid and development. Bes and other experts are featured in a newly published report by the Geneva Health Forum on ‘Unlocking Private Sector Engagement for more Resilient Health Systems.’  …”

“…Axmed, founded in 2024, identified developing country medicine procurement systems as a niche opportunity for win-wins.   While bulk procurement has long been a practice of multilateral groups like the Global Fund, little attention has been given to practices in national marketplaces.  In LMICs, those are often characterized by outdated, manual purchasing systems, complex regulations, and fragmented patterns of demands, driving inefficiencies and markups of 250% or more. Axmed’s Business to Business (B2B) technology platform aggregates medicine demand across countries and presents it to manufacturing suppliers.  ……As a for-profit social enterprise, AXMED caps its markup at 10% in a market where markups of 250% are common, and redeploys 30% of profits back into the health systems it serves.”

PS: “Large private-sector firms are also reshaping partnerships in LMICs. GE Healthcare is a flagship example.  In the past 15 years, the medical technology company — which controls about 60% of the global medical device market — has developed partnerships in more than 160 countries, with a focus on low- and middle-income settings, said Chris Bonnett, who heads its strategic projects initiatives.”

PS:  “the 2025 collapse of USAID proved to be a turning point for AXMED’s new procurement model – fast-tracking its uptake. The company fast-tracked deployment of its B2B system. What began as a proof of concept became a scalable model.  This year, the system is now set to expand to more than 20 LMIC countries, primarily in Africa, supported by a second $5 million Gates Foundation grant and additional investor backing.”

Global health governance & Governance of Health

CGD (note) – G20 Policies to Improve Development Prospects in Low-Income Countries

C Kenny;  https://www.cgdev.org/publication/g20-policies-improve-development-prospects-low-income-countries

“… In a note issued in October, I suggested that the G20 could coordinate around a goal of Zero Low-Income Countries by 2040, and in a note released today, I point to a number of policies G20 countries could individually or collectively introduce to help reach that goal…..”

“This note considers how the G20 could support more rapid growth in low-income countries (LICs)—countries with a GNI per capita below $1,145 (1.5 percent of the US level, or 9 percent of China’s)….”

Re trade, debt finance, aid… but also including Global Public Health.

On the latter: “The G20 might lead a global fight against major diseases that disproportionately affect LICs. This might include a commitment to end malaria and HIV as significant health threats through a combination of elimination, vaccination, and other prophylactics and improved treatment options….”

“… A G20 commitment toward more rapid progress against HIV and malaria should involve increased commitments to the Global Fund (which combats HIV, TB, and malaria) alongside bilateral support for combating the diseases. It should also involve greater global cooperation on technological advances toward vaccines, prophylactics, and affordable treatments. A G20 working group might propose more specific measures….”

·         Related  CGD blog: Time for an International Development Research Projects Association

“I propose that the G20 should support directed open-access technology research into these issues and potentially back a new global institution dedicated to research, development, and rollout of such technologies. …. . It builds on an idea that Lee Robinson, Euan Ritchie, and I proposed for a development institution modeled on the US Advanced Research Projects Agency….”

“For a global public good like technology, and for an institution aimed at the world’s poorest countries, the World Bank might be a suitable secretariat, and a financial intermediary fund a suitable financing vehicle. The IDARPA (International Development Research Projects Association) fund would be a specific institutional financing mechanism to back research, pilots, trials, patent buyouts, and prizes, and act as an institutional vehicle for funding advance market commitments for technologies with specific application to countries below the IDA threshold….”

Global Nation (Briefing) – The security and geopolitical benefits of aid

Anna Hope;   https://globalnation.world/publications/the-security-and-geopolitical-benefits-of-aid/

“The findings set out in this briefing are based on two academic papers: What geopolitical returns does ODA bring? by Dr Simone Dietrich and Nicolas Bau and Identifying Mutual Interests: How Donor Countries Benefit from Foreign Aid by economists from the Kiel Institute. They form part of a project led by the Kiel Institute for the World Economy and Global Nation to examine and build the evidence base for mutual interest official development assistance (ODA or ‘foreign aid’). ‘Mutual interest ODA’ is aid that genuinely serves recipients’ development goals and, in doing so, also benefits donor countries.”

Key messages: “Aid is proven to:
Directly and significantly reduce the risks of terrorism.
Reduce recurrence of conflict, and mitigate the large-scale forced migration that follows.
Avert the economic costs of conflict that also impact donor countries.
Improve donor countries’ international standing and diplomatic influence (as long as that aid meaningfully benefits recipients).”

CGD (blog) –  Why Is the EU Still Giving Grants to Countries that Could Borrow? Rethinking EU Budget Support Ahead of the 2028-2034 MFF

M Gavas et al ; https://www.cgdev.org/blog/why-eu-still-giving-grants-countries-could-borrow

“Budget support—providing funds directly to partner governments to be spent through national budgets—is a cornerstone of the European Union’s external action toolkit. In 2023, the EU managed €11.1 billion in active budget support programmes, making it one of the largest providers globally. The provision of budget support strengthens partner country systems, anchors reform dialogue, and reinforces institutional capacity. But a significant share of the EU’s grant-based support is directed toward countries that could take out concessional loans instead. These are countries that retain market access and are at low or moderate risk of facing debt distress. In a context of tighter fiscal space and increasing geopolitical demands on the EU budget, this warrants reconsideration. Our new study, conducted in partnership with Lion’s Head Global Partners, examines how better calibrating the grant–loan mix could significantly increase financing capacity and development impact under the next Multiannual Financial Framework (MFF), without expanding the overall budget envelope.”

·         Related CGD Policy paper- A Renewed EU Budget Support Framework to Maximise Leverage and Impact

“Drawing on a comparative assessment of international best practices and financial modelling of alternative grant–loan configurations, this paper explores how EU budget support can be strengthened to expand financing capacity, enhance development impact, and increase leverage in the run-up to the 2028–2034 Multiannual Financial Framework. It outlines options for optimising the grant–loan mix and estimates the potential gains from a more strategically calibrated financial toolkit.”

International Affairs – Multiplexity 2.0: power and pluralism in the post-liberal age 

Nora Fisher-Onar et al; https://academic.oup.com/ia/article-abstract/102/2/319/8509047?redirectedFrom=fulltext

Introduction to a special issue. « This article, and the special section in International Affairs it introduces, ask: how can we best read the post-liberal era of world politics? The resurgence of hard power has led many to turn to realism, even as a liberal lens reveals key features of the world we inherited. Meanwhile, diverse state and non-state actors around the globe are (re)asserting their voices in international affairs. This introduction to the special section builds on Amitav Acharya’s work to offer a vision of ‘multiplexity 2.0’ that captures the interface of hard power, soft power and global diversity. It does so by unpacking the key components of Acharya’s concept—‘multiplicity’ and ‘complexity’. Doing so, we contend, captures: 1) the rapidly multiplying set of actors, ideas and structural forces shaping our system’s transformation, while 2) reading the interactions between these parameters through the lens of complexity theory. A ‘multiplicity + complexity = multiplexity 2.0’ approach captures non-linear, multidirectional patterns for an ultimately more ‘realistic’ reading of world (dis)order. »

·         Full issue: with the special section – see International Affairs

Project Syndicate –  The Middle-Power Moment?

Ian Bremmer; https://www.project-syndicate.org/commentary/middle-power-moment-opportunities-to-collective-mobilization-by-ian-bremmer-2026-03

« With American and Chinese behavior causing unease globally, the world’s middle powers know that opportunities to defend their own interests will not remain open forever. But whether and how effectively such a diverse grouping can mobilize itself very much remains to be seen. »

Excerpt: “More broadly, the biggest challenge for middle powers lies in finding common interests across such a diverse group. While non-US Western leaders generally agree that the rules-based international order is worth protecting, many in the Global South are quick to point out that Western values are not universal. Any middle-power strategy and architecture that treats non-Western powers as rule-takers rather than partners in rulemaking is doomed to produce empty alliances and weak institutions. The only way forward, then, is to address the issues most urgent for Global South governments: development investment, debt management, climate finance, and technology access. »

« Despite these many challenges, middle powers know that opportunities to defend their interests from US and Chinese dominance won’t remain open forever. If they fail to act, the world’s two biggest powers will lock in bilateral arrangements – in infrastructure, digital systems, and security – across the developing world. Once those deals are made and the relationships consolidated, it will be much harder for others to check US or Chinese dominance. »

Third World Quarterly – Powerful but dysfunctional? The Group of 77 and UN multilateralism

M-O Baumann et al.   https://www.tandfonline.com/doi/full/10.1080/01436597.2026.2629594#abstract

 “…. Despite its influence in the General Assembly, little is known about the G77’s internal processes. This article addresses this gap by examining the group’s decision making and how it shapes multilateral negotiations and outcomes in the General Assembly. It introduces an ideal-type model of intra-group interest aggregation and assesses how this function unfolds in the G77 and with what effects on UN negotiations….”

“The authors argue that while the group can leverage its numerical strength, there are noteworthy deficits in its interest aggregation function. Specifically, limited inclusiveness, the dominance of a few member states, and the lack of informed input can undermine effective multilateralism and reinforce North–South tensions.”

UHC & PHC

Lancet Primary Care -February issue

https://www.thelancet.com/issue/S3050-5143(26)X2002-7

Editorial:  PEN-Plus: a first step to better care 

NYT – A third of Americans have cut spending or borrowed money for health care

https://www.nytimes.com/2026/03/12/health/health-costs-cutting-back.html

“As medical costs rise, more than 80 million people have made sacrifices like skipping meals and driving less, a new survey finds. “

Pandemic preparedness & response/ Global Health Security

GAVI – Lassa fever is going undiagnosed in West Africa, risking global spread

P Joi; https://www.gavi.org/vaccineswork/lassa-fever-going-undiagnosed-west-africa-risking-global-spread

“A new Lancet study says undiagnosed infections of the Ebola-like disease are endangering patients in West Africa and beyond.  Lassa fever, a haemorrhagic disease similar to Ebola, often goes undiagnosed: new research in Liberia shows that 11% of people with a fever not suspected to be Lassa turned out to have the disease, and children made up 43% of cases. …”

·         For the new study, see  the Lancet Infectious Diseases.

Lancet Correspondence – Nipah virus: a regional threat south Asia keeps underestimating

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00450-2/fulltext

“Since 1999, when Nipah virus was first identified in Malaysia, it has repeatedly emerged in south and southeast Asia, quietly exploiting ecological and social susceptibilities. The danger of Nipah virus is in its persistence, that is, it is periodic, lethal, and preventable. Recent cases in India and Bangladesh are not anomalies and are a reminder of a virus causing recurrent outbreaks for more than two decades, with high mortality, frequent infections of health-care workers, and no approved vaccines or treatments…”

Nature News – Using mosquitoes to vaccinate bats could curb the spread of deadly diseases

https://www.nature.com/articles/d41586-026-00795-3

“But scientists say there are practical and ethical challenges to overcome before the strategy could be deployed in real-world settings.”

“Mosquitoes that have been designed to carry vaccines in their saliva were used to inoculate bats against the rabies and Nipah viruses. Scientists are investigating whether this technique could stop such viruses from ‘spilling over’ from bats to people. But other researchers are sceptical about whether the strategy could be implemented in the wild….”

Based on a study in Science Advances.

Planetary health

Project Syndicate – Africa Is Reimagining Climate Finance

Saliem Fakir (African Climate Foundation);  https://www.project-syndicate.org/commentary/africa-mobilizing-climate-finance-through-investment-platforms-like-jetps-by-saliem-fakir-2026-03

“Foreign donors – including governments, NGOs, and development agencies – have long based climate-finance decisions on their own perceptions of risk, imposing solutions that do not necessarily reflect African priorities or perspectives. But with new investment platforms, Africa is taking matters into its own hands.”

“…… One prominent example is South Africa’s Just Energy Transition Partnership, a pioneering investment platform that seeks to align climate-related finance – particularly to support decarbonizing the energy system – with broader strategies for economic development and growth. Since the concept’s introduction at the 2021 United Nations Climate Change Conference in Glasgow (COP26), Indonesia, Vietnam, and Senegal have followed South Africa’s lead in signing JETPs with the advanced economies of the International Partners Group.  As the Africa Expert Panel noted in a recent report, investment platforms like JETPs provide a structured mechanism for identifying bankable projects and reducing the cost of capital. …”

Plos Climate – Translating national climate policies to resilience actions at the subnational level in low resource settings: Lessons from Ghana’s health systems

https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000779

By Rudolf Abugnaba-Abanga  et al.

The Conversation – Which climate policies actually make a difference? Our new analysis has the answer

X Fernandez-I-Marin et al ;  https://theconversation.com/which-climate-policies-actually-make-a-difference-our-new-analysis-has-the-answer-277013

« Our new research analysed 1,737 individual climate policies across 40 countries over 32 years, and we identified 28 policies that consistently reduce emissions across diverse contexts. More importantly, we developed a new approach that could transform how researchers evaluate policies in any field where complexity keeps growing….”

“… Our research shows that effective climate action doesn’t depend on finding one perfect solution. Multiple pathways exist, but some instruments prove more reliable than others – carbon pricing, taxation and investment in renewable energy research are the star players who will improve any team they join….”

Covid

Cidrap News – Recent pandemic viruses, including SAR-CoV-2, spread directly to people without adaptation, researchers say

https://www.cidrap.umn.edu/covid-19/recent-pandemic-viruses-including-sar-cov-2-spread-directly-people-without-adaptation

“Contrary to prevailing belief, an evolutionary analysis finds no evidence that most viruses with epidemic or pandemic potential that jumped from animals to people were shaped by selection in a lab or prolonged evolution in an intermediate host—challenging claims that SARS-CoV-2, the virus that causes COVID-19, was engineered in a lab. “

“A University of California (UC) San Diego–led research team analyzed viral genomes to characterize natural selection under the hypothesis that zoonotic viruses (Ebola, Marburg, mpox, influenza A, and SARS-CoV-2) need to adapt before infecting people and achieving sustained human-to-human spread. They focused on the evolutionary period right before outbreaks, when viruses would be expected to leave detectable traces of any substantial adaptation. The researchers validated their approach using known examples of artificially selected viruses grown in cell culture or lab animals, which showed clear and reproducible evolutionary footprints distinct from natural transmission.  The findings were published late last week in Cell….”

Infectious diseases & NTDs

HPW – Uganda Extends Successful Malaria Intervention to Older Children

https://healthpolicy-watch.news/uganda-extends-successful-malaria-intervention-to-older-children/

“After five years of focusing on malaria prevention through Seasonal Malaria Chemoprevention (SMC) in the Karamoja region in northeastern Uganda for children under the age of five, Uganda’s Health Ministry has decided to extend the intervention to children up to the age of 10.”

“SMC is the intermittent administration of a curative dose of antimalarial medicine to children at high risk of severe malaria living in areas with seasonal transmission, regardless of whether they are infected with malaria. …”

Nature Medicine (News) – Mosquito-borne viruses, vaccine-borne hope

https://www.nature.com/articles/d41591-026-00014-6

“From chikungunya and dengue to yellow fever and Zika, mosquito‑transmitted diseases are spreading with urbanization, travel and climate change. A new generation of vaccines, trials and public‑health tools aim to keep ahead of the threat.”

NCDs

Global Health Action – Integration of ear and hearing care services in low- and middle-income health systems: a systematic review and qualitative synthesis

https://www.tandfonline.com/doi/full/10.1080/16549716.2026.2633877

By Carmen de Kock & Lucy Gilson.

Social & commercial determinants of health

International Journal of Social Determinants of health and health services (Editorial) –  Power, Precariousness, and Health Equity: The Contested Terrain of Population Health

C Muntaner et al;  https://journals.sagepub.com/doi/full/10.1177/27551938261421775

With an overview of the papers in the issue.

Sexual & Reproductive health rights

HPW – EU Opens Funds for Safe Abortion Access But Long-term Financing Remains Uncertain

https://healthpolicy-watch.news/eu-funds-for-safe-abortions/

“In a landmark decision, the European Commission is allowing member states to utilize existing EU funds to finance access to safe abortions. This move represents a significant shift in European reproductive health, although it stops short of providing financial certainty for women seeking essential reproductive healthcare….”

Plos GPH –Framing reproductive narratives: A thematic discourse analysis of news representations of childlessness in 86 countries (2015–2025)

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005695

By S F Taqwim et al.

International Journal for Equity in Health -The impact of the United States’ distancing from the UN and withholding WHO funding on maternal and child health and nutrition in the Latin America & Caribbean region

https://link.springer.com/article/10.1186/s12939-026-02785-3

By M-A Moreno et al.

Neonatal and child health

Lancet GH – The incidence and antimicrobial resistance of Shigella-attributable diarrhoea in young children in low-income and middle-income countries from the multicountry Enterics for Global Health (EFGH) Shigella Surveillance Study: a prospective, facility-based hybrid surveillance study

M T Yousafzai et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00534-0/fulltext

« We established the burden, serotypes, and antibiotic resistance patterns of Shigella-diarrhoea among young children in LMICs to inform vaccine trial planning and eventual vaccine introduction in high-burden countries….”

TGH – Childhood Nutrition Challenges in India

J Sofi;  https://www.thinkglobalhealth.org/article/childhood-nutrition-challenges-in-india

“Ultra-processed food consumption and rising sedentary behavior mean India’s children will enter the workforce already managing chronic illness.”

Adolescent health

Plos GPH – No more single stories: The case of global adolescent pregnancy care

Farnaz Sabet et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006088

“In this essay, we use the example of care for pregnant girls to provide insights into the consequences of adopting one dominant framing when responding to complex social and health conditions. We draw on a published systematic review of interventions for pregnant adolescents in LMIC, which found the evidence on interventions to support these girls through their pregnancy was scarce. The findings were particularly surprising given the large amount of literature on poorer outcomes associated with adolescent pregnancy. Systematic reviews can expose evidence gaps, but they often do not analyse why the evidence is missing. This essay argues that a dominant framing adopted from the Global North, that adolescent pregnancy is a public health problem only in need of prevention, has contributed to the neglect of high-quality care for pregnant girls….”

Access to medicines & health technology

FT –  Co-founders behind pioneering Covid vaccine to step down from BioNTech

https://www.ft.com/content/be408389-32e4-41c4-a831-ee49e0b5cf1f

(gated) “Uğur Şahin and Özlem Türeci are leaving German group to launch their own mRNA venture.”

·         See also Euractiv – BioNTech founders quit CEO roles to build AI-powered mRNA therapies  (not gated)

Lancet Therapeutics – New drug therapies for hypertension

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02064-1/abstract?dgcid=raven_jbs_etoc_email

“Despite the availability of effective antihypertensive therapies, global blood pressure control rates remain unacceptably low. Contributing factors, such as low treatment adherence, therapeutic inertia, and rising multimorbidity, underscore the need for innovative approaches to improve hypertension care. New antihypertensive drug therapies that act on physiological pathways beyond those targeted by conventional drug classes are emerging. These therapies include small interfering RNA agents that inhibit angiotensinogen synthesis as a novel approach to inhibit the renin–angiotensin system, and new strategies to more selectively modulate aldosterone, such as aldosterone synthase inhibitors and non-steroidal mineralocorticoid receptor antagonists. There is also growing interest in therapies to enhance the action of the natriuretic peptide system. Although these innovations present valuable therapeutic opportunities, their benefits must be carefully balanced against considerations of safety, cost, clinical outcomes, and equitable access—all of which are crucial to reducing the residual burden of cardiovascular and chronic kidney disease.”

Health Research Policy & Systems – Catalysing vaccines research, development and manufacturing in Nigeria: a qualitative exploration of industry stakeholders’ knowledge, perceptions and experience

https://link.springer.com/article/10.1186/s12961-026-01442-z

By Godspower Onavbavba et al.

Human resources for health

Human Resources for Health – Health workforce planning methods in rural and remote primary care: a scoping review

https://link.springer.com/article/10.1186/s12960-026-01060-4

by G Argus et al.

Euractiv – Southern Italy scrambles for doctors after US pressure on Cuban programme

https://www.euractiv.com/news/southern-italy-scrambles-for-doctors-after-us-pressure-on-cuban-programme/

“Calabria offers relocation support and housing incentives to recruit foreign doctors.”

Decolonize Global Health

Plos GPH – Navigating power hierarchies in the “field”: A qualitative exploration of researcher experiences

Michelle Lokot, M Khan et al ; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006048

« … This study applies an intersectional lens to explore how to tackle power hierarchies (including race, gender, age, education/expertise) during visits in the “Global South”, based on a case study of an academic institution in the United Kingdom. …  The study finds that positionality influences how participants view the role of power hierarchies in shaping research dynamics. Senior staff tended to be less critical of power hierarchies, while early-career researchers were more inclined to feel power hierarchies needed to be challenged. Across multiple types of research relationships we find that seniority is a powerful dynamic that shapes interactions during visits. Institutional power is also an overarching force that often limits individual researcher efforts to shift power. Our study identifies five key recommendations for Northern-based institutions in particular: 1) challenge extractive practices and assumptions associated with research in the “field”; 2) advocate for more equitable institutional policies and practices on contracting and budgeting in Northern institutions that constrain efforts to shift power; 3) build in time for ongoing reflection on power and positionality within research teams; 4) ensure visits to “the field” are planned with Global South partners; 5) conduct further research on power hierarchies to tackle specific dimensions of power. »

BMJ GH –  Research capacity and decolonisation in Sub-Saharan Africa: a bibliometric analysis

R Tamaki et al ; https://gh.bmj.com/content/11/3/e021609

« SSA faces a critical mismatch between its high disease burden and its limited capacity to generate scientific research needed to address local health challenges. Higher international collaboration in SSA is correlated with both greater citation impact and diminished local leadership.…”

“Our findings underscore the need to focus on structural equity, in addition to the quantity and quality, in global health research. To decolonise knowledge production, international partnerships must prioritise local leadership, long-term investment and alignment with regional health needs; our metrics, RSI and BARI, offer practical tools to monitor these goals and guide policy reform. Equitable research ecosystems will require both capacity building in SSA and behavioural shifts in high-income country funders and institutions.”

AI & health

Nature Health – Safety of a large language model-based clinical decision support system in African primary healthcare

A Agweyu et al ; https://www.nature.com/articles/s44360-026-00082-5

“In a retrospective analysis of 1,469 patient encounters, a large language model-based clinical decision support system deployed across 16 outpatient clinics provided recommendations generally aligned with local guidelines, but with contrasting results on safety and relevance.”

Nature Health – Large language model diagnostic assistance for physicians in a lower-middle-income country: a randomized controlled trial

Ihsan Ayyub Qazi et al; https://www.nature.com/articles/s44360-025-00007-8

In Pakistan.

IDS (report) – Smart City Surveillance in Africa: Mapping Chinese AI Surveillance Across 11 Countries

https://www.ids.ac.uk/publications/smart-city-surveillance-in-africa-mapping-chinese-ai-surveillance-across-11-countries/

“This report provides the most comprehensive account to date of smart city surveillance in Africa. Expert researchers draw on their contextual experience of their own countries in detailed reports on Algeria, Egypt, Kenya, Mauritius, Mozambique, Nigeria, Rwanda, Senegal, Uganda, Zambia, and Zimbabwe.  The research focuses on the use of smart surveillance technologies in public spaces – including facial recognition and vehicle number plate recognition – and the analysis of this data, often using AI, at centralised control centres. The research traces the evolution of surveillance from colonial-era intelligence networks to today’s digitally enabled public spaces monitoring systems. It identifies the key actors, including government departments and agencies, foreign technology companies, and local private sector actors involved in the supply and implementation of Smart Cities.”

·         Related coverage in the Guardian –   ‘Invasive’ AI-led mass surveillance in Africa violating freedoms, warn experts

Plos Med – Quantify unmet medical need across the disease landscape – A large language model-based methodology

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004798

By E W Sharp et al.

Miscellaneous

What crisis? This crisis. (Response to The Lancet)

Tina D Purnat (via LInkedin);  https://www.linkedin.com/pulse/what-crisis-response-lancet-tina-d-purnat-xtnme/

“David Scales and I sent the below response to a comment by the Editor-In-Chief of The Lancet, but it was rejected because it was deemed too long. We are posting it here instead.”

“Horton’s recent Comment (“Information Crisis—What Crisis?) dismisses concerns about our information ecosystem as mere “human conceit” and is headed for a similar reckoning. His core argument—that Hannah Arendt identified the same problems in 1967, so there’s nothing new here—actually proves the opposite point. Yes, Arendt wrote about propaganda and truth in crisis. But she was writing amidst television’s revolutionary impact on society, not describing some timeless human condition…..”

Do read on.

Papers & reports

WHO – Global research agenda on knowledge translation and evidence-informed policy-making: prioritizing research for better decision-making

https://www.who.int/publications/i/item/9789240118867#:~:text=11%20March%202026,into%20effective%2C%20equitable%20health%20policies.

“This publication presents the first Global research agenda on knowledge translation and evidence‑informed policy‑making (KT/EIP) developed by the World Health Organization to strengthen the use of evidence in health decision‑making. Although public health research has expanded significantly, evidence is not yet used consistently to inform policies and practice. KT and EIP help bridge this gap by making research accessible, relevant and actionable.  Developed through a global, inclusive process involving experts from 38 countries, the agenda identifies 19 priority research areas focused on what works in KT/EIP, what enables or hinders evidence use, and how methods and tools can be improved. It serves as a practical guide for researchers, policy‑makers, funders and partners to align efforts and translate evidence into effective, equitable health policies.”

The Handbook of Social Protection: Evidence and New Directions for Low- and Middle-Income countries

Edited by Rema Hanna, Benjamin A. Olken; https://direct.mit.edu/books/oa-edited-volume/6103/The-Handbook-of-Social-ProtectionEvidence-and-New

“A much-needed guide exploring social protection on poverty, inequality, health, and government finance—from cash transfers to unemployment insurance—in low- and middle-income nations.”

Plos GPH – Top ten research priorities for Essential Emergency and Critical Care: A modified Delphi process

Ryan Rhys Ellis et al (The EECC Prioritisation Group); https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005262

“Critical illness leads to millions of preventable deaths each year. Essential Emergency and Critical Care (EECC) is a pragmatic, globally relevant approach designed to address critical gaps in basic life-saving care. This study identified the top ten research priorities to guide the development of EECC over the next five years. …”

Tweets  (via X & Bluesky)

Gabriel Zucman (thread)

“Forbes just released its latest annual ranking of global billionaires. The pace at which extreme wealth is rising is simply staggering: The wealth of global billionaires now reaches the equivalent of 17% of world GD.”

“What this means is that if billionaires (about 3.000 households) spent all their wealth, they could buy 17% of everything that is produced in a given year globally. In 1987 – the first year of the Forbes billionaire list – this number was 3%.”

“The problem is global. And with the plutocratic capture of a growing number of governments, the AI revolution, and the dismantling of progressive taxation, the trend is bound to accelerate.”

“It has become urgent to create the new alliances, the new forms of international cooperation that will fight to safeguard democracy against this powerful oligarchic current. This is the defining battle of the 21st century.”

“We’re seeing the premises of this new international alliance: From Bernie Sanders in the US, to Zack Polanski in the UK, Pedro Sanchez in Spain, Lula in Brazil, a growing number of leaders are joining forces…”

Jean Kaseya

“Africa’s market for medicines and vaccines is worth over US$50 billion each year, yet less than 1% of the vaccines used on the continent are manufactured in Africa. Today at  @AfricaCDC , I opened the African Manufacturing Pre-Marketplace Forum, co-organised by Africa CDC and Gavi, the Vaccine Alliance @gavi ) — a concrete step toward changing that reality.”

The Pandemic Fund

“The Pandemic Fund’s CSO Board Representatives hosted a Civil Society Townhall with 50+ leaders from across regions. Discussions focused on MDB-civil society cooperation in Pandemic Fund projects and the Fund’s new methodology for identifying high-risk, high-need countries—a key framework for the next call for proposals.”

Podcasts 

Global Health Matters – Inside Track: a new series: Broken chairs, horses and audiences

https://www.youtube.com/watch?v=OxQzeojZAQk

“ The Inside Track, a new series from Global Health Matters offering context, clarity and foresight that you won’t find in traditional news shows. Each episode brings host Garry Aslanyan together with two recurring voices: Catherine Kyobutungi, who brings insight from the frontlines of health research and policy in Africa, and Ricardo Baptista Leite, a physician and global thinker on health, politics and AI. Together, they unpack the headlines with candid conversations grounded in lived experience. …”

“In our first episode of The Inside Track, we examine the fragile state of information integrity in global health. Garry, Cathrine and Ricardo unpack how misinformation spreads, why trust erodes and what responsibility health leaders carry in this environment. We explore how perception, belief and narrative shape public understanding — especially in the wake of COVID-19. We also react to a recent Guardian article linking climate change to chikungunya in Europe, questioning why warnings so often fail to translate into sustained action. …”

With  ‘end of world beliefs’ increasingly common according to new research, local bible groups diligently reading up on the Book of Revelation and the rest of us starting to wonder what Nostradamus actually “foresaw” on the demise of the “rules-based order” back in his time (now that religious nutcases are mostly in charge in the US, Israel and Iran), on top of it all, it’s Friday the 13^th again!  In other words: time for your weekly IHP read : )

After International Women’s Day  (celebrated last Sunday), (mostly) men continued to f**k up the planet for the remainder of the week.  Pentagon figures put the cost of the third Gulf Warat  1 billion a day, an  underestimate it turned out so far. That’s awful enough, but no doubt the many complexity thinkers among you already saw a plethora of ‘ripple effects’ coming long before “God’s instrument” Donald & his luminary ‘Minister of War’ did so. Egged on by Gulf War 3, the polycrisis is clearly on speed now. (hint for Adam Tooze: time to update the term ‘polycrisis’, it sounds a bit benign for the current scary times, and also doesn’t take the ‘agency’ of some of the dumber Sapiens leaders enough into account, I feel)

In this week’s issue, we also pay plenty of attention to the Commission on the Status of Women in New York (where among others the merger of UNFPA and UN Women is being discussed, and Trump & co already suffered an ‘Epic Defeat’). In Geneva, it’s increasingly  crunch time for the  PABS annex discussion, with the forthcoming formal negotiations scheduled for March 23rd-28th.  And in Addis, a landmark summit on fungal diseases took place.  

End of last week, the US State department alsolaunched a new umbrella (global health) funding platform,  a “supplemental framework through which the Department of State may identify and support projects that complement, extend, and/or fill identified gaps in the implementation of … bilateral MOUs. “   We also already want to flag here Gavi’s first-ever vaccine budgets.    

Tim Schwab posted yet another Substack post on the Gates/Epstein links, “How Epstein & Gates harmed public health and global security”. Commenting on a previous post by Schwab, Matthew Canfield nailed it (on LinkedIn): “How can a foundation that claims to “empower women and girls” be so deeply entangled with Epstein? As CEOs step down, and royals, former diplomats, and other collaborators are arrested, the silence about Gates is shocking.“     

MostGlobal health big hitters indeed remain “soundly asleep”  on the issue. Perhaps it’s the age. Well, let’s hope they stop napping now that Jocalyn Clark  argues  in the BMJ that “… the Epstein files should no longer be ignored by those of us in the global health community…”. Clark puts things also in broader (global health re-imagining) perspective:  “…   “… The [Epstein] saga raises a broader need: for critical debate about the role and influence of powerful financiers in global health, especially now as traditional sources of support dwindle. Billionaire philanthropists are one group in need of scrutiny, but so too are the tech robber barons, petro-states, and human rights abusing regimes that will increasingly be looked to for support and patronage—and all too willing to oblige—as the fledgling global health architecture is reimagined….”  

In other dire news, a 2026 AMR Benchmark report warned that so far “growth of drug resistance is outpacing industry-wide efforts”. And on the planetary health front, new research showed climate change is speeding up   ( with the planet now warming at a rate of around 0.35 ºC per decade). You probably already noticed. Another study pointed out that “Extreme heat already affects one in three people, globally” “… making it hard even for young, healthy people to safely do normal physical tasks in many regions”.  Chances are the rising temperatures will further jeopardize global physical inactivity, which, by the way, has remained stubbornly ‘high and unchanged for the past two decades’ (see Nature Health).   

In short, maybe Pete Hegseth is the “Call of Duty” Nostradamus of our times, after all. At least if we paraphrase him a bit: could it be that mankind is “Toast and (increasingly) we know it”?   

Though from a more upbeat angle, as somebody put it on X: what is currently going on in the Strait of Hormuz is probably ‘the best advertisement for green energy the world has ever seen’.

Sadly, that’s about the only silver lining I can discern.  Meanwhile, the horror in the Middle East continues, with no end in sight.

PS: Today’s Featured article on Mali (in French, see below) is a new contribution by researchers from the International Health Policy Research Network (IHP Res Net).   

And do check out also the 6  IHP correspondents  for this year: Duha Shellah, Eunice Lobo, Pratistha Singh, Relindis Ma-gang Tapang, Sabu K U and Shubham Gupta.  We’re looking forward to their contributions this year!

Enjoy your reading.

Kristof Decoster

·         International Women’s Day

·         Gates & Epstein files

·         Global Health Reform & Reimagining (& post-2030)

·         More on Global Health Governance & Financing/Funding

·         UHC & PHC

·         Bilateral health agreements & US Global Health Strategy

·         PPPR & GHS

·         Flu, Measles, Dengue

·         Trump 2.0

·         NCDs & Commercial Determinants of Health

·         SRHR

·         AI & digital health

·         Planetary Health

·         Migration & health

·         Conflict/War/Genocide & health

·         Access to Medicines, Vaccines & other health technologies

·         Some more papers, reports & publications of the week

·         Miscellaneous

International Women’s day (8 March)

Lancet Comment –  When the rules are rewritten, strengthen the coalition for gender justice

S Hawkes, K Buse, J Clark et al (all members of the Lancet Commission on Gender and Global Health); https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00423-X/fulltext

“In April, 2025, we contributed, with many international colleagues, to the report of the Lancet Commission on Gender and Global Health, “Achieving gender justice for global health equity”—the result of a 5-year review of the history and politics of gender justice within the global health system. While noting formidable challenges, the Commission identified milestones of progress and urged the global health community and its allies to press forward for equality and justice recognising gender justice is foundational to global health’s effectiveness, legitimacy, and sustainability. What a difference a year makes. …”

“…three features exacerbate attacks on gender justice in the present moment. First, largely unregulated and unaccountable digital platforms profit from algorithms that amplify socially and politically polarising content—including misogyny and anti-gender misinformation and disinformation—because it drives engagement and advertising revenue. The rise of the so-called manosphere, a loosely connected network of digital communities advancing misogynistic and anti-feminist narratives, the proliferation of AI-generated sexual imagery, and absent or inadequate legal protections against cyber-harassment in much of the world9 contribute to sexual and gender-based abuse in digital spaces and beyond, with impacts on women’s health, wellbeing, livelihoods, and participation in public and political life… Second, well funded transnational networks, often fuelled by authoritarian populism and religious nationalism, coordinate anti-gender strategies and weaponise gender… Third, some governments across western Europe, including the UK, that previously positioned themselves as champions of gender justice and rights are shrinking development assistance budgets, with severe impacts on programmes and services related to sexual and reproductive health and rights (SRHR)…”

“…In line with International Women’s Day (IWD) 2026 and its theme, “Rights. Justice. Action. For ALL Women and Girls”, we believe it is vital to hold the line, preserve hard-won gains, and implement strategies across sectors. To carry the Commission’s principles forward, we propose a four-point agenda for action….”      Do read what this entails.

And they conclude: “… Across the global health community, retreat, complacency, or silence are not viable options. Instead, the field must build on existing efforts to defend the rights, health, and wellbeing of the vast majority who are not served by autocrats, kleptocrats, and billionaires running authoritarian and exclusionary power structures. We recognise and commend those who are showing the way to uphold gender justice…

Lancet Editorial – Gender equality and equity: essential for health and society

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00456-3/fulltext

Today’s Lancet Editorial.

“The terms gender, equity, and equality have been fiercely contested and increasingly instrumentalised over the past year….  These developments are part of a broader hostility to ideas of gender equality and equity, with the growing influence of far-right parties and religious extremist civil society organisations that has led to highly restrictive laws against LGBTQI+ communities and abortion in countries such as Uganda and Poland. As a result, multilateral organisations, companies, and funders—including those working in health—have become guarded about explicitly addressing issues of gender, equity, and equality. But these terms are not just academic or ideological concepts; granting everyone the same rights and opportunities while addressing the unique circumstances different genders face is vital for the health of all.  March 8 marks International Women’s Day, and it is worth noting the continuing disparities and inequities that impact women’s health….”

Lancet Comment – Why investing in women’s health is a societal imperative

Isa Bijloo et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00404-6/fulltext

Authors conclude: “Investing in women’s health is not only a matter of equity but a strategic imperative for public health and economic sustainability. However, the funding gap for female-specific disorders is a multifaceted issue driven by historical bias, societal stigma, inadequate awareness, and lack of proper funding priorities possibly due to lack of female representatives among policy makers and investors. Addressing this gap requires concerted efforts from the medical community, pharmaceutical and health technological companies, policy makers, and advocacy organisations to ensure that female-specific disorders are urgently prioritised. Increasing awareness, advocating for greater representation, improving education on these topics, and encouraging targeted funding are all essential steps towards bridging this gap. The question is no longer whether we can afford to invest in women’s health, but whether we can afford not to.”

UN News – Women’s rights are regressing worldwide, warns UN gender equality chief

https://news.un.org/en/story/2026/03/1167081

“As an increase in conflicts leads to a significant spike in gender-based violence, women across the world face a “justice gap” with discriminatory laws reported in most countries, according to a report from gender equality agency UN Women, released on Wednesday. “

“The report titled Ensuring and Strengthening Access to Justice for All Women and Girls, shows how laws are being reshaped to restrict women’s freedoms, silence their voices, and allow abuse without consequence.  …. … The report found five key areas that prevent fairness in outcomes for women and girls, who face greater barriers to justice than men in nearly 70 per cent of the countries surveyed.  Discriminatory legal frameworks, social norms, gaps between laws and implementation, traditional justice systems independent from the state, and conflict settings all serve to reinforce inequalities and prevent advancing meaningful justice for women. …”

“Together, these barriers mean that women worldwide have 64 per cent of the legal rights of men whilst 54 per cent of countries lack consent based legal definitions of rape….”

Devex – Sheryl Sandberg pushes a $175 billion case for ending child marriage

https://www.devex.com/news/sheryl-sandberg-pushes-a-175-billion-case-for-ending-child-marriage-111959

“This is not just a social issue or a human rights issue, but an economic issue,” philanthropist Sheryl Sandberg told Devex.

“The billionaire philanthropist — who served as Facebook’s first chief operating officer for over a decade — …  today, Sandberg is taking on one of the biggest obstacles to female leadership worldwide: child marriage, a practice that forces 12 million girls out of school every year. “

“To tackle that issue, Sandberg commissioned a report from Columbia University that outlines the human and economic costs of child marriage. The report includes new analysis from the Washington, D.C.-based think tank, the Center for Global Development, which found that child marriage costs the world $175 billion every year — the result of the elevated health risks, lost education, and reduced earnings that take their toll on child brides.”

“By contrast, the report estimates that it would cost $1.3 billion to reduce child marriage by 30% over the next five years. It’s a comparison Sandberg has seized on as a way to reframe the issue for those who control aid budgets, philanthropic dollars, and government budgets, arguing that child marriage represents a massive, avoidable economic loss across the world.”

PS: The report was cochaired by former U.S. Secretary of State Hillary Clinton.

“… The report recommends investing in three core areas to combat child marriage, including education, reproductive health care, and norm-change programs. It also pushes donors to prioritize countries that host the highest numbers of child marriages, including countries such as Niger and the Central African Republic, where 76% and 61% of girls under the age of 18 are married, respectively.”

Guardian –  Gen Z men twice as likely as baby boomers to believe wives should obey husbands

https://www.theguardian.com/world/2026/mar/05/gen-z-men-baby-boomers-wives-should-obey-husbands

“Global survey shows young men hold more traditional views about gender roles than older generations.”   Based on a 29-country survey which included Great Britain, the US, Brazil, Australia and India.

“… The annual research was conducted by Ipsos and the Global Institute for Women’s Leadership at King’s College London, and revealed a stark difference in the beliefs of different generations of men when it comes to gender roles…”

·         PS: on a more optimistic note, see Afrobarometer – AD1080: Africans strongly support women’s autonomy in marriage and reproductive decisions, but are divided on contraceptive access

“Large majorities favour sex education and allowing pregnant girls to stay in school.”

Gates & Epstein files

Devex Pro Insider: When philanthropy becomes the crisis

https://www.devex.com/news/devex-pro-insider-when-philanthropy-becomes-the-crisis-111939 

(gated) “Philanthropy positions itself as the solution in times of crisis. But what happens when philanthropy becomes the crisis?”

“What happens when the world’s most powerful philanthropist becomes a liability — and the sector he bankrolls can no longer afford to look away?  The renewed scrutiny around Bill Gates’ relationship with Jeffrey Epstein — amplified by newly released documents — has landed at a tricky time for global development. Gates denies wrongdoing and says he laments meeting Epstein. The Gates Foundation says it “regrets having any employees interact with Epstein in any way.” But this debate is no longer just about personal judgment. It’s about power and how we all view modern philanthropy….”

Dropsite – Epstein Received Sensitive Military Intelligence Amid Gates Foundation Polio Campaign in Pakistan

https://www.dropsitenews.com/p/epstein-sensitive-military-intelligence-bill-gates-pakistan-polio?hide_intro_popup=true

“Justice Department emails show that Epstein helped the Gates Foundation gain access to the Taliban—and received confidential reports and intelligence on Pakistani military operations.”

“Documents released by the U.S. Department of Justice reveal surprising details about one particular episode: Jeffrey Epstein’s involvement with the Bill and Melinda Gates Foundation’s efforts to eradicate polio in Pakistan. Epstein long maintained a close personal relationship with Gates as well as with officials from his charitable foundation, which he used to steer resources toward politically sensitive research projects and technology firms.  The email correspondence in the disclosures about Pakistan came a few years before the collapse of the U.S.-backed government in neighboring Afghanistan. They also suggest that Epstein’s interest in the region was not strictly limited to public health matters. In a series of emails on the polio vaccination campaign from the International Peace Institute (IPI)—a nongovernmental organization that Epstein funded and often used as a vehicle for backchannel diplomatic efforts—Epstein also received confidential reports and on-the-ground military intelligence, including sensitive information about NATO operations at Zhob Airport, a small domestic airport in Balochistan, only an hour’s flight away from the Afghan capital in Kabul.  … … Epstein leveraged his relationship with Gates and contacts in the region to become a central figure in Pakistan’s anti-polio efforts from 2013 to 2018….”

Tim Schwab – “The Breakfast Club” lampoons Bill Gates over Epstein apology

https://timschwab.substack.com/p/the-breakfast-club-lampoons-bill

(27 Feb) “The hugely popular podcast and radio show, “The Breakfast Club,” yesterday gave Gates the ‘Donkey of the Day’ award. Clearly, Gates’s damage-control efforts around Epstein are not going to plan.”

Schwab concludes: “…Jeffrey Epstein presents a rare opportunity to hold Bill Gates accountable, and to finally have a larger public debate about extreme wealth and billionaire philanthropy—the common ground that initially brought Epstein and Gates together. As I wrote on Monday, the entire field of elite philanthropy is long overdue for a major overhaul, or dismantling—and the Epstein-Gates affair should be the trigger. At the absolute bare minimum, Bill Gates must be removed from the Gates Foundation.”

·         And a link: Nature Editorial – Funding from individual donors: lessons from the Epstein case

“ Universities need to establish and empower compliance teams to ensure adherence to ethical funding policies.”

Global Health Reform and Re-imagining (& post-2030)

HISP (final report) – EU and Like-minded Donors’ Reflection Process on Reform of the Global Health Architecture

https://www.hera.eu/news/hisp-report-reflection-process-reform-global-health-architecture 

Published this week. “… a report prepared by the consultant team contracted through the Knowledge Hub for Health, Inequalities and Social Protection (HISP), and led by hera, proposes reforms across five priority areas: normative guidance; financing and resource mobilisation; market shaping and equitable access; data and surveillance; and coordination and governance. It calls for strong political leadership, genuine country co-creation, streamlined efforts and clear accountability to deliver meaningful progress in 2026….”

·         Related:  Euractiv (Pro) – Aid cuts push EU to rethink global health system, WHO role  

(gated)   “A new reflection paper will likely inform the EU’s upcoming global health plans”

The Partnership for International Politics and Diplomacy for Health (collaboration between the Stockholm School of Economics and Karolinska Institutet)  –   Insights on global health reform discussions, trends and perspectives: March 2026

Part three (and well worth a read).  https://www.globalhealthdiplomacy.se/insights-on-global-health-reform-discussions-trends-and-perspectives-march-2026

From earlier this week. “We note that the boundaries between what initially emerged as siloed global health reform initiatives are softening, with greater awareness and exchange across different conversations. While it is vital to continue pursuing alignment, it needs to occur at a productive and pragmatic level resulting in tangible improvements.  Cost-cutting across global health institutions is increasingly perceived as an effort to remain, not reform. Most of the attention has so far been paid to the future of Gavi, Global Fund and WHO, with less being said about reforms of other global health financing institutions as well as disease-specific partnership, all of which contribute to the current fragmented landscape. Finding a solution for the three major institutions alone is unlikely to resolve the complexity and verticalization within the global health system.”

“South-led coalitions have the best prospects for cultivating the legitimacy required to drive global health reform. The Accra Reset stands out in this regard, having secured high-level international backing. Nevertheless, equally crucial for its success will be sustained and unified backing from African leadership as well as from other regions.”

“Across the reform discussions, the point of contention does not seem to be whether health sovereignty is desirable, but whether it can be combined with enhanced multilateral cooperation. Proposed mechanisms for transitioning to self-sufficiency might falter not because of technical flaws or insufficient data, but due to a lack of underlying trust, both trust within countries and trust between actors.”  

“The prevailing dynamics may help explain growing calls for transactional and reciprocal partnerships, with equality being demonstrated through transparent articulation of benefits for all parties and ‘win-win’ arguments. However, the very duplication and inefficiency that deter some actors from reinvigorating multilateral cooperation risk being reproduced amidst the proliferation of ‘minilateral’, ad hoc partnerships…..”  “ ODA is not only diminishing in LMICs’ health financing budgets; it is also gradually receding from most high-income countries’ diplomatic toolkits. The transition away from aid should therefore not be seen as a one-sided process but a shift affecting stakeholders across the global health ecosystem leading to different kind of partnerships build on mutual interest and responsibilities.”

Africa CDC – Multilateral Cooperation for a Reformed Global Health Ecosystem

https://africacdc.org/news-item/multilateral-cooperation-for-a-reformed-global-health-ecosystem/

Communiqué on the Hybrid high-level dialogue convened by the Republic of South Africa and the Republic of Ghana with support from Africa CDC ( in Addis, 14 February 2026)

Excerpts: “We, Heads of State and Government and leaders of regional and global institutions, met in Addis Ababa at the Africa Centres for Disease Control and Prevention (Africa CDC), on the margins of the 39th African Union Assembly, in a hybrid high-level dialogue convened by the Republic of South Africa and the Republic of Ghana, to advance multilateral cooperation towards a reformed global health ecosystem and a strengthened global health architecture….”

“… we call for great- er/strengthened cooperation amongst key global health actors, and a more streamlined approach to policy shaping. Country ownership and responsible sovereignty must sit at the centre of a reformed global health ecosystem, alongside shared responsibility and accountability for global public goods for health, including pandemic prevention, prepared- ness, and response. This reformed ecosystem must contribute to strong, integrated and resilient health systems, with universal health coverage and primary health care as their foundation.”

“We reaffirm our unwavering commitment to multilateralism in an increasingly interconnected and interdependent world. A rules-based multilateral system—reinforced by empowered regional institutions, including Africa CDC, the Pan American Health Organization, and the European CDC—remains indispensable to advancing solidarity, fair burden-sharing, and equitable access to life-saving tools and innovations to address our shared challenges and risks.”

Guardian – ‘A viable alternative’: UN rapporteur outlines plan for redistributive global economy

https://www.theguardian.com/environment/2026/mar/03/un-de-schutter-outlines-plan-for-redistributive-global-economy

“Olivier De Schutter says ‘frivolous and destructive demands’ of ultra-rich restrict fight against inequality.”

“…  to tackle the interwoven crises of rising inequality, ecological collapse and a resurgent far-right politics, a new economic agenda is needed.  “The scarce resources we have should be used to prioritise the basic needs of people in poverty and to create what is of societal value rather than serve the frivolous desires of the ultra-rich.”…”

“… Next month, De Schutter said he will publish his “roadmap for eradicating poverty beyond growth”, the result of an informal “beyond growth coalition” he formed that includes UN agencies, academics, civil society and unions.   The aim of the roadmap is to expand the range of policy options available to governments, multilateral institutions and development agencies in the fight against poverty. Among the moves it is considering are a universal basic income, job guarantees, debt cancellation or an extreme wealth tax.”

“Critically, De Schutter says the roadmap will coincide with two other initiatives: one instigated by the UN secretary general, António Guterres, which looks at replacing GDP as the key measure of economic success, and a second report by a G20 panel of independent experts on global inequality led by the renowned economist Joseph Stiglitz…..”

“… “This moment offers us a realistic opportunity to shape the post-2030 agenda with a viable alternative that will reconcile planetary boundaries with social justice and the fight against poverty and inequalities. That’s the challenge and the opportunity.”…”

“As part of this process, De Schutter is calling for a permanent UN body to be established to oversee the fight against inequality. It would aim to oversee a number of measures designed to ensure “the economy is redistributive and sustainable by design rather than encouraging destructive growth and then trying to make up for the mess that creates.”

Nature (Editorial) – Going ‘beyond GDP’ should not mean sidelining the SDGs

https://www.nature.com/articles/d41586-026-00657-y

“The UN Sustainable Development Goals represent a carefully-crafted road map for future human and planetary prosperity.”  This editorial focuses more on the SDG indicators.    Excerpts:

“…Towards the end of next month, the United Nations will publish one of its most important reports this year. Its High-Level Expert Group on Beyond GDP, appointed by UN secretary-general António Guterres, will set out its recommendations for measures of progress on development that complement and go beyond gross domestic product (GDP), ensuring that what matters to people, the planet and the future is fully recognized…..” “The group’s recommendations will be considered by UN member states in September, at the next general assembly. If adopted, governments will move to the next phase, which is to discuss the necessary steps to implement them….

“… The group has already produced an interim report and is consulting with diverse stakeholders through in-person and online events. But some researchers and policymakers are concerned that the final recommendations will not adequately incorporate the work done on the indicators for the 17 UN Sustainable Development Goals (SDGs), the world’s current plan to end poverty and achieve environmental sustainability. Progress on the SDGs is measured against more than 200 unique criteria — many more than just GDP. The high-level group is likely to recommend a much smaller number.”

“Earlier this week, a group of specialists responsible for ensuring that the SDG indicators are robust and transparent presented the UN with a report on lessons learnt from a decade of their work. The report says: “A central lesson from the SDG global monitoring experience is that future efforts should build on what already exists rather than start anew.”….”

This “Inter-Agency Expert Group on SDG Indicators” …  organized the SDG criteria into three tiers…

The Editorial concludes: “… All of the SDG indicators were established — and some continue to be reviewed — in a similarly deliberative way. The process of improving them is dynamic, not static. It is a decade-long example of how to create indicators so that they are robust, transparent and inclusive. There have never been no similar evidence-based processes to create prosperity indicators on this scale. That process needs to be studied, and it deserves wider recognition. We hope that the UN’s Beyond GDP advisers will continue to engage with and learn from the framework.”

Nature Health – Regional development goals can improve global health in an era of diminished multilateralism

Olusoji Adeyi & Ramanan Laxminarayan;  https://www.nature.com/articles/s44360-026-00089-y

Must-read. “With almost all of the Sustainable Development Goals not being achieved amid declining global solidarity, countries would be better served by regional development goals.”

Plos Med (Perspective) – From crisis response to country control: Restoring agency and sustainability in global health

Eberere Okereke; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004961

“Global health is at a structural inflection point. Crisis-driven architectures saved lives but entrenched fragility and dependence. Sustaining progress now requires restoring country agency, strengthening national institutions, and securing predictable, sustainable health financing.”

Excerpts: “… The global health ecosystem was never structured with a clear transition from emergency response to sovereign control. Many flagship global health initiatives were not primarily designed to support countries in taking long-term control of their health systems; they were designed to compensate for its absence. As a result, responsibility and authority have become misaligned. Governments are expected to deliver results without full control over resources or priorities. Accountability flows upward to funders rather than outward to citizens. When financing tightens or global attention shifts, hard-won gains become vulnerable, and national institutions are left exposed.”

Now, “… Health sovereignty has re-entered the global debate in this context. It is sometimes framed as resistance to global cooperation or a retreat into nationalism. That framing is misleading. Sovereignty in health is not about isolation: It is about agency. It refers to a country’s authority over priority-setting, budgetary control, and accountability mechanisms, combined with the institutional capability to deliver on those choices. Without that agency, global health remains inherently fragile.  These concerns are increasingly being acknowledged by governments and global agencies themselves. ….”

Okereke concludes: “Ultimately, success must be redefined. Lives saved will always matter. But so should ministries that can plan and execute, budgets that can absorb shocks, and systems that continue to function when external funding declines. If this shift is taken seriously, future success will be evidenced by fewer parallel systems, more predictable domestic financing for core functions, and clearer lines of accountability between governments and their populations. The risk of inaction is equally concrete: repeated cycles of crisis, dependence, and fragility, with diminishing returns on global investment.  Global solidarity remains essential. Shared threats such as pandemics, climate change, and antimicrobial resistance demand collective action. But solidarity cannot substitute for agency, nor can it rely indefinitely on crisis narratives to justify externally concentrated power. The window for deliberate, country-led reform is narrowing.”

American Journal of International Law – Symposium on Global Health at a Crossroads Part II

https://www.cambridge.org/core/journals/american-journal-of-international-law/ajil-unbound-by-symposium/global-health-at-a-crossroads-part-ii

Part two was published this week, with a number of interesting articles again.

·         And a link: The Future of Development Cooperation Coalition Newsletter #2  (by CGD & Future of Development Cooperation Coalition)

“The Coalition is now moving into direct consultations on our work, starting this month in Mexico City…”

More on Global Health Governance & Finance/Funding

IISD – UN80 Revised Draft Resolution on Mandate Implementation Review Available

https://sdg.iisd.org/news/un80-revised-draft-resolution-on-mandate-implementation-review-available/

“Based on the revised draft, the Informal Ad Hoc Working Group on the Mandate Implementation Review would continue as the Working Group on Mandate Reform, to conclude its work by the end of the UNGA’s 81st session. Among other actions, this working group would develop: a toolkit to support Member States decision making across the mandate lifecycle; criteria to guide decisions on the renewal, adaptation, merger, replacement, or retirement of mandates; and modalities to guide review of the existing stock of mandates.”

PMNCH – Cross-Constituency Working Group on Financing for WCAH

https://pmnch.who.int/our-work/cross-constituency-working-groups/cross-contituency-working-group-on-wcah-financing

Via LinkedIn:

“Financing for women’s, children’s and adolescents’ health (WCAH), including sexual and reproductive health and rights (SRHR), is facing mounting pressure. Stagnating domestic health expenditure, declining development assistance and rising debt burdens are constraining fiscal space, placing hard-won gains at risk and threatening the sustainability of essential services.   In many low- and middle-income countries, public spending remains insufficient to deliver WCAH services through primary health care and universal health coverage platforms. As financing pressures intensify, there is growing concern that equity and long-term resilience will be compromised.”

“To respond to this challenge, PMNCH is establishing a Working Group on Financing for WCAH to strengthen coordinated advocacy, policy influence and accountability in support of its 2026–2030 strategy.   The Working Group will focus on:

• Strengthening domestic resource mobilization and financing accountability
• Sustaining and reshaping global solidarity for health financing
• Elevating WCAH within national and global financing and policy decision-making processes

We are honored that this Working Group will be co-led by Joy Phumaphi and Landry Tsague Dongmo, MD MPH PhD, two respected leaders and longstanding champions of women’s, children’s and adolescents’ health within the PMNCH partnership. “

Devex (Pro) – How Novo Nordisk’s profits are reshaping global health funding

Andrew Green – Devex;  

(gated) “The Novo Nordisk Foundation is drawing new scrutiny as it emerges as a major global health player.”       On its ‘enterprise foundation’ model.

“The Novo Nordisk Foundation is flexing. Flush with profits from obesity and diabetes treatments Ozempic and Wegovy, the Danish enterprise foundation has ramped up grantmaking from almost 3.9 billion Danish krone in 2018 to nearly DKK 10.1 billion in 2024 — and kicked off 2026 with an eye-popping $860 million pledge to Denmark’s BioInnovation Institute, its largest donation so far. As bilateral aid shrinks and the Gates Foundation plans its 2045 sunset, NNF is moving fast to fill space on the global stage.  “They are internationalizing rapidly, but part of this internationalization is the realization that if you want to have an impact, you need to bring things to scale,” says Adam Moe Fejerskov, an expert on sustainable development and governance at the Danish Institute for International Studies.”

“But NNF is no ordinary philanthropy, writes Devex contributing reporter Andrew Green. It controls Novo Nordisk A/S through Novo Holdings — and when drug revenues soar, so does giving. And critics say the lines can blur. “It can be difficult to know where the foundation starts and ends,” Fejerskov says — especially as advocates push the company to lower insulin prices….”

Global Policy – Colonial Nostalgia, Neo-Colonial Extraction, or Domestic Protectionism? Three Hypotheses on Rubio’s Munich Address and the Global South

S Klingebiel & A Sumner; https://www.globalpolicyjournal.com/blog/05/03/2026/colonial-nostalgia-neo-colonial-extraction-or-domestic-protectionism-three

“Andy Sumner and Stephan Klingebiel lay out the contours of the new ‘nationalist conditionality regime’.”

“… The resource extraction dimension of Rubio’s agenda requires sustained empirical attention. Securing a unified supply chain for critical minerals demands terms of trade that disadvantage weaker states. Technological advancement in AI relies entirely on imported raw materials. The proposed transatlantic alliance seeks to secure these assets, with no indication of equitable technology transfer to the Global South. Such asymmetrical trade practices well illustrate the characteristics of what we have termed the ‘nationalist conditionality regime’.

PHM – New PHM global coordinator: “Palestine is a symbol of resistance for a new world”

https://phmovement.org/new-phm-global-coordinator-palestine-symbol-resistance-new-world

Wide-ranging interview.

“Pharmacist Aziz Rhali is to lead PHM with a vision of Palestine as global resistance symbol, advancing the health movement’s strategic vision.”

“The People’s Health Movement (PHM) has appointed pharmacist Aziz Rhali as its new Global Coordinator. A former President of the Moroccan Association for Human Rights and member of the Board of Directors of the Global Sumud Flotilla, Rhali will succeed Roman Vega while overseeing the partial relocation of PHM’s Secretariat to its Middle East and North Africa (MENA) region. In this interview, PHM Europe co-coordinator Juliette Mattijsen and Rhali examine the political moment coinciding with the start of his coordination term, PHM’s plans and vision for the coming period, and the significant challenges ahead…..”

Devex – EIB says it’s ‘carrying the flag of development’

https://www.devex.com/news/eib-says-it-s-carrying-the-flag-of-development-111991

“The European Investment Bank pledges $1 billion for African electrification, expands vaccine financing, and launches its third Gender Action Plan, even as it boosts European defense investments.”

“The European Investment Bank will maintain its investment in climate, gender, and health despite its increased focus on defense and competitiveness within the European Union, said EIB President Nadia Calviño in response to questions posed by Devex at the annual EIB Global Forum in Luxembourg this week. EIB will invest $1 billion in Mission 300, a joint initiative by the World Bank Group and the African Development Bank meant to provide electricity to 300 million people in sub-Saharan Africa by 2030. It will also expand its existing financing of vaccine manufacturing in Senegal, Rwanda, and Ghana to now include South Africa as well. The vaccines will target cholera, polio, and pneumonia, Calviño said….”

“For EIB, the Africa-focused investment represents both a health security play and a geopolitical one — anchoring European capital in strategic sectors on the continent. Around 40% of EIB’s finance outside Europe currently goes to Africa…..”

Aidspan – Shaping markets for health: How the Global Fund plans to secure affordable health products for the future

https://www.linkedin.com/pulse/shaping-markets-health-how-global-fund-plans-secure-affordable-njpzf/

“In mid-February 2026, the Global Fund Secretariat presented an update to its Board during a meeting held on 12–13 February in Geneva. The discussion focused on how the organization plans to improve access to lifesaving health products and prepare countries for the future as more nations increasingly rely on domestic financing for health programs.  The Secretariat explained that it has been working on what it calls a “NextGen Market Shaping” approach. In simple terms, this means using the Global Fund’s position as a major global purchaser to negotiate lower prices, ensure quality, and help new technologies reach countries faster. The update looked at what has worked so far and what needs to evolve as the organization moves into the next grant cycle, known as Grant Cycle 8 (GC8)….”

“… The Secretariat identified four main priorities for the next grant cycle. First, it wants to continue to invest in innovation: new medicines, diagnostics, and prevention tools are in constant development. The Global Fund wishes to continue helping to introduce those tools into countries as quickly and at as lower cost. … Second, the Secretariat wants to expand regional cooperation in procurement. When countries buy together instead of separately, they can negotiate lower prices. This is similar to buying in bulk at a wholesale shop. The Global Fund plans to help countries and regional organizations work together to place joint orders, share information and harmonize standards. Third, the Secretariat will focus on keeping markets healthy. A healthy market means there are enough suppliers, prices are fair, and products remain available. If only one company produces a medicine, prices can rise and supply can become unstable. The Global Fund wants to support competition and monitor risks so that markets remain stable. Fourth, the Secretariat wants to expand something called non-grant financed procurement. Traditionally, the Global Fund provides grants to countries, and part of that money is used to buy medicines and health products through its pooled procurement system. This system enables countries to take advantage of the lower price levels since the Global Fund procures items in bulk. Non-grant financed procurement gives the countries the advantage of accessing the system when they use their own funding. Under this model, countries can continue using the same system even when they are buying with their own money. This allows them to benefit from negotiated prices and quality-assured products….”

·         In other Global Fund related news, check out this new UNAIDS report – Review and mapping of Global Fund investments in priority comorbidities in Grant Cycle 7 to improve the health and well-being of people living with or at risk of HIV and/or TB

This report maps Global Fund investments in HIV & TB comorbidities across 100+ countries.

CESP – Global Health Governance in South and Southeast Asia in a Time of Geopolitical Flux

N Monteiro, D McCoy et al ; https://csep.org/blog/global-health-governance-in-south-and-southeast-asia-in-a-time-of-geopolitical-flux/

“…. the Centre for Social and Economic Progress (CSEP), in partnership with the United Nations University–International Institute of Global Health (UNU-IIGH), convened a two-day regional consultation in New Delhi in November 2025. Participants from South and Southeast Asia, including government officials, regulators, scholars, technical experts, and practitioners, reflected on what this moment in time means for the region and how emerging governance arrangements might better reflect regional priorities.  What emerged was neither a call for wholesale institutional replacement nor a rejection of the global governance architecture, but rather a growing recognition that South and Southeast Asian countries need to be more deliberate in articulating shared priorities, identifying strategic entry points for cooperation in a fragmented, politicised, and financially constrained global health landscape.”

With some interesting points made.

Journal of Public Health in Africa (Editorial) – Charting Africa’s digital public health future: Five priorities for action

N Ngongo, J Kaseya et al ;   https://publichealthinafrica.org/index.php/jphia/article/view/1857/2807

Africa CDC authors outline five priorities to move from fragmented pilots to scalable, interoperable digital public health systems.

HPW – Innovative Finance Can Strengthen Fragile Health Systems 

https://healthpolicy-watch.news/innovative-finance-can-strengthen-fragile-health-systems/?feed_id=765&_unique_id=69a1c056251e8

“Financial innovation is a key, underused tool that can be mustered to strengthen humanitarian outreach in crisis settings, while also strengthening public health systems over the long term, according to a new report published by The Geneva Health Forum.  “New sources of financing are developing, breaking with the traditional vision of charitable action financed by grants from humanitarian agencies and fundraising,” the report states.   “Blending funds, implementing insurance systems, micro-levies and ‘sin’ taxes, regionalizing production, volume guarantees, co-investing and co-pay mechanisms, derisking, and the variability of licensing systems are all avenues worth exploring.”  The report was the product of a GHF-organized event at the Geneva AidEx conference in October 2025 – an international gathering focused on humanitarian aid, disaster response, and development innovation. “

“… The report concludes with ten key messages that frame both the potential and the limits of innovative finance in global health….”

Health Ministers Are Not Clinicians-in-Chief: Leadership, Power, and the Avoidance of Subordination

Emilie S K Besson ;   https://www.linkedin.com/pulse/health-ministers-clinicians-in-chief-leadership-power-koum-besson-o8bse/

“…health leadership is increasingly a site where sovereignty is either exercised or quietly conceded.  … In recent debates on sovereignty—whether financial, industrial, or institutional—one point is often missed. Sovereignty is not something states simply have. It is something they practice. In his Davos’s speech, Canada Prime Minister Mark Carney has been explicit about this in economic governance: sovereignty is exercised through negotiation capacity, institutional coordination, and the ability to preserve optionality under constraint. States that lack these skills do not lose sovereignty through dramatic rupture. They surrender it incrementally—agreement by agreement, reform by reform. Health sovereignty is no different….”

“Yet, as I mentioned in a previous article, in most contemporary discussions of health sovereignty, we rarely ask whether countries have invested in the skills that make sovereignty actionable. We do not ask whether they have built negotiation capacity, attempted regional coordination before entering bilateral engagements, preserved optionality in long-term agreements, or protected their epistemic authority even when conceding financially.  Instead, sovereignty is often discussed in terms of outcomes—who funds what, who sets priorities—rather than in terms of the leadership capacities that shape those outcomes…..”

“… This essay is inspired by a recent opinion piece published in Times Higher Education, titled “Health systems need more than just doctors. They need systems thinkers,” written by Dr. Meike Schleiff and Kabir Sheikh ….”  “Their argument is deceptively simple, yet politically charged. Health systems, they remind us, are not technical delivery mechanisms. They are social institutions—shaped by people, power, and values. Leading them therefore requires more than biomedical or even public health expertise. It requires systems thinking, political judgment, and the ability to navigate contested interests…..”

“One line from their piece deserves particular attention:  “Resilience thinking, while valuable, risks lowering ambition. It shifts focus from reimagining and redesigning systems to simply coping with adversity.”   In many African contexts, this observation lands uncomfortably close to home….

“… Effective health leadership under constraint requires capacities that are rarely taught in clinical or public health training:  negotiating under asymmetric power, understanding fiscal rules and macroeconomic constraints, coordinating regionally to expand bargaining space, protecting epistemic authority when evidence is contested, preserving optionality rather than locking systems into dependency paths. Without these skills, expanded authority risks producing a familiar pattern: technical responsibility without political leverage. Leadership becomes the art of managing scarcity rather than reshaping its causes…..

She concludes: “… Beyond Resilience, Toward Re-Imagination:  The question is not whether doctors can be good health ministers. Many are!  The question is why resilience has become a proxy for leadership—and why system redesign remains perpetually deferred….”

Project Syndicate – Global Health Financing Needs a Reset

Bertrand Badré  (Chair of the Project Syndicate Advisory Board, CEO and Founder of Blue like an Orange Sustainable Capital)  & Johanna Benesty (Boston Consulting Group);  https://www.project-syndicate.org/commentary/global-health-aid-needs-broader-financial-base-by-bertrand-badre-and-johanna-benesty-2026-02

“With major donor countries slashing their foreign-aid budgets, the financial foundations of global health have come under strain, revealing structural weaknesses long masked by steady public funding. The solution lies in building a more resilient system that combines grants, concessional loans, and private capital.”

“… More broadly, the Boston Consulting Group estimates that projects representing roughly 20% of national health spending, and potentially up to 30% of global portfolios, could attract return-seeking investors. To this end, such projects should be viewed through an investment lens, with clearer business models, cash flows, and risk-return profiles….”

For the fans: “Unlocking that potential requires making health outcomes legible to investors. While public donors focus on traditional indicators such as lives saved and mortality reduction, private and impact investors often look for quantitative frameworks that link investments to the Sustainable Development Goals and to portfolio-level performance. A prime example is the SDG Blue rating system. Developed by Blue Like an Orange Sustainable Capital, it assigns each investment a score from zero to ten based on its contribution to selected SDGs. We need more such models, because the latest wave of ODA cuts underscores the need to rethink how global health is financed. National and global portfolios should be broken down into distinct project types, each matched to the form of financing most suitable for its risk profile. Government grants and highly concessional loans should remain focused on low-income countries, vulnerable populations, and essential public goods, while infrastructure-heavy and service-based initiatives with clear revenue models can be structured to attract private and impact capital. Blended arrangements can bridge these two extremes, aligning public, philanthropic, and private resources….”

Brunswick – Global State of Philanthropy (Jan 2026) – Toward Billionaire Philanthropy

https://www.brunswickgroup.com/app/uploads/GlobalStateofPhilanthropySurvey.pdf

PS: Brunswick is a global advisory firm.

“…This second 2025 wave finds that public support for billionaire philanthropy has proven unexpectedly resilient at a global level despite declining institutional trust, heightened scrutiny of donors in the media and politics, and economic pressures. At the same time, that support is increasingly conditional , grounded in expectations of transparency and accountability, and focused on broadly shared priorities…”   (in the section “ahum”)

Bilateral health agreements & US Global Health Strategy

HPW – US Speeds up Signing of Bilateral Health Agreements, DRC Lawyers Challenge Minerals Deal

https://healthpolicy-watch.news/us-speeds-up-signing-of-bilateral-health-agreements-drc-lawyers-challenge-minerals-deal/

(2 March) “The United States has moved at speed to secure several new bilateral health Memoranda of Understanding (MOUs) in the past week, including, for the first time, four in Latin America – with the Dominican Republic, El Salvador, Guatemala and Panama. To date (2 March), the US has signed 24 bilateral health MOUs in terms of the Trump administration’s America First Global Health Strategy….”

“The four Latin American agreements involve smaller grants and are almost wholly focused on disease surveillance. The other 20 bilateral agreements are all with African countries – mostly previous recipients of health grants via the now disbanded US Agency for International Development (USAID) and decimated US President’s Emergency Fund for AIDS Relief (PEPFAR).  Several of these countries are facing dire shortages of medicines for HIV, tuberculosis, and maternal and child health as a result of the US withdrawal of funds.”

“The five-year MOUs are aimed at rapidly transferring financial responsibility for these key health services to countries themselves – as some, such as Kenya, Uganda and the Democratic Republic of Congo (DRC) – derived over half their HIV budgets from donors, particularly the US. In the DRC, for example, at least half the antiretroviral medication it used was covered by the US…..  However, the parting price for these transitional MOUs includes extensive investment in infectious disease surveillance networks. The aim is to supply the US with pathogen information within a week of any outbreak to not only “keep America safe” but to give US firms exclusive access to pathogen information, which will enable them to make vaccines, medicines and diagnostics to combat these….”

PS: In both DRC and Guinea, there were first minerals MoU, before the health agreements were signed.

KFF Tracker: America First MOU Bilateral Global Health Agreements

KFF;    (Updated as of 2 March). 

TGH – Tracking the “America First” Bilateral Health Agreements

A Hirschfeld, J Dieleman et al;  https://www.thinkglobalhealth.org/article/tracking-the-america-first-bilateral-health-agreements

(absolute must-read)  “Think Global Health’s analysis found gaps between country needs and new cofinancing commitments with the United States.”

“This interactive assesses the sustainability and scope of the cofinancing obligations under the MOUs. Toward this effort, we analyze the partner governments’ recent and projected health spending, examine how U.S. funding is expected to change under the agreements, and evaluate the available text of the MOUs. We will continue to update the interactive as new MOUs are signed and their full texts become publicly available….”

Excerpt: “… Our analysis suggests that some countries, such as Liberia, could face significant year-over-year drops in U.S. funding for health alongside sharp increases in cofinancing expectations that exceed previous spending projections. Other agreements, such as Mozambique’s, more closely reflect the country’s spending capacity. Accompanying press releases signal a shift in U.S. assistance toward health security and away from health areas that received earlier support, including family planning, maternal health, and children’s health. Countries could choose to continue funding those areas independently, but may need to target spending on U.S. priorities to meet cofinancing requirements, adding further strain in arenas where health aid has been cut….”

Among others including a table, showing that “Country co-investments vary widely across MOUs, but recipients will sponsor about a third of their domestic health funding, on average.”

Guardian – Rising anger over ‘lop-sided’ and ‘immoral’ US health funding pacts with African countries

https://www.theguardian.com/global-development/2026/feb/27/rising-anger-over-lop-sided-immoral-us-health-funding-pacts-africa-countries

Analysis from end of last week. “Zimbabwe refuses to sign agreement and Kenya faces a court case over data sharing as new aid deals come under scrutiny.”

Some related links:

·         Medicines for Africa –    African Countries are Choosing Health Sovereignty by Refusing to Exchange Minerals, Genetic and Epidemiological Data in Exchange for Pennies

·         Global Health Unfiltered –  How Zimbabwe Walked Away from a $367 Million U.S. Health Deal   (with some more detail on the Zimbabwe stance)

Quotes: “…. The breakdown was not the result of bureaucratic failure or miscommunication. It was a deliberate act of sovereignty, and it signals something much larger than one failed deal….

“The Broader Context: America First vs. African Agency…. … A Sign of Africa’s Geopolitical Maturation?….”

“Zimbabwe’s government has been careful to frame its stance not as anti-American hostility, but as a principled stand for equitable partnership. “This growing continental reflection should not be misconstrued as anti-American sentiment,” Mangwana wrote. “On the contrary, it is a sign of Africa’s maturation as a geopolitical actor, one that seeks partnerships based on equality rather than patronage.”…”

PS: A few related tweets by BK Titanji:     “Some countries like Zimbabwe and Zambia are pushing back due to the grossly exploitative nature of these agreements which harken to a more colonial time but there’s a real human cost to standing up to the U.S.  ….For example : 1.2 million Zimbabweans are currently receiving HIV treatment through U.S.-supported programs. The rollout of lenacapavir, celebrated in Harare just days before the negotiations collapsed, now faces an uncertain future…..”

Africa Business Insider – US marks strategic return to the Sahel with $147M health deal in Burkina Faso

Solomon Ekanem;  https://africa.businessinsider.com/local/lifestyle/us-marks-strategic-return-to-the-sahel-with-dollar147m-health-deal-in-burkina-faso/zzlfwxy

“The United States is signaling a renewed strategic push into West Africa’s volatile Sahel region, sealing a $147 million health deal with Burkina Faso in a move that blends humanitarian support with geopolitical recalibration.”

“The renewed American focus on military-led Sahel states raises strategic questions. The Sahel sits atop significant reserves of uranium, gold and emerging critical minerals vital for energy transition technologies.  While there is no official clause tying health funding to mineral access or military basing rights, geopolitical logic suggests Washington is keen to prevent further erosion of influence in a region where Russia and  China are expanding their footprint….”

BMJ Opinion – Global health in a new era of US extraction

Sophie Harman; https://www.bmj.com/content/392/bmj.s394

“The US is targeting African countries with bilateral deals that squeeze governments to secure health security at substantial costs, writes Sophie Harman.”

Among others, with focus on Kenya.

Excerpts: “Global health is not exempt from extractive practices. As I previously warned, with President Trump, it is as important to look at what he is building as much as what he is destroying. For all its talk of “local ownership,” the America First Global Health Strategy is clear about the US’s interest in global health and why: new markets for US products and services. The current US administration’s does not aim to improve health worldwide, instead it intends to make US companies richer and facilitate “leveraging US global health leadership to compete with China.” What is less transparent is how this strategy will be put into practice. To this end, all of us interested in the future of global health should turn our attention to Kenya.”

“… Although the deals seem to focus superficially on greater local ownership and sustainability, Trump and the global right are effectively adopting progressive language for non-progressive ends. If something looks too good to be true—for example, alignment with global health priorities, guarantees of sovereignty, and reduction of dependency—it probably is. The Kenyan deal is the only one out of the 15 deals where the “cooperation framework” has been made public. In it, we can see what is on offer, what is up for grabs, and the political fallout of the deal, all of which are a prescient warning for all states entering into deals with the US….”

“…Data are the new oil in global health, and data on emerging infectious diseases is big currency for US companies. The concern is not only in regard to how these data are used, but the sale of data back to countries at a higher price. For example, if data from Kenya are used to develop new drugs by a US pharmaceutical company, there is a likely risk is that these drugs will be sold to Kenya at a higher price than US markets.”   “… The interests of the US in the new era of extraction are clear. Entering a deal with the US government is a potential lose-lose for states. These countries risk losing resources and opportunities for wealth creation in their own countries, threatening alliances with China for relatively small advances in health, and creating political turmoil in domestic courts. Zimbabwe is the latest state to recognise this, rejecting a lopsided US health deal…”

US-Africa data deals ‘entrench’ exploitation, ethicists warn

https://www.researchprofessionalnews.com/rr-news-africa-partnerships-2026-3-us-africa-data-deals-entrench-exploitation-ethicists-warn/

“Trump’s data-for-aid agreements raise concerns over trust, sovereignty and benefit-sharing.”

“Recent agreements between the United States and African countries that trade access to national health data for healthcare funding risk undermining trust in research and care, two bioethicists warn. Writing in the Journal of Medical Ethics this week, Keymanthri Moodley, distinguished professor in the Department of Medicine at Stellenbosch University in South Africa, and Brian Earp, associate professor of biomedical ethics at the National University of Singapore, say that tying essential healthcare access to data-sharing could erode public trust in both healthcare and research in African nations.”

“When access to healthcare is linked to large-scale data-sharing agreements negotiated under conditions of unequal power, patients and communities may perceive health systems as serving external interests rather than primarily protecting their own,” they write. “Such perceptions—especially where longstanding histories of extractive research and resource exploitation remain salient—can weaken confidence in consent processes, blur the boundary between care and data extraction, and reduce willingness to engage with healthcare or research initiatives over time.”

·         For the Editorial in Journal of Medical Ethics – Data for dollars? The ethics of trading African health data for American investment: lessons from the US–Kenya deal      (by K Moodley et al)

“In this Editorial, we place the recent Kenyan–US agreement within its broader historical context and identify specific ethical risks that would need to be addressed if such data-for-funding exchanges are to meet minimal conditions of fairness and public trust. We conclude with practical recommendations for designing and governing such agreements so that they can avoid charges of data extractivism and instead support proportionate benefit-sharing, appropriate risk management and ongoing accountability….”

Devex – State Department eyes tuberculosis breakthroughs

https://www.devex.com/news/state-department-eyes-tuberculosis-breakthroughs-111994

“Jeffrey Graham, the head of the State Department’s Global Health Security and Diplomacy Bureau, emphasized how the “America First” approach is refocusing U.S. efforts on tuberculosis and beyond. The State Department’s global health chief is on the lookout for “the next lenacapavir” — but this time, he hopes that will mean an innovation for tuberculosis instead of HIV….”

““We’re thinking, alongside these [memorandums of understanding] that we’re signing with governments, how do we set aside [money] for innovations?” said Jeffrey Graham, the senior bureau official for the State Department’s Bureau of Global Health Security and Diplomacy, speaking at a tuberculosis-focused briefing for congressional staffers on Tuesday. …. … Graham’s presence at the briefing — which was led by author and tuberculosis advocate John Green, and included two tuberculosis survivors from the U.S. and Cameroon — suggested tuberculosis will continue to top the agency’s health agenda in the years ahead.”

PS: “Tuberculosis was listed alongside three other diseases — HIV/AIDS, malaria, and polio — in the State Department’s “America First” global health strategy, which was published in September 2025. In that document, the agency stated that by 2030, it would aim to reduce tuberculosis incidence and mortality by 80% and 90%, respectively, from 2015 figures. During the congressional briefing, Graham reiterated that support and linked forward progress to the State Department’s new approach to global health more broadly….. “Countries need to take the lead,” Graham said, arguing that this should include nations with a high burden of tuberculosis, a disease that the World Health Organization estimates kills 1.2 million people every year.”

“… Nineteen of those 24 (bilateral health) agreements include investments in tuberculosis prevention and response, Graham said, both on the part of the partner country and the U.S….”

Devex – Are faith-based organizations the future of the AIDS response?

Andrew Green; https://www.devex.com/news/are-faith-based-organizations-the-future-of-the-aids-response-111955

“The new America First Global Health Strategy cuts off U.S. support to local organizations to fight HIV, except for faith-based organizations. But what happens to services for the communities faith groups cannot access?”   With focus on Zambia in this analysis (but the analysis goes broader).

Green reports from Zambia on what it will mean if the Trump administration only gives HIV funding to religious organizations and not to other civil society and community groups.

The Elders – The New Age of Resource Competition Needs Transparency

Helen Clark & Ellen Johnson Sirleaf; https://www.project-syndicate.org/commentary/global-resource-competition-demands-transparency-democratic-accountability-by-helen-clark-and-ellen-johnson-sirleaf-2026-02

“As countries scramble to secure the minerals needed for clean energy, digital technologies, AI, and defense industries, the new era of resource competition implies both great promise and grave peril. Transparency is essential to ensure that producer countries are not left poorer, more divided, and more indebted than before.”

“… There are proven models for doing this well. For more than two decades, the Extractive Industries Transparency Initiative has shown that openness and accountability are possible, even in politically complex environments. Today, 55 countries adhere to the global standards it has created for the extractive sector, working alongside companies and civil-society groups. This approach now needs to be scaled up and adapted specifically for critical minerals….”

UHC & PHC

Lancet Global Health – Measurement matters: implications of the newly revised Sustainable Development Goal 3.8.2 financial protection indicator for global monitoring

Bingqing Guo & Karen Ann Grépin; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00536-4/fulltext

“In December, 2025, the latest Universal Health Coverage Global Monitoring Report (GMR) was launched. Like previous GMRs, it reaffirmed that the world is off track to achieve the financial protection component of the 2030 Sustainable Development Goals (SDGs; ie, SDG 3.8.2). At current levels of progress, 24% of the world’s population will still face financial hardship in 2030. Financial protection and financial hardship are closely related: households facing financial hardship are considered not to have financial protection. What is notable, however, is that the GMR now relies on a newly revised financial protection indicator, leading to fundamentally new narratives of national, regional, and global financial protection progress. The new SDG 3.8.2 indicator, endorsed by the 56th UN Statistical Commission in March, 2025, after a comprehensive review process, replaces both the catastrophic and impoverishing health expenditure indicators as the official SDG financial protection indicator. Due to indicator revision, the 2025 GMR now estimates that the proportion of the global population that faced financial hardship in 2019 was 12·7 percentage points higher than previous estimates based on the catastrophic expenditure (CATA, 10% threshold) indicator, and 21·8 percentage points higher based on the impoverishing expenditure indicator (IHE). This disparity translates into an additional 773 million people facing financial hardship in 2019 compared with that previously estimated by the 2023 GMR. Whether these new estimates provide us with a clearer picture of progress towards universal health coverage depends on whether the new indicator improves on earlier measurement approaches….”

“… the new indicator now includes a larger portion of the poor and excludes a larger segment of the rich …”

“…  despite these improvements, the new indicator inherits the unaddressed limitations of the previous indicators. The new indicator still relies upon OOPEs, the estimation of which depends heavily on survey design features that can be inconsistent across countries and over time. The new indicator also fails to account for forgone care for financial reasons, an important financial hardship dimension that must be taken into account for global monitoring. Additionally, the new indicator counts any OOPE as financial hardship among the relatively poor, including those that are very small (ie, a penny) or highly predictable, even if these are not the most vulnerable to the adverse effects of financial hardship… … Finally, the new indicator continues to rely on data from infrequently repeated cross-sectional household surveys; for Azerbaijan, Honduras, and Uzbekistan, the latest surveys were conducted more than 20 years ago. Even with a new indicator, financial protection measurement will not improve much without better and more standardised data on OOPE, consumption, and income…..”

And so authors conclude: “Although the recent GMR represents an advance in monitoring the 2030 SDG agenda, there is still significant room for improvement. Including forgone care, improving estimates of OOPE, and increasing the frequency of surveys should also be key priorities for global monitoring of financial protection. Such data would also enable a deeper discussion on the detrimental effects of OOPE and what is required to reach universal health coverage…”

Montreux Collaborative – Meeting report

https://res.cloudinary.com/dueqwfdln/image/upload/v1772083584/2025_Montreux_Collaborative_meeting_report_f71e01697b.pdf

Report on the 7th Meeting of the Montreux Collaborative for Fiscal Space, Public Financial Management and Health Financing (from December 2025).

With three pillars: Deepening the fundamentals; exploring new territories; putting accountability at the center.

WHO – WHO releases updated Health Inequality Data Repository and Health Equity Assessment Toolkit

https://www.who.int/news/item/03-03-2026-who-releases-updated-health-inequality-data-repository-and-health-equity-assessment-toolkit

“WHO has released updated versions of two key resources as part of the Health Inequality Monitor to strengthen data accessibility and usability for health equity.”

“The WHO Health Inequality Data Repository (HIDR), the largest public repository of health inequality data, has been updated with the latest available data from publicly available sources. It now contains over 13 million data points that capture more than 2400 health indicators and 22 dimensions of inequality.  The newly released Version 7 of the Health Equity Assessment Toolkit (HEAT and HEAT Plus) software includes improved functionality for the analysis and reporting of health inequalities. HEAT (Version 7) is preloaded with the 2025 HIDR data update….”

TGH – Human-Centered Design for Resilient Global Health-Care Systems 

K Chawla; https://www.thinkglobalhealth.org/article/human-centered-design-for-resilient-global-health-care-systems

“By codesigning health systems with communities, governments can dismantle siloed care.”

Current “….disruptions make it imperative for countries to invest in adaptable, locally driven systems. Human-centered design (HCD) offers a practical pathway forward for this transition. HCD is a problem-solving approach that prioritizes the needs and experiences of frontline users when developing policies, services, and interventions. It creates bottom-up health policy, codesigns health systems with communities, and focuses on context-relevant outcomes….”

“But redesigning alone is not enough. Health systems need to be supported by enabling conditions in domestic financing, operations, workforce capacity, and accountability. As LMIC governments shift away from donor-driven, disease-specific programs, HCD can facilitate dismantling siloed care. To build health systems that can respond to hyperlocal needs and transnational health shocks, LMICs should ensure universal access to integrated emergency, critical, and operative care (ECO), part of World Health Assembly Resolution 76.2 (2023). That resolution emphasizes the need for deverticalization or comprehensive, integrated perioperative care that transcends narrow, illness-specific health-care service delivery. It encompasses perioperative care, disaster preparedness, maternal health, trauma services, and pandemic response. By applying HCD, countries can better inform national ECO-related solutions to strengthen integrated health-care service delivery….”

PPPR & GHS

Africa CDC – Africa CDC and Japan Institute for Health Security (JIHS) Sign Cooperation Agreement to Strengthen Global Health Security

Africa CDC; 

(5 March) “The Africa Centres for Disease Control and Prevention (Africa CDC) and the Japan Institute for Health Security (JIHS) have signed a Memorandum of Cooperation (MOC) to strengthen bilateral collaboration in health security, infectious disease control, research, and public health capacity development.” “…The collaboration supports Africa CDC’s Strategic Plan (2023–2027)and theAfrica Health Security and Sovereignty (AHSS) Agenda. …”

Security & Dialogue – Feminist pandemic preparedness: women and the political economy of health security

S Harman;  https://academic.oup.com/sd/advance-article/doi/10.1093/secdia/xhaf011/8501254?searchresult=1&login=true

“This article explores how women are integrated into pandemic preparedness measures to deliver health security. The article pursues this aim by developing the idea of feminist pandemic preparedness, an idea explicitly drawn from the interconnections between feminist international political economy (IPE) and feminist security studies (FSS). Feminist pandemic preparedness seeks to reframe the central dilemma of pandemic preparedness–how to reconcile public health security needs with state economic interests–to how to reconcile public health security initiatives with the political economic lives of women. The article pursues this contribution in two parts. Part one situates the idea of feminist pandemic preparedness within existing debates on global health security, securitization of health, and the relationship between emerging scholarship on feminist health security, feminist security studies, and feminist IPE. Part two explores how women are being integrated into existing pandemic preparedness measures: 1) the World Health Organization (WHO)’s reform of the International Health Regulations (IHR2005), Pandemic Agreement, and Independent Panel for Pandemic Preparedness and Response; and 2) the World Bank’s Pandemic Fund; and 3) and Africa CDC’s Partnerships for African Vaccine Manufacturing (PAVM).”

Project Syndicate – Preparing for AI-Enabled Bioweapons

Sania Nishtar ; https://www.project-syndicate.org/commentary/ai-bio-threats-global-health-security-by-sania-nishtar-2026-03

Sania Nishtar sees an urgent need for global coordination and financing to confront new pathogens with pandemic potential.

“The prospect of bioweapons developed by non-state actors has lent new urgency to multilateral pandemic preparation and response efforts. Yet at a time when AI has made such threats exponentially greater, the funding model that sustains critical health-security safeguards is collapsing.”

Concluding: “… The question of how we fund these capabilities is part of a larger debate about the role of ODA in a changing world. We will need to start thinking about ODA in two ways: as a tool for poverty reduction and economic development, and as a means of financing public goods and building global resilience. Collective health defense calls for collective responsibility….”

Lancet Microbe – Research on the genome of microorganisms: ethical considerations and recommendations regarding the incidental bystander sequencing of human genetic material

K Bartholomeeussen, R Ravinetto et al; https://www.sciencedirect.com/science/article/pii/S2666524725002691

“In genomic research primarily targeting microorganisms (or pathogens), a substantial risk exists that the presence of human genetic bycatch is not sufficiently recognised, and that the potential harm of unwarranted analysis, access, or sharing of human genetic bystander data is also insufficiently acknowledged or mitigated. In this Personal View, we contend that mandatory risk mitigation measures are necessary, more so in view of the likely increase of sharing of materials and pathogen sequence information under the WHO Pandemic Agreement and the related Pathogen Access and Benefit Sharing framework.”  Authors propose a four-step approach to mitigate such risks.

7-1-7 Alliance – 7-1-7 data insights: Closing the response gap in vaccine-preventable disease outbreaks

https://717alliance.org/success_stories/closing-response-gap-in-vaccine-preventable-disease-outbreaks/

“New data reveals a surprising performance gap: countries respond faster to outbreaks of novel pathogens than to vaccine-preventable disease.”

“New 7-1-7 data reveals that while detection and notification are strong in vaccine-preventable outbreaks (VPD), response lags dramatically. Only 39% of VPD outbreaks complete early response actions within 7 days, making them 35% less likely to meet the response target than outbreaks of diseases we’re less prepared for….”

Analysis of 7-1-7 data across 12 countries.

Telegraph – Vaccine sovereignty is not a luxury – it is a national security imperative

Jonathan Van-Tam;  https://www.telegraph.co.uk/global-health/science-and-disease/vaccine-sovereignty-is-a-national-security-imperative/

“The UK needs to urgently expand vaccine production at home and consider a possible partnership with the EU to prepare for the next crisis.”

“… The Tony Blair Institute has just issued a new paper on vaccine sovereignty; in it, bespoke modelling illustrates the potential cost of complacency….”

Opinion: Access to vaccines test of Nordic leadership

J Kim & Anders Nordström; https://globalbar.se/2026/02/opinion-access-to-vaccines-test-of-nordic-leadership/

“In a time of threatened health security, unequal access to vaccines and reduced global funding, the Nordic region faces a choice: to lead jointly and thereby strengthen the opportunities for the Nordic life science industry – or to become vulnerable, writes Jerome Kim, Director-General of the International Vaccine Institute (IVI), and Anders Nordström, Sweden’s former ambassador for global health.”

“Following a recent mapping of Nordic capacities and a regional conference on vaccine research, development, and manufacturing in Stockholm, the conclusion was clear: individually, the Nordic countries are small. Together, they form one of the world’s most innovative regions. A joint Nordic 100 Days Mission exercise would transform cooperation from aspiration into real preparedness. Mark Carney’s warning applies here as well. In health, as in geopolitics, middle powers that fail to coordinate risk having decisions made over their heads—about access, supply, and security. Those who act together, by contrast, can shape the rules of the game. Sweden has shown what is possible. The next step is Nordic….” “ Middle powers must act together. In global health, the cost of failing to do so is measured in human lives.”

And a link:

·         DNDi – Pandemic preparedness: Novo Nordisk Foundation renews its support to DNDi and THSTI to continue the development of broad-spectrum antivirals

Flu, Measles, Dengue…

HPW – WHO Updates Flu Vaccine in Response to Rapid Spread of New Variant

https://healthpolicy-watch.news/who-updates-flu-vaccine/

“The World Health Organization (WHO) announced its updated recommendations for the 2026-2027 Northern Hemisphere seasonal flu vaccine on Friday, a critical adjustment driven by the rapid global dominance of a new A(H3N2) variant known as subclade K.  Following four days of intense consultation by the Global Influenza Surveillance and Response System (GISRS), experts finalized the flu vaccine composition to ensure it matches circulating threats….”

“While announcing these seasonal updates at a press conference on Friday, Dr Maria Van Kerkhove, WHO’s Director ad interim for Epidemic and Pandemic Management, pointed to the broader danger of respiratory viruses, warning that “the threat of an influenza pandemic is real and everpresent”. …

“She emphasized the critical need for flu vaccination to protect against severe disease and death. There are around a billion cases of seasonal influenza annually, including three to five million cases of severe illness. It causes an estimated 290,000 to 650,000 respiratory deaths annually, according to the WHO….”

HPW – US Measles Elimination Status Review Postponed: WHO Claims for Technical Reasons

https://healthpolicy-watch.news/us-measles-elimination-review-postponed/

“The World Health Organization (WHO) has pushed back against speculation that a critical review of the US measles elimination status was delayed until November for political reasons. Rather, the WHO said that there were strong technical reasons for postponing the review from April until November so that more data could be collected.  This came as US health officials asked an independent panel to delay its review of the country’s measles elimination status until later this year.  The review of the measles elimination status is now set to happen after the US midterm elections, reportedly sparking concerns over political motives. However, authorities strongly insist that the extensive delay is necessary to guarantee an uncompromising and exhaustive epidemiological review of recent circulation data.  It is essential that “all of the data, all of the evidence, all of the analysis has been done and scrupulously done,” noted Kate O’Brien, the director of the Department of Immunization, Vaccines, and Biologicals, at WHO….”

“The review, which is to be led by the Pan American Health Organization (PAHO), WHO’s regional arm in the Americas, could lead to the embarrassing loss of the US status as a country that has eliminated measles, due to the multiple outbreaks that have occurred there over the past year.    And it comes at a time when PAHO, a semi-autonomous entity, is keen to retain the US as a partner – even after the US pulled out of WHO as a global entity….”

Guardian – ‘Viruses don’t know borders’: US anti-vaccine rhetoric could impact global measles crisis

https://www.theguardian.com/society/2026/feb/28/anti-vaccine-rhetoric-global-measles-crisis

“Experts say global measles vaccination rates are falling as Trump officials signal a deprioritization of the virus.”

“The US government has amplified anti-vaccine rhetoric and signaled that it does not consider measles to be a priority, which could have global ramifications as countries around the world have lost or are on the brink of losing measles elimination status….”

LSHTM – First global “early warning system” for dengue launches

https://www.lshtm.ac.uk/newsevents/news/2026/first-global-early-warning-system-dengue-launches

“A new online dashboard will give researchers, governments, and the public a real-time picture of the global dengue situation for the first time.”

“The Global Dengue Observatory, developed by researchers at the London School of Hygiene & Tropical Medicine (LSHTM) and supported by the AXA Research Fund, now part of the AXA Foundation for Human Progress, draws together the latest data from 88 countries around the world to estimate the current number of dengue cases each month at both a national and a continental level.”

Trump 2.0

NYT –  States Move to Limit Access to H.I.V. Treatment

https://www.nytimes.com/2026/03/02/health/hiv-drugs-ryan-white.html?unlocked_article_code=1.QFA.4qEV.FvXYbFdnGZox&smid=url-share

“Citing shortfalls in federal support, about 20 states are toughening eligibility requirements for patients in drug assistance programs.”

Guardian – Trump administration is failing to address spread of measles, experts say

https://www.theguardian.com/us-news/2026/mar/05/trump-administration-measles

“As number of cases climbs past 1,000, experts say CDC is not taking obvious steps amid funding cuts.”

Stat – MAHA goes global: Inside the rise of the Make Europe Healthy Again movement

https://www.statnews.com/2026/03/03/maha-movement-spreads-meha-make-europe-healthy-again/

“Anti-vaccine activists, right-wing politicians, and medical freedom campaigners join forces.”

“The formation of a group called MEHA — Make Europe Healthy Again — may initially seem counterintuitive. Here in the U.S., MAHA leaders often cite European policies as a model, and communities there tend to have longer life expectancies, fewer health disparities, and cheaper medicines. But echoing its American counterpart, the new group says it aims to prevent chronic diseases, protect the environment, promote scientific transparency, and help Europeans “reclaim [their] health and sovereignty.” It has also attracted a mix of anti-vaccine activists, right-wing politicians, and medical freedom campaigners who warn that the continent’s regulators are captured by “corrupted science” and that its public health systems are akin to “tyranny”…”

Reuters – Elon Musk to avoid deposition about DOGE, dismantling US foreign aid agency

Reuters

No surprises there… : “Elon Musk, ​the billionaire and former adviser to President Donald ‌Trump, will not have to sit for a deposition about his tenure leading the Department of ​Government Efficiency and his role in ​dismantling the U.S. Agency for International Development, ⁠a U.S. appeals court ruled on Wednesday….”

Devex – US Export-Import Bank chief details what’s in Trump’s Project Vault

https://www.devex.com/news/us-export-import-bank-chief-details-what-s-in-trump-s-project-vault-111996

“EXIM President and Chair John Jovanovic talks about the importance of securing critical minerals.”

“…The EXIM Bank is hoping for at least, as it provides a $10 billion loan complemented by roughly $2 billion in private capital to the so-called vault — also known as the U.S. Strategic Critical Minerals Reserve — which aims to purchase and store some 60 critical minerals ranging from lithium and cobalt to rare earth elements….”

“The goal is for EXIM to act as a financial backstop that allows the U.S. to buy raw minerals at scale when prices are stable or favorable, which individual companies might struggle to do on their own due to financial risk…”

NCDs & Commercial Determinants of health

Among others, with a few reads related to World Obesity Day (4 March).

Guardian – More than 220m children will be obese by 2040 without drastic action, report warns

https://www.theguardian.com/society/2026/mar/04/more-than-220m-children-will-be-obese-by-2040-without-drastic-action-report-warns

“World Obesity Federation says half a billion children will be overweight and calls on governments to act to create healthier environments.”

“… Globally, in 2025 about 180 million children were obese. But new figures from the World Obesity Federation suggest that by 2040, about 227 million of all 5- to 19-year-olds will have obesity and more than half a billion will be overweight. According to the federation’s 2026 world obesity atlas, that would mean that at least 120 million school-age children would have early signs of chronic disease caused by their high body mass index (BMI)…..”

“… The report identifies significant regional inequalities. The 10 countries where more than half of school-age children are overweight or have obesity are all in the western Pacific region or the Americas, while the fastest growth in obesity rates is predominantly in low- and middle-income countries.”

“The report calls for greater efforts to create healthy environments, including sugar taxes, limits on junk food advertising and policies to help children lead more active lives….”

HPW – Urgent Need to Expand Access to GLP-1 Medicine to Reduce Obesity

https://healthpolicy-watch.news/urgent-need-to-expand-access-to-glp-1-medicine-to-reduce-obesity/

“ Most people living with obesity are now in low and middle-income countries (LMICs), according to the World Obesity Federation (WOF) – yet people living in these countries are least likely to have access to the Glucagon-Like Peptide-1 (GLP-1) medicine that is transforming treatment outcomes in wealthier countries.  …. … these medicines are scarce in LMICs despite the growing need. Between 2010 and 2022, obesity more than doubled across all LMICs and tripled in low-income countries, according to the WOF….”

“… “Without deep price reductions and scalable care systems, obesity treatment will remain out of reach, and health systems will continue to absorb the far higher costs of untreated disease,” according to the Medicines Patent Pool this week…. ….However, access to GLP-1 medicine should improve as the key compound patents for semaglutide (Wegovy) expire within the next few months, with generic medicine poised to enter the market….”

Lancet GH (Health Policy) – From endorsement of the WHO Acceleration Plan to Stop Obesity to national implementation: country progress on health system preparedness to scale up a comprehensive obesity chronic care programme

Francesca Celletti, et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00496-6/fulltext

“Addressing the global obesity crisis requires health systems that move beyond prevention to include care and treatment. However, translating global policy into national implementation remains challenging. Through the WHO Acceleration Plan to Stop Obesity, 34 countries committed to reducing the prevalence of obesity by 5% by 2030. Using the plan’s operational model, we applied a policy and impact cycle and created a 100-day challenge platform, to support 12 countries to integrate and scale chronic obesity care within their health systems. This paper captures the approaches, system design, progress, and lessons in expanding access to chronic obesity care across the life course. Results show that political commitment, structured implementation, and targeted technical support enabled rapid progress in service design and delivery readiness. Stakeholder engagement, community participation, and data-driven planning emerged as key enablers of success. The countries in this study provide a blueprint for embedding obesity care at scale, underscoring the need for a coordinated global response.”

BMJ (Opinion) – Treatment with GLP-1 drugs must not replace obesity prevention in low and middle income countries

K Buse et al ; https://www.bmj.com/content/392/bmj.s407

Published just ahead of World Obesity Day. “Prevention policies and budgets must be protected and aligned with the expansion of GLP-1 weight loss drugs, argue Kent Buse and colleagues.”

Also with a five point agenda to align treatment and prevention: “

·         Link public coverage of GLP-1s to implementation of structural prevention policies
• Establish ring-fenced prevention funding floors
• Earmark health taxes to support prevention and primary care
• Require transparency in procurement and budget impact
• Build firewalls against commercial interference and publish public dashboards”

Plos GPH – “Who the hell is upstream pushing them all in?” Reclaiming public health’s defining metaphor to counter the commercial determinants of health

May C. I. van Schalkwyk et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006045

“Public health policy and practice are often described by means of a metaphor that depicts interventions as “upstream” efforts to prevent people from falling into a river, from which they must be rescued “downstream” by overwhelmed healthcare services. The upstream-downstream metaphor has been described as public health’s defining metaphor. We apply a commercial determinants of health lens to re-engage with the initial intentions of McKinlay’s seminal 1975 essay from which this metaphor emerged, and to critique its current uses. We examine how the upstream-downstream metaphor has come to be used in ways that depart radically from its original intent, which was to characterise the practices of powerful commercial actors who profit from the production of harm and disease. The subtle but important shift in language from people being pushed, to falling into the river, among other depoliticising processes, contributes to an individualising and victim-blaming approach to health harms, deflecting from the role of commercial power and practices. There is a pressing need to reclaim public health’s defining metaphor as part of the wider agenda to address commercial determinants as the major public health challenges of our time.”

Community Dentistry and Oral Epidemiology (Commentary)  – Constituting Global Oral Health: Toward a policy-relevant and action-oriented scientific discipline

H Benzian et al ; https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.70054?domain=author&token=Z2TAQIXYFUPTBKAGN8V3

With four core arguments for constituting global oral health as a policy-relevant and action-oriented scientific discipline.

HPW – Historic HPV Vaccination Campaign in India to Boost Fight Against Cervical Cancer

https://healthpolicy-watch.news/hpv-vaccination-campaigns-boost/

“India launched the most extensive free Human Papillomavirus (HPV) vaccination initiative in history to systematically combat the rising toll of cervical cancer. This ambitious 90-day campaign aims to inoculate nearly 12 million 14-year-old girls before the preventative shot is permanently integrated into the country’s universal immunization schedule….”

PS: “Concurrently, South Africa is drastically elevating its own historical battle against the devastating disease through high-level political intervention. A massive new national push to completely eliminate cervical cancer will be officially inaugurated by the country’s highest office in the coming weeks. “It is no longer the minister of health who is going to launch this campaign to end cervical cancer, it will be the president himself,” confirmed South African Minister of Health Aaron Motsoaledi.”

“… According to the WHO immunization dashboard, The African region has made spectacular strides in localized coverage, officially overtaking Europe to claim the second-highest first-dose HPV vaccination rate globally…”

SRHR

Lancet – The need for improved sexual health among survivors of sex trafficking

Lao-Tzu Allan-Blitz et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00217-5/fulltext

“In 2021, an estimated 6·3 million people were trafficked for sexual exploitation. Survivors experience profound sexual and reproductive health consequences, including sexual dysfunction, trauma-related conditions, and sexually transmitted infections (STIs). STI prevalence among trafficked women might be 22 to 111 times higher than in populations who have not been trafficked. Women who are trafficked for sex are also substantially more likely to experience pregnancy and abortion. Limited access to, and engagement in, care increases the risks for pelvic inflammatory disease, infertility, obstetric complications, and long-term physical and emotional harms. However, sexual health is more than the absence of disease. WHO defines sexual health as a state of wellbeing in relation to sexuality. Positive sexual health embraces a holistic view of sexuality that accepts a diversity of activities, affirms freedom to experience sexual pleasure, highlights the need for open and honest communication, and reinforces the importance of safety. Sex trafficking directly undermines that state of wellbeing….”

“Sex trafficking is a human rights violation: Responses need to overcome factors at the individual, societal, and structural level, which include control by traffickers, limited resources, language barriers, immigration status, confidentiality concerns, and stigma from health-care providers…. … Restoring sexual health for trafficked individuals requires more than clinical treatment—it demands coordinated, trauma-informed, and rights-based systems that address medical, psychological, social, and structural determinants of wellbeing.”

Plos Med – From pain to policy: Improving endometriosis awareness, diagnosis, and treatment

Alexandra Tosun  (on behalf of the PLOS Medicine Staff Editors);  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004981

“Despite affecting 190 million women worldwide, endometriosis remains underdiagnosed, under-researched, and underfunded. Tackling awareness gaps, diagnostic delays, and inadequate treatment requires earlier education, increased funding, and recognition of endometriosis as a systemic disease—redefining pain, equity, and investment in women’s health.”

Reuters -Women at risk as Taliban curbs hit Afghan healthcare, UN expert warns

Reuters;  

“Restrictions imposed by the Taliban are jeopardising the lives of women and their children who are sometimes denied emergency treatment, a U.N. human rights expert said on Friday.”

ITM – Respectful maternity care in sub-Saharan Africa: A matter of life and death

By Anteneh Asefa et al; https://www.itg.be/en/health-stories/articles/respectful-maternity-care

“A recent study shows how mistreatment during childbirth at health facilities in sub-Saharan Africa can have lasting consequences for women’s mental health, long after they leave the maternity ward. The findings were published in eClinicalMedicine, part of the Lancet Discovery Science.”

AI & Digital health

Geneva Health Files – Digital Health and AI in Global Health Governance: The Discussion at the World Health Organization

https://newsletter.genevahealthfiles.com/digital-health-and-ai-in-global-health-governance-the-discussion-at-the-world-health-organization/?ref=geneva-health-files-newsletter

“Bianca Carvalho brings you a report from discussions on AI and digital health, that took place at WHO’s Executive Board meeting in Geneva last month. Some countries want WHO to take on a greater role in navigating the interface between global health and AI.”

Quotes: “The debate on digital health and AI governance reflects broader shifts in global health governance. As health systems become more data-driven, digital policy is becoming inseparable from health policy. (The American bilateral health deals with Africa, are also a case in point. These deals demand access to data systems in countries in exchange for aid.)  The debate at WHO also raised deeper structural questions about global governance of emerging technologies: who governs health data, how innovation incentives can be balanced with equitable access, and how global standards can respect national sovereignty while enabling global cooperation.”

Carvalho concludes: “… As WHO Member States move toward negotiating the next Global Strategy on Digital Health (2028–2033), the interplay between multilateral health governance and emerging digital alliances will likely shape whether AI in health evolves under fragmented national models or within a more coordinated and equity-oriented global framework.”

Devex Pro – Is Anthropic building Rwanda’s AI future — or its dependence?

https://www.devex.com/news/is-anthropic-building-rwanda-s-ai-future-or-its-dependence-111946

(gated) “Experts say the partnership could expand AI access in health and education, but warn it may deepen vendor lock-in, data risks, and reliance on foreign tech.”

“Anthropic’s new memorandum of understanding with Rwanda to deploy artificial intelligence tools in health and education has drawn both praise and skepticism, highlighting a deeper question facing many African governments: Will partnerships with foreign AI firms build domestic capacity — or deepen reliance on foreign technology stacks?  The new three-year partnership aims to match “Rwanda’s needs and priorities” by providing AI tools, developer access, and training to public servants and health systems, but the details of the agreement haven’t been shared….”

Exemplars in Global Health (brief) – Cross-country synthesis: Digital Health

Exemplars in Global Health;  

“This cross-country synthesis brief brings together high-level insights from the Digital Health Exemplars retrospective research, drawing on lessons from five countries—Brazil, Finland, Ghana, India, and Rwanda—that have successfully used digital tools to strengthen their primary health care systems. These countries represent a range of digital ecosystem maturities, offering practical lessons that are relevant across diverse contexts…”

Guardian – Tech firms and AI farming tools ‘playing with the food system’, warns thinktank

https://www.theguardian.com/global-development/2026/mar/03/tech-firms-ai-farming-tools-food-system-security

“Google, Microsoft and Amazon among companies using algorithms and AI to influence what crops are grown and how, say critics.”

“Tech companies and industrial agriculture are “playing with the food system” by using AI and algorithms to undermine farmers in choosing what the world eats, leading food security experts have warned.  Companies such as Google, Microsoft, Amazon, IBM and Alibaba are working with industrial agriculture firms to influence what crops are grown and how, according to a report by the thinktank International Panel of Experts on Sustainable Food Systems (IPES-Food).  The result, the experts say, is a “top-down” approach to farming systems where large companies tell farmers what to grow, often focusing on the most productive and profitable crops.”

““Companies are playing with the food system, and we can’t afford to have that played with,” said Pat Mooney, a Canadian author and expert on agriculture who contributed to the Head in the Cloud report, adding that these companies tend to focus only on five crops: corn, rice, wheat, soya beans and potatoes….”

Planetary Health

Guardian – Vanuatu moves forward with UN climate resolution despite Trump opposition

https://www.theguardian.com/world/2026/mar/05/vanuatu-un-climate-crisis-trump

“Pacific island says the US weakened its proposal to advance a key climate ruling but vows to hold major polluters accountable.”

“The Trump administration’s attempt to sink a UN resolution demanding countries act on the climate crisis has caused cuts to the proposal but hasn’t entirely killed it, according to the tiny Pacific island country spearheading the effort. The US has demanded that Vanuatu, an archipelago in the south Pacific, drop its UN draft resolution that calls on the world to implement a landmark international court of justice (ICJ) ruling from last year that countries could face paying reparations if they fail to stem the climate crisis.  Vanuatu, one of several Pacific island countries that consider themselves existentially threatened by the climate crisis despite doing little to cause it, said it had to remove sections of its proposed resolution in the hope that a reduced version could be adopted at the UN in a vote later this month…”

Devex – Legal opinion warns development banks may violate climate law

https://www.devex.com/news/legal-opinion-warns-development-banks-may-violate-climate-law-112001

“The opinion argues major multilateral lenders — and their shareholder governments — risk violating international law if they continue financing fossil fuel projects.”

“A coalition of civil society organizations is calling on four major multilateral development banks to meet their climate obligations, citing a new independent legal opinion that argues the institutions — and their shareholder governments — could be breaching international law by financing fossil fuel-related projects. The opinion was written by scholars Johanna Aleria P. Lorenzo and Jolene Lin in November. “

““[The opinion] is the first to address the legal obligations of multilateral development banks and their member states to act on climate change,” Jason Weiner, the executive director and legal director of Bank Climate Advocates, which commissioned the legal work, told Devex. “We see this as a watershed moment for climate ambition at MDBs.””

“In a series of letters sent on March 3 to the European Investment Bank, the Inter-American Development Bank, the Asian Infrastructure Investment Bank, and the African Development Bank, the group Bank Climate Advocates, alongside 33 other organizations, informed the banks of the “stringent” climate obligations under international law that, according to the opinion, apply to both MDBs and their member states. Three similar letters were sent to the World Bank Group, the Asian Development Bank, and the European Bank of Reconstruction and Development in late 2025….”

Rockefeller Foundation – Building a Realistic Utopia: Richard Horton on Collaborating for Planetary Health

https://www.rockefellerfoundation.org/bellagio-breakthroughs/building-a-realistic-utopia/

“Planetary health explores the connection between the health of people, civilizations, and the natural systems on which they depend. …. The field was first defined at a 2014 convening at the Bellagio Center held by The Rockefeller Foundation and The Lancet – one of the world’s most respected medical journals. The subsequent report laid out the core principles of planetary health and offered key recommendations, such as engaging the scientific community in economic and governance issues and redefining prosperity to incorporate quality of life, health, and protection of natural systems…”

“Dr. Richard Horton has served as The Lancet’s editor-in-chief for nearly 40 years, and he has been a leading voice on planetary health from the very beginning. We spoke to Horton about what planetary health means, how the 2014 Bellagio Center convening drove the development of the field, and what makes him hopeful about the future health of our planet….”

Excerpt: “… How has the way you talk about planetary health changed over the last ten years?  At the beginning, I talked a lot about civilizational collapse, which is a bit of a downer. A decade on, we realize that creating fear isn’t a very effective way of making change happen. If I tell you you’re going to die from climate change, you’re likely not going to feel mobilized to do anything about it, because, again, it’s a downer. But if I tell you that climate change is the biggest opportunity for global health in the 21st century, your whole psychology changes, because “opportunity” means you can do something. You have agency. You can use this moment to achieve good things. It’s a win-win situation.  We made that switch with planetary health. You can put it in positive terms, talking about how planetary health is about the factors that can lead to a thriving, sustainable, flourishing society. Making people enthusiastic because there’s something positive and optimistic that they can achieve is the best way to convince people to act. We have to talk about the positive things that we can do to improve our democracies, our economies, and our environments….”

(debatable strategy in my view, in times of planetary emergency…)

HPW –  African Universities Launch Climate-Health Hubs Amidst Escalating Global Crisis

https://healthpolicy-watch.news/african-climate-health-initiative/

“Two regional research hubs that aim to develop climate adaptation strategies that reduce health impacts are to be established in Ghana and South Africa under the terms of a new £40 million climate-health initiative led by African universities and the Wellcome Trust, announced on Thursday.  Along with the two hubs in South Africa and Ghana, an additional £20 million has been earmarked for a third hub in East Africa, with the site yet to be determined.”

“The aim is to develop provide policymakers on the continent with tailor-made scientific data and strategies for shielding vulnerable populations from the intensifying health threats of extreme heat, flooding, air pollution and worsening nutrition – which already kill millions of people every year.…”

Nature News – Climate shocks, not just warming, threaten malaria control efforts in Africa

https://www.nature.com/articles/d41586-026-00491-2?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=59447181

“Climate change is expected to affect mosquito and parasite survival, reshaping malaria risk. But extreme weather could be a more immediate danger to disease control.”

Based on important new  research from end of January. 

IDS – When Heat Becomes a Health Emergency: Why HeatNexus Matters Now

Nasreen Jessani; https://www.ids.ac.uk/opinions/when-heat-becomes-a-health-emergency-why-heatnexus-matters-now/

“From 9–13 February, researchers, policymakers, practitioners, and community partners from across Africa, Asia, the Pacific, and Latin America gathered in Kuala Lumpur for the HeatNexus Network Convening. Co-hosted by Monash University Malaysia and the Institute of Development Studies (IDS), the meeting marked a critical moment for a growing global effort to understand—and respond to—one of the most urgent but under-recognised public health challenges of our time: extreme heat.”

“…HeatNexus is a Wellcome-funded programme bringing together nine interdisciplinary research projects working across 12 low- and middle-income countries. Collectively, these projects are testing real-world heat adaptation interventions— Economic and Health Impact assessments of Heat Action Plans in India, Community-designed health action plans and early warning systems in rural Mexico, housing and malaria co-benefits in Kenya, nature-based solutions for outdoor workers in Tanzania, Cool Roof trials across five countries, behavioural and structural interventions in Malaysia, sustainable and affordable heat adaptation strategies in urban and rural Pakistan, multicomponent interventions to reduce heat impacts on pregnant women and infants in South Africa and Zimbabwe, and addressing heat impacts on vulnerable populations in South Africa and Ghana.”

PS: “… What distinguishes HeatNexus is not just the quality of its science, but its approach. The programme treats heat as a complex, social, and health issue—not simply a climatic one. It centres vulnerable populations, values community knowledge, and invests in networks and capacity alongside research outputs.”

·         Related:   Nature Medicine – Advancing a new generation of heat-health warning system in China  (by Tiantian Li et al)

Climate change News – Uganda cites contentious IEA fossil fuel scenario backed by Trump administration

https://www.climatechangenews.com/2026/03/02/uganda-cites-contentious-iea-fossil-fuel-scenario-backed-by-trump-administration/

“Critics of the African nation’s oil ambitions say referencing the International Energy Agency’s most pessimistic scenario for climate action is a risky policy.”

“Uganda’s government has defended plans to ramp up its nascent oil industry by citing a contested scenario for rising fossil fuel use that is favoured by the Trump administration over more climate-friendly models.  Energy analysts have warned that the East African nation’s drive to fund development by producing and exporting oil is a risky strategy due to projections of cost overruns and over-supplied markets as the world transitions away from fossil fuels….”

“Asked to comment on such warnings, a spokesperson for the Petroleum Authority of Uganda (PAU) referred to the Current Policies Scenario outlined in the International Energy Agency’s World Energy Outlook 2025 (WEO) report. One of several different scenarios in the report, that scenario is the most negative on climate action – assuming current policies and no further emissions cuts – and projects that oil demand will continue to rise until at least 2050. …”

Carbonbrief –  Analysis: Half of nations meet UN deadline for nature-loss reporting

https://www.carbonbrief.org/analysis-half-of-nations-meet-un-deadline-for-nature-loss-reporting/

“Half of nations have met a UN deadline to report on how they are tackling nature loss within their borders, Carbon Brief analysis shows.”

“This includes 11 of the 17 “megadiverse nations”, countries that account for 70% of Earth’s biodiversity.  It also includes all of the G7 nations apart from the US, which is not part of the world’s nature treaty.  All 196 countries that are part of the UN biodiversity treaty were due to submit their seventh “national reports” by 28 February, of which 98 have done so….”

“Their submissions are supposed to provide key information for an upcoming global report on actions to halt and reverse biodiversity loss by 2030, in addition to a global review of progress due to be conducted by countries at the COP17 nature summit in Armenia in October this year.”

World Inequality Database (Working paper) – Planetary Habitability, Global Convergence and Structural Transformation, 2026-2100

https://wid.world/news-article/planetary-habitability-global-convergence-and-structural-transformation-2026-2100/

“What level of economic prosperity and well-being is compatible with global convergence (equality between countries) and the preservation of planetary habitability? Or, to put it differently, what kind of structural transformation is needed and how should we redefine the notions of prosperity and well-being so that the objective of global convergence between countries does not compromise planetary habitability?  In this paper, Lucas Chancel, Cornelia Mohren, Moritz Odersky, Thomas Piketty, and Anmol Somanchi construct a new historical multi-sector global database* covering 57 countries and regions from 1970 to 2025 and develop an input-output projection model to 2100. They study scenarios in which all countries converge to the same per capita GDP level by 2100, and assess under what structural and energy conditions this convergence is compatible with the 2°C climate target. Unlike standard climate-economy models, they examine sectoral reallocation toward immaterial sectors as a climate determinant, rather than treating it as a byproduct of development….”

Findings:

·         “… Global convergence to €60,000 (2025 PPP) per capita by 2100 is compatible with limiting warming to 2°C only under very strict conditions combining rapid decarbonization with deep structural transformation (“sobriety”).

• Rapid energy transition alone is not sufficient: achieving the 2°C target also requires a drastic reduction in working hours (roughly halving global annual hours), a major shift in consumption from material to immaterial sectors (e.g. education and health), and substantial changes in food habits (including large reductions in red meat consumption and deforestation).
• The core “Sustainable Convergence” scenario—combining fast decarbonization, sectoral reallocation, worktime reduction, and food system transformation—just stays within the 2°C limit, while alternative scenarios (“Productivist Convergence” and “Persistent Inequality”) lead to temperature increases above 4°C by 2100.
• Structural composition matters as much as GDP levels: a higher-income world with strong shifts toward immaterial sectors can yield lower long-run warming than a lower-income world without such shifts.
• The Sustainable Convergence pathway improves comprehensive well-being (including the value of leisure time and planetary habitability) in all regions relative to higher-GDP but high-emissions alternatives.
• Implementing this pathway would require massive investment—around 10–12% of global GDP annually over 2030–2060—and major distributional and institutional changes, with financing largely borne by the global rich.”

Migration & Health

Lancet Planetary Health – Framing climate change, migration, and health as a syndemic

Patricia Nayna Schwerdtle et al; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00016-1/fulltext

“Simplistic framings of “climate migrants” obscure the complexity of climate-related mobility and its health implications. Such framings overlook the interrelated dynamics shaping the intersection of climate change, migration, and health. In this Comment, we propose a more integrative conceptual approach by understanding climate change, migration, and health as a syndemic. This framing foregrounds the mutually reinforcing nature of social and biological processes and supports a systems-based perspective that can inform robust research, and more equitable and effective policy and practice….”

Conflict/War/Genocide & Health

HPW –WHO: War with Iran Paralyzes Dubai’s Global Humanitarian Supply Hub

https://healthpolicy-watch.news/who-war-with-iran-paralyzes-dubais-global-humanitarian-supply-hub/

“The US-Israeli war with Iran, which has paralyzed air travel across the Middle East, has also frozen deliveries of vital medical supplies from the world’s largest humanitarian supply hub in Dubai to conflict-wracked countries from Afghanistan to Lebanon, said the World Health Organization on Thursday. “

“Operations at WHO’s logistics hub for global health emergencies in Dubai, are currently on hold due to insecurity,” said WHO Director General Dr Tedros Adhanom Ghebreyesus at a WHO press briefing in Geneva…. … “More than 50 emergency supply requests from 25 countries are currently affected. And $6 million in medicines for Gaza as well as $1.6 million in polio laboratory supplies are also held up,” Balkhy said. WHO’s emergency operations across the region currently face a 70% funding gap, she added. “Without urgent financial support, essential services will cease and preventable suffering will deepen.”  … The Dubai hub, alongside one of the world’s busiest airports, also serves as a logistics junction for WHO-supported medical supplies traveling to Africa, South-East Asia and beyond. …”

“Last year, WHO’s global health emergencies logistics hub in Dubai fulfilled more than 500 emergency orders for 75 countries across all six WHO regions. However, humanitarian health supply chains are now being jeopardized,” said Balkhy.  “

“… As the arc of the war extends across most of the region’s air space,  WHO is exploring alternative overland supply routes as an alternative to air transport together with UNICEF and the World Food Programme, said Annette Heinzelmann – EMRO emergency director … …. “We are assessing the possibility of working through our other UN logistic hubs, notably in Nairobi and in Brindisi, which are close to the region… we are also working with our logistics hub in Dakar to look into alternative shipment routes,” Heinzelmann said …”

Telegraph – Emergency supplies for nuclear or chemical attack distributed across Middle East, says WHO

https://www.telegraph.co.uk/global-health/terror-and-security/emergency-supplies-for-nuclear-attack-middle-east/

“Radiation protection and specialist medical training are included in mitigation plans disseminated across the region.”

Devex – Aid groups win court reprieve from Gaza ban

https://www.devex.com/news/aid-groups-win-court-reprieve-from-gaza-ban-111963

“The decision comes days after 19 organizations petitioned Israel’s High Court over new registration rules, which would have required the groups to provide detailed staff information to the Israeli government.”  “ Israel’s High Court of Justice has allowed some of the world’s largest aid groups to continue operating in the Gaza Strip, a decision that affects Médecins Sans Frontières, Oxfam, the Danish Refugee Council, and 34 other organizations in the territory….”

BMJ GH – Getting unstuck: reframing health systems strengthening and resilience in fragile and conflict-affected settings

C Truppa, B Marchal et al ; https://gh.bmj.com/content/11/2/e020061

« The concepts of health systems strengthening and health systems resilience are conceptually different but often used interchangeably in health policy and systems research and practice. Operationalising them can be difficult, but both are particularly relevant in contexts of conflict, violence and institutional fragility. In the current landscape of increasing complexity of humanitarian crises and constrained resources, understanding their meaning can be helpful to reaffirm their significance and value for achieving equitable access to care for the most vulnerable populations.  We propose reframing health systems strengthening and resilience across three key dimensions: actors, levels and time. Donors and multilateral and international organisations need to explicitly recognise and engage a broader range of local health systems actors, including community-based, faith-based and non-state actors, alongside national authorities. Actors should work across levels, from individual and communities to district and national domains, minimising gaps and vulnerabilities. It is also crucial to adopt longer time frames in the conception, design, implementation, monitoring and evaluation of interventions to strengthen health systems and increase their resilience in fragile and conflict-affected settings. This timeframe shift can help mitigate potential unintended long-term consequences of short-term interventions, support sustainability, improve learning capabilities and enhance transformation.  …. Such a three-pronged shift demands a deeper engagement with the affected communities and local health actors. It entails transferring decision-making power to them rather than exclusively transferring risks. This can ground health systems strengthening and resilience interventions in the contextual reality and needs rather than in externally defined priorities and frameworks. »

International Journal of Social Determinants of Health and Health Services – Deconstructing Resilience and Reconstructing Palestinian Endurance and Resistance

R Glacaman; https://journals.sagepub.com/doi/abs/10.1177/27551938261423037

“This commentary critiques the concept of resilience in general drawing on the international literature, followed by an analysis of its application to Palestinians living in the Israeli occupied Palestinian territory (the West Bank, including Palestinian East Jerusalem, and the Gaza Strip).”

Access to medicines, vaccines & other health technologies

Reuters – South Africa seeks local production of Gilead’s HIV prevention drug

Reuters; 

“South Africa is asking ​local drugmakers to start a process to make Gilead Sciences’ long-acting HIV prevention drug, lenacapavir, domestically, ‌in a push to bring production to the region where it is most needed.  The government is working alongside international partners, including Unitaid and the United States Pharmacopoeia, to identify which local company could make the twice-yearly injection safely, effectively and affordably, and provide any ​support needed. They will then recommend that company to Gilead….”

·         Related: UNITAID press statement – Unitaid and USP provide technical and market support to strengthen regional manufacturing and supply resilience 

·         And via Devex check-up :    

“South Africa has been one of the countries hardest hit by U.S. aid cuts. That includes being blocked from a U.S. program to provide African countries with access to lenacapavir, a twice-yearly injectable to prevent HIV infection.   So South Africa is jump-starting a process to make lenacapavir locally. With the support of Unitaid and a host of other partners, South Africa today launched an official call to identify at least one local manufacturer capable of producing lenacapavir to international standards. This is the first step in trying to secure a voluntary license for a prospective manufacturer from Gilead, which holds the primary patent on the medicine.”

“Gilead has issued voluntary licenses to six generic manufacturers already, though none are on the African continent. Unitaid and its partners actually worked with one of those manufacturers, Dr. Reddy’s Laboratories, to secure a yearly price of $40.   Robert Matiru, the director of programs at Unitaid, tells me that would be the floor for an agreement that might emerge from the current process in South Africa.  “We’re going to be trying our best to get the best access commitments, but at the minimum, what we’ve secured with other licenses,” he explains.  A potential manufacturer should be identified within a month, at which point Unitaid and its partners will work to try to facilitate an agreement between the company and Gilead. That might mean bringing in technology transfers, technical assistance, or even connecting the manufacturer to financing from a development finance institution.  “We’re bringing in different instruments to make this a successful attempt to get a local producer in South Africa,” Matiru tells me. If all goes well, he envisions the “journey to the finish line” to be anywhere from two to three years, securing an affordable supply of lenacapavir not just for the country, but the southern African region.”

Lancet World Report – The boom in counterfeit obesity drugs

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00461-7/fulltext

“Driven by high prices, lack of insurance, and a desire to lose weight, the proliferation of fake and falsified obesity drugs is prompting public health concern. Sophie Cousins reports.”

Science News – ‘Truly spectacular’ drug for sleeping sickness simplifies treatment, raising hopes for eradication

https://www.science.org/content/article/truly-spectacular-drug-sleeping-sickness-simplifies-treatment-raising-hopes-eradication

“European regulators greenlight new one-dose compound that could help African countries get rid of an ancient burden.”

“Acoziborole is the latest in a series of dramatic improvements in the treatment of sleeping sickness, largely thanks to the work of the Drugs for Neglected Diseases Initiative (DNDi), a Switzerland-based nonprofit…..”

·         Related: DNDi press release – Acoziborole Winthrop, developed by DNDi and Sanofi, receives European Medicines Agency positive opinion as three-tablet, single-dose treatment for most common form of sleeping sickness

“…. The therapy, given as a single dose of three tablets, could offer a simpler alternative to longer, more complex regimens and help support the World Health Organization’s (WHO) goal of eliminating the disease by 2030.  Sanofi will donate the medicine to WHO through its philanthropic arm Foundation ….”

Devex –   WHO backs pooled TB testing to expand diagnosis and cut costs

https://www.devex.com/news/who-backs-pooled-tb-testing-to-expand-diagnosis-and-cut-costs-111962

“It includes pooled testing for tuberculosis in resource-constrained settings, allowing governments to screen more people for TB without additional costs.”

“The World Health Organization issued new recommendations that experts say would help expand testing for tuberculosis while helping governments save money.  The recommendations include the use of near point-of-care molecular tests for diagnosing TB over smear microscopy, which checks for the presence of TB bacteria from an individual’s sputum sample using a microscope. While inexpensive, using smear microscopy can miss TB cases and can be time-consuming. WHO also recommends the use of tongue swabs in cases when individuals cannot produce sputum samples. Another recommendation is the use of pooled testing for resource-constrained settings, where sputum samples from several individuals are mixed in one vial and tested together for TB. It requires no further testing if the pooled sample tests negative. However, if the test comes back positive, each sample needs to be retested individually….”

E&K (Analysis) –  Africa’s Vaccine Manufacturing Ambition: Between Declaration and Delivery Informed by Presidential Declaration in Addis Ababa on 14 February 2026

Short (8p) analysis published ahead of the extraordinary summit in Nairobi, chaired by Ruto.

Via LinkedIn: https://www.linkedin.com/posts/drjosearono_africas-vaccine-manufacturing-ek-consulting-activity-7430936825017503746-_lhQ/ 

“On 14 February 2026, African Heads of State adopted a Presidential Declaration in Addis Ababa reaffirming a commitment to produce 60% of the continent’s vaccine needs locally by 2040. …

“Analysis by E&K Consulting Firm – drawing on a deep-dive into Senegal’s vaccine ecosystem and the 14 February Presidential Declaration — identifies a specific structural gap. Not a funding gap, exactly. A navigational gap.  Facilities get funded. Technology transfer agreements get announced. Per-dose incentive structures get designed with increasing sophistication. ….”

– But who is doing the work in between?
– Who is modelling which antigen portfolios each manufacturer can actually compete in, given technology transfer pipelines and UNICEF procurement rules?
– Who is mapping regulatory pathways against AVMA milestone triggers — pathways the E&K Consulting Firm‘s analysis acknowledges are subject to regulatory authority review with timelines that are far from automatic?
– Who is advising governments on how to sequence national manufacturing policy so it reinforces the continental framework rather than fragmenting it? – Who is capturing what is working across 25 simultaneous projects so the ecosystem learns rather than repeats?….”

Some more papers, reports & publications of the week

Lancet Viewpoint – Health justice

Sudhir Anand; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02163-4/fulltext

“Justice in health is often conflated with health equity, a topic that has given rise to an extensive literature in recent decades. … … Justice in health is a much broader concept than health equity, and health inequalities have only a partial overlap with health inequities, which are themselves a small subset of health injustices. To show these differences, it is necessary to first identify and analyse the constitutive elements of health justice. After providing a comprehensive account of health justice, the exact relationship between health inequality, health inequity, and health injustice is elucidated and formalised. The account presented of health justice reveals that it has many and varied faces that require distinct attention and remedial action. This Viewpoint develops the idea of health justice as a plural conception, draws on the literature on justice from philosophy and economics, and investigates its application and reach in the space of health. See the panel for terms of reference used in this Viewpoint. Several distinctions are invoked in identifying and contrasting different facets of health justice and injustice. These distinctions include substantive justice versus process fairness, comparative versus non-comparative justice, and compensatory and distributive justice. Within distributive justice, the health implications of alternate principles—equality, priority, sufficiency, and efficiency—are examined and evaluated. Many faces of health justice are thus exposed that go well beyond the unitary face of health equity and help address the multiple types of injustice observed in the health sphere.”

Miscellaneous

HPW – Ghana and Senegal Consider Harsher Measures Against LGBTQ People

https://healthpolicy-watch.news/ghana-and-senegal-consider-harsher-measures-against-lgbtq-people/

“The Parliaments of both Ghana and Senegal are considering harsher penalties for same-sex relationships.”

“Last month, Ghana’s Parliament had its first reading of an anti-LGBTQ Bill, which is now being considered by its Committee on Constitutional, Legal and Parliamentary Affairs. Meanwhile, Senegal’s Cabinet approved a Bill for its Parliament last month that will double the maximum penalty for same sex relationships – up to 10 years in prison….”

Global health governance & Governance of Health

Geneva Solutions – As the financial crisis deepens, UN faces growing pressure to cut salaries

https://genevasolutions.news/global-news/as-the-financial-crisis-deepens-un-faces-growing-pressure-to-cut-salaries

“The US is pressing the UN to cut staff pay to ease its budget crisis. Unions in Geneva say compensation is being misrepresented, but other states are also warming to the idea.”

Global Policy – Renewal of the UN Requires Investment and Democratic Reform

A Bummel; https://www.globalpolicyjournal.com/blog/02/03/2026/renewal-un-requires-investment-and-democratic-reform

“Andreas Bummel argues that reform of the UN requires democratic world governance and that research suggests support for it remains widespread.”

“ Strengthening the UN and multilateralism more broadly requires strengthening their democratic character and moving beyond a strictly state-centered model.  In an interdependent world, basing international cooperation solely on governments is increasingly untenable. Narrowing the political imagination only deepens cynicism and reinforces the very paralysis government leaders claim to oppose.    One forward-looking and long-standing proposal, ready to be picked up, is the creation of a world parliament, an elected body representing people rather than governments, mandated to address global challenges and advance the global common good. This vision, which could be implemented incrementally in a UN context, has strong popular backing even in times of nationalism, polarization and authoritarian resurgence as a new survey shows…..”

IDS – Shaping China-global South cooperation in a contested world order

https://www.ids.ac.uk/news/shaping-china-global-south-cooperation-in-a-contested-world-order/?utm_source=bluesky&utm_medium=social&utm_content=ap_pkcoi3db1e

“A new book by Professor Jing Gu, Senior Research Fellow at the Institute of Development Studies, explores how cooperation between China and countries across the global South works in practice. The book examines how China’s provinces engage with African partners, how development cooperation is structured and negotiated, and how risks, bargaining, and institutional constraints shape outcomes in a changing global economic and political landscape….”

Global Health Governance: Refocusing global health priorities: the dynamics of agenda setting in Global Health in the Global South

Vivek ND ; https://blogs.shu.edu/ghg/files/2026/02/Fall-2025-GHG-Issue.pdf#page=30

“This paper examines the complex process of global health agenda-setting, focusing on the Global South, particularly India. It explores how various stakeholders – governments, international organizations, and civil society, shape health priorities and policies. Drawing on critical political economy and historical perspectives, the study analyzes the role of political, economic, and social factors influencing health agenda setting. … …. Key findings reveal a shift in global health financing dynamics, with increasing reliance on philanthrocapitalist and multi-bi funding mechanisms, diverting focus from traditional multilateral institutions like WHO. This shift raises concerns about the short-term prioritization of health issues at the expense of longterm goals, while also highlighting the growing influence of private actors on global health policy. The analysis emphasizes the importance of international norms, economic interests, and institutional frameworks in shaping health policies, particularly in low-income countries. The paper concludes by addressing the power imbalances in global health governance, underscoring the need for more inclusive and equitable approaches to health policy. It advocates for collaboration across borders and the prioritization of marginalized communities to address systemic health disparities in the Global South.”

CGD (blog) – The “Triple Threat” Facing Think Tanks

H Dempster et al; https://www.cgdev.org/blog/triple-threat-facing-think-tanks

“For over 100 years, think tanks have been instrumental in shaping policy around the world, developing ideas and synthesizing complex information for policymakers, political leaders, and journalists. However, think tanks are now facing a “triple threat”—from a shifting funding landscape; artificial intelligence; and rising polarization—all of which intersect and reinforce each other.

This was our main takeaway from the recent On Think Tanks School, held in Barcelona last month…”

… This blog outlines some of our takeaways (largely from a development-focused, Global North-based, think tank perspective) identifying ways in which we need to adapt to remain relevant at a time when the public needs us most….”

Global Security: Health, Science and Policy – The UAE’s niche diplomacy in the Middle East: authoritarian strategies of a middle power

Mordechai Chaziza et al; https://www.tandfonline.com/doi/full/10.1080/23779497.2025.2577421

“This study analyzes how the United Arab Emirates (UAE) leverages niche diplomacy as an authoritarian middle power to expand its global influence, construct normative legitimacy, and navigate structural constraints in the international system. Focusing on high-visibility sectors, humanitarian aid, renewable energy, health, culture, and sports, the UAE converts sectoral specialization into symbolic capital, enhancing its diplomatic reach while deflecting scrutiny of its domestic governance. Rather than treating niche diplomacy as technocratic or apolitical, the study frames it as a strategic instrument of identity formation and regime legitimation. The UAE case challenges conventional international relations (IR) assumptions that associate normative influence with liberal democracies, illustrating how authoritarian states can retool soft power mechanisms for strategic gain. By addressing gaps in the literature on Middle Eastern middle powers and authoritarian diplomacy, the study contributes to a more nuanced understanding of how non-democratic regimes shape global agendas through functional, performative, and reputational strategies.”

Global health financing

Telegraph – UK charities turn to corporate donors to offset aid cuts

https://www.telegraph.co.uk/global-health/climate-and-people/uk-charities-turn-to-corporate-donors-to-offset-aid-cuts/

“One source from a major aid charity told the Telegraph the unprecedented cuts has forced it to diversify.”

“British aid agencies are becoming increasingly dependent on wealthy philanthropists and corporate partners to make up budget shortfalls.”

“… A source at one of the UK’s main aid charities told the Telegraph: “We are having to diversify because the scale of the cuts has been so unprecedented….”    “Looking ahead, it seems pretty clear that long-term survival will depend on reliable partnerships with large corporations as well as high-net-worth philanthropists. This is more likely to work for single projects with fixed, achievable aims that have a more easily measurable impact than with less defined unrestricted spending. There will certainly be significant changes to how we operate.”

UHC & PHC

Lancet World Report –Bangladesh’s ambitious new health plans

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00458-7/fulltext

“The country’s new government has promised to prioritise primary care and public health spending after years of neglect. Samaan Lateef reports.”

World Bank – How Scale-Up Happens : Financing, Political Economy, and Delivery in Social Assistance Expansion

https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099082825150531902

By U Gentilini et al.  Executive summary with 10 key messages.

The Conversation – Do doctors treat poorer patients differently? Our study in Tunisia found they do – in subtle ways

T Powell-Jackson et al ; https://theconversation.com/do-doctors-treat-poorer-patients-differently-our-study-in-tunisia-found-they-do-in-subtle-ways-274988

“As health economists interested in the behaviour of healthcare providers, we sought to explore an understudied driver of health inequalities in Tunisia: whether doctors treat patients from different socioeconomic backgrounds differently during a clinical encounter….”

GAVI – We studied primary care in 6 rich countries – it’s under unprecedented strain everywhere

F Goodyear-Smith https://www.gavi.org/vaccineswork/we-studied-primary-care-6-rich-countries-its-under-unprecedented-strain-everywhere

(first published in the Conversation).   “Like other high-income countries, Australia and New Zealand are leaning on GPs to solve increasingly complex health needs – without the necessary investment.”

“…. across many high-income countries, despite very different health systems, primary care is under unprecedented strain.  Our recently published paper presents case studies from the United Kingdom, the Netherlands, Canada, the United States, Australia and New Zealand.  All show governments are leaning on primary care to solve increasingly complex health needs. At the same time, bureaucracies are demanding more documentation, compliance, performance metrics and administrative work.”

“However, very little new investment is going into the four parts of primary care that matter most:  continuity: seeing the same health provider over time, rather than pinballing from one specialist to another; comprehensiveness: getting the whole family’s physical, mental and social health care from one place; coordination: ensuring all the different people and services involved in a patient’s care work together smoothly, information is shared and roles are clear, so patients don’t fall through the cracks; first-contact care: being able to get an appointment with a doctor or nurse you know, when you need it.”

HP&P – Integration of complementary and alternative medicine in the Indian health system: how the state inadvertently undermines policy implementation 

Gupteswar Patel et al;     https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag025/8503067?searchresult=1

“India’s AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) integration policy emphasises medical pluralism. However, implementation occurs within a complex health system where the state apparatus, through its governance and policy processes, affects health services and outcomes. This study explores how state and policy complexities shape AYUSH integration processes and practitioners’ capacities in primary healthcare…”

Pandemic preparedness & response/ Global Health Security

Lancet Microbe – Pathogen access and benefit sharing in a pandemic: working towards fair exchange?

J Radeino Ambe   et al   (on behalf of he Ethics Working Group of the Coalition for Equitable Research in Low Resource Settings (CERCLE) )  https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(26)00031-5/fulltext

“ In this Comment, we highlight key aspects of the PABS System that fail to ensure fairness; however, despite these limitations, we support its ambition…..”

BMJ GH (Analysis) – Collective action for responsible global health data sharing and use

https://gh.bmj.com/content/11/3/e022013

On behalf of the data sharing discussion group.

Planetary health

IDS – New study reveals China’s global role in renewable energy transition

https://www.ids.ac.uk/news/new-study-reveals-chinas-global-role-in-renewable-energy-transition/

“The most comprehensive and transparent analysis of China’s role in the global energy transition shows a significant shift to renewables compared to the past decade, dominated by mega solar projects in Asia and Africa, but varying to include niche areas like biomass in some places.”

Guardian – Global sea levels have been underestimated due to poor modelling, research suggests

https://www.theguardian.com/environment/2026/mar/04/global-sea-levels-underestimated-poor-modelling-research

“Analysis shows average levels are 30cm higher than thought, and up to 150cm in south-east Asia and Indo-Pacific.”  Latest research, published in Nature.

PS: “Rising sea levels are a major threat to coastal communities across the world, and the UN Intergovernmental Panel on Climate Change (IPCC) estimates that by 2100 levels may rise by 28-100cm…. “ 

WHO Bulletin – Justice in priority-setting for research on health and climate change

S Bhaumik; https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.25.294480.pdf?sfvrsn=aa43e96f_3

“…. Here, I examine and describe the dimensions of justice in setting priorities for research on health and climate change using the weaving approach, which is common in Eastern and Indigenous knowledge traditions. Rather than proposing new conceptual frameworks, this approach integrates established concepts from diverse domains to clarify their intersections. Weaving also enables the pursuit of shared meaning on the topic of enquiry among all those involved or interested. This epistemological stance offers a distinct contribution, by fostering dialogue and debate across disciplines and knowledge systems. Drawing on Western constructs of justice and global health ethics, this article weaves concepts together in a nonprescriptive manner….”

Bhaumik concludes: “…The weaving of justice in our global knowledge system on climate and health is and should remain a pursuit that requires collective resolve, and not just in research priority setting….”

Journal of Public health – Human rights underpin climate action for global health and just transition: from awareness and analysis to political and legal action 

David W Patterson, R Guinto, B M Meier et al; https://academic.oup.com/jpubhealth/article/47/Supplement_1/i48/8316634

“This article examines the imperative for human rights under international law as a foundation for the public health response to climate change….”

Critical Public Health (Editorial) – The ‘Blue Pacific’: ocean governance and planetary health

Joe Thomas et al ; https://www.tandfonline.com/doi/full/10.1080/09581596.2026.2629078

“The objective of this paper is to offer a brief reflection on the emerging opportunities of the ‘Blue Pacific’ and its interconnectedness with global health governance and planetary health.”

“… Ocean governance is rapidly emerging as a powerful force for ensuring planetary health in myriad ways. This article briefly discusses the idea of ‘Blu Pacific’, highlights and unpacks it, and reviews some ocean governance mechanisms. Emerging threats and challenges to ocean governance are identified. The interaction between planetary health and ocean governance is reflected upon. Some emerging threats to ocean governance and to SDG 14 have also been identified….”

Mpox 

Cidrap News – Analysis suggests rope squirrels are a natural reservoir of mpox virus

https://www.cidrap.umn.edu/mpox/analysis-suggests-rope-squirrels-are-natural-reservoir-mpox-virus

“A report in Nature details a case of likely direct interspecies mpox virus (MPXV) transmission from a fire-footed rope squirrel to wild sooty mangabey monkeys in a Cote d’Ivoire national park in 2023….”

Infectious diseases & NTDs

Science News – New HIV cure approach forces hidden virus into tripping immune sensor

https://www.science.org/content/article/new-hiv-cure-approach-forces-hidden-virus-tripping-immune-sensor

“Strategy gains momentum after promising results in cell studies and infected people.”  Presented last week at an HIV/AIDS conference in Denver.

GAVI –  Malaria vaccination reduces hospitalisations, deaths of children in northwestern Nigeria

https://www.gavi.org/vaccineswork/kebbi-malaria-vaccination-rolls-back-hospitalisations-deaths-children

“One year after the malaria vaccine was added to the routine immunisation schedule in Nigeria’s Kebbi State, health authorities and caregivers are counting the gains.”

“…Nigeria grapples with the world’s largest malaria case-load, carrying 27% of the global burden and about 30.9% of the 569,000 deaths recorded worldwide in 2023. Of the country’s 36 states, Kebbi has the highest malaria prevalence at 49% of children under five and the highest mortality.  In a momentous step forward against that scourge, Nigeria received 1 million doses of the R21 vaccine with support from Gavi, the Vaccine Alliance, UNICEF and the World Health Organization (WHO). Kebbi State was allotted 595,980 doses to be integrated into the state’s routine immunisation schedule from December 2024….”

The Conversation – When floods hit, the risk of malaria follows: how disaster systems can prepare better

T de Jager et al ; https://theconversation.com/when-floods-hit-the-risk-of-malaria-follows-how-disaster-systems-can-prepare-better-275829

« When floods sweep through southern Africa, the most visible damage is immediate: homes washed away, crops destroyed, clinics disrupted, families displaced. These images dominate headlines and humanitarian appeals.  But as floodwaters recede, a quieter, slower-moving crisis often follows – in those same communities that are already struggling to recover.  In parts of Mozambique, Malawi, Tanzania, Zambia, Zimbabwe and South Africa, severe rainfall and flooding in early 2026 reshaped daily life for hundreds of thousands of people. As communities clear debris and try to rebuild livelihoods, they are also entering the most dangerous window for malaria transmission….”

« We are scientists from the University of Pretoria Institute for Sustainable Malaria Control. Our institute has the Remote Sensing for Malaria Control in Africa programme, which uses satellite data, remote sensing and environmental modelling to study malaria. It focuses on how climate variability and change influence transmission drivers like rainfall, temperature, surface water, land usage, cross-border movement, vector ecology and parasite patterns. »

« As climate-driven floods become more frequent in southern Africa, they are not only washing away infrastructure. They are reshaping malaria risk in ways that entrench poverty and threaten fragile progress towards elimination….”

BMJ Editorial – Trachoma: the final push for global elimination

E Habtamu et al ; https://www.bmj.com/content/392/bmj.s384

“Eliminating the leading cause of infectious blindness is achievable but needs recalibrated strategies and renewed commitment.”

Plos GPH – Principles and priorities for integrated tuberculosis screening and care: A modified Delphi consensus exercise

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005954

By Claire Jacqueline Calderwood et al.

Science News – Many heat-stressed tropical insects are reaching their limits

https://www.science.org/content/article/many-heat-stressed-tropical-insects-are-reaching-their-limits

“Vast study in Peru and Kenya confirms limited defenses against rising temperatures, redoubling climate concerns.”

“Insects living in the lowland tropics have evolved to deal with brutal heat. But many of them are close to their limit, according to a massive study that assessed the heat tolerance of hundreds of species. The findings, published today in Nature, provide an unprecedented view of what temperatures tropical insects can deal with—and reinforce concerns about the risk that climate change poses for insect biodiversity. …”

AMR

Nature Medicine – Evaluation of antimicrobial resistance governance across 193 countries to inform the 2026 Global Action Plan update

Weiye Chen et al;   https://www.nature.com/articles/s41591-026-04257-1

“An evaluation across 193 countries for the Global Action Plan update showed that countries with strong multisectoral governance and early surveillance adoption achieved long-term improvements in reducing antimicrobial resistance. “

Plos Med (Perspective) – Better, not just fewer: Rethinking antibiotic prescribing

Giorgia Sulis et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004941

“Clinical decision support tools can curb unnecessary antibiotic use, but success depends on more than technology. Here, we explore behavioral, equity, and governance challenges in tackling antimicrobial resistance, and why “better, not just fewer” prescriptions are essential.”

And a link:

·         Cidrap News –  GARDP to explore animal antibiotic as a potential superbug treatment

NCDs

Economist – A cancer diagnosis can push people to crime

https://www.economist.com/graphic-detail/2026/03/01/a-cancer-diagnosis-can-push-people-to-crime

“Even generous welfare states are not immune to a “Breaking Bad” effect.”

“In Breaking Bad, a mild-mannered chemistry teacher reinvents himself as a drug lord after learning he has terminal cancer. A new study suggests the television show’s plot is less outlandish than it seems. Researchers in Denmark and the Netherlands find that the likelihood of a cancer patient committing a crime is 14% higher in the decade following their diagnosis than the baseline rate among people yet to develop the disease….”

BMJ Editorial – Revisiting the diagnostic classification for low back pain

C B Oliveira et al ; https://www.bmj.com/content/392/bmj.s353

“Greater recognition of “non-spine” causes and impact on urgency of care escalation is needed.”

Nature Health (Perspective) – Colombo Call to Action for diabetes prevention and control in South-East Asia

https://www.nature.com/articles/s44360-026-00067-4

“This Perspective describes the Colombo call to action, a roadmap for countries in South-East Asia to accelerate diabetes prevention and care….”

Guardian – Quarter of healthy years lost to breast cancer are due to lifestyle factors, research finds

https://www.theguardian.com/society/2026/mar/02/healthy-years-breast-cancer-lifestyle-factors

Cfr a new study in the Lancet Oncology.  “Largest study of its kind suggests high red meat consumption has biggest impact, followed by smoking.”

Guardian – Weight loss drugs may stop people getting addicted to drugs and alcohol, study finds

https://www.theguardian.com/science/2026/mar/04/weight-loss-addiction-drugs-alcohol-study

“US study suggests GLP-1s, used to treat type 2 diabetes, could also reduce risk of people already using substances from overdosing.”

“Weight loss drugs could help people avoid getting addicted to alcohol, tobacco and drugs such as cannabis and cocaine, a study has found.  They could also reduce the risk of people already addicted to illicit substances having an overdose, ending up in hospital or dying, according to research published in the British Medical Journal….”

Social & commercial determinants of health

Global Health Governance – When civil society persists: explaining the complex politics of soda and ultra-processed food taxation and regulation policy reform in Colombia

E Gomez; https://blogs.shu.edu/ghg/files/2026/02/Fall-2025-GHG-Issue.pdf#page=43

« In the area of global health and development, the new field of the commercial determinants of health has highlighted the various ways that major food and beverage industries shape politics, policy, and society in industries’ favor. However, little is known about the conditions under which industries gradually lose their policymaking power. Filling in this lacuna in the literature, this article examines the case of Colombia and reveals the important role that civil society, i.e., NGOs, activists, and academics, play in gradually overcoming corporate power and introducing beverage taxation and food labeling regulations that go against industry preferences. The concept of civil society’s power in persistence is introduced to encapsulate this general process: i.e., despite business opposition and threats, societal persistence in pressuring government for reform can gradually alter the perceptions and interests of congressional leaders and even previously opposed presidents in favor of reform. This power in persistence derives from broad public support and financial backing, in turn motivating activists to use policy tactics such as information sharing and educating policymakers…”

Global Policy – Reforming International Investment Treaty Practice: Comparing Policy Innovation in Australia and Uruguay

Dori Patay, Gastón Ares, Gerónimo Brunet, Anne Marie Thow; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70146

« The Philip Morris lawsuits against Australia and Uruguay in the early 2010s highlighted the need to reform international investment agreement (IIA) practices to ensure that governments do not give up their regulatory autonomy for foreign investment. We undertook a policy analysis to reveal how interests, ideas and institutions shaped reform in IIA treaty practice to protect health policy autonomy in Australia and Uruguay after the Philip Morris investor-state dispute settlement cases…”

·         Finally, the Lancet also features a number of letters today – check the authors’ reply: Ultra-processed foods in research and policy – Authors’ reply  (by C A Monteiro et al)

Sexual & Reproductive health rights

Plos GPH – Expert consensus on pre-eclampsia risk screening tools for low- and middle-income countries: Development of a new Target Product Profile

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005766

Annie R. A. McDougal et al.

Access to medicines & health technology

TWN – CSOs rally against Trump’s trade tactics threatening access to drugs

https://www.twn.my/title2/health.info/2026/hi260205.htm

See also last week’s IHP newsletter. “More than 100 civil society organizations (CSOs) from around the world are calling for a global trade policy framework that safeguards access to affordable medicines and rejects agreements negotiated under coercive conditions.  They argued that the Trump administration is leveraging US trade power – particularly through the imposition of extreme tariffs – to pressure countries into binding commitments that could weaken the availability and affordability of essential medicines, raising concerns about public health and equity in the global trading system…”

Health Sciences report – The Current Landscape and Future Prospects of Vaccine Manufacturing in Africa: Challenges, Innovations, and Opportunities: A Narrative Review

Courage  Chandipwisa et al;  https://onlinelibrary.wiley.com/doi/pdf/10.1002/hsr2.71926

“Africa’s vaccine manufacturing capacity is constrained by limited production infrastructure, a shortage of skilled personnel, and inadequate technical resources. These challenges are compounded by financial constraints, heavy reliance on donor support, and restricted access to technology transfer. In remote regions, regulatory fragmentation and weak cold chain infrastructure further hinder vaccine distribution. Promising innovations such as mRNA platforms, heat‐stable formulations, and microarray patches offer potential breakthroughs, but progress in scaling up manufacturing remains slow despite international partnerships and funding support. To achieve vaccine self‐sufficiency, Africa must strengthen its research ecosystem, build a skilled workforce, and expand domestic manufacturing capabilities.”

Decolonize Global Health

BMJ Opinion – Language and geographical bias limits global health research

https://www.bmj.com/content/392/bmj.s436

“Research in global health must expand its scope beyond English language publishing to ensure inclusivity, writes Abdourahmane Ndong.”

Guardian – My sexual freedom odyssey: what ancient African wisdom can teach us about pleasure today

N D Sekiamah;  https://www.theguardian.com/global-development/2026/mar/03/sexual-freedom-ancient-african-wisdom-teach-us-about-pleasure-today-nana-darkoa-sekyiama

“By speaking to women across the continent, I discovered how reclaiming pre-colonial rites and rituals can help us find joy in our bodies.”

AI & health

Science (Commentary) – Global majority countries must embed critical minerals into AI governance

C T Okolo;   https://www.science.org/doi/10.1126/science.aef6678

« Over the past decade, an increasing number of Global Majority countries—broadly characterized as economically developing countries in Africa, the Caribbean, Asia, Latin America, the Middle East, and Oceania—have introduced national artificial intelligence (AI) strategies. However, many of these frameworks overlook a critical dimension of AI governance: the strategic importance of critical minerals. As geopolitical tensions intensify around access to computing infrastructure, Global Majority countries must recognize that their mineral reserves represent leverage points for transforming their respective positions in the global AI value chain….”

The Invisible Gatekeeper

https://aipublichealth.substack.com/p/the-invisible-gatekeeper?triedRedirect=true

“How context routers decide what AI “knows” when it answers, and why public health leaders need to understand them.”

Papers & reports

WHO Bulletin March issue

https://pmc.ncbi.nlm.nih.gov/search/?term=((%22Bulletin+of+the+World+Health+Organization%22%5BJournal%5D)+AND+104%5BVolume%5D)+AND+3%5BIssue%5D

Theme issue on ‘Ethics and climate health research’.

The Milbank Quarterly – How Corruption Influences Population Health

I Kyriopoulos et al ; https://www.milbank.org/quarterly/articles/how-corruption-influences-population-health/

« This study examines the link between corruption and mortality. We find that corruption is associated with higher mortality, particularly in low-income countries. It is also linked to lower government revenue and distorted government expenditure patterns, which may contribute to resource misallocation and constraints in health financing. »

« Our findings contribute to the literature on upstream determinants of health by highlighting the relevance of institutional and political economy factors for population health. The Sustainable Development Goals on combating corruption and improving health are found to be complementary. Efforts to address corruption could align with and support public health objectives. »

The American Journal of Bioethics – Beyond Good and Bad: Rethinking Solidarity and Coercion in Public Health

Tess Johnson, S A Karim et al;  https://www.tandfonline.com/doi/full/10.1080/15265161.2026.2632018#abstract

“We analyze the terms solidarity and coercion, and argue that they cannot be used alone as moral judgements of public health actions. Rather, they are better considered as descriptive terms that are merely frequent proxies for normative terms such as justice or utility. We illustrate our argument by reference to three case studies: school reopenings in the USA, mandatory isolation measures in the UK, and vaccine distribution within the EU….”

Tweets  (via X, LinkedIn & Bluesky)

Shakira Choonara

Reflecting on the WHO DG race:

“Interesting read via Health Policy Watch: My thoughts: in the race for WHO DG, male leaders seem to be pitched more strongly than female leaders when it comes to top contenders for the post, also the key concerns and arguments of support are focused on fiscal reforms/ experience and also centred on the US returning to the organization, and experience and mandate of stronger health systems and increasing access universal health coverage seems to be on the backburner.”

Project Syndicate article quote

“@JosephEStiglitz @KalondoMonica @MichaelMarmot call for an automatic IP waiver on all critical pandemic therapies and products, which would be triggered the moment the  @WHO issues its formal pandemic declaration.    Project Syndicate: Inequality Will Make the Next Pandemic Worse

I’m feeling slightly nostalgic these days for the times, not so long ago, where one could still read about a fairytale “Grand Global health convergence by 2035” in a top medical journal or other merry “cosmopolitan moments”  on the horizon. In the year 2026, things feel slightly different.  Earlier this week, an EV alumna put it aptly on Whatsapp:  “Since some time, I’ve been wondering whether this is how people lived before WW II. Living ‘normal lives’ and keep doing regular things while the global craziness just keeps increasing. Something happens and then I think, “Well, this is the worst that can happen. But global super powers surprise me over and over again.”    And not in a good way, obviously.

Indeed, whenever you think we’ve reached rock bottom, Darth Donald and some of the other people currently in charge ‘trump’ it again in the new and largely lawless ‘Age of Resource Competition’.  Americans in particular must have felt super proud of their political system earlier this week, when during a war press conference, their ‘Commander in Chief’ was waxing about the “lovely drapes” in the “very, very beautiful new White House ballroom” in the making, just as his wife Melania was addressing the Security Council (apparently ‘Championing Peace Through Education”), and all while  Christian nationalists seem to have taken over a fair bit of the US military. Egged on by Pete “American Psycho“ Hegseth (the US ‘minister of War’), they seem rather keen on speeding up biblical end times  these days. Downright chilling.

When people later analyze what happened over the past few years (well, if we still get the chance), they’ll probably acknowledge that in addition to the raw & lawless power used by fascist leaders (Putin, Trump, Netanyahu, and yes, certainly also Khamenei…) and extremist movements, it was also the blatant double standards by most European and “like-minded” hapless leaders that killed the  (already heavily flawed) post-WWII ‘rules-based order’.  Where this will end? Nowadays, I’m just hoping not in “the Rapture”.

But as this is still a global health policy & governance newsletter, let us come back one last time on Gates and the Epstein files. Yes, you might think “this is  last week’s news”, but then again, you would be wrong. Let me briefly explain why, bullet-point style.

• When it comes to Gates’ individual behaviour, there’s certainly no ‘smoking gun’ – at least as far as we know. Dodgy, perhaps, yes (of the kind that breaks marriages), but not illegal.  (Or, in line with this week’s theme, in more or less Christian terms – at least the Christianity I remember from my catholic upbringing: “Whoever has never done anything dodgy, can throw the first stone.” )
• However, when it comes to the more structural links between Gates and Epstein (as well as by his Foundation), there’s more than enough in the Epstein files to warrant an independent investigation.  Tim Schwab already made that case convincingly in a few recent posts.  In his words: ““…Jeffrey Epstein presents a rare opportunity to hold Bill Gates accountable, and to finally have a larger public debate about extreme wealth and billionaire philanthropy—the common ground that initially brought Epstein and Gates together.”   This week, further news broke on Epstein’s involvement in  the polio eradication campaign in Pakistan (via Dropsite). Also timing wise, Gates is in far bigger trouble than Bill Clinton (who seems to have had no relationship with Epstein anymore after the latter’s conviction).
• You might well argue, there’s no ‘hard evidence’ yet, it’s mainly news reports etc. That’s right but the truth is: we will only know for sure if there’s actually an independent investigation (as compared to Gates interviews in “friendly” mainstream media and Gates foundation press statements). 
• And let’s not forget: usually global health can’t stop lamenting ‘conspiracy theories’ and misinformation jeopardizing public health. How on earth would you like to stop conspiracy theories re Gates & Epstein if you don’t set up an independent investigation?    By way of example, quoting the last sentence in the abovementioned Dropsite article: “…Now this entire Epstein saga will just give more oxygen to anti-vaccine hysteria and put millions of Pakistani children at risk. Just the thought of Gates and Epstein ‘helping’ children is enough to give any parent nightmares.””

• And so: whoever is currently  ‘reimagining’  global health, but decides to look away from this major governance problem in the global health architecture, might as well close shop.   As then clearly, they’re not doing their job: last time I checked, the Gates Foundation was part and parcel of the Global Health architecture. (#doublestandards?) So maybe, ahum, the ‘reimaginers’ should “refocus on their core mandate”?  

In any case, it’s now up to Helen, Anders, Peter P and all the others to do what’s needed. And yes, I know there’s one mitigating factor: that at this dire point in time, global health can’t do without the Gates billions. But I’m afraid that argument doesn’t suffice. More, I bet many Gates Foundation staff and grantees  agree.   Time to clean up the governance of the Gates foundation. But that won’t happen if global health’s Big Shots aren’t starting to push for it. 

Perhaps International Women’s Day   (8 March) is a good time to boldly set up a ‘Friends of an independent investigation of the Gates foundation’? : )

Enjoy your reading.

Kristof Decoster

–          Epstein files & (global) health

–          Global Health Reform & Reimagining (& post-2030 thinking)

–          More on Global Health Governance & Financing/Funding

–          Global Tax Justice & Reform

–          UHC & PHC

–          US Global Health strategy & bilateral health agreements

–          Impact aid cuts & ongoing transition

–          Trump 2.0

–          PPPR

–          Covid origins

–          HIV

–          SRHR

–          Commercial determinants of health & NCDs

–          AI & digital health

–          Planetary health (& financing)

–          Access to Medicines, Vaccines & other health technologies

–          WASH & health

–          Conflict/War/Genocide & health

–          Some more reports, collections & publications of the week

–          Miscellaneous

Epstein files & (global) health

BBC – Bill Gates ‘took responsibility’ over Epstein ties in staff meeting, foundation says

https://www.bbc.com/news/articles/cnv6rjp468ro

(25 Feb) “Bill Gates “took responsibility for his actions” and addressed his links to convicted sex offender Jeffrey Epstein during a meeting with staff from his charitable foundation, the organisation said.”

“Bill spoke candidly, addressing several questions in detail,” the Gates Foundation said in a statement. The Wall Street Journal (WSJ) reported that Gates apologised to staff, said he had two affairs with Russian women which Epstein later found out about, and in relation to the late financier said: “I did nothing illicit. I saw nothing illicit.” 

“Gates acknowledged that he had two affairs with Russian women that Epstein later discovered, but that they did not involve Epstein’s victims…”

“… A spokesperson for the Gates Foundation said in a statement: “This was a scheduled town hall with employees, which Bill does twice a year.”   “In the conversation, Bill answered questions submitted by foundation staff on a range of issues, including the release of the Epstein files, the foundation’s work in AI, and the future of global health…”

·         See also the Guardian – Bill Gates apologizes to foundation staff for Jeffrey Epstein ties

“Microsoft co-founder admits affairs and calls meetings ‘huge mistake’ but denies involvement in Epstein’s crime.”

“.. “To be clear, I never spent any time with victims, the women around him,” said Gates, whose foundation is one of the world’s leading global health philanthropies. Still, the men’s relationship was definitely “the opposite of the values of the Foundation and the goals of the Foundation”, he said. “And our work is very reputational sensitive. I mean, people can choose to work with us or not work with us.”

Devex – Gates-Epstein ties expose philanthropy’s ‘hypocrisy,’ experts say

https://www.devex.com/news/gates-epstein-ties-expose-philanthropy-s-hypocrisy-experts-say-111903

(gated) “Is the scandal embroiling Bill Gates symptomatic of larger moral dilemmas in billionaire philanthropy?”

“For critics, the issue isn’t only about reputational fallout for one foundation, but about the broader culture that elevates billionaire donors as moral arbiters of global health and development. When private wealth plays an outsized role in shaping public priorities, they argue, scrutiny of how that wealth was built — and the networks around it — becomes unavoidable.”

A few quotes:

“Hypocrisy is at the core of philanthropy, and we all have to come to terms with that,” Maribel Morey, a historian of U.S. philanthropies, told Devex.  “It’s not usually saints who become industry leaders and who amass significant amounts of wealth,” she said. “The path towards wealth accumulation is fraught from a moral perspective.”…”

“That debate is unfolding as aid budgets shrink and foundations loom larger. The Seattle-based Gates Foundation awarded $4.5 billion in grants in 2025 and $5.4 billion the year before. “The situation and the system that we’re in most of the time, honestly, you just have to kind of take the money,” says Alex Evans, a U.K.-based philanthropy consultant. “With something as massive as the Gates Foundation, and with USAID gone, what else is anyone going to do?”…”

Tim Schwab – The Epstein files should end Bill Gates’s philanthropic career

Tim Schwab;  

From earlier this week. “The troubling photos, emails and text messages should signal the start of the end for our self-anointed humanitarian-in-chief. The Gates Foundation’s do-nothing board of directors also must be removed.”

Quote: “… The foundation’s institutional decision to pursue a philanthropic relationship with someone like Epstein is not just reckless, but outrageous. The project gave the pedophile credibility and legitimacy—at the highest levels of polite society and elite philanthropy—that almost certainly helped immunize him from scrutiny, and that probably enabled Epstein’s campaign of abuse….”

Tim Schwab – Gates’s responds to Epstein, digs hole deeper

https://timschwab.substack.com/p/gatess-responds-to-epstein-digs-hole

Somehow I found this second blog from Schwab more convincing than the first one. “As the Gates Foundation ramps up its damage control efforts, Bill Gates personally addresses foundation staff about his ties to Epstein. His remarks only magnify the need for his removal.”

A few quotes:

“… The Gates Foundation has always stood firmly behind their patron. The Wall Street Journal, which was the first to report on Gates’s newest comments, quoted a foundation spokesperson praising its leader because he “spoke candidly, addressing several questions in detail, and took responsibility for his actions.” This comment speaks volumes to how far removed the Gates Foundation remains from anything resembling accountability on Epstein. It should be clear that Bill Gates isn’t taking responsibility. If you examine his remarks, you find a man claiming ignorance and issuing empty apologies, if not also describing himself as an unwitting victim of Epstein….”

Schwab concludes: “… My own view, as I wrote on Monday, is that the Gates Foundation, institutionally, no longer has the legitimacy to undertake a serious process of accountability. For years, the foundation’s governing board has sat on its hands and failed to address the Epstein-Gates affair. Since 2019, they could have and should have done a major investigation and dealt with this issue. For this reason, I think the entire board, most importantly Bill Gates, needs to be removed.”

BMJ – Doctors were complicit in Epstein’s abuse—survivors must now be our priority

https://www.bmj.com/content/392/bmj.s351

“A spectacle around Jeffrey Epstein’s depravity is overshadowing rights and justice for the survivors of the sex offender and his network, which included doctors, writes Jocalyn Clark.”

K Bertram – It isn’t just “locker room talk”. It’s called abuse.

https://katribertram.wordpress.com/2026/02/22/it-isnt-just-locker-room-talk-its-called-abuse/

Bertram: “…On why we ignore abuse of power – and how quickly we normalize hateful rhetoric and policy. My next blog is on who and whose stories are centred in these narratives, and what associations we have with images used.”

Global Health Reform & Reimagining (and post-2030 thinking)

International Journal for Equity in Health – Health equity and the global social contract: beyond incrementalism and illusionary solidarity

M Mulumba et al;   https://link.springer.com/article/10.1186/s12939-026-02773-7

“The Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) have been celebrated as global social contracts, yet their reliance on voluntary commitments and aspirational targets conceals a structural flaw. By divorcing poverty and inequity from colonial histories, debt regimes, and extractive global finance, these frameworks function as a neocolonial placebo: soothing global conscience while entrenching asymmetries of power and resources. Drawing on examples from debt distress, vaccine apartheid, and intellectual property monopolies during COVID-19, this commentary demonstrates that global health governance operates less as solidarity than as economic containment. Reparative justice provides the necessary rupture. A post-2030 Global Social Contract must impose enforceable obligations on former colonial powers, embed structural restitution through debt and tax justice, and democratise health governance under the principle of Common but Differentiated Responsibilities. Anything less risks reproducing selective generosity while abandoning equity to the logics of extraction and impunity…”

UK Govt – Global Partnerships Conference to build new international coalitions to tackle shared challenges

UK Government;  

“UK to cohost major international conference to reshape response to global challenges. The Conference will bring together partners from around the world to underscore need for more diverse forms of finance, cutting-edge technology and a focus on local leadership to drive solutions. It will establish new partnerships for international cooperation based on modern and diverse coalitions.”

“The Global Partnerships Conference will bring together a diverse coalition of governments, international organisations, philanthropists, investors, innovators, civil society, business and technology leaders on 19–20 May….. The Conference will build new coalitions to respond to shared challenges, unlock investment, support country-led resilient growth, and build alliances for international cooperation – making the UK and our partners safer, more resilient and prosperous…. Taking place in London, Foreign Secretary Yvette Cooper will co-host, alongside the Republic of South Africa, independent philanthropic organisation Children’s Investment Fund Foundation and the UK’s impact investor and development finance institution, British International Investment….”

Lancet Offline – A new narrative for global health?

R Horton ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00403-4/fulltext

A few excerpts:

“…There is an emerging view that we need a completely new global health narrative. The story that drove global health’s political claim to strategic importance 25 years ago was rooted in macroeconomics—extreme poverty is the biggest obstacle to sustainable economic growth; the causes of extreme poverty are a small number of preventable and treatable diseases; by tackling those diseases, poverty can be defeated and economic growth secured. Global health was foundational for development. But extreme poverty is no longer the world’s only challenge. Climate. Pandemics. Conflict. Migration. Demography. Digital. The story of global health needs to be rewritten to embrace this new context.”

“One narrative that we are being invited to endorse comes from the US Government: its 2025 America First Global Health Strategy. There are two propositions. First, that the global health system is broken, inefficient, wasteful, and creates perverse incentives that perpetuate those failures. Second, that advances in health will come not through multilateral partnerships, but rather from stronger bilateral relationships that aim explicitly to further the interests of both countries. The US is implementing this vision through aggressive Memoranda of Understanding that demand long-term preferred access to a country’s markets in return for short-term foreign assistance—neocolonialism on steroids. Meanwhile, The Global Fund is facing a period of internal turbulence. Global health cognoscenti question whether the Fund will survive to a Ninth Replenishment. The Fund’s Board has launched a recruitment campaign for an Executive Director to succeed Peter Sands in 2027. Some observers wonder if the nomination committee will have an unconscious bias towards American candidates to appease an unpredictable US administration. Perhaps an American Executive Director would be the quid pro quo for Trump’s latest pledge of US$4·6 billion. Mark Dybul’s name has been mentioned (he led The Global Fund from 2012–17). Looking ahead, the future for health as a political priority looks bleak. The G20 will be hosted by President Trump in Miami on Dec 14–15. Health is not on the agenda. WHO is soon to undergo its own spell of turmoil as it enters a protracted (and distracting) process for electing a new Director-General. And uncomfortable truths—corruption, incompetence, and bad policies—continue to be glossed over. Now is an urgent moment. The world is dangerously off-track to meet the SDGs. Who will call it out?”

More on Global Health Governance & Finance/Funding

GFO – 54th Global Fund Board meeting: the crossroads is drawing closer

https://www.linkedin.com/pulse/54th-global-fund-board-meeting-crossroads-drawing-closer-aidspan-b3w8f/?trackingId=FZjxvxnxSiOyb0THXGK02A%3D%3D

“This new issue of the GFO is essentially devoted to the 54th Global Fund Board meeting held in Geneva on 12–13 February 2026. It highlights a turning point: under pressure from shrinking aid and the weight of the United States, the Fund is accelerating prioritization and transition, with the risk of shifting risk onto African countries and weakening community responses – especially for key populations. The editorial calls for clear transition scenarios, non-negotiable safeguards, and full transparency on Grant Cycle 8 trade-offs.”

Very much recommended, this editorial!

·         Related:  Devex – Global Fund fundraising shortfall hits country allocations

“As bilateral aid shrinks and health systems strain, the Global Fund’s $10.78 billion allocation signals tighter resources ahead for countries already struggling to maintain services.”

Lancet World Report – Candidates prepare for WHO Director-General election

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00411-3/fulltext

Recommended read. “There is a wide field of unofficial candidates. Whoever succeeds will take the helm of an agency in turmoil. John Zarocostas reports from Geneva.”

Geneva Health Files – Leading The World Health Organization: Challenges & Opportunities Ahead For A New Director-General [GUEST ESSAY]

Geneva Health Files;

“ In this edition, we bring you a guest essay from leading global health scholars – Michel Kazatchkine, Ilona Kickbusch and Peter Piot – where they raise ten questions facing the future leader of the WHO…..”

Re staking a claim for the future, the governance metrics for the new DG, and the new DG’s ability to take on difficult political equations.

Journal of Health Politics, Policy & Law – The World Health Organization and the Shifting US and Global Political Orders

M Kavanagh et al ; https://read.dukeupress.edu/jhppl/article/51/2/329/403375/The-World-Health-Organization-and-the-Shifting-US

“The withdrawal of the United States from the World Health Organization (WHO) raises crucial questions about its future as the governing international organization for health. The executive order on withdrawal was one of President Donald Trump’s first acts in his second term. Because the United States is WHO’s biggest funder and most powerful state backer, withdrawal could indicate an existential threat. However, almost simultaneously member states passed a new international Pandemic Agreement expanding WHO’s authority. How should these conflicting signals be understood? Analyzing WHO’s decline in a context of broader US and geopolitical shifts, the authors find that withdrawal is the outcome of the end to broader political orders of neoliberal internationalism on which WHO depended for legitimacy rather than idiosyncratic Trump politics. WHO’s reliance on certain international norms and power structures leave it compromised. US normative and institutional shifts are far more difficult for WHO to navigate than in past political eras. Therefore, international relations research suggests that avoiding catastrophic impacts depends on reform actions by WHO officials, other member states, and US actors. States and others in the United States will face harm from WHO decline, and the authors suggest that US actors have legal standing to challenge withdrawal. Complacency and inaction may be WHO’s biggest risk.”

“…. If we are right, and WHO is caught between shifting political orders at both the global and the US national levels—in a type of moment famously called “the time of monsters” (Gramsci 1975: 311)—then minor reforms are unlikely to settle the crises. Inertia has been shown to exacerbate problems for international organizations facing withdrawal. WHO officials will need a far stronger geopolitical analysis to navigate the rocky road ahead….”

Africa CDC – Africa CDC statement on the outcomes of the 39th ordinary session of the African Union Assembly

https://africacdc.org/news-item/africa-cdc-statement-on-the-outcomes-of-the-39th-ordinary-session-of-the-african-union-assembly/

(23 Feb) “The African Union held its 48th Ordinary Session of the Executive Council and 39th Ordinary Session of the Assembly from 11–15 February 2026 in Addis Ababa, Ethiopia. During the sessions, Heads of State and Government adopted landmark decisions that significantly advance Africa’s Health Security and Sovereignty Agenda. The decisions included the following:….”

“…Heads of State and Government acknowledged the strides achieved in preventing and responding to disease outbreaks and endorsed the transition from the New Public Health Order (NPHO) to the Africa Health Security and Sovereignty (AHSS) Agenda, which will serve as the guiding continental framework for long-term health sovereignty, resilience, and self-reliance. The AHSS Agenda is built on five mutually reinforcing pillars that operationalize sovereignty across the health ecosystem…”

Do check the whole statement.

PS: it also includes a short section VII on Global Health Governance & partnerships: “The Assembly strongly supported Africa CDC in its application for membership and representation in major global health initiatives, including Gavi, CEPI, the Global Fund, and the Pandemic Fund, as well as its broader mandate to unify Africa’s voice in global forums such as the G20, G7, World Health Assembly, and Joint External Evaluation processes.  The Assembly called upon Member States and partners to collaborate with Africa CDC to ensure that global partnerships reinforce, rather than substitute, Member State commitments, and to align procurement and support with continental priorities for local manufacturing and health sovereignty…..”

Devex – WHO’s Africa chief on why health system reform is a marathon

 https://www.devex.com/news/who-s-africa-chief-on-why-health-system-reform-is-a-marathon-111869

(gated) “Dr. Mohamed Janabi, the new regional director of the World Health Organization’s office for Africa, outlined his vision for advancing health sovereignty for countries across the continent.”

“In the wake of drastic foreign aid cuts that abruptly hit health systems across the continent, his first seven months in office were marked by a period that was “very intense for stabilization, refocusing, rebuilding confidence in our systems,” he said during a Devex Pro event last week. On top of that, health authorities across Africa responded to 114 health outbreaks on the continent last year….”

“Did the [aid] cuts affect us? Definitely,” he said during a recent Devex Pro Briefing, noting that in some countries, there will be disruptions of up to 60% in areas such as essential health services, maternal care, vaccinations, surveillance, and workforce training.”

“Janabi said there’s a cure: cost-effective interventions — with a focus on disease prevention rather than more expensive responses.   “The savior of my continent is investing in primary health care — is investing in universal health coverage. This will rescue us,” he said. “It’s always cheaper to prevent it. It’s always cheaper to intervene within 72 hours.””

“But perhaps the most important component is health sovereignty — and moving away from a model where the global north parachutes in with its solutions…”

Lancet Comment – Fundamental PEPFAR reform risks a period of structural vulnerability in the HIV response

Jirair Ratevosian, Chris Beyrer; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00369-7/abstract

(must-read)    Excerpts:

“… 1 year after the policy disruptions that reshaped the US President’s Emergency Plan for AIDS Relief (PEPFAR), the global HIV response has entered a second year of structural transformation. In early 2025, the programme faced the most uncertain period in its history, marked by the absence of reauthorisation, the suspension of foreign assistance spending by the US Government, and the beginning of major shifts in PEPFAR programme implementation. Those conditions have not fully resolved. The continued lack of long-term reauthorisation by the US Congress has allowed further programmatic and structural changes to proceed, radically redesigning how PEPFAR operates and how the global HIV response is coordinated….”

“…At the same time, the US administration is pursuing multiyear bilateral health agreements shaped by the America First Global Health Strategy,  using PEPFAR resources as a central pillar of broader health financing integrated with malaria, tuberculosis, and polio programmes in priority countries….”   “…. breaking apart PEPFAR’s long-standing system of coordination across US agencies—once a core strength of the programme has become one of the most consequential changes. The previous model, which closely tied HIV outcomes, community programming, and diplomatic engagement across US agencies, served as the operational backbone linking epidemiological evidence to programmatic action. Its replacement by bilateral transition mechanisms, outcome-based contracting, and new audit structures has weakened standardised planning and reporting processes, reducing comparability across countries, and could potentially undermine real-time course-correction when challenges are identified. Additionally, without clear indicators and regular, transparent reporting on HIV outcomes, the current administration’s bilateral approach risks eroding oversight of programme performance, implementation quality, and financial stewardship, and may ultimately weaken sustained congressional support. “

“The resulting model is structurally distinct from the framework that drove two decades of global HIV gains  … … … The changes to PEPFAR under the current US administration represent a marked departure from the principle of HIV exceptionalism that guided the global response for two decades. Although framed in terms of efficiency and national ownership, bilateral arrangements negotiated at the country level often have insufficient institutional safeguards, which historically protected rights-based and community-led programming for marginalised populations. The deprioritisation of politically sensitive prevention efforts risks widening the gap between where resources are allocated and where new infections are occurring among marginalised key populations.”

“…These structural and policy shifts matter because they are unfolding at a time when the epidemiology of HIV is becoming more concentrated, uneven, and politically complex. New infections now primarily occur among key populations and their networks—eg, men who have sex with men, transgender women, sex workers, people who inject drugs, and adolescent girls and young women in eastern and southern Africa.  At the same time, the geography of the epidemic is changing. Although several high-burden African countries achieved substantial reductions in HIV incidence over the past decade, HIV transmission continues to expand in eastern Europe and central Asia, Latin America, and parts of the Middle East and north Africa. Epidemic control now depends less on broad HIV service expansion and more on precise, population-focused prevention strategies often delivered in contexts where stigma, criminalisation, and political resistance remain substantial barriers.   …One of the most consequential shifts of the past year is the erosion of community-led key population programming as a result of changes to financing and implementing PEPFAR-supported programmes….”

Authors also sketch a path forward.   And conclude:”… The coming years will determine whether this transformed architecture can preserve PEPFAR’s legacy while adapting to a changing world—or whether the global HIV response enters a period of slower, less certain progress.’

Via Devex Check-up – update re UNAIDS

Devex; 

“Meanwhile, UNAIDS — which is cutting more than half its staff and scaling back its country presence amid donor funding shortfalls — is cautiously hopeful that the $45 million allocated by the U.S. Congress for fiscal year 2026 will come through.  If it does, the funding could ease some of the program’s financial strain this year. At a town hall earlier this month, a UNAIDS official told staff the secretariat has secured $21 million from the Netherlands for 2026, but other donors — including the U.S. — have yet to disburse their contributions.”

“A major unknown is whether U.S. funding will come with conditions. UNAIDS told me this week it does not yet know “what conditions, if any, are specified.” Still, during the town hall, Executive Director Winnie Byanyima reassured staff that the agency is not backing away from supporting communities’ access to HIV services. If U.S. funds cannot be used for certain programs, she said, UNAIDS would draw on other resources to continue that work….

Devex Pro – Can FIND regain donor trust after a wave of setbacks?

https://www.devex.com/news/can-find-regain-donor-trust-after-a-wave-of-setbacks-111731

“FIND CEO Dr. Ifedayo Adetifa believes 2026 will be “a recovery year” for his organization. But some of FIND’s top donors’ grants remain on pause.”

(gated) “FIND, the Geneva-based foundation globally known for its work in improving access to health diagnostics, wants to move past a tumultuous period marked by grant suspensions and project terminations. But instead of a fresh start, it is facing new staff layoffs and continued donor grant suspensions that have left staff members worried about the future of the organization and its work….”

Lancet Letter – Watching the watchers: a reply from Global Health Watch 7

R Labonté & C Bodini ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00289-8/fulltext

Replying in detail to Horton’s ‘Watching the Watchers’ series.

Excerpt: “We agree with Horton’s comment in part 2 about the implications of the Trump administration’s and other states’ rejection of the global multilateralism that prevailed in the early 2000s, and the anarchic international disorder that will, as Horton argues, increase the corporatisation of health systems. However, it is important to remember that the international order the Trump administration seeks to undermine is itself a neoliberal one, marked by the privatisation of health systems and transformation of public resources into some form of private capital accumulation. The World Bank and International Monetary Fund policies, although muted in the post-2000 Millennium Development Goals and Sustainable Development Goals era, were very much a part of this neoliberal order. Paradoxically, neoliberalism’s present dismantling by the Trump administration might create the necessary space for a new and more equitable order to arise—a Schumpeterian bout of creative destruction. However, can a wellbeing economy or ecosocialist global order overcome autocrats and fascists? Or will great powers politics prevail?…”

Christian Aid  – The state of play of IMF conditionality

https://www.christianaid.org.uk/news/policy/state-play-imf-conditionality

“As the IMF reviews its day-to-day practices in the global South, can it break free from paternalism, or does it continue to know best?”

“As of October 2025, 86 countries were indebted to the International Monetary Fund (IMF) – that’s nearly half of the world and includes 18 out of the 26 poorest countries. As the IMF functions as a lender of last resort to governments facing balance of payment problems, these figures reflect a global debt crisis and the high price countries are still paying for the Covid-19 pandemic and the intersecting crises that followed. It is also indicative of the central role the IMF continues to play in shaping the world’s economic policy infrastructure. Its main tool for doing so is the policy conditionality that accompanies most of its lending programmes. This year, the IMF will be reviewing its programme design and conditionality, known as the Review of Conditionality (RoC), as well as the policy advice it provides to all countries every year in its Review of Surveillance. Together, these reviews will shape the institution’s day-to-day work in the global South for the next five to ten years – so it’s worth taking a closer look at what could be gained – or lost – and what it tells us about the power of the IMF in shaping global economic decision-making.   “

WHO Human Rights Unit shut down

Via the weekly Health and Human Rights news digest:

“The World Health Organization’s Policy, Law and Human Rights Unit was shut down this week with its leaders, Natalie Drew Bold and Michelle Funk, announcing their departure from WHO. The closure follows ‘considerable restructuring’ attributed to the withdrawal of the United States from WHO. The departing team stressed the continuing importance of resources generated by their work, including the QualityRights initiative. Resources related to mental health, substance use, disability, general health, human rights and development are still available at WHO, as well as at MiNDBank, a global online platform….”

NPR – China and the U.S. alter foreign aid strategies

F Tanis;   https://www.wwno.org/npr-news/2026-02-24/china-and-the-u-s-alter-foreign-aid-strategies

Worth a read, even if mainly quoting American experts.

“… Foreign aid has long been a way for the United States and China to gain soft power and influence — providing public services in low-income countries that help them tackle poverty and disease, and engaging with people to build cooperation over the long run. For decades, the two countries had adopted separate international aid strategies. But the Trump administration has dismantled much of the United States’ traditional foreign aid systems and is charting a new path, while China has also been adjusting its approach —stepping up visible contributions to global institutions while scaling back some of the large infrastructure projects that once defined its strategy.”  “The result is a moment of convergence and competition: the U.S. is moving toward a more transactional model long associated with Beijing, and China is positioning itself to become a bigger presence in global health and development…”

“China, over the past 5 years, has slowly moved away from the big bilateral deals and is now funding small projects in low income countries and getting more involved with the United Nations. In 2021, President Xi Jinping announced a new initiative—called the Global Development Initiative—modeled more closely after what the U.S. had been doing, according to Huang…. …
China began doing what it calls “small and beautiful” projects to address poverty and health issues.”

PS: “Looking at China’s moves in 2025, experts say the picture is more complicated. Jennifer Bouey, chair of the Global Health department at Georgetown University and co-author of the research project with Dolan, has looked at official documents and policy papers from China and says there’s a sense of opportunity after the U.S. aid cuts.  “China is now thinking, ‘Okay, now the U.S. is retreating from the U.N., retreating from WHO. This is a time for China to build its global influence, dominating the international organizations, and at the same time to have a platform to expand its economic footprint,’ ” Bouey says. …Still, China spent about the same overall on foreign aid in 2025 as it did in previous years, says Bryan Burgess, who tracks China’s aid spending at the College of William and Mary.  “They’re doing short term measures to win over hearts and minds, but they’re not investing in the sort of infrastructure and sustainability that big diseases need to get eradicated,” Burgess says.  Both he and Rolland say China won’t be rushing to fill the gap left by the U.S. “I don’t think it’s fully ready to take that role of a global health provider, and it’s probably started feeling the stones. That’s a Chinese expression to say, ‘we’re advancing very prudently in that direction.‘” Rolland says.  However, it’s clear that China will try to increase its influence through foreign aid, as the U.S presence appears to wane, she says….”

People’s Dispatch – Economics of Health for All: the plan to put health at the heart of the global economy

https://peoplesdispatch.org/2026/02/20/economics-of-health-for-all-the-plan-to-put-health-at-the-heart-of-the-global-economy/

“At the World Health Assembly in May, member states may endorse an unprecedented strategy declaring that health is not a cost – but the best investment an economy can make.”

“… Despite its limitations, the strategy is paving a way for a new kind of economics, one that is more humane. For fifty years, the global health menu has offered variations on the same theme: more aid, more efficient delivery, better metrics. The Economics of Health for All (EH4A) strategy offers something else entirely. It asks countries to redesign the economic order….”

“Whether the strategy can deliver on its vision depends on battles still unwaged. But for the first time in a generation, the question is no longer whether health belongs in economic policymaking. It is what kind of economy we are willing to build.”

Devex – Britain’s international aid cuts have failed. It’s time to change course

A Lovett (ONE);   https://www.devex.com/news/britain-s-international-aid-cuts-have-failed-it-s-time-to-change-course-111935

“Britain’s international aid cuts have failed. It’s time to change course.”

“A systematic analysis of the U.K.’s decision to slash its aid budget one year on shows that none of the original justifications for the cuts stand up to scrutiny.”

“It is clear that the prime minister’s decision to slash U.K. aid has not resolved the defense funding challenge, balanced the country’s books, or helped the government’s popularity…”

“… Overall, as historical analysis shows, Keir Starmer has joined a group of British prime ministers who share two features in common: the biggest cutters of international aid are also the most unpopular prime ministers in modern history. That is not a causal relationship — but cutting aid certainly does not form part of a winning electoral strategy….”

“But perhaps the most striking recent development is that the U.K., in claiming to follow the U.S. lead, now in fact occupies the top spot on the aid cuts leaderboard. “

·         Related:  One year since UK aid cuts, 93 INGO leaders highlight devastating impact

“One year on from the UK aid cuts, the UK INGO sector has issued a joint statement, reflecting on the devastating consequences of the cuts and calling on the UK government to recommit to an ambitious international development agenda. “

Independent –  How debt relief for developing countries could help reverse the devastating consequences of UK aid cuts

https://www.independent.co.uk/news/uk/politics/debt-labour-aid-cuts-africa-b2925671.html

“New analysis finds that debt relief for developing countries – which the UK could play a key role in orchestrating – could more than offset the impact of UK aid cuts. Nick Ferris reports”

“… new analysis produced by the charity CAFOD – which is based on research from the University of St Andrews and Save the Children and shared exclusively with The Independent – finds that the devastating impact of UK aid cuts could be more than counteracted by debt relief, which would effectively see developing countries’ debts partially cancelled or restructured.”

“The analysis finds that if the debt-servicing costs of low-income countries were reduced to a “more sustainable level” of around 10 per cent, enough fiscal breathing room would be created to see massive gains across health, education, water works and sanitation…..”

PS: “campaigners argue that the UK has a unique role to play in using legislation to drive forward debt relief, due to the fact that 45 per cent of bonded sovereign debts are governed under English law, as a result of the City of London’s importance as a global financial centre. That share increases to 90 per cent when only the debt-loaded developing countries currently eligible for debt relief under the G20 Common Framework – the existing multilateral debt-relief system – are considered….”

Global tax justice & reform

CESR – From mandate to machinery: the unresolved structural questions of the UN Tax Convention

M E Mamberti; https://www.cesr.org/from-mandate-to-machinery-the-unresolved-structural-questions-of-the-un-tax-convention/

“On February 13th, the Intergovernmental Negotiating Committee (INC) negotiating the future UN Framework Convention on International Tax Cooperation (UNTC) plus two early protocols (one on cross-border services, and one on dispute prevention and resolution) finalized its fourth substantive sessions in New York. As countries re-group online in inter-sessional (regrettably closed) meetings and prepare for the next in-person sessions in August, we discuss here some of the key issues that sparked controversy in February.”   (A bit technical but well worth a read)

UHC & PHC

Health Systems 2050 roundtable explores South Africa’s future readiness

https://www.afro.who.int/countries/south-africa/news/health-systems-2050-roundtable-explores-south-africas-future-readiness