·         79^th WHA: key events & highlights so far

·         WHA79 – Ebola outbreak

·         WHA79: Hantavirus outbreak

·         WHA79: More on PPPR & GHS

·         WHA79: Global Health reform

·         WHA79: DG race

·         WHA79: Climate & Health

·         WHA79: More analysis, advocacy, reports, …

·         More on Global Health Governance & Financing/Funding

·         Trump 2.0

·         Development Cooperation reform

·         More on UHC & PHC

·         Access to Medicines, Vaccines & other Health technologies

79^th World Health Assembly : key events & highlights so far

We start with a more or less chronological overview, since last weekend.  Focusing on some of the main highlights & key events first of all. In next WHA79 related sections, we’ll then delve deeper into some of the key agenda items.

PS: resource: WHO Tracker:  https://who-track.phmovement.org/node/699   With PHM views on various agenda items.   The WHO Watchers also publish daily briefs.

PS: we start this subsection with some ‘agenda/backdrop’ related overviews, as the WHA was about to kick off. And then provide a chronological overview of some of the key highlights so far (till Tuesday lunchtime).  (obviously: no way we can be comprehensive…)

Geneva Health Files – Ebola Declared a Public Health Emergency of International Concern; Hantavirus Outbreak Foreshadows the World Health Assembly

https://newsletter.genevahealthfiles.com/ebola-hantavirus-outbreaks-foreshadow-the-world-health-assembly/?ref=geneva-health-files-newsletter

Starting from a WHO media briefing last Friday and then the PHEIC announcement on Saturday. Which provided for an even more worrying backdrop of this WHA than already was the case. “…quick update on the outbreaks of Ebola and the Hantavirus, from a briefing by the World Health Organization, yesterday, on May 15, 2026. … At the cusp of the World Health Assembly, when 192 member states of the World Health Organization gather in Geneva starting Monday, these outbreaks are as much a sombre reminder of the fragility of health, as they are about the importance of collective efforts to safeguard health…..”

PS: re the Ebola outbreak: “WHO Response: DG Tedros said WHO has released $500,000 from the WHO contingency fund for immediate response, including surveillance, contact tracing, and laboratory capacity….” Operational Challenges: The region is highly volatile with significant population mobility due to mining and cross-border trade, which increases the risk of transmission. Vaccination Status: Testing is underway to confirm the specific strain; while Zaire strain vaccines are licensed, protocols are being readied for experimental vaccines should they be required for other strains….”

HPW – Outbreak Threats, Geopolitical Divides and Financial Crises Hover Over 79th World Health Assembly

https://healthpolicy-watch.news/outbreak-threats-geopolitical-divides-and-financial-crises-hover-over-79th-world-health-assembly/

Must-read analysis as WHA79 was kicking off.  With also some key quotes from a pre-WHA high-level event at the Graduate institute (Sunday).

 “As the World Health Assembly Opens Monday in Geneva it will have to grapple with shrinking global health budgets; new outbreak threats, including a new WHO-declaration of a public health emergency in Africa over an Ebola virus strain that lacks any vaccine; and an increasingly fractured geopolitical space with deep disputes over Iran, Ukraine, Gaza, and Taiwan spilling into debates. “

PS: “…. In the last round of PABS talks in early May, some member states led by Colombia appealed for a ‘new method’ for approving the agreement that departs from the traditional “all or nothing” consensus modes of negotiations – including voting in stages over portions of the text where there is general agreement.  Indeed consensus has become more and more difficult to reach in a sharply polarized world, said WHO’s former Legal Counsel, Gian Luca Burci, speaking at a high-level WHA preview event staged Sunday by the Global Health Centre of the Geneva Graduate Institute.  …” ““Consensus is difficult and it can create imbalances,” Burci observed, noting that just one or two powerful nations can block agreement by all of remaining WHA member states. “There are many different views. Is that a good approach, or is it sometimes better to vote? Because consensus gives a veto, and vetoes sometimes are used by big, powerful countries. It’s very difficult for a weak country to stand in the way, and so, in a way, it creates imbalances.” “The increased politicization of global health agendas has also led to more stalemates, stand-offs and bitter member state confrontations, leading to more voting as well,  Burci noted.  And this year’s 79th session is likely to continue that trend. …”

PS: re the funding situation: “The good news is that following reductions of nearly a quarter of its workforce, WHO’s $4.2 bilion budget for 2026-27 is now 90% funded, according to a report to the WHA by the Director General. At the same time,the figure includes $739.8 million in projected resources from commitments that have not yet been definitively secured….”

PS:  re Global Health reform: “ As an initial response by WHO, WHA will consider approval of a new joint UN-WHO process to support review and reforms in the “global health architecture”.    But the initiative lacks ambition in terms of actually taking a hard look at institutional mandates and how they could be streamlined, said Wellcome’s CEO, John-Arne Røttingen, also speaking at the GHC event. He noted that the WHA mandate doesn’t extend to any serious examination of the oft-competing roles and responsibilities of the UN’s global health institutions. These institutions include not only WHO, but also UNAIDS, UNICEF, UNDP, UN Women and the UN Population Fund (UNFPA).    “I am concerned about the risk being that we are not bold enough, really, and that we become incremental instead of going for bolder reforms,” Røttingen observed. “I’m really concerned about the current drafted mandate for the joint WHO process –  because it’s really, from an architecture point of view, about changing the wallpaper and the colors of the painting.”

PS: “…At the same time, reforms need to go far beyond making global health institutions more efficient.  Reforms need to ensure that national health systems regain “sovereignty” over their health services in terms of both financing and programmatic control, pointed out Magda Roballo, co-chair of the UHC 2030 Steering Committee, also speaking at the GHC event.  And that can only happen through bigger changes in trade, debt structures and employment.   “The health ecosystem depends on structures that have been built over eighty years,” she noted, “and they all have a major influence on health. If we don’t look into the bigger picture, that’s a very high risk to health reform,” she said.   “It is true that as health agents we don’t have the power to change what is going to happen in the fiscal and the financial space, but we need to interact with the reforms in the global financial architecture and the UN 80 initiative. If we are going to change what is the landscape for the future of the health sector.”

PS: “More profoundly, both rich and poor nations still have to come to terms with the fact that while health ‘sovereignty’ is an increasingly popular slogan today in many nations, countries remain deeply interdependent in terms of the health security everyone craves, added GHC Director Suerie Moon, at the event.   And this requires cooperation on almost every front – from the financing of health systems to the health products nations produce and consume and capacity to conduct surveillance, research and collaborations that protect everyone better from disease threats.   “Covid kick-started this move towards “health sovereignty,” and recent events have made some hit the accelerator,” … “However, the desire for health sovereignty is bumping up against the hard reality of health interdependence. No country can fully protect the health of its people on its own. “

HPW – Zero for 52: WHO Warns World Set to Miss Every Global Health Target by 2030

https://healthpolicy-watch.news/zero-for-52-who-warns-world-set-to-miss-every-global-health-target-by-2030/

With some key messages from the World Health Statistics report, published last Wednesday.

“The world is on course to miss every one of the 52 health-related Sustainable Development Goal targets by 2030, the World Health Organization has warned, as ministers from its 194 member states gather in Geneva for an assembly tasked with reversing that trajectory.  With malaria cases rising, maternal deaths still occurring at nearly three times the targeted rate and childhood vaccination coverage plateauing or falling in some regions, progress on global health goals has slowed, stalled or reversed across virtually every measure since 2015, according to the 2026 edition of the WHO’s World Health Statistics report….”

HPW – Tedros: ‘We Live in Difficult, Dangerous and Divisive Times’

https://healthpolicy-watch.news/tedros-we-live-in-difficult-dangerous-and-divisive-times/

““From conflicts to economic crises to climate change and aid cuts, we live in difficult, dangerous and divisive times,” World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus told the opening plenary of the World Health Assembly (WHA) on Monday.”

“While geopolitical disagreements have delayed Tedros’s official WHA address until Tuesday morning, the Director General acknowledged in a brief welcome that the WHO “has been through a difficult period as a result of sudden and steep cuts to our funding”….”

“The organisation’s budget is 90% funded, although some of the funds are pledged rather than in the bank….”

“Spain’s Prime Minister Pedro Sánchez, a WHA special guest speaker, appealed for solidarity and multilateral support for global health to combat “the pandemic of egotism and selfishness”….”

“… The WHA is considering how to reform the “global health architecture”. Ghanaian President John Dramani Mahama, also a special guest speaker at the plenary,  appealed for a more inclusive system of multilateralism. “I’m concerned about whispers I have heard that the draft resolution [on global health reform] seeks to protect existing organisational mandates and prohibit the recommendation of mergers or consolidations,” said Mahama, who is championing Africa’s health sovereignty through the Accra Reset Initiative…..”

·         Related:  WHO Director-General’s opening remarks at the 79th World Health Assembly high-level welcome – 18 May 2026

Devex – John Mahama warns health reforms must consider mergers, new mandates

https://www.devex.com/news/john-mahama-warns-health-reforms-must-consider-mergers-new-mandates-112517

“The Ghanian president, who is pushing for bold reforms in global health governance, told countries at the 79th World Health Assembly that “we must be brave enough to look at institutional mandates and mergers without fears.””

“During this week’s meetings, WHO is proposing a joint process on reforming the global health architecture, which will culminate in a final report to be considered by the World Health Assembly in 2027. But some have criticized the proposal because it won’t include recommendations on revising the mandates of specific organizations, or propose mergers or consolidations — ostensibly because those are under the purview of the governing bodies of each institution….”

“Mahama — who has been the face of the Accra Reset, a reimagining of global health governance where individual countries have more sovereignty — raised concerns about this limitation and warned against protecting institutional mandates over pursuing meaningful reform….

PS: “… It is this “gloomy outlook,” he said, that prompted the launch of the Accra Reset and sets the backdrop for this year’s WHA. Mahama touted multiple health reforms in Ghana, including a fund to support healthcare for people with noncommunicable diseases, and said the country is on track to no longer need funding from Gavi, the Vaccine Alliance by 2030…..”

HPW – Member States Support Extended Deadline for Talks on Pandemic Agreement Annex

https://healthpolicy-watch.news/member-states-support-extended-deadline-for-talks-on-pandemic-agreement-annex/

“All World Health Organization (WHO) member states supported the extension of talks on the last outstanding piece of the Pandemic Agreement, the Pathogen Access and Benefit-Sharing (PABS) annex, at the World Health Assembly’s (WHA) Committee A on Monday.  … A draft annex will either be presented at next year’s WHA or at a special WHA if agreement is reached beforehand, according to the report….”

“Several of the many member states speaking on PABS in Committee A expressed confidence that the annex would be completed by the end of the year. However, divisions between developed and developing countries remained stark….”

WHO Director-General’s address to Member States at the 79th World Health Assembly – 19 May 2026

https://hq_who_departmentofcommunications.cmail20.com/t/d-e-guddhlk-ikudkhluul-t/

On Tuesday morning. Do read in full. Overview of everything WHO did the past year.

Guardian – WHO head ‘deeply concerned’ by Ebola outbreak as cases and deaths rise in DRC

https://www.theguardian.com/world/2026/may/19/ebola-outbreak-drc-who-tedros-adhanom-ghebreyesus-deeply-concerned

“At least 130 people thought to have been killed, says Tedros Adhanom Ghebreyesus before emergency meeting.”

Geneva Health Files – Health Emergencies & Political Votes Intersect to Spark Off Tense Start to the World Health Assembly

https://newsletter.genevahealthfiles.com/health-emergencies-political-votes-intersect-to-spark-off-tense-start-to-the-world-health-assembly/

“The political aspects of global health essentially blew up at the plenary discussion on the very first day of the Assembly. There were three votes on Russia-Ukraine, Iran-Gulf Countries, and Palestine-Israel. … …. In the midst of these raw debates, countries are also putting out their vision on reforming how global health should be governed. And the discussions on reforms will be one of the most significant this year….”

“So contentious was the plenary session [on Monday] that there was no time for the DG’s main speech on day one. …”

WHA79 – Ebola outbreak in the DRC

WHO – Epidemic of Ebola Disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern

https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern

(17 May) The official PHEIC announcement by Tedros. “Pursuant to paragraph 2 of Article 12 – Determination of a public health emergency of international concern, including a pandemic emergency of the International Health Regulations (2005) (IHR), the Director-General of the World Health Organization (WHO), after having consulted the States Parties where the event is known to be currently occurring, is hereby determining that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), but does not meet the criteria of pandemic emergency, as defined in the IHR….”

·         Coverage & analysis via Stat:   “An Ebola species called Bundibugyo is causing the cases. Health officials have less experience dealing with this strain — there have only been two documented Bundibugyo outbreaks before — and there are no licensed vaccines or therapeutics for the viral species. … “

“… There are a number of signs, the WHO said, of “a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread…..”

·         And via Science News –  WHO declares major outbreak of rare Ebola virus species an international emergency  (16 May)

“…. But the apparent scale of the outbreak makes a response harder, given the number of contacts that need to be traced and tests that need to be run, says Jason Kindrachuk, a virologist at the University of Manitoba. It also suggests the outbreak may have started many weeks ago. “It’s a heck of a lot of cases to be under the radar,” Rimoin says.”

“Part of the reason appears to be that early tests didn’t detect Ebola Bundibugyo, says Placide Mbala, head of epidemiology and global health at INRB. The regional health center of Bunia, where the cases were first tested, uses a diagnostic machine called Genexpert that only recognizes Ebola Zaire, the most common Ebola virus species and the cause of almost all previous outbreaks in the DRC. ….”

PS: “This is the ninth time a Public Health Emergency of International Concern has been declared since the special designation system was introduced in 2005, and the third one for an Ebola outbreak. Tedros appears to have invoked the emergency status based on information from the two countries, without awaiting the advice of a special Emergency Committee, which is the normal procedure….”

“The lack of a licensed vaccine—which helped bring recent Ebola Zaire outbreaks under control—will make the fight harder, Kindrachuk says. “

Africa CDC Calls for Urgent Regional Coordination Following Ebola Virus Disease Outbreak in Ituri Province, DRC, and Imported Ebola Bundibugyo Case Reported by Uganda

Africa CDC;

(15 May) Africa CDC is clearly also very concerned. “The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring the confirmed Ebola Virus Disease outbreak in Ituri Province, Democratic Republic of the Congo (DRC), and the imported Ebola Bundibugyo case reported by the Uganda Ministry of Health. Africa CDC is working with national authorities and partners to support a rapid, coordinated regional response aimed at interrupting transmission, protecting communities and reducing the risk of cross-border spread…..”

Africa CDC – Africa CDC Declares the Ongoing Bundibugyo Ebola Outbreak a Public Health Emergency of Continental Security

https://africacdc.org/news-item/africa-cdc-declares-the-ongoing-bundibugyo-ebola-outbreak-a-public-health-emergency-of-continental-security/

“ The Africa Centres for Disease Control and Prevention (Africa CDC), acting on the recommendations of its Emergency Consultative Group (ECG), has officially declared the ongoing Bundibugyo ebolavirus disease outbreak affecting the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of Continental Security (PHECS). This declaration, under Article 3, Paragraph F of the Africa CDC Statute, empowers the organisation to lead and coordinate responses to significant public health emergencies across the continent…”

“… The declaration follows extensive consultations at political, strategic and technical levels, including consultations with H.E. Mahmoud Ali Youssouf, the African Union Commission chairperson; H.E. Cyril Ramaphosa, President of South Africa and the African Union Champion for Pandemic Preparedness, Prevention and Response (PPPR); and consultations with Member States affected or at risk. This declaration was built on recommendations from the ECG, chaired by Professor Salim Abdool Karim, which reviewed the evolving epidemiological situation, regional risks, response capacities, and the implications of the confirmed Bundibugyo ebolavirus strain. …”

PS: Jean Kaseya decided to fly back from Geneva (where he was going to attend the WHA) to manage the Ebola outbreak.

Reuters – Flawed tests and funerals allowed Ebola to spread undetected, sources say

Reuters; 

“First known case died April 24, outbreak declared May 15; Lab used testing cartridges for wrong Ebola strain; Funeral gathering caused cases to ‘explode’, official says; WHO laments ‘critical four-week detection gap’.”

FT: Lethal Ebola virus outbreak triggers urgent international quest for vaccine

https://www.ft.com/content/d777cf65-4c8e-40ea-a173-92905d1684ab

“A World Health Organization advisory group is due to would meet on Tuesday to recommend candidate jabs to prioritise for clinical trials, the global health body said. It will assess data including an analysis by the Coalition for Epidemic Preparedness Innovations (Cepi), which was set up after failures in the international response to a previous Ebola crisis.   …”

“… “If there was ever a time that we could show the world why Cepi is needed and show the world why the 100-day mission is needed, it’s now,” Nicole Lurie, the organisation’s executive director for preparedness and response, told the FT. “We’re happy to accept that responsibility, but obviously we need help from partners — particularly financial help in the long run.””

“DR Congo and Uganda would make the final decision on whether to press ahead with any vaccine candidates endorsed for clinical trials by the WHO experts, the global health body said….”

“… Lurie said Cepi had provided information from a survey of research teams and companies working on drugs that might be effective against the Bundibugyo virus behind the outbreak. The organisation hoped soon to announce partners in the quest for a jab, she added, although she declined to give a timescale for when one might be developed….”

·         See also  Stat – With no approved vaccine for Ebola outbreak, experts weigh testing a long shot

“Animal study suggests Merck’s Ervebo, designed for another strain of the virus, may offer some protection.”

“… there is a tiny bit of scientific evidence that suggests the existing licensed Ebola vaccine, Merck’s Ervebo, might offer some protection against this virus, even though it is designed to target a different species of Ebola, Zaire ebolavirus. … … The World Health Organization and scientists who study these viruses are debating whether Ervebo could help contain this outbreak. A meeting of a group of experts who advise the WHO on development of needed vaccines is scheduled for Tuesday, and the question of whether Ervebo should be put to the test will be on the agenda, Vasee Moorthy, acting lead of WHO’s R&D Blueprint group told STAT…..

Science Insider – Scientists play catch-up to startling Ebola outbreak

https://www.science.org/content/article/scientists-play-catch-startling-ebola-outbreak

Must-read analysis. “Testing, sequencing, and clinical trial efforts spring to life as Bundibugyo virus spreads.”

“…. By Friday night, the World Health Organization (WHO) and Africa Centres for Disease Control and Prevention (Africa CDC) had convened a meeting and chosen the most promising candidate drugs to test in a clinical trial. The next morning, a trial protocol had been adapted to those drugs for submission to regulatory authorities in the DRC and Uganda. By this evening, two teams from Uganda and the DRC had published three genome sequences from the virus online, which should help scientists track how it is spreading. “Amazing work from those two teams—bloody fast turnaround!” says Kristian Andersen, an evolutionary biologist at Scripps Research….”

“…. At WHO’s Friday night meeting, a monoclonal antibody cocktail called MBP134 and the antiviral drug remdesivir were chosen as the best candidates for a clinical trial. A trial protocol called PARTNERS, developed at the University of Oxford for an emergency situation like the current outbreak, could be used to test both….”

PS: “Karim says his team is feeling the absence of the United States Agency for International Development (USAID), which played a role in managing the mpox emergency in 2024 but was dismantled last year. “Basically, the U.S. has become unreliable as a partner, so we have to carry on.”…”

·         See also Nature News – Exclusive: Race begins to trial Ebola drugs amid current outbreak

“Clinical trials for treatments against Ebola Bundibugyo virus are ‘in a strong position’ to be launched quickly in the Democratic Republic of the Congo and Uganda.”

Stat – U.S. bans entry from Ebola-affected countries as American patient is identified

https://www.statnews.com/2026/05/18/cdc-ebola-travel-ban-announced-uganda-congo-south-sudan/

“The ban, which affects the DRC, Uganda, and South Sudan, is in effect for 30 days.”

WHA79 – Hantavirus outbreak

HPW – WHO to Coordinate Research on ‘Natural History’ of Hantavirus Transmission

https://healthpolicy-watch.news/who-to-coordinate-research-on-natural-history-of-hantavirus-transmission/

“The World Health Organization said Friday it is embarking on a plan to coordinate studies in more than 20 countries to “better understand the natural history of the disease” following an outbreak of the Andes strain of the hantavirus linked to the cruise ship MV Hondius.  While stressing that the risks to the public remain low, officials also warned that more infections could still emerge during a six-week long incubation period.”

“Speaking at a press briefing, WHO Director-General Tedros Adhanom Ghebreyesus said the agency’s “current priorities are to continue to better understand the epidemiology of the Andes virus, including how this outbreak began and spread,” adding that WHO is “working with more than 20 countries to coordinate studies to better understand the natural history of the disease.”  More needs to be understood about potential human-to-human modes of transmission of this particular species of hantavirus, he and other WHO officials at the briefing acknowledged. While hantavirus is usually transmitted by rodents, the Andes species can be transmitted between people. But key questions remain regarding modes of virus transmission and the length of time that an infected person could remain infectious to others, even after testing negative for the virus. ….”

PS: “Since the outbreak has so far been contained, and no dangerous virus mutation has been identified, WHO has not called for an emergency meeting of hantavirus experts, said Abdirahman Mahamud, Director Health Emergency Response Operations. Convening an emergency committee would be a required step to any WHO declaration of a global public health emergency…”

Geneva Solutions –Hantavirus: what happens when countries walk away from WHO

https://genevasolutions.news/global-health/hantavirus-what-happens-when-countries-walk-away-from-who

“… the hantavirus may become a litmus test for the organisation as it raises a fundamental question about what international health cooperation looks like when the institutions designed to facilitate it are called into question….”   (eg: by US and Argentina the past year, first of all).

“… a media storm has fuelled speculations of another Covid-19, including a wave of finger-pointing reminiscent of the pandemic. The governments of Uruguay and Chile, where the ship’s suspected patient zero, a Dutch ornithologist, had travelled in the preceding weeks, have both denied that the chain of transmission could have originated in their territories, while authorities in Ushuaia have argued the incubation period should also rule out the town as the source. So far, investigations have not confirmed anything….

“Suerie Moon, director of the Global Health Centre at the Geneva Graduate Institute, says this reaction is normal. “All countries have an interest in not being blamed or not being stigmatised, so you need a neutral, independent, impartial body to say this is what the evidence is showing us,” she says. That is the WHO’s role precisely – an information broker between countries party to the International Health Regulations, which requires them to flag these types of events. “In an outbreak and in a crisis, information flow is one of the single most important and strategic areas,” says Moon. … …. Despite Argentina’s exit from the WHO, it remains a party to the IHR and, according to Biscayart, continues to comply with its information-sharing regime…..

“… Despite the political noise, cooperation appears to be continuing on a technical level. (with Argentina & the US)…”

“… This week, countries will consider how to handle Argentina’s exit formally. Buenos Aires, with the backing of Israel, is pushing for the World Health Assembly to acknowledge the withdrawal, but some states are wary of endorsing a text that could make it look easy and embolden others to follow suit.  “A solution has to be found that keeps the pathway open for countries to return,” says Moon. “If the message is too hardline, saying no country can withdraw, I think you risk a backlash from that.” While other political leaders may certainly be tempted in the future to go down that path, she doesn’t believe “an epidemic of withdrawals” is afoot. “WHO is too important for protecting public health at the national level for too many countries,” she says….”

Telegraph – Top WHO official: I’m relieved it isn’t bird flu, but we’re in a ‘make or break’ phase for hantavirus

https://www.telegraph.co.uk/global-health/science-and-disease/maria-van-kerkhove-who-official-hantavirus-outbreak/

“Maria Van Kerkhove says diagnosis felt like dodging a bullet, but warned the outbreak’s evolution is at a critical juncture.”

“… while the world may have escaped a worst case scenario for now (i.e. bird flu), the Andes virus still poses very real risks – and the response has just entered a “make or break” phase, says Dr Van Kerkhove.  Soon, it will be clear if the outbreak is going to burn out or spark a new transmission chain. …”

Milbank Quarterly – The Hondius Outbreak Shows What Happens When the CDC Retreats from the World

L Gostin; https://www.milbank.org/quarterly/opinions/the-hondius-outbreak-shows-what-happens-when-the-cdc-retreats-from-the-world/

Also with a path towards restoration.

·         And a link:    The Conversation – Hantavirus in Africa: why climate change, rats and weak surveillance are worrying scientists  by W Preiser et al.

WHA79:  More on PPPR & GHS

2026 GPMB report – The world is on the edge of even greater pandemic damage

https://hq_who_departmentofcommunications.cmail19.com/t/d-e-gudykkd-ikudkhluul-j/

“Expert group tasked with global monitoring warns pandemic risk is outpacing investments.”

The 2026 GPMB report was launched on Monday in the margins of the 79th World Health Assembly.

“A decade after Ebola exposed dangerous gaps in outbreak preparedness –  and six years after COVID-19 turned those gaps into a global catastrophe – the evidence is clear: the world is not safer from pandemics.    A new report from the Global Preparedness Monitoring Board (GPMB), A World on the Edge: Priorities for a Pandemic‑Resilient Future, finds that as infectious disease outbreaks become more frequent they are also becoming more damaging, with widening health, economic, political and social impacts, and less capacity to recover from them.”

“The Board warns that a decade of investment has not kept pace with rising pandemic risk.  New initiatives have improved aspects of preparedness, but overall these efforts are being offset by the growing effects of rising geopolitical fragmentation, ecological disruption, and global travel, especially as development assistance falls to levels not seen since 2009 ….

“The report analyses a decade of Public Health Emergencies of International Concern (PHEICs), from Ebola in West Africa to COVID-19 to mpox, assessing their impacts on health systems, economies and societies.  On key measures – such as equitable access to diagnostics, vaccines and therapeutics – the world is moving backwards….”

“… The GPMB – which will conclude its mandate in 2026 – identifies 3 concrete priorities for political leaders to reverse these trends: establish a permanent, independent monitoring mechanism to track pandemic risk; advance equitable access to life-saving vaccines, tests and treatments by concluding the Pandemic Agreement; and secure robust financing for both preparedness & ‘Day Zero’ response activities.”

·         Coverage via the  Guardian  – Infectious diseases such as hantavirus and Ebola becoming more frequent and damaging, say experts

PS: “… In Geneva, Prof Matthew Kavanagh, director of the Georgetown University Center for Global Health Policy & Politics, said aid cuts may have played a role in leaving the world “playing catch-up against a very dangerous pathogen”.    “Because early tests looked for the wrong strain of Ebola, we got false negatives and lost weeks of response time. By the time the alarm was raised, the virus had already moved along major transport routes and crossed borders.  “This crisis didn’t happen in a vacuum. When you pull billions out of the WHO and dismantle frontline USAID programmes, you gut the exact surveillance system meant to catch these viruses early. We are seeing the direct, deadly consequences of treating global health security as an optional expense.”…”

Devex – Germany pledges an additional €25 million to WHO

https://www.devex.com/news/germany-pledges-an-additional-25-million-to-who-112524

“Germany adds €25 million to WHO to shore up outbreak surveillance and emergency response as the agency grapples with widening budget pressures.”

“Germany has pledged an additional €25 million ($29 million) to the World Health Organization in 2026 to help fund core functions that remain chronically underfunded, particularly in health security. These include surveillance systems, outbreak prevention, and emergency response. Announcing the contribution at an event cohosted with WHO’s Hub for Pandemic and Epidemic Intelligence in Geneva, German Health Minister Nina Warken said that recent outbreaks of hantavirus and Ebola “have shown us that the safety of patients worldwide also depends on WHO activities and infrastructure.”…”

PS: “The new commitment comes after Germany had halved its 2026 contribution to the Berlin-based pandemic hub from €30 million to €15 million.”

“Sandra Gallina, director-general for health and food safety at the European Commission, said the hub needs to have sustainable financing and be recognized in the institutional setup of WHO and not just be financed as a project. … … Dr. Chikwe Ihekweazu, executive director of WHO’s health emergencies program, added that the agency is currently responding to 36 graded health emergencies worldwide….”

WHA79 – Global Health Reform

African Health leaders forge unified position on Global Health Reform ahead of WHA79 in Geneva

https://techreviewafrica.com/news/5486/african-health-leaders-forge-unified-position-on-global-health-reform-ahead-of-wha79-in-geneva#0

(17 May) “African health and finance leaders have convened in Geneva to align a unified continental position on reforms to the global health architecture ahead of the 79th World Health Assembly (WHA79).  The high-level meeting of the African High-Level Ministerial Committee (AHLMC) on Reform of the Global Health Architecture brought together ministers and senior officials to consolidate Africa’s priorities and strengthen its collective voice in global health negotiations….”

Paper – Navigating Global Health Architecture Reform Efforts – Between Reform and Fragmentation

S Grude, V Kerry et al; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=6753079

“…. we aimed to map 11 key initiatives of global health architecture reform through predefined categories, addressing domains, mechanisms, thematic areas, governance and financing. The 11 initiatives included are: Accra Reset; Africa CDC Health Security and Sovereignty Initiative; European Donor Alignment; Gavi Leap; Health Works Leaders Coalition; HEAR CSO Consortium; Lusaka Agenda; Sevilla Platform of Action; US Bilateral Health Agreements; WHO Global Health Architecture Reform Process; Wellcome Trust Convening Dialogues. Applying a comparative analysis, we identified key areas of consensus, duplication, fragmentation, gaps and emerging themes. To help further understanding, we share details of the current experience in Uganda with a focus on financing as a case-study. We find that most initiatives target shaping alignment/efficiency or financing/funding as primary domains, while capacity building is largely missing. This creates a disconnect between reform ambitions and capacity to deliver. While governance is intrinsic to any architecture reform, we found diverse approaches leading to unclear governance and accountability overall. Further, while financing and funding underpins any capacity for realistic reform and progress, there is a lack of concrete detail on how increased fiscal space and such capacity will be created nor a strong acknowledgment of the need for increased financing amid ongoing cuts. We conclude by highlighting critical outstanding questions to further guide the reform process, including design, governance, mandates, financing, milestones, financing, and accountability.”

Wellcome (Report summary) – Rethinking the future of global health: a global dialogue

Wellcome;

“This report distils key insights from Wellcome’s global dialogue on global health reform. The meeting brought together stakeholders from around the world to explore practical pathways for strengthening the global health architecture.  “

With 6 key takeaways.

WHS Perspectives – It’s about power – not architecture

I Kickbusch; https://www.worldhealthsummit.org/whs-perspectives/ilona-kickbusch-it-s-about-power-not-architecture

Must-read analysis from end of last week.   Excerpts:

“The current debate about reforming the global health architecture is, at its core, a debate about power — who holds it, who is losing it, and who intends to use this moment of rupture to consolidate it on new terms.  It is remarkable how thoroughly this political reality has been obscured by the procedural vocabulary in which the present architecture debate is conducted: “coherence,” “coordination,” “efficiency,” “fit for purpose.” These are the preferred terms of those who benefit from keeping the structural conditions producing health inequity off the table. These are intellectual property regimes that restrict technology transfer, financial architectures that extract capital from low- and middle-income countries at rates vastly exceeding development assistance, care workforce supply chains organized around the systematic export of trained health workers from countries that cannot afford to lose them and data extraction through tech companies and b-lateral deals. A serious reform agenda would require confronting the political and economic interests of precisely the states that dominate global health governance.”

“… The US withdrawal from WHO and bilateral deals are best understood as chokepoint politics: the systematic leveraging of indispensable positions — financing, data flows, regulatory standard-setting, pathogen access — to reorder global dependencies….”

“WHO’s constitutional uniqueness must be defended, not diluted: … Strengthening WHO means strengthening its assessed contribution base even further, thus creating an institution that would be harder to instrumentalize. That is why the recent – albeit still insufficient – increase of assessed contributions was such a breakthrough. It will be the most important legacy of the present Director-General to his successor. A well-resourced, politically independent WHO with genuine enforcement capacity and a broad assessed contribution base would challenge the states and industries that currently profit from the absence of binding global health law. WHO’s constitutional uniqueness must be defended, not diluted. The impulse to “streamline” and “coordinate” the broader ecosystem frequently means reducing WHO to a technical secretariat — stripping it precisely of its unique legal authority….”

“As Antonio Gramsci predicted, in times of change «a great variety of morbid symptoms appear”. The architecture debate lacks a political theory of change adequate to the rupture, but there is perhaps one priority goal that all architecture initiatives should commit to take forward: how to build the material conditions — manufacturing, surveillance, workforce, data sovereignty — that make equity structural and tangible. These are the building blocks of a serious reform agenda. A critical part of this is to create the material conditions for WHO to support this agenda for change by playing a key role in building the foresight and organizational designs to apply when political windows of opportunity open and to use its convening power to support the building of new coalitions to move forward.”

Devex Pro – What does WHO need to do to actually remain relevant?

https://www.devex.com/news/what-does-who-need-to-do-to-actually-remain-relevant-112505

(gated) “During a Devex Pro Briefing, Pete Baker and Anders Nordström argued that while no institution can replace WHO, it must refocus on its core functions, rethink its geographic structure, and overhaul its financing model.”  They do lay different emphases, though.

“Most experts who spoke to Devex agreed: The world needs the World Health Organization, and no other institution can replace it. But with a financing model akin to a “negative circular death spiral,” the organization’s leadership is being severely hampered by those who fund it.  “I would say most of the blame on most of these issues lies with the member states … and beyond that, philanthropy,” said Pete Baker, the deputy director of the global health policy program at the Center for Global Development, during a recent Devex Pro Briefing. “The way they fund WHO does not allow that leadership and prioritization that they claim to want the WHO to do.”  “Baker worries WHO is not aligning resources with its core mandate, particularly as staffing cuts appear to fall disproportionately on Geneva (HQ).”

“WHO relies heavily on earmarked voluntary contributions, writes Devex Senior Editor Rumbi Chakamba, which means donors often determine what gets funded. Last year, only $214 million of the $2.5 billion WHO received in voluntary contributions was flexible — a situation that limits the organization’s ability to lead.  “The debate over funding is closely tied to a broader issue: trust,” Rumbi writes.”

“Anders Nordström, the senior adviser for international politics and diplomacy for health at Karolinska Institutet, said such lapses in confidence could be fixed by high-quality staff and transparency — adding that when WHO leadership worked closely with member states on budget negotiations, countries were more willing to support the organization as a whole….”

·         And via Devex:  Meet me in the lobby

“One item generating plenty of buzz on this year’s agenda is WHO’s proposed process to transform the global health architecture, …  But in my meetings ahead of the assembly, one source offered a reality check: The “real decisions” about the future of global health are unlikely to happen in formal committee rooms. Instead, they’ll happen in the lobby of the InterContinental hotel, the unofficial headquarters of global health dealmaking….”

Delivery Associates (paper) – From Consensus to Capability: Closing the Gap Between Global Health Reform and Results

https://www.deliveryassociates.com/news-insights/closing-the-gap-between-global-health-reform-and-results

“Health system reform has produced real consensus. What’s missing is the delivery capacity that makes country leadership — and better health outcomes — possible.”

WHA79 – WHO DG race

BMJ Feat article – Who will be the next leader of the beleaguered WHO?

https://www.bmj.com/content/393/bmj.s911

“Amid global disorder and heightened demands for reform, the campaign for the next director general of the world’s health agency is perhaps its most important ever. Jocalyn Clark reports.”

Includes a box with the potential candidates. Timeline of the race.

“Commentators with deep experience of WHO who spoke to The BMJ agree that restoring stability to global health efforts and reforming the organisation are urgent priorities in this leadership campaign. But simmering underneath the growing campaign chatter is divided opinion on how political WHO—and its next director general—should be.”

With the views of J Nkengasong, S Harman, P Patnaik, L Gostin and many others.

Bangkok Post – Thailand seeks candidate for top WHO job
https://www.bangkokpost.com/thailand/general/3248864/thailand-seeks-candidate-for-top-who-job

From early May already.  “Thailand has begun the process of selecting a candidate to run on behalf of the country for the post of director-general of the World Health Organization (WHO), with a joint committee established to oversee the search.  The move follows a Cabinet resolution on April 28 approving Thailand’s nomination of a candidate for the top position at the WHO, Public Health Minister Pattana Promphat said on Sunday.  The Ministry of Public Health has been tasked with leading the selection process, with support from the Ministry of Foreign Affairs and other relevant agencies.”

WHA79 – Climate & health

Guardian – Declare climate crisis a global public health emergency, experts tell WHO

https://www.theguardian.com/environment/2026/may/16/who-should-declare-climate-crisis-global-public-health-emergency-experts-say

“The climate crisis should be declared a global public health emergency by the World Health Organization, or millions more people will die unnecessarily, leading international experts have said. The independent pan-European commission on climate and health, which was convened by the WHO, concluded the climate crisis was such a worldwide threat to health that the WHO should declare it “a public health emergency of international concern” (PHEIC).

“… The 11-strong independent commission, which includes former health and climate ministers, said: “Far from being a fading priority or fake news, climate change poses an immediate and long-term threat to health, economic, food, water, environmental, personal, community and national security.” …. … The commission also urged governments to stop subsidising fossil fuels…”

·         The Lancet (Comment) –  Pan-European Commission on Climate and Health: recommendations for accelerating climate action for health  (by K Jakobsdottir & A Haines)

“The independent Pan-European Commission on Climate Change and Health was instigated by the WHO Regional Director for Europe, Hans Kluge, in response to growing concerns about the effects of climate change on health in the region, which encompasses 53 countries extending into central Asia….” “ … The report of the Pan-European Commission on Climate Change and Health, Call to Action, launched on May 17, 2026, recommends actions in four domains (panel). … The reports also lists some implementation challenges.

HPW – WHO Member States Should Treat Fossil Fuels like Tobacco – as a Public Health Threat

J Miller  (Executive Director of the Global Climate and Health Alliance) ; https://healthpolicy-watch.news/who-member-states-should-treat-fossil-fuels-like-tobacco-as-a-public-health-threat/

“Just as health leaders reframed tobacco from a consumer product to a public health threat, they can now help shift the narrative on fossil fuels.”

“In the coming days, the annual World Health Assembly will convene in Geneva. Following the recent Santa Marta Conference on Transitioning Away from Fossil Fuels, national health ministers and global health leaders have both an opportunity and responsibility to address the root cause of the climate-induced health crisis: fossil fuels….”

WHA79: more analysis, reports, advocacy…

Geneva Rules (3): Power, Proximity, Priority

Habib Benzian ; on Substack ; 

“The formal and informal diplomacy of the World Health Assembly.”

“The World Health Assembly operates in two diplomatic theatres: the formal Assembly and the ecosystem of side-events around it. The first has an agenda, rules of procedure, committees, regional consultation groups, and resolutions. It is where Member States speak, negotiate, endorse, delay, soften, and decide. The second is less formal, but not less consequential. It unfolds through side events, diplomatic breakfasts, donor lunches, closed roundtables, civil society briefings, receptions, corridor conversations, hotel meetings, and quiet bilateral exchanges. It is where issues compete for visibility before they acquire formal standing, where coalitions are built before they are announced, and where proximity to power begins to look like political relevance.”

“Together, these two theatres tell us something about power, proximity, and priority in global health. Priority is what the official agenda seems to establish. Proximity is what the informal ecosystem makes visible. Power is what determines whether either one changes anything….”

In conclusion: “… The official World Health Assembly is where global health speaks in resolutions. The Assembly around the Assembly is where it tests which issues, actors, and framings are ready to be recognised….”

Stat (Opinion)– First hantavirus, now Ebola: What two outbreaks reveal about global preparedness

K Kuppali; https://www.statnews.com/2026/05/15/ebola-outbreak-drc-hantavirus-who/

“International health emergencies cannot be managed by countries acting alone.”

“These outbreaks are biologically different, geographically distant, and epidemiologically unrelated. But together they reveal something deeply important about the current state of global health: Outbreaks are becoming more frequent, more complex, and increasingly difficult to contain in a world that is less prepared than it should be. … And perhaps most concerning, many outbreaks are now unfolding in environments already weakened by overlapping crises and political and health insecurity leading to fragile health infrastructure, workforce shortages, misinformation, and limited laboratory capacity…..”

More on Global Health Governance & Financing/Funding

Devex – How BillionScale Health plans to scale breakthrough technologies

https://www.devex.com/news/how-billionscale-health-plans-to-scale-breakthrough-technologies-112501

(gated) “Former Malaria No More CEO Martin Edlund is launching BillionScale Health — a new nonprofit betting that blended finance, market shaping, and breakthrough technologies can drive the next era of global health progress.”

“….Today, BillionScale Health officially opens its doors, launching a mission to identify, scale, and support five breakthrough health solutions across the world. The first of those projects is already up and running: a spatial mosquito repellent that just last week, the State Department and The Global Fund to Fight AIDS, Tuberculosis and Malaria agreed to distribute across 10 countries with a high burden of malaria…..”

GPIN’s May 2026 letter from our Chair, Stephen Chacha

Global Public Investment Network;   

Rising political momentum on Global Public Investment.   Excerpt:

“Last week I was in Nairobi for a meeting of the Coalition of Governments on Global Public Investment, convened by Senegal’s Minister of Foreign Affairs, H.E Cheikh Niang.  Senegal and Colombia co-chair the coalition, which brings together countries committed to advancing political dialogue and practical collaboration to renew international cooperation anchored on the principles of GPI…”

“The Nairobi meeting, held on the sidelines of the Africa Forward Summit, brought together eighteen governments from four regions of the world – Africa, Latin America and the Caribbean, Asia, and Europe – to discuss how, in this new era, shared global challenges can be resourced through the global public investment framework.  The acceleration of momentum in the past 10 months has been inspirational to see, since the launch of the Coalition of Governments on Global Public Investment as part of the Sevilla Platform of Action at the Fourth International Conference on Financing for Development (FfD4). We once had not much more than a handful of interested governments. Today, over 30 countries are already involved in the coalition. And the number is growing….”

PS: “… … At the same time as the meeting in Nairobi, the OECD was gathered in Paris – and GPIN was there too.  Zane Dangor, Director-General of South Africa’s Department of International Relations and Cooperation, encouraged OECD members to get behind global public investment. He highlighted how the work of the Coalition of Governments on Global Public Investment is driven by countries in the Global South and connected in partnership with countries in the Global North. He emphasised how GPI embodies the transformative visions that South Africa is pursuing through the Ubuntu Commission, and that African countries have put forward through the Accra Reset.

Sara Pantuliano, Executive Director of ODI Global, was frank with OECD members about the end of the old order, and urged OECD countries to “embrace the concept of global public investment”, drawing their attention to what was happening in Nairobi. “The GPI approach,” she noted, “is pushing for a narrative and institutional evolution away from donor-recipient dynamics, towards a system in which all countries contribute, all benefit and all decide; more and better public money for our common global challenges.” … Global public investment has grown from an aspirational idea to a practical and politically viable policy choice – one that is now being readied by pioneer governments for implementation….”

Lancet GH – Methods with consequences: analysing demographic diversity in global health governance and knowledge production

Kim R Van Daalen, S Abimbola et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00054-9/fulltext

“Structural inequities remain deeply embedded in global health governance and knowledge production, shaping which voices are heard and whose expertise and priorities are valued. Attempts to understand patterns of systematic exclusion have inspired numerous initiatives to assess the demographic diversity of those producing knowledge and governing global health. However, in the absence of systematically reported demographic data, scholars often rely on proxy self-identification (eg, cued language in online biographies assumed to be authored or endorsed by the person themself) or external inference methods (eg, based on name, photo, or language) for demographic characteristics. This Review critically examines the strengths, limitations, and ethical concerns of these different approaches, and proposes guidance based on five pillars that support their more responsible use: (1) practising critical refusal; (2) prioritising self-reported methods; (3) aligning methods with purpose and context; (4) embedding safeguards in data storage, reporting, and sharing; and (5) ensuring transparency and reflexivity. …”

TGH – Busting 10 Myths About Health Taxes

https://www.thinkglobalhealth.org/article/busting-10-myths-about-health-taxes

“Ahead of the World Health Assembly, Resolve to Save Lives CEO Tom Frieden discusses how health taxes can raise money and improve physical well-being.”

Trump 2.0

The Aid report  – A shock to the system: Global Health after US aid cuts

https://static1.squarespace.com/static/68daaa80aff98f78bf74c64d/t/6a048f08a221fb07cb42235d/1778683656042/Global+Health+Report.pdf

(16 p) In case you missed this. “… The abrupt freeze and rollback of U.S. foreign assistance in early 2025 disrupted far more than clinics and medical supply chains. Across dozens of countries, the systems that connected people to care — community health workers, peer educators, mobile outreach teams, referral networks, and psychosocial support programs — were weakened or dismantled, reshaping access to health services in ways that are only now becoming fully visible. …”

Development Cooperation reform

Devex – What to expect at the UK’s Global Partnerships Conference

Devex;  

(gated) “The two-day conference will be a referendum on development’s future … or, depending on who you ask, a lot of waffle.”

“Today in London, the United Kingdom hosts the Global Partnerships Conference, a stab at building development alliances after more than a year of dismal headlines for global aid budgets. … The conference — jointly hosted by the U.K., South Africa, the Children’s Investment Fund Foundation, and British International Investment, or BII — was originally conceived as an opportunity to reenvision aid, and first announced by the former U.K. foreign secretary David Lammy. But it has been taken on by the Foreign Commonwealth & Development Office after Lammy was moved from the role late last year, including by development minister Jenny Chapman….”

The conference is far from the only forum for discussion about the future of aid… …
Devex Business Editor David Ainsworth and contributing reporter Susannah Birkwood have a comprehensive rundown of the issues to watch — including the U.K.’s enthusiasm for tapping into private sector money to make development run. That’s accompanied by some industry skepticism that mobilizing private finance can have anything like the impact of the official development assistance, or ODA, it’s trying to replace. The U.K.’s DFI, British International Investment, did kick things off with a nice splashy announcement of a $300 million renewable power platform in India, the first investment through the £1.1 billion climate finance initiative British Climate Partners….”

Global Policy – Reimagining Development Cooperation: The Four Faces of ‘Mutual Interest’

A Sumner & A Klingebiel;  https://www.globalpolicyjournal.com/blog/18/05/2026/reimagining-development-cooperation-four-faces-mutual-interest

(recommended read) “The OECD Conference on the Future of International Development Co-operation convened in Paris on 11-12 May 2026. Andy Sumner and Stephan Klingebiel consider one core idea arising.”

ODI (Expert Comment) – Reform or retire: how DAC donors must change to stay relevant

S Pantuliano; https://odi.org/en/insights/reform-or-retire-how-dac-donors-must-change-to-stay-relevant/

“The ‘development system’ as we’ve known it for decades is facing a twin crisis. First is a crisis of solvency: official development assistance (ODA) fell by roughly $50 billion between 2024 and 2025. Core development finance is down 26%, humanitarian funding down 36%. Second – and perhaps more fundamental – it is facing a crisis of legitimacy: the benevolent donor model is running out of moral capital at exactly the moment it has run out of money.”

“… The World Economic Forum’s Global Future Council on Reimagining Aid, which I co-chair with Bright Simons, has structured its work along three axes: power, finance, technology. The present moment calls for key transformative shifts across each….”

Global Policy – What to Play Next: Development after the End of Development

H Janus et al; https://www.globalpolicyjournal.com/blog/18/05/2026/what-play-next-development-after-end-development

“Heiner Janus and Michael Roll argue that the largest aid contraction on record coincides with a reopened decades-old fault line: what “development” means, who it serves — and how the field can reinvent itself for what comes next.”

“Interesting article on the meeting convened by the University of Manchester’s Global Development Institute in mid-April, which asked: is the era of Development over? And if so, what replaces it?”   With different views.

More on UHC & PHC

Lancet Primary Care – World Family Doctor Day 2026: compassionate care in a digital world

Viviana Martinez-Bianchia ; https://www.thelancet.com/journals/lanprc/article/PIIS3050-5143(26)00067-1/fulltext

« On May 19, 2026, the World Organization of Family Doctors (WONCA) marks World Family Doctor Day with a theme that speaks to a defining challenge of our time: how to preserve compassion as care becomes increasingly digital. I write this Comment not only as the President of WONCA, but as a practicing family doctor, one who, like many colleagues, has spent years navigating the tension between the demands of documentation and the desire to be fully present with patients….”

« … Can we safeguard compassion as technology transforms care?  The answer, increasingly, appears to be yes, but only if we are deliberate. AI is not inherently humanising or dehumanising. Its impact depends on whether it supports or displaces the therapeutic relationship….”

Access to Medicines, Vaccines & other health technologies

HPW – WHO Moves to Expand Access to Fast-Acting Insulin and Popular Weight Loss Drug Semaglutide

https://healthpolicy-watch.news/new-who-prequalification-track-for-popular-weight-loss-drug-and-fast-acting-insulin-aims-to-accelerate-access/

“On the five-year anniversary of the Global Diabetes Compact, WHO has issued a call to manufacturers to submit requests for “prequalification” of generic versions of the GLP-1 weight-control drug semaglutide and newer, fast-acting insulin analogues. The call is part of a broader initiative to accelerate access to life-saving diagnosis and treatment which remains out of reach for most people living with diabetes in developing countries.  “

PS: “… the recent expiration of the core patent for the weight-loss drug Semaglutide in India, China and Brazil in March may signal a big change for Africa as well. Domestically, the patent expiration has already led to expanded generic production in countries that are drug manufacturing as well as export powerhouses.  And therein lies the role of the WHO prequalification of that and other products, to ensure that the products purchased and sold are quality-controlled.   “WHO Prequalification does not re-evaluate whether semaglutide works or is safe –  that has already been established through clinical trials, subsequent approvals by stringent national regulatory authorities and confirmed by its inclusion on the WHO Essential Medicines List,” said WHO’s Bianca Hemmingsen, technical lead for diabetes….” “ “What WHO Prequalification assesses is whether a specific [generic] manufacturer can produce semaglutide at the required quality standard. The WHO invitation to manufacturers opens a pathway to apply for prequalification of GLP-1 receptor agonists, specifically semaglutide, for the first time.”

Stat – U.K. advocacy groups threaten court action over a key provision in the pharma trade deal with the U.S.

https://www.statnews.com/pharmalot/2026/05/17/uk-advocates-threaten-court-action-over-pharma-trade-deal-with-us/

“At issue is the degree to which the government can alter cost-effectiveness outcomes for medicines.”

Lancet GH – From evidence to action: taking stock of the Lancet Global Health Commission on medical oxygen security after a year

Ahmed E Rahman et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00059-8/fulltext

“In February, 2025, we published the Lancet Global Health Commission on medical oxygen security, presenting the first global estimates of medical oxygen needs and oxygen access gaps and the solutions to close them. We concluded that mobilising resources to close the large and inequitable access gaps will save lives, accelerate progress towards the Sustainable Development Goals, and reduce the risk of the next respiratory pandemic causing mass fatalities. In the year following publication, despite witnessing the most significant reduction in global health funding on record, there has been promising progress. Although we recognise that major investments are still urgently needed, we highlight some of the substantial achievements which align with the Commission’s key statement….”

The Comment also lists priority areas for further progress in 2026.

GAVI – Gavi to propose new incentives aimed at advancing vaccine manufacturing in Africa

https://www.gavi.org/news/media-room/gavi-propose-new-incentives-aimed-advancing-vaccine-manufacturing-africa

(15 May)  “Gavi, the Vaccine Alliance today announced that it will seek Board approval to deploy US$ 189 million to support the rapid development of Africa’s vaccine manufacturing ecosystem. Funding is intended to super-charge Gavi’s African Vaccine Manufacturing Accelerator (AVMA) by tackling bottlenecks and procuring up to 70 million vaccine doses from start-up manufacturers….”

“… With Gavi’s African Vaccine Manufacturing Accelerator (AVMA) expected to make its first cash disbursement to an African vaccine manufacturer in the second half of 2026, Gavi, the Vaccine Alliance today proposes further measures totaling US$ 189 million of additional investment to further aid development of Africa’s vaccine manufacturing sector. The measures, named AVMA+, are slated to be presented to Gavi’s Board in July. AVMA+ has been designed to provide additional support in two key areas, firstly addressing specific regulatory and market entry bottlenecks that are acting as a brake on investment and secondly by providing guaranteed demand to African producers by directly purchasing up to 70 million doses of African-manufactured vaccines, following competitive tender processes, once those vaccines reach the market. …”

MPP and Roche sign licence agreement to expand access to influenza treatment in LMICs

https://mailchi.mp/medicinespatentpool.org/mpp-newsletter-licence?e=46c53663f9

“The Medicines Patent Pool (MPP) and Roche have signed a voluntary licence agreement to expand access to baloxavir marboxil (Xofluza®), an innovative antiviral treatment for influenza recommended by the World Health Organization (WHO) and approved by the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA). This agreement will enable generic manufacturers to develop, produce and supply baloxavir in 129 low- and middle-income countries (LMICs), creating additional supply pathways for equitable access, which is particularly important during a pandemic, when demand is the highest. MPP is launching an Expression of Interest to identify qualified generic manufacturers with the required capacities to support development and supply.”

Africa Health Watch –   “Africa is Not a Real Market:” The Fragmentation Problem Behind Africa’s Health Manufacturing Ambitions

Africa Health Watch;

With some reflections from the World Health Summit Regional Meeting, Nairobi 2026.

“The continent of Africa spends billions annually on medicines, vaccines and health commodities, but faces fragmented and externally-driven demand for homegrown vaccines, poor economies of scale and short-term financing models that limit the business case for local manufacturers. At the World Health Summit Regional Meeting in Nairobi, conversations around Africa’s vaccine manufacturing ambitions moved beyond production capacity to a harder question: can the continent create a reliable market for African-made health products?”

Global health events

UN News – World Urban Forum opens in Baku as housing crisis and climate shocks intensify

https://news.un.org/en/story/2026/05/1167517

“Soaring housing costs, climate shocks and conflicts are leaving millions without adequate shelter – but what can be done? As the 13th UN World Urban Forum opens on Sunday in Baku, Azerbaijan, participants will grapple with solutions to a deepening global housing crisis. The conference, organized by UN-Habitat together with Azerbaijan, opens on Sunday 17 May and runs through Friday, 22 May.”

“…The theme of the forum is a call to action: Housing the World: Safe and Resilient Cities and Communities. According to the UN, nearly 2.8 billion people today are living in inadequate housing conditions, while more than 300 million have no home at all. With close to 70 per cent of the global population expected to live in cities by 2050, the crisis is only set to intensify….”

“… The crisis goes far beyond bricks and mortar. Housing is increasingly seen as a cornerstone of human dignity, urban resilience and even global stability. Its impacts ripple across every aspect of life, the UN warns – straining healthcare and education systems, weakening economies and fraying the social fabric….”

·         See also  UN News – 1.1 billion people live in slums. Can they be housed in dignity?

·         See also UN News – Housing crisis takes centre stage at World Urban Forum in Baku

“Now is the time to place housing at the heart of sustainable development. That was the message delivered on Monday by UN Secretary General António Guterres to participants at a global forum on urban sustainability under way this week in Baku.”

“… Housing rises up the global agenda: UN‑Habitat officials describe the summit as a major step in elevating housing and urbanisation to the highest political level…..”

Global health governance & Governance of Health

Alliance (Feature story) – How countries are rethinking their national public health agencies

https://ahpsr.who.int/newsroom/news/item/14-05-2026-how-countries-are-rethinking-their-national-public-health-agencies

Recommended Feat story based on a publication from a few weeks ago. “… Recognizing the need for evidence on NPHA governance, the Alliance for Health Policy and Systems Research and the WHO Health Emergencies Programme convened a multicountry learning programme. Eleven countries participated: Algeria, Brazil, Ethiopia, Fiji, Germany, Japan, Pakistan, the Republic of Korea, Rwanda, Singapore and Sri Lanka. …”

Collective learning. With 4 governance dimensions.

CEPS – Beyond borders: how HERA can unlock global health as a true public good through data and knowledge sharing

H Vu et al;  https://www.ceps.eu/ceps-publications/beyond-borders-how-hera-can-unlock-global-health-as-a-true-public-good-through-data-and-knowledge-sharing/

“This paper examines how global health can be strengthened as a true global public good through improved international cooperation, exploring how the European Health Emergency Preparedness and Response Authority (HERA) can drive this effort. …”

Devex – Germany’s accidental rise to become the world’s largest donor

https://www.devex.com/news/germany-s-accidental-rise-to-become-the-world-s-largest-donor-112458

(gated) “As U.S. aid retreats, Germany has emerged as the world’s largest donor — forcing Berlin to redefine development policy amid budget cuts, geopolitical pressure, and growing skepticism at home.”

Planetary health

Climate Change News – Health risks from climate change spur stronger public support for action, research finds

https://www.climatechangenews.com/2026/05/18/health-risks-from-climate-change-spur-stronger-public-support-for-action-research-finds/

“A survey by the Climate Opinion Research Exchange (CORE) for Wellcome in four countries found high support for government action to tackle the health impacts of the climate crisis.”

“Informing people about the health risks linked to climate change is twice as likely to spur public support for government-led climate action than messages focused on economic or environmental impacts, an international study has found.  Based on a survey of around 30,000 respondents in Brazil, India, Japan and South Africa carried out in late 2025, the report published this month by the Climate Opinion Research Exchange (CORE) and the Wellcome Trust reveals strong public support for climate action….”

Covid

HP&P – Participation of Civil Society Organisations and Academia in COVID-19 Governance: Insights from a Six Country Study 

Sumegha Asthana et al; https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag063/8679240?searchresult=1

The countries are: Nigeria, Singapore, South Africa, Bangladesh, Jordan, and the United Kingdom

AMR

Nature (Outlook) – Six key developments in the fight against antimicrobial resistance

https://www.nature.com/articles/d41586-026-01373-3?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=61887605

“Antibiotics designed by artificial intelligence, immunotherapy for resistant infections and other highlights from studies and trials.”

NCDs

Lancet Regional Health Africa – Epidemiology of visual impairment and blindness in Africa: a systematic review and Bayesian meta-analysis

Samuel Kyei et al; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00046-5/fulltext

“Estimates of visual impairment (VI) and blindness in Africa are limited by outdated surveys, regional data gaps, and methodological heterogeneity. This study aimed to determine the pooled prevalence and leading causes of VI and blindness, disaggregated by key demographics, to inform public health action….”

FP Analytics – Cognitive Health as a Social and Economic Priority

https://fpanalytics.foreignpolicy.com/2025/10/23/cognitive-health-social-economic-priority/

“Addressing Alzheimer’s disease through early detection and diagnosis.” “Dementia costs the world over $2Trillion a year and is projected to surpass $10T by 2050.”

Nature Health – A scoping review and meta-analysis of functioning problems across 41 African countries

Maria Charumbira et al; https://www.nature.com/articles/s44360-026-00126-w

« A scoping review of 1,154 studies from 41 African countries shows that around 40% of adults with leading disabling conditions experience interconnected rehabilitation-amenable functioning problems, highlighting the need for integrated rehabilitation strategies.”

Lancet Public Health (Viewpoint) – The International Agency for Research on Cancer: from global evidence to national action

Anna Schmütz; https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00091-5/fulltext

“As we mark the International Agency for Research on Cancer (IARC) 60th anniversary, this is an opportunity to reflect on our contribution to cancer evidence and action. Global cancer incidence continues to rise, with the largest proportional increases projected in countries that are the least equipped to respond. However, the central challenge is no longer only to produce evidence, but to understand why evidence is translated into policy and practice in some settings more effectively than in others. Drawing on the International Agency for Research on Cancer Impact in Practice series—30 country reports co-produced with national partners across IARC participating states—we examine how shared international cancer science influences policy and practice in national settings. Four recurrent pathways help explain that translation…”

Social & commercial determinants of health

BMJ GH – Whose voice counts? Public participation as a legal and commercial determinant of health in South Africa

https://gh.bmj.com/content/11/5/e021501

By S Mahomedy et al.

Access to medicines & health technology

Critical Public Health – Addressing fragmented pharmaceutical procurement in Africa and charting future directions: a narrative review

https://www.tandfonline.com/doi/full/10.1080/09581596.2026.2670791

By Majani Edward et al.

JAMA (Editor’s note) – Advancing Pharmacoequity in Asthma

JAMA

“ Pharmacoequity, a term coined in a 2021 article in JAMA, is a specific component of health equity focused on fair and just access to appropriate medications, regardless of race, ethnicity, income, insurance coverage, and other social factors….”

Miscellaneous

UCL Global Business School for Health and WHO sign agreement to advance learning health systems and evidence-informed policy

https://www.who.int/news/item/15-05-2026-ucl-global-business-school-for-health-and-who-sign-agreement-to-advance-learning-health-systems-and-evidence-informed-policy

“University College London (UCL) and the World Health Organization (WHO) have signed a Memorandum of Understanding (MoU) to formalize collaboration on learning health systems and the use of evidence in policy.  The partnership also marks an important step in the establishment of the Centre for Global Health Systems and Policy at UCL, which will serve as a platform for bringing together research, education, and partnerships to support more adaptive, equitable, and contextually grounded health systems….”

Papers & reports

WHO – Improving public health in health systems : Guidance for country-level policies and actions

https://iris.who.int/items/d570ce18-85a7-4109-ab5b-62bb07a1ef89

“This WHO guidance provides an evidence-informed framework to strengthen the integration of public health within health systems at country level. It responds to persistent gaps in the prioritization of public health functions, highlighted by increasing global health challenges such as pandemics, noncommunicable diseases and environmental threats….”

Tweets  (via X, LinkedIn & Bluesky)

Carsten Staur (DAC)

(re the OECD future of development cooperation meeting of last week): “An emerging new world order, challenging global rules, the very purposes of engaging, the idea of national interests – the world as we knew it is increasingly challenged, and so are the very parameters of international development co-operation. …. The timing was excellent for the OECD Conference on the Future of International Development Co-operation last week, convening leading development co-operation thought leaders and practitioners for two inspiring days in Paris – … “

“A few overall takeaways from discussions at the Conference:

A clear and unequivocal recognition from all sides of the paramount importance of partner countries’ ownership of their own development and the need for development co-operation providers to align with partner country priorities, policies and plans.

A strong understanding of the changing rules of the game and a stronger integration of development co-operation in foreign policy.

A clear focus on the importance of South-South and Triangular Co-operation and for DAC members to engage and support these modalities.

A renewed emphasis on national interests as a key driver for the political priorities of many providers, but also a recognition that this interest and its expression in the concept of ‘mutual interests’ could take many forms, and that it could co-exist with solidarity rationales for co-operation, centered on poverty reduction.

A broad recognition that the rationale and purpose of ODA is changing, including growing emphasis on humanitarian assistance, on mobilization of development finance, and on climate and other global public goods, but that poverty reduction remains in focus, and that ODA remains essential for those countries who do not have access to other source of finance.  “

Andrew Green

(from a few nice threads  on the Accra Reset ‘Clarion call’ event from Monday, and follow-up event on Tuesday morning)

“Mahama insists Accra Reset will “break the distance from declarations we make at podiums and factories and clinics we build on the ground.” He outlines a new financing mechanism for maternal health and bioinnovation intended to have its first deal in place ahead of this year’s UN General Assembly.”

With the 79^th World Health Assembly now in full swing in Geneva, for once we send you an early update on Tuesday, mostly compiling the great work of colleagues from Devex, Health Policy Watch, Geneva Health Files and many others, split between the ‘Palais’ and the WHO headquarters this year (for the official sessions), ànd also no doubt in many side events in the city. Occasionally, I watch the odd hybrid event here and there, like the Graduate institute’s pre-WHA briefing  on Sunday,   themed “Can global health (still) make progress under rupture? “,  or the Accra Reset ‘clarion call’   (with a rather vigorous ‘MC’) on Monday evening. There’s quite some buzz around the Accra Reset – and for good reason. The Ghana president, John Mahama, certainly gives the impression he means business.

You get some of the main info from these and other sessions in our curated compilation – stay tuned for the follow-up (part 2) on Friday. You will notice that in this issue, we split up the WHA79 content in a first subsection with more or less chronological focus on the ‘main highlights’ so far, and then dig a bit deeper into various agenda items (and related publications) in follow-up subsections.

By the way, we quite enjoyed Suerie Moon’s “termites in the wood” metaphor (on the impact of bilateral health agreements of the US, vs some of the multilateralism needed), at the pre-WHA briefing on Sunday, ànd it also struck us that Wellcome’s John-Arne Røttingen, usually fairly diplomatic and nuanced, grumbled  ‘bullocks’   when describing the limits to the mandate of the  Joint Process on global health reform. We agree with him ‘tinkering at the edges’ is no longer an option.

Finally, while clearly the new and worrying Ebola PHEIC gets a lot of attention at the WHA (and in this newsletter), we would also like to draw your attention here to the Pan-European Commission on Climate Change and Health, which argued we need to “Confront climate change as a catastrophic threat to human health, security, and social stability”. Among its (17) recommendations: “Declare the climate crisis a global public health emergency” (PHEIC).

Would be long overdue, moreover.

Enjoy your reading.

Kristof Decoster

·         WHO DG race

·         Global Health Reform & Reimagining

·         The Future of Development Cooperation

·         Run-up to the 79th WHA (18-23 May, Geneva): primers

·         Run-up to WHA79: More pre-analyses, reports, advocacy, reads on agenda items, …

·         Africa Forward Summit (Nairobi) (11-12 May)

·         More on Global Health Governance & Financing/Funding

·         America First Global Health strategy & bilateral health agreements

·         Trump 2.0

·         HIV

·         UHC & PHC

·         Hantavirus outbreak

·         More on PPPR & GHS

·         NCDs & Commercial determinants of health

·         SRHR

·         International Nurses Day (& more on HRH)

·         Planetary Health

·         Access to Medicines, Vaccines & other health technologies

·         Conflict/War & Health

·         AI & Health

·         Some reports & series of the week

·         Miscellaneous

WHO DG race

WHO – Process for the election of the Director-General of the World Health Organization – Report by the Director-General

https://apps.who.int/gb/ebwha/pdf_files/EB159/B159_10-en.pdf

One of the preparatory documents (for the upcoming WHA). Among others on two candidates’ fora that will be organized.

·         Some coverage & analysis via  HPW – WHO Sets Out Timetable and Ethical Guardrails for Election of New Director-General; but Loopholes Remain

“As the campaign to elect a new World Health Organization Director-General officially opens, a timeline and guidelines for the process have been published by outgoing DG Dr Tedros Adhanom Ghebreyesus for consideration by member states at next week’s World Health Assembly and the upcoming Executive Board. While these aim to promote a transparent and level playing field, structural loopholes remain.”

(after the Covid time)   “…The current contest expects a full return to “normal” physical in-person campaigning at regional committee sessions. However, a “new normal” is also unfolding under complex conditions, as the WHO grapples with a sharply polarized body of member states and a drastically reduced budget following the United States’ withdrawal last year, forcing it to implement massive, ongoing workforce reductions.”

“To maintain fairness in this highly pressured, post-pandemic landscape, WHO has published a draft set of guidelines that would help create a firewall between candidates’ campaign activities and official organisation business – rules that will be particularly important for candidates that emerge from within WHO’s ranks. …”

PS: “The Director-General’s recommendations on the election process, to be reviewed by Member States at the upcoming World Health Assembly and Executive Board, aim to reinforce established parameters from the previous election cycle. But enforcement still relies mostly on ‘good faith’ as compared to legally binding measures.”

PS: “WHO staff members who join the race will have to go on leave – but Regional Directors may be exempt”: “….Yet, past precedent has explicitly exempted WHO Regional Directors from this rule – due to their status as WHO officials elected by member states. This means that potential candidates such as Hanan Balkhy, Regional Director of WHO’s Eastern Mediterranean Region, or Hans Kluge, European Regional Director, could theoretically campaign while remaining in their positions – while other potential candidates such as Assistant Director-General Jeremy Farrar, would have to spend months on leave in order to compete, at a sharp inherent professional and financial disadvantage.”

Geneva Solutions – ❝The next WHO leader will need to be a multitasking political acrobat”

P Patnaik;  https://genevasolutions.news/global-health/the-next-who-leader-will-need-to-be-a-multitasking-political-acrobat

“Tedros Adhanom Ghebreyesus’s successor will need a strong strategy and their political wits about them to address member state defections, shaky financial prospects and an expanding to-do list of global health issues, writes Priti Patnaik, founder of Geneva Health Files.”

Mail & Guardian – Search on for next WHO chief

N Makgana & P Kadima; https://mg.co.za/thought-leader/opinion/2026-05-08-search-on-for-next-who-chief/

Including ‘Traits of an ideal WHO director general‘  (from the Global South’s perspective).

Global Health reform & reimagining

GPF – Global health in crisis: Six theses on the role of private actors

K Seitz; https://www.globalpolicy.org/en/publication/global-health-crisis-six-theses-role-private-actors

One of the reads of the week.

“Global health is in the midst of a profound structural crisis. Massive cuts in public funding, coupled with an already growing dependence on private actors, weak multilateral institutions and rising inequalities, are jeopardising the human right to health. 4.5 billion people have no access to basic health services. Against this backdrop, new ways of mobilising funds are being discussed. Many see an opportunity in the even greater involvement of private actors. However, this should be carefully examined and structured so that it actually has a sustainable impact, particularly for the poorest and most marginalised populations worldwide, and does not primarily serve the interests of private actors. Democratic oversight, human rights-based policies, strong public institutions and genuine civil society participation are crucial to realising the right to health worldwide. Only by strengthening the World Health Organization (WHO), ensuring greater transparency, regulating private influence and investing in public health systems and social security systems can a just global health order for all be achieved.” “ Against this backdrop, Brot für die Welt, Global Policy Forum Europe and Misereor have formulated six theses on the role of private actors in global health and recommendations for action for the German government and the Bundestag in this briefing paper.”

·         Related:   Less public funding, more private influence: Who calls the shots in global health policy? (by K Seitz & J Hanne)

“The funding crisis puts global health system under enormous pressure.”

“The increasing power and growing influence of private actors has three far-reaching consequences, based on our paper on the growing influence of private actors in global health: Profit motives determine access to medicines; Those who pay have a say: private actors are increasingly influencing political decisions; Competing actors and self-interest complicate coordination within the global health system.”

“Germany, too, is increasingly relying on private actors…”

Seitz & Hanne recommend 6 actions to the German government.

MOPAN – Mapping of Organisational Mandates Against Future Priority Health Functions

MOPAN

First in a series of three papers.

“The current configuration of mandates, across nine multilateral organisations, is “not yet” fit to deliver the six functions that a reformed global health architecture will need. Both mandate expansion and a lack of collaboration and alignment among organisations, especially at the country level, have created overlap – and likely inefficiencies – in delivering priority global health functions. While mandate rationalisation is necessary, greater emphasis should be placed on understanding and reforming the underlying financing, accountability, and governance arrangements, and the incentives underpinning them, that currently drive mandate evolution and expansion. The organising framework for the future architecture should place rationalisation, collaboration, and comparative advantage at its core.”

Background: “… the purpose of this study is to provide evidence about global health mandate and practice across nine multilateral organisations as a basis for making concrete decisions on global health reform. The objectives are to: 1. map foundational and evolving mandates of the nine multilateral organisations against potential future global health priorities; and 2. explore the relationship between mandate and practice to assess how organisations collaborate to deliver global health functions. This study is the first of three outputs aimed at supporting global health reform dialogue. Output 2 (September 2026) will use this foundation to assess comparative advantage across the six priority global health functions. Output 3 (December 2026) will identify reform pathways. The study is timed to inform the WHO-hosted Joint Process, WHA79 (May 2026) and the ongoing Accra Reset…..”

Check out the main findings.

Telegraph – The global health system must radically change to survive and thrive

S Nishtar; https://www.telegraph.co.uk/global-health/science-and-disease/the-global-health-system-must-radically-change-to-survive/

“The current model is unsustainable. The focus must be on building a leaner, more efficient global health system led by a reformed WHO.”

She lists three reform objectives.

Chatham House – Global health reform cannot wait for a new world order. Middle powers must act now

I Kickbusch https://www.chathamhouse.org/2026/05/global-health-reform-cannot-wait-new-world-order-middle-powers-must-act-now

“The World Health Assembly in Geneva presents a narrow window of opportunity for action to save multilateral cooperation on global health. Three things need to happen.”

Cfr Kickbusch: “My take on #globalhealth and #middlepowers with reference to #Carney and #Stubbs.”

Also a good read ahead of the World Health Assembly.

The Partnership for International Politics and Diplomacy for Health –  Global Public Goods and Global Functions for Health: A New Brief from the Partnership

https://globalhealthdiplomacy.se/global-public-goods-and-global-functions-for-health-a-new-brief-from-the-partnership

“As debates about reforming the international health system intensify, the Partnership has published a new brief examining two concepts that are central to those debates but frequently confused: Global Public Goods (GPGs) and global health functions. The aim of this brief is to revisit the concept of GPGs in health and explore how it differs from global health functions — and why that distinction matters for effective reform of the international system.”

“GPGs are goods — products, shared frameworks, policies, infrastructure, norms or conditions — whose benefits are “non-excludable” and “non-rivalrous”. Once provided, no country can be excluded from them, and one country’s use does not diminish another’s. In contrast to GPGs, global health functions are the activities that the international ecosystem for health performs. Some, but not all, of these functions produce GPGs. The conflating of the two terms is not just an academic debate – it has real consequences for prioritization, governance, and financing.”

“Loose definitions of GPGs and global functions may perpetuate the overly expansive mandates of existing global institutions in need of reform, misaligned financing as ODA declines, duplication between global, regional, and national actors, and misguided prioritization in reform processes. Conceptual clarity around these concepts will support efforts to refocus the international ecosystem for health on its comparative advantages and added value. This may include strengthening the international system’s role in pandemic preparedness, norm-setting, promoting research, setting surveillance standards, and market shaping.”

K Bertram (blog) – Should’ve, Would’ve, Didn’t…

https://katribertram.wordpress.com/2026/05/11/shouldve-wouldve-didnt/

“A recent post by Pete Baker (CGD) about the (now WHO-led) global health architecture reform process made me want to cry, scream, chuckle, sigh, and state “I told you so” – all at the same time. Over the past two years, our sector has again been in reform frenzy – to then decide it won’t reform. … Why is reform so difficult, especially when we know we should’ve, and nearly would’ve – but then didn’t, again and again?”

Here are five reasons and lessons to get things right the next time we try. …

A bit early days perhaps, to declare the global health reform dead, but Bertram makes a few very valid points.  On the importance of veto-players, a closing window of opportunity, …

TGH –  Centering Women, Children, and Adolescents in Global Health Reform

H Clark & R Khosla; https://www.thinkglobalhealth.org/article/centering-women-children-and-adolescents-in-global-health-reform

“In an era of fiscal pressure, omission does not produce neutrality; it can produce retrenchment by default.”

“Much debate is swirling around global health architecture. From the UN80 Initiative and the reshaping of the World Health Organization (WHO) following severe funding cuts to the Accra Reset and the Lusaka Agenda, policymakers are exploring how to build a system that is more efficient, coherent, focused on country-level impact, and financially sustainable. Yet in these important conversations, the health and rights of women, children, and adolescents are not center stage. This is not simply a matter of wording; it is a matter of political priority. What is not clearly named is rarely protected in practice.”

“Today’s reform agenda is shaped by compelling principles—of equity, primary health care, country ownership, governance coherence, and sustainable financing. These priorities are important, but WCAH and sexual and reproductive health and rights (SRHR) need to be explicitly centered in them. As institutions adapt to tightening resources and make structural change, the absence of clear safeguards for WCAH and SRHR risks sidelining those most vulnerable…..”

“Let’s take a leaf from the book of the Joint Political Declaration on the Reform of the Global Health Architecture, which was adopted in April by the Group of Seven (G7) in Lyon, France. It explicitly reaffirmed sexual and reproductive health and rights as a core component of global health architecture reform, highlighting the importance of making such commitments operational in practice….”

Clarke & Khosla then list four Priorities for Inclusive Reform.

Devex Check-up (update)  on the possible merger of UN Women and UNFPA

A Green; https://www.devex.com/news/devex-checkup-the-hantavirus-cruise-ship-outbreak-reveals-a-us-cdc-adrift-112464

“It’s been two weeks since the United Nations published its much-awaited full assessment of the potential benefits of a merger between UN Women and the U.N. Population Fund. It turns out the final report is not very different from the initial assessment. The main addition is that it outlines three possible merger pathways: creating a composite entity similar to the model used to establish UN Women — the option the report describes as its “preferred” approach — or having either agency integrate the other.”

“But many member states’ questions remain unanswered. The full assessment does not include any alternatives to a merger or an analysis of its implications on the ground. The argument? It’s “beyond the current scope provided by the Secretary General.” The big question now is whether the U.N. General Assembly will be persuaded that a merger makes sense. From what Jenny is hearing, the executive boards of both agencies will hold informal briefings on UN80 later this month ahead of their formal board meetings in June. Those discussions could help shape what happens next…..”

HPW – WHA79 Must Make Universal Health Coverage the Compass for Global Health Architecture Reform

A Khogali, A Lal et al ; https://healthpolicy-watch.news/wha79-must-make-universal-health-coverage-the-compass-for-global-health-architecture-reform/

“Leaders of the international NGOs, Save the Children, Seed Global Health, AMREF, and LSE Health make five asks to member states attending next week’s 79th World Health Assembly, as they take the first steps to launch a joint UN process for reforming the global health architecture.”

PS: “The appointment of Thailand and Andorra as co-facilitators for negotiations on the 2027 UN High-Level Meeting on UHC is politically significant. The 2027 UHC High Level Meeting (HLM) cannot become a separate process alongside GHA reform discussions. It should serve as one of the accountability mechanisms for reforms currently being debated in Geneva….”

“In the lead-up to the 2027 UN High Level Meeting on UHC, we call for five key changes:

“Anchor GHA reform in UHC and country ownership; Invest in PHC and sustainable financing; Strengthen the health workforce for UHC; Institutionalize social participation and accountability; Safeguard UHC in crisis and conflict settings.”

NCD Alliance – Global health reform cannot succeed without NCDs and civil society, leaders warn ahead of WHA79

https://ncdalliance.org/stories/news-blogs/2026/global-health-reform-cannot-succeed-without-ncds-and-civil-society-leaders

“Ahead of the 79th World Health Assembly in Geneva, NCD Alliance, City Cancer Challenge, and the Partnership for International Politics and Diplomacy for Health convened a webinar calling for noncommunicable diseases (NCDs), including mental health and neurological conditions, to be placed at the centre of global health architecture reform.”

“As WHA approaches, NCDA and partners are calling for the WHO joint process on global health architecture reform to include civil society and people living with NCDs from the outset.  “

Future of Development Cooperation

OECD meeting on the future of development cooperation (11-12 May, Paris)

https://www.oecd-events.org/e/future-of-development-co-operation/en/content/resources

Theme of the meeting in Paris: ‘Charting Strategic Directions’.

The aims were: “Day one will focus on visions for a new era. Participants will debate ideas for a new era of development cooperation, including new goals, principles, and paradigms. Day two will consider strategic directions for purpose and impact. Decision makers and experts will discuss proposals for the future of development cooperation and stress-test proposals from key initiatives, including the OECD Development Assistance Committee (DAC) Review.”

Check out some background resources, research papers, short briefs…

As mentioned in the intro, a related OECD flagship report is expected for September/October.

Devex@OECD – So, what is the future of development?

Devex ;

Special Devex issue related to the OECD summit in Paris.   Excerpts below.

“What is the state of international development right now, and how do we make it better?
That was the essential question under discussion in Paris this week, at the Future of Development Co-operation conference hosted by the Organisation for Economic Co-operation and Development on Monday and Tuesday.”

·         Re the Accra Reset: “The conference kicked off with a keynote from Nana Oye Bampoe Addo, deputy chief of staff for the administration of Ghana, on the Accra Reset, the ambitious African-led program to change the shape of development spearheaded by her president, John Mahama. …
Addo gave more detail on the high-level panel on health reform — an initiative announced by Mahama at Davos in January — which she said will begin engagement at the World Health Assembly next week, and publish a final report at the meeting of the United Nations General Assembly.”

“Alongside the panel, she said, there will be a mechanism to deliver change called HINGE — the Health Investment National Gateways Enabler — although so far, there is little information on what the mechanism will do, how it will work, or how it is funded….

“Addo also stressed that Mahama and his team have much broader ambitions than health. She spoke of his plans for what are called sovereign prosperity spheres, to be unveiled at the African Union midyear summit in Egypt next month, which will see partner countries have the ability to launch joint financial instruments, although once again, the speech was scant on details about how these will function in practice….” “ And she hinted at wider ambitions around training national experts in fields such as health, finance, mining, and digital infrastructure, and around freedom of movement between countries in order to better share skills.”

“Addo also gave her support to the idea of development reform. “The Accra Reset does not reject global cooperation,” she said. “It seeks to reset the terms of that cooperation” — not as charity, but as “a strategic investment in stability.”

·         PS: “South-south cooperation” was also one of the themes.

·         re OECD (and DAC) reform:  “ Garrido, a former Costa Rican minister, highlighted key changes that the OECD is pushing toward — a renewed case for aid, increased ownership of the process from the global south, and stronger forms of accountability and evidence.”

“… OECD is currently in the middle of a review process looking at the governance and structure of the Development Assistance Committee, or DAC — but it’s a process which is open to criticism. Some parts of civil society see the DAC members as currently disengaged with aid issues, as they grapple with their own problems — the United States with an internal culture war and Europeans with economic weakness and internal strife…. … She spoke sincerely of her ambition to bring more stakeholders into the discussion, and to make the DAC more inclusive and accountable to the global south. But the key will be to see what actually emerges from the review process.”

·         … What happens next? “At the end of the conference, a group of leaders sat down to talk about what happens next. Their key conclusions: We need to look to a future which appears very different from the present, and plan for it. And in order to do so, we need to both reinvent the existing order, and create a new one.  Wook-jin Chang of South Korea highlighted the fact that we are only three years from the conclusion of the Sustainable Development Goals, which everyone knows we will not hit. So there will need to be a reimagining. What comes next?   The process of deciding this looks likely to launch a thousand documents. Following the conference in the U.K. next week, the likely outcome would be a compact on international cooperation. At the upcoming Hamburg Sustainability Conference next month, a high-level commission will launch on global north-south cooperation….

IDS – Recentring the global development agenda: the value of a diversity of voices and views

P Taylor et al ; https://www.ids.ac.uk/opinions/recentring-the-global-development-agenda-the-value-of-a-diversity-of-voices-and-views/

“Amid several initiatives to reset the agenda and forge new global partnerships for development cooperation, we need to remember what was learned in the past and reorientate towards the agendas and needs of people living in poverty or who are marginalised and disempowered. Citizens want and deserve an active role in developing their own futures.”

“… many conversations are again happening about the future of international development cooperation. Multiple initiatives are currently underway, some global, for example the Future of Development Cooperation Coalition, and the OECD’s initiative on the Future of Development Cooperation. At the same time, the UK is preparing for a Global Partnerships Conference hosting participants from around the world to ‘build new international coalitions to tackle shared challenges’.  This is just a small sample of a wider array of conversations and dialogues seeking to chart a pathway towards a shared future, in which the overall international development cooperation system will become far more sensitive to national realities than it currently is….”

Devex (Opinion) – The $1.3 trillion gap: Why development needs partnerships

J Chapman; https://www.devex.com/news/the-1-3-trillion-gap-why-development-needs-partnerships-112468

“Aid alone cannot close today’s development gap. It is essential to cultivate coalitions that bring in new investment and expertise; something the upcoming Global Partnerships Conference will drive forward. »

« In a new essay, U.K. Minister of State for International Development and Africa Jenny Chapman argues that traditional aid alone cannot close the $1.3 trillion annual financing gap facing Africa. As global economic integration shifts from a tool of progress to a weapon of geopolitical competition, she explains why the international community must move beyond fragmented responses toward genuine partnerships grounded in mutual respect rather than old hierarchies. Chapman suggests that the future of impactful development lies in “convening without controlling” — aligning private capital, philanthropy, and government expertise to support countries in leading their own development. By treating low- and middle-income nations as “stakeholders, not spectators,” the United Kingdom and its partners aim to shift power, decision-making, and resources closer to those best placed to deliver….”

CGD (blog) – What Are We Watching for at the UK’s Global Partnerships Conference?

I Mitchell, P Baker et al;  https://www.cgdev.org/blog/what-are-we-watching-uks-global-partnerships-conference

“Next week, the UK co-hosts its conference on the future of international development. Foreign Secretary Yvette Cooper will host the event, alongside South Africa, the Children’s Investment Fund Foundation and the UK’s impact investor and development finance institution, British International Investment.”

“There’s potential for new and helpful voluntary actions from the private sector; but governments remain the actors that matter. The government hopes to agree a “Compact” to signal shared intent to strengthen international cooperation; but the draft excludes practical commitments, and so I’ll be looking out for three things:  (1) Will the UK offer anything progressive on its own policy on development? It seems clear that this won’t involve more spending; but what about committing to publish evidence of what works, illicit finance; debt; access for students from low-income countries, or research and development (R&D) collaboration? (2)  Is there any sign that governments committed to multilateralism will better coordinate their strategy and approach (to counter those that do not)? As my colleague Mikaela Gavas notes below, this is a system in crisis—but even like-minded countries are continuing to operate in their national silos on which countries and institutions they support. (3) Will there be an explicit link to the UK’s G20 agenda next year? There are some 120 developing countries that don’t have a seat at the G20 (now including co-host South Africa) but who fundamentally rely on the economic system it oversees. The UK could make a connection with the issues raised at the conference and its agenda next year….”

And a paragraph more specifically on: “Will the UK set out a clear vision for global health reform?”  (by Pete Baker)

“The UK government have stated that reform of the global health architecture will be a key priority of the conference, and related events will happen in Geneva alongside the World Health Assembly. But what is the UK’s vision for the future here? Perhaps the conference will bring some much-needed clarity on this. Superficially it appears committed to substantial change: officials are actively involved in all reform processes, and the Foreign Secretary noted in March “Everyone agrees that it needs to be simplified and streamlined”. But its actions suggest otherwise—it has provided very substantial funding to Gavi and Global Fund with no meaningful requirements for reform. The UK has so far provided no public articulation of what its priorities are for reform or what its vision is for a better architecture. This may be a lack of transparency, or more likely, given its policies and actions don’t align, it speaks to a lack of internal agreement on its vision. We would like to see its vision better articulated during the conference. Specifically, the UK should commit to a lean WHO focused on its global functions, and a greater role for the Multilateral Development Banks s in broad health system financing, such as through an IDA Health Window.” “

Atlantic Council – Making aid work in the new geopolitical era will be an uphill battle

Stefan Dercon;   https://www.atlanticcouncil.org/content-series/freedom-and-prosperity-around-the-world/making-aid-work-in-the-new-geopolitical-era-will-be-an-uphill-battle/

“Short-term wins for aid can weaken state capacity and entrench dependency. Aid works where governments are committed, not just where poverty is highest. The technocratic era is over; aid is reverting to a geopolitical tool, not a neutral development instrument.”

Run-up to the 79^th WHA (18-23 May, Geneva): primers

https://www.who.int/about/governance/world-health-assembly/seventy-ninth

·         Preparatory documents: https://apps.who.int/gb/e/e_wha79.html

·         And via WHO Watch: WHO Tracker (related to WHA79): https://who-track.phmovement.org/node/699 : stay tuned for policy briefs etc!

You find a number of primers from the pre-WHA79 week in this subsection.  In a next pre-WHA related subsection, you find some more reads & analyses.

Geneva Solutions – WHO says its finances are stable, but uncertainties loom

https://genevasolutions.news/global-health/who-says-its-finances-are-stable-but-uncertainties-loom

“A year after the US exit from the global health body, WHO officials say finances are secure, for now. But amid donor cuts, rising inflation, and future economic uncertainties, will funding be sufficient to meet its needs?”

“Earlier this month, senior officials at the World Health Organization (WHO) told journalists in a newly refurbished pressroom at the agency’s headquarters that its finances were “stable”. Following a year that saw its biggest donor withdraw as a member, forcing it to cut 25 per cent of its staff, its financial chief said that 85 per cent of its 2026 and 2027 budget had been financed. “While we are looking at resource mobilisation, we’re also looking at tightening our belts,” Raul Thomas, assistant director general for business operations and compliance, explained, admitting that the WHO “will have great difficulty mobilising the last 15 per cent”.”

Including also the view of Suerie Moon.

“Suerie Moon, co-director of the Global Health Centre at the Geneva Graduate Institute, explains that every year at the WHO, there’s “a non-stop effort” to ensure funding. She says a continued reliance on non-flexible, voluntary funding earmarked for specific projects, as well as donors withholding contributions – sometimes for political leverage – complicates the organisation’s financial plans. Meanwhile, ongoing cuts and predictions of a global economic downturn stemming from the war in the Middle East may further aggravate the situation, as costs rise and member states focus on national spending needs….”

“Since the dramatic drop in funding from the US, formerly the WHO’s biggest contributor, Moon highlights that there hadn’t been a “sudden jump by non-traditional states to compensate for the US”. Last May, at the World Health Assembly, China pledged $500 million in voluntary funding until 2030, a sharp rise from the $2.5m it contributed over 2024 and 2025.  The WHO did not respond to questions from Geneva Solutions about how much of the pledged amount had been disbursed. China’s mission in Geneva did not respond to questions raised about the funding.  Other countries, particularly Gulf states, have meanwhile been increasing their voluntary contributions to the organisation in recent years. Similarly to “western liberal democracies have in the past”, Moon explains that they may be seeking “to raise their profile and prioritise health as one of the issues that they would like to be known for”. She noted that the shift in the UN agency’s list of top donors may affect how it manages the money….”

PS: “… Amid these financial uncertainties, WHO executives say the organisation is also reviewing its expenditure through “sustainability plans”. This includes working more closely with collaborating centres, including universities and research institutes that support WHO programmes and are independently funded…”

PS: “The upcoming change in leadership will also be a strategic moment for the organisation to boost its coffers.  Moon says the race for the top job at the organisation may attract funding from candidates’ home countries, which could be seen as a strategic opportunity.
Given the relatively small size of the WHO budget, compared to some government or agency accounts, “you don’t have to be the richest country in the world to dangle a few 100 million dollars, which could go a long way in their budget,” the expert notes. The biggest ongoing challenge, however, will be whether major donors will announce further aid cuts. In the medium and longer term, “countries will have to  agree on the step up every two years, and there’s always drama around that.””

HPW –  WHO Gender Parity Dips Amidst Staff Cuts, but Women Advance Slightly in Professional Ranks

https://healthpolicy-watch.news/who-gender-parity-dips/

“A dramatically shrinking World Health Organization has seen a slight decline in overall gender parity amidst restructuring. However, strict recruitment policies and targeted job cuts have actively boosted female representation within the organisation’s professional ranks. At the same time, deep regional disparities in gender representation remain unresolved, with men holding  the overwhelming majority of staff posts in the African, South-East Asian and Eastern Mediterranean regions.”

PS: “Headquarters is bearing the heaviest burden of the realignment. Official projections indicate that Geneva and Global Shared Services will shrink by 29% by June 2026, losing over 800 staff members. Meanwhile, the proportion of personnel based in country offices has increased to nearly 46% of the remaining global workforce. This deliberate geographic shift reflects a strategic institutional goal to build a significantly leaner administrative headquarters while vigorously protecting country-level health delivery. “The development aid era is over. WHO Geneva needs to be much smaller,” as diplomatic sources who spoke to Health Policy Watch framed it.”

PS: “The WHO currently faces a funding gap of approximately $630 million, representing roughly 15% of its $4.2 billion base budget for the upcoming 2026-2027 biennium. Officials have managed to shrink this deficit through aggressive reprioritisation, extensive staff cuts, and a 50% reduction in travel costs. This represents a massive reduction from the initial projected deficit of $1.7 billion…”

Concluding: “… As attention turns to the next World Health Assembly and the election process for a new Director-General, the incoming leader will inherit a downsized organisation that boasts a stronger female representation in its professional ranks in several regions – yet remains fundamentally fractured by severe budget constraints and glaring regional disparities.”

Geneva Health Files – The Real Costs of Restructuring at the WHO: Financing, Staffing and Mandates [WHA79 PRIMER]

P Patnaik; https://newsletter.genevahealthfiles.com/the-real-costs-of-restructuring-at-the-who-financing-staffing-and-mandates-wha79-primer/?ref=geneva-health-files-newsletter

“This edition gets you up to speed on the implications of what the restructuring and realignment at the WHO has meant for the organization’s mandate as a result of deep funding cuts in 2025. Indicators on finance and staffing have implications for governance in the context of such a realignment of the organization’s priorities. Countries will review these matters next week at the Assembly. This edition includes an update on the elections process for the next Director-General of the WHO.”   “…. four segments to this edition: Finance, Human Resources, the Membership Question, and the Elections for a new Director-General.”

Some key points:

“Funding cuts reveal deep impact on WHO’s numbers. For the year ended December 2025, contributions from countries have been lower than the year before (2024). Many countries continue to pay their membership dues late. (Assessed contributions from countries accounted for 13% of revenue.). Voluntary contributions were 83% of the total revenue. Of the voluntary contributions of US$ 2567 million (to the programme budget), 8% was fully flexible or thematic, and was earmarked for specified programmes. The WHO has had to review and suspend some areas of work following funding cuts triggered by the United States. “

·         And for the second part of the Geneva Health Files Primer – Revamping Global Health Architecture: Reforms by “Reports” [WHA79 PRIMER]

“In our edition today, a second of the two part primers this week, we present what’s coming up on the reforms discussion at the World Health Assembly next week…. … We also present a mapping of the parallel reforms discussions that have occurred over the last few months. Pia Mehdwan brings all these strands into a single analysis….”

Among the key messages: “Just as WHO means different things for different countries, the role of allied actors such as Gavi – The Vaccine Alliance, for example, also has different meanings for different countries. Some are more dependent on such actors, than others. In short, there are nuances in how countries view the reforms discussion. Activists say that without the aspirations of communities, reflected in these discussions, whatever comes next will be far from what is needed on the ground….”

UN Foundation – Global health in transition at WHA79

M Moss; https://unfoundation.org/blog/post/global-health-in-transition-at-wha79/

Another primer. Among the issues to watch: “Extending efforts on global health equity and security. … Forging a shared vision for global health architecture… Launching a new decade of AMR action. … Opening bell for the next WHO Director-General race.”

CGD – Three Issues to Watch at WHA79: WHO Funding, Prioritisation, and Leadership of Global Health Architecture Reform

P Baker;    https://www.cgdev.org/blog/three-issues-watch-wha79-who-funding-prioritisation-and-leadership-global-health-architecture

“The 79^th World Health Assembly (WHA) kicks off next week. There are three key issues I am watching closely: WHO financing, WHO prioritisation within its limited budget, and WHO’s leadership of the global health architecture reform process. With the WHA papers now online, all three are unfortunately not looking good.”   “1) WHO financing is deteriorating – less money, and less flexible money; 2) WHO prioritisation is failing – deeds do not match words; 3) WHO leadership of the global health architecture has been set up to fail…”

Baker concludes: “…We need a lean WHO that prioritises the global good, and we need a WHO that can lead. Unfortunately, member states have systematically prevented the WHO leading by further earmarking and restricting resources it has available and undermining its global health architecture reform process.”

Run-up to WHA70: More pre-analyses, reports, advocacy, reads on agenda items, …

World Health Statistics Report 2026

https://www.who.int/news/item/13-05-2026-global-health-gains-face-threat-of-reversal

On Wednesday, 13 May, WHO launched the World Health Statistics Report 2026, its flagship annual compilation of global health and health-related indicators. 

“Urgent action for stronger health systems backed by improved data is needed to protect progress.”

“The world is falling short on health targets, with progress uneven, slowing, and in some areas reversing, according to the World Health Statistics 2026 report, published today by the World Health Organization (WHO).  While there have been meaningful improvements in global health over the past decade, with millions benefiting from better prevention, treatment and access to essential services, persistent and emerging challenges mean that the world remains off track to achieve any of the health-related Sustainable Development Goals (SDGs) by 2030….”

Do dig into the findings.

For example on UHC: “Progress towards universal health coverage is losing momentum. Since 2015, progress in health service coverage index has slowed, while financial hardship remains widespread. Fewer than 4 in 10 countries are still making progress on both fronts.”

TWN – WHO: World Health Assembly to Adopt Strategy on Economics of Health for All

Dian Maria Blandina; https://www.twn.my/title2/health.info/2026/hi260502.htm

“The upcoming 79th World Health Assembly (WHA) is set to adopt a ten-year strategy on the economics of health for all. … … The WHA resolution 77.13 requested the Director-General to develop a strategy on how to implement an economics of health for all approach, including priority actions for Member States and other actors….”

“Earlier, the 158th meeting of the World Health Organization (WHO) Executive Board unveiled a draft strategy on the Economics of Health for All (2026 -2030)]. Moving beyond appeals for increased health financing within existing economic structures, the strategy proposes a fundamental reorientation of economic policy itself toward the attainment of universal health and wellbeing. The strategy successfully consolidates and legitimates a growing consensus around health as an economic investment rather than a social expenditure. Yet for all its ambition and foresight, the strategy leaves critical gaps unaddressed, chief among them the structural constraints facing Global South economies….”

With three gaps in particular.

TGH –  Argentina, the WHO, and an Exit Door That Doesn’t Exist 

S A Dallal; https://www.thinkglobalhealth.org/article/argentina-the-who-and-an-exit-door-that-doesnt-exist

“Argentina’s proposed departure from the World Health Organization raises complex legal questions about treaty withdrawal and global health governance.”

Habib Benzian – Geneva Rules (1): Seeing the World Health Assembly Differently

Habib Benzian;  

Episode 1 of “A series on what global health reveals when it gathers in Geneva.”

“Over the next two weeks, I am going to write about the Assembly. This is not simply an annual meeting, but a setting in itself. It is the very moment each year when the formal architecture of global health becomes visible. Ministers, ambassadors, WHO officials, donors, technical agencies, NGOs, foundations, industry-adjacent actors, academics, advocates, consultants, and journalists all gather in and around Geneva. Some sit around the official rooms. Many more work in the corridors, side events, receptions, hotel meeting rooms, and carefully curated roundtables that encircle the Assembly. For a few days, global health shows its machinery.”

“That machinery is not always hidden. A lot of it is public, recorded, livestreamed, captioned, translated, archived, written and transcribed in resolutions and official reports. The WHA agenda is available. The documents are online. The speeches can be watched. The formal rules do exist and they matter. Member States negotiate text. Committees meet. Resolutions are adopted. Programmes are approved. Budgets are discussed. Director-General speeches are scanned for meaning. For anyone who cares about global health governance, none of this is theatre in the sense of being fake.  But it is theatre in other ways. It has scripts, roles, staging, choreography, entrances, exits, hierarchies, and rituals of recognition or respect. The Assembly is often described as WHO’s parliament. That is true, but incomplete. It is also a ritualised performance through which global health determines who belongs, which issues merit serious consideration, which forms of evidence matter, what kind of conflicts may be named and which disagreements must be toned down into language that 194 Member States can tolerate. “

“This matters because, at the WHA, decisions often take the form of language. A word added to a resolution could create a mandate. A phrase removed may close one. Success can mean getting an idea into official text, avoiding a stronger formulation, citing an earlier pledge, or putting an issue from a technical report to a decision point. The politics are rarely only in the vote. They are in the sentence that survives….”

Episode two – Geneva Rules (2): What Geneva Knows

H Benzian; H Benzian;  

“The city that shows how global health behaves.”

With focus on the ‘informal architecture’ in Geneva during the WHA (and otherwise).

Excerpt:   “…The visible assembly is only one part of this ecosystem. Around it sits another Geneva: side events, diplomatic breakfasts, donor lunches, closed roundtables, civil society briefings, receptions, corridor conversations, hotel meetings, and quiet bilateral exchanges. And beyond that sits the city’s deeper geography. On the right bank, international Geneva: WHO, the Palais des Nations, the missions, the agencies, the humanitarian architecture. On the left bank, financial Geneva: private banks, wealth managers, foundations, and the older machinery of discretion. Between them, along the lake and the river, sit the hotels that connect both worlds. The Hotel InterContinental, closest to the UN, becomes during WHA week more than a hotel….”

Decilion – Two Open-Source MCPs for WHO’s Global Health Data, Ahead of WHA 2026

https://decilion.com/insights/gho-ghed-mcp/

“Two open-source tools that make WHO’s flagship health databases directly answerable from any AI assistant — released ahead of next week’s World Health Assembly.”

“Next week, delegates from 194 member states convene in Geneva for the seventy-ninth World Health Assembly. Health systems strengthening, universal health coverage, and the financing that connects the two will sit near the top of the agenda. Much of the evidence the room will draw on lives in two of WHO’s flagship public databases — the Global Health Observatory (GHO) and the Global Health Expenditure Database (GHED). Today, we are open-sourcing two small tools that make those databases directly accessible from the AI assistants global-health researchers are already using every day….”

Africa Forward Summit (Nairobi, Kenya -11/12 May)

Reuters – African leaders urge credit reforms at Nairobi summit with France

Reuters;  

“African leaders seek easier credit access at Nairobi summit; Leaders criticize global credit ratings, propose African agency for fairer assessments; France aims to rebuild partnerships in Africa amid waning influence in former ​colonies.”

Africa Forward Summit Adopts Landmark Declaration on France Partnership

https://africabrief.substack.com/p/africa-forward-summit-adopts-landmark

“Adopted in Nairobi on May 12, 2026, the Nairobi Declaration is expected to feed into preparations for the G7 Summit in Évian, France, in June.”

“… In health, the declaration prioritizes universal health coverage, pandemic preparedness, One Health approaches, regional manufacturing of vaccines and medicines, and health sovereignty through technology transfer and the African Pooled Procurement Mechanism.”

And re “Financial Architecture and Resource Mobilization”:  “ Participants called for reforms in the international financial system, including better IMF quota representation for Africa, enhanced voice on the Executive Board, debt sustainability measures, and increased concessional financing.

They urged major economies to address global macroeconomic imbalances that harm African development. A separate “Call to Action” on global excessive imbalances and a “Joint Statement on Renewed International Partnerships” stress the need for blended finance, private sector mobilization, public-private partnerships, domestic resource mobilization, and innovative instruments such as guarantees and debt-for-development swaps….”

Africa CDC – Statement by Africa CDC on the Biovac–Proparco Investment Milestone Announced on the Sidelines of the Africa Forward Summit

https://africacdc.org/news-item/statement-by-africa-cdc-on-the-biovac-proparco-investment-milestone-announced-on-the-sidelines-of-the-africa-forward-summit/

“Africa CDC congratulates Biovac and Proparco on the announcement of this important investment collaboration on the sidelines of the Africa Forward Summit.  This milestone represents another significant step forward in advancing Africa’s Health Security and Sovereignty Agenda through strategic investments in local vaccine manufacturing capacity.”

“The mobilization of US$180 million to support the expansion of a multi-vaccine manufacturing facility, including technology transfer, production scale-up, and working capital, demonstrates growing confidence in Africa’s pharmaceutical manufacturing potential and the strength of partnerships committed to strengthening the continent’s health manufacturing ecosystem….”

“Beyond Proparco, the consortia is supported by other key partners including the European Investment Bank through the Human Development Accelerator (HDX), International Finance Corporation and should conclude shortly with support from African-based DFIs. The European Investment Bank and Proparco’s investments represent half of the funding and have been made possible through European Commission financial guarantees. Africa CDC also recognizes the catalytic role of Gavi, the Vaccine Alliance and the African Vaccine Manufacturing Accelerator in helping unlock this opportunity and creating a viable pathway for locally manufactured vaccines to reach the market….”

Africa CDC and Aspen advance Long-term Vaccine Supply Partnership for Africa

https://africacdc.org/news-item/africa-cdc-and-aspen-advance-long-term-vaccine-supply-partnership-for-africa/

“Africa Centres for Disease Control and Prevention (Africa CDC) and Aspen Pharmacare are in advanced discussions on a long-term demand and supply alignment framework aimed at strengthening sustainable vaccine manufacturing in Africa.”

“Announced on the margins of the Africa Forward Summit, the engagement reflects a shared commitment to building viable and sustainable markets for African-made vaccines and advancing Africa’s Health Security and Sovereignty Agenda. … …The proposed collaboration seeks to address this imbalance by exploring a multi-year framework focused on strengthening local manufacturing capacity and supply security. The discussions will initially focus on: Priority vaccine antigens; A progressive scale-up of supply, with the potential to reach tens to hundreds of millions of doses annually over time; and Competitive and sustainable pricing approaches aligned with market benchmarks….”

·         See also  Reuters – Africa CDC and Aspen Pharmacare aim to boost vaccine output in Africa

“ The African Union’s public health agency and South African drugmaker Aspen Pharmacare  are in talks ​on a long‑term framework aimed at boosting vaccine production on the ‌continent, after the COVID‑19 pandemic exposed its overreliance on imports.  Africa Centres for Disease Control and Prevention (Africa CDC) and the continent’s largest pharmaceutical company said on Tuesday the talks are ​focused on building viable markets for vaccines produced in Africa as ​part of efforts to improve health security and reduce the continent’s ⁠reliance on imports.”

“… The talks are ​centred on selecting priority vaccine antigens, gradually scaling up supply with the potential to reach ‌tens ⁠to hundreds of millions of doses annually, and pricing products in line with market benchmarks, the organisations said in a statement. …  Africa CDC and Aspen said they will also discuss procurement, ​financing and risk‑sharing.”

More on Global Health Governance & Financing/Funding

European Commission strengthens global health security with new Global Health Resilience Initiative

https://ec.europa.eu/commission/presscorner/detail/en/ip_26_1074

(13 May) “Today, the European Commission adopted a Global Health Resilience Initiative. This strategy positions the EU as a reliable and frontline actor in global health by scaling up global prevention, preparedness and response to future health threats and addressing resilience gaps in health systems. It sets out the strategic framework for future EU action…”

With five key priority areas:  “Promoting a more effective and less fragmented global health architecture. Supporting resilient and country-led health systems. Reinforcing international-level prevention, preparedness and response to global health threats and crises. Diversifying global supply chains and manufacturing of key health products. Bolstering societal resilience by fostering trust in science and countering health dis- and misinformation to ensure global health policymaking remains anchored in scientific evidence and cooperation…”

“To translate these priorities into action, the Global Health Resilience Initiative includes nine flagship measures at national, regional and global levels, with the aim to enhance preparedness, improve coordination and build resilient systems around the world. Their implementation will begin between 2026 and 2027.”

HPW – EU Announces Bold Global Health Resilience Initiative Amidst Geopolitical Ruptures

https://healthpolicy-watch.news/eu-global-health-resilience-initiative/

Must-read coverage and analysis.  “The European Commission announced its long-awaited Global Health Resilience Initiative on Wednesday. While the policy roadmap aims to support partner countries’ transition toward health sovereignty amid historic aid cuts and shifting geopolitical realities, global health experts are concerned about its heavy reliance on private financing.”

“As global health gains face a severe threat of reversal from stagnating health system coverage and emerging pathogens, the European Commission’s newly announced strategic guidance seeks to do more than just fill funding gaps. It outlines key priorities and flagship actions designed to fundamentally revamp the multilateral health architecture and support partner countries’ transition toward health sovereignty amid a rapidly changing funding landscape.  The proposed strategy, issued in a formal communication to the EU parliament and the member states, reinforces the pivot away from fragmented development assistance. Instead of relying solely on traditional grants, European policymakers intend to use “de-risking” tools and blended finance – combining public funds with loans and guarantees – to help partner countries build self-sustaining sovereignty for their national health systems….”

“… Ahead of the upcoming World Health Assembly in Geneva next week, the Global Health Resilience Initiative is a recommitment to the World Health Organization (WHO). However, to overcome the deep fragmentation of the global health landscape caused by competing funds, the Commission is actively advocating for a leaner, more streamlined institutional architecture – which now includes not only WHO, but UNAIDs, UNICEF and other health-related bodies under the UN umbrella…. … “

“… To better coordinate these efforts, the strategic proposal aims to significantly step up alignment between European member states before major international replenishments and key financing milestones. This approach involves creating a comprehensive map of all European global health investments to actively eliminate redundancies and boost donor synergies.”

“This unified diplomatic front will be supported by a novel global health and resilience tracker. Developed in collaboration with the World Bank, the Organisation for Economic Co-operation and Development (OECD), and the WHO, this tool will initially focus on pandemic preparedness, prevention, and response by mapping both the domestic spending of partners and the international support they receive….”

“…  the Global Health Resilience Initiative leverages the EU’s external action tool, the Global Gateway, to mobilise up to €300 billion in investments. By shifting away from direct grants, the strategy relies on blended finance – using loans and guarantees – to de-risk and incentivise substantial private sector involvement in emerging economies.  According to Commissioner Síkela, this approach has already successfully channelled over €6 billion specifically into health projects by the end of 2025. The flagship initiative on Manufacturing and Access to Vaccines, Medicines and Health Technologies in Africa (MAV+) is part of this and exemplifies the strategy, having directed roughly €2 billion toward building pharmaceutical manufacturing capacities across the African continent, including investments in South Africa and Senegal….. …The Communication signals the Commission’s intent to formalise this approach within the EU’s executive branch, cementing a policy shift that explicitly aligns international development with European economic security and competitiveness. In practice, this means that while partner countries receive investments to build their resilience, European pharmaceutical and biotech firms are now strategically positioned to access these expanding, rules-based markets as a complementary alternative to relying solely on exports….”

PS: “… By formally embedding the “One Health” principle into the European external agenda and recognising the intrinsic connection between human health, animal health, and resilient natural ecosystems, the strategy shifts focus toward “deep prevention” – the ability to identify and address environmental threats before pathogens cross from animals to humans. This aligns directly with the EU’s 2022 Global Health Strategy, effectively positioning the new Resilience Initiative as the financial muscle needed to deliver on those earlier promises.”  …. Acknowledging that climate change, biodiversity loss, and environmental degradation drive these dangerous zoonotic spillovers, the bloc announced it would be pushing for stronger environmental safeguards within multilateral treaties. “

“… While the initiative rightly acknowledges the way in which institutional fragmentation can exacerbate, rather than address, global health threats, civil society critics were quick to note that the EU’s new initiative largely ignores the political drivers of health inequality. Critics warn that increasing the role of private corporations in the health systems of low-income countries could also fuel higher health care costs and inequalities – and undermine the goal of  ‘health sovereignty’…”

The analysis also includes apt criticism from Karolin Seitz (Global Policy Forum).

·         See also Politico –  EU trumpets its reliability on global health as US slashes foreign aid

“Its new plan calls out countries that “instrumentalize” health for political or economic gains.”

“As the U.S. and other Western countries pull back from foreign aid, the European Union is trying to position itself as the grown-up still showing up. In a new global health strategy unveiled Wednesday, the European Commission cast the EU as a steady partner for developing countries at a moment when global health funding is shrinking and becoming increasingly transactional….”

·         And Euractiv – EU announces new global health plans – but without fresh funding  (gated)

Africa CDC and the Federal Democratic Republic of Ethiopia Officially Launch CPHIA 2026 to Advance Africa’s Health Security and Sovereignty Agenda

https://africacdc.org/news-item/africa-cdc-and-the-federal-democratic-republic-of-ethiopia-officially-launch-cphia-2026-to-advance-africas-health-security-and-sovereignty-agenda/

(8 May) “Preparations for the continent’s foremost health gathering, the Conference on Public Health in Africa (CPHIA) 2026, have gained momentum following the official launch by the Africa Centres for Disease Control and Prevention (Africa CDC) and the Government of the Federal Democratic Republic of Ethiopia.”

“Today’s launch symbolises our determination to build healthier and more resilient Africa fully aligned with the aspirations of the African Union’s Agenda 2063,” said H.E. Ambassador Hadera Abera,State Minister of Foreign Affairs of the Federal Democratic Republic of Ethiopia. “CPHIA 2026 is necessary, it helps to advance Africa from dependency to transition to self-reliance from vulnerability to resilience from fragmentation to coordinated continental action.” Planning for the landmark conference, set to take place in Addis Ababa from 23 to 27 November 2026, is now underway…”

“Held under the theme “Africa’s Health Security and Sovereignty: Transformation from health dependency and vulnerability to ownership and resilience,” CPHIA 2026 will provide a strategic continental platform to advance Africa-led solutions, strengthen resilient health systems, and accelerate implementation of the Africa Health Security and Sovereignty agenda….”

Lancet Regional Health Africa – America first and the right to science: implications for African health sovereignty

M Mulumba et al ; https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00040-4/fulltext

Coming back on the bilateral health agreements, among others.

“The most contentious elements of these Bilateral Global Health Agreements (BGHAs) lie within their data and specimen-sharing appendices. These clauses mandate that African states transfer physical specimens and genetic sequence data of pathogens with epidemic potential to U.S.-approved laboratories within a mere 120 h of detection. Strikingly, while the funding cycles are strictly limited to five years, the pathogen-sharing commitments persist for 25 years. Furthermore, extraterritorial data access for U.S. agencies or private contractors remains in force for 10 years after termination, regardless of any changes in host-country governance. By imposing a five-day turnaround, the AFGHS effectively grants a non-Party to the WHO Pandemic Agreement monopolistic, priority access to biological resources long before multilateral systems can even be activated.  “

“This transactional turn should be scrutinised not merely as a diplomatic dispute, but as a serious concern under the International Human Rights Law. Extracting pathogens without ensuring equitable African access to the resulting medical countermeasures directly violates the right to enjoy the benefits of scientific progress established under Article 15 of the International Covenant on Economic, Social and Cultural Rights. It structurally limits African governments’ ability to secure for their populations the benefits of scientific progress. At the same time, the agreements reportedly incentivise the procurement of foreign products, systematically marginalising local regulatory efforts by the African Medicines Agency and weakening nascent continental manufacturing efforts, such as South Africa’s Afrigen mRNA hub….”

Mulumba et al conclude: « … Africa’s response is not simply oppositional; it is increasingly institutional. The Africa CDC has operationalised the Africa’s Health Security and Sovereignty agenda. The recent launch of the Africa Genome Archiving for Response and Insight (AGARI) platform is especially important because it anchors genomic data production, storage, security, and governance within the continent, transforming fragmented national silos into a more coherent sovereign regional resource….”  “« The struggles unfolding across Kenya, Zimbabwe, Zambia, and the DRC are far more than disputes over funding allocations. They reflect a wider contest over who will govern the infrastructures, data, and scientific futures that increasingly shape African health systems, and whether Africa will remain a passive beneficiary or an equal co-architect. In this context, sovereignty means retaining the power to refuse extractive arrangements in favour of continental frameworks that value African lives as much as African Pathogens. To remain a shared endeavour, global health must abandon bilateral transactionalism and embrace a multilateralism rooted in human rights, reciprocity, and African health sovereignty. »

Lancet Comment – Vaccine impact in Gavi-supported countries: balancing evidence with policy needs

I Osei et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00935-9/abstract

“… As the incidence of previously debilitating vaccine-preventable childhood diseases diminishes due to vaccination efforts, the perceived importance of immunisation could become less evident to the public. Amid rising vaccine hesitancy and the spread of misinformation, it is increasingly important to continue demonstrating the tangible impact of vaccines globally…”

Comment related to a new Lancet study:  Quantifying relative health impact across Gavi, the Vaccine Alliance’s portfolio in 117 countries at the subregional level: a modelling study  (by  K Gaythorpe et al)

“… In this context, the modelling study by Katy Gaythorpe and colleagues from the Vaccine Impact Modelling Consortium (VIMC) in The Lancet, which assesses the health impact of various vaccines across 117 Gavi-supported countries, provides a timely and thorough quantification of how vaccines contribute to reductions in disease and mortality globally….”

The Comment concludes: “…With the shift in vaccine funding shortfalls and Gavi’s new compact envelope financing model, which grounds funding in country-led priorities, future areas of work by VIMC could focus on providing evidence to support country-level decision making.”

PS: Among the findings of the study: “…Overall, we observed human papillomavirus (11·24 [95% uncertainty interval 10·88–11·64]) and measles (6·09 [4·90–7·07])vaccines averting a higher number of deaths per 1000 vaccinations than others. For other vaccines, the impact ratios varied across subregions and activity types. Due to parameter, structural, and stochastic uncertainty, the ranges of these ratios often overlap.” And interpretation: “Decisions around which vaccines to use are increasingly important in the context of Gavi’s country vaccine budgets. Robust metrics that allow comparison between vaccines are thus essential to inform discussions. The vaccine impact ratios presented in this study can be used to complement other evidence to support effective planning and prioritisation in national immunisation programmes”

TGH – Public Health as Diplomacy: China’s Southeast Asia Strategy

Faye Ng Yu Ci and Yanzhong Huang ; https://www.thinkglobalhealth.org/article/public-health-as-diplomacy-chinas-southeast-asia-strategy

“China’s contributions to Southeast Asia grow more significant as the United States scales back its global health commitments.”

BMJ (Analysis)- Global health security and pandemic preparedness: Europe’s leadership challenge

https://www.bmj.com/content/393/bmj-2026-090050

“Óscar Fernández and Hylke Dijkstra argue that the EU’s multilateral nature can be a strength as it seeks a greater leadership role in global health security and governance.”

Another (and recommended) article in the series ‘Geopolitics of global health’.

Key messages: “The US’s effective withdrawal from multiple global health initiatives creates space for renewed leadership that resists the divisive pressures of an increasingly geopolitical world. In principle, the EU is uniquely suited to take a leadership role in global health security, given its financial and regulatory potential and history of multilateralism. The EU has struggled to demonstrate leadership, including during the WHO Pandemic Agreement negotiations, as it has prioritised a cohesive stance rather than flexibility and external engagement, particularly with countries in the global south. The pandemic agreement’s potential as a multilateral milestone for global health security rests on leadership that promotes shared benefits and equitable partnerships, rather than a competitive mindset and the pursuit of narrow, self-serving agendas.”

BMJ – Why Europe and UK must step up to challenge of global health

M McKee & M Khan;  https://www.bmj.com/content/393/bmj.s830

“If Europe retreats others will set priorities that may not support equity, multilateralism, or public health.”

“… The World Health Assembly (WHA) in May 2026, therefore, arrives at an unusually consequential moment. Decisions taken in Geneva this year will shape surveillance systems, access to countermeasures, and the capacity of future emergency responses on which clinicians depend. Core annexes of the pandemic agreement—a rare international health treaty, negotiated since the end of covid-19—remained unresolved in the run up to the WHA; trust between countries in the global north and global south is fragile; and WHO continues to face sustained political pressure and tightening financial constraints. Although attention may focus on a single treaty, the implications are far wider. This WHA will test whether multilateral health governance can still function amid geopolitical rivalry, fiscal retrenchment, and declining solidarity….”

“… The choices made at this WHA will shape global health security for a long time. Whether global health governance recovers or continues to fragment may depend on whether Europe and the UK realise that it is in their own interests to drive genuine benefit sharing and equity.”

Lancet GH (Comment) – Elimination in the age of retrenchment: what hepatitis reveals about the future of global health

Noah M Trudeau et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00104-X/fulltext

« Over the past decade, stand-alone disease programmes have been replaced by integrated delivery models aligned with primary health-care reform. The push for triple elimination of HIV, hepatitis B virus (HBV), and syphilis emerged as a compromise designed to preserve gains from past investments while limiting the long-term costs of sustaining them. Viral hepatitis programmes were encouraged to supplement existing HIV platforms, leveraging procurement systems and clinical infrastructure. That design is now fractured. …”

« … In parallel, the shift in HIV management towards long-acting prevention and treatment regimens is likely to reduce the global procurement of oral tenofovir, a drug widely used for HBV suppression. Falling demand risks shrinking production volumes, weakening market incentives, and raising prices as economies of scale erode. HBV programmes could therefore face supply instability, reduced commercial attention, and the widening of affordability gaps. Viral hepatitis exposes the paradox of global health financing: remarkable biomedical potential coexisting with chronic political neglect. Approaches for effective antiviral suppression exist, and elimination targets are described under the Sustainable Development Goals (SDGs). However, hepatitis was consolidated with HIV when convenient and neglected when costly….”

« … The challenge, therefore, is not to withdraw but redesign. Triple elimination should shift from short-term maintenance towards time-bound support that builds robust health systems, strengthens regional cooperation, and increases meaningful participation from patients and communities. If hepatitis continues to orbit as a fiscal satellite of HIV, it will recede alongside HIV. However, if the current moment catapults elimination into political accountability, hepatitis could become emblematic of a post-aid paradigm grounded in self-determined stewardship. »

America First Global Health strategy & bilateral health agreements

Devex – US launches partnership for American-developed mosquito repellent

https://www.devex.com/news/us-launches-partnership-for-american-developed-mosquito-repellent-112488

“SC Johnson has produced a spatial repellent to prevent malaria. It partnered with the Trump administration and the Global Fund to procure and distribute the product in 10 countries, aiming to reach 60 million people over three years.”

“Wisconsin-based company SC Johnson, the U.S. State Department, and the Global Fund to Fight AIDS, Tuberculosis and Malaria inked a new partnership to expand access to a spatial repellent to prevent malaria. This alliance falls in line with the ethos of the Trump administration’s America First Global Health Strategy, which is working to promote American-developed products abroad.”

“… the agreement is to procure and distribute the product in 10 of the highest burden malaria countries, aiming to reach 60 million people with 30 million units of the product over three years. While they don’t have specifics on the countries yet, the partnership will initially focus on sub-Saharan Africa, while also working to expand access in southeast Asia, according to the company.”

“And the product will be produced on the African continent. SC Johnson launched two manufacturing lines last year at a plant in Nairobi with the capacity to produce up to 20 million units of the spatial repellent each year….”

Devex with the latest on the Kenya deal

https://www.devex.com/news/devex-checkup-a-who-process-in-question-112474?utm_term=Autofeed&utm_medium=Social&utm_source=Bluesky#Echobox=1778771885

“Kenya’s Court of Appeal issued an interim order on Tuesday, allowing the government to temporarily proceed with the implementation phase of its $2.5 billion bilateral health framework agreement with the U.S. government, pending a full hearing. The court did not provide further details on its decision, but said it will give a detailed ruling in October….”

Science Insider – Trump administration cuts CDC’s key role in global program to stop HIV

https://www.science.org/content/article/trump-administration-cuts-cdc-s-key-role-global-program-stop-hiv

“State Department would send PEPFAR money directly to countries, which could then pay fees to health agency for help.”

“The Trump administration has struck what some see as the final blow to the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which over 23 years has saved the lives of an estimated 26 million people in poor countries living with HIV. The Department of State says that as of 30 September, support for PEPFAR by the Centers for Disease Control and Prevention (CDC) will end in most countries. …. … guidance issued on 5 May by the State Department, which oversees PEPFAR and disburses its funding, reconfigures CDC’s role so it’s largely each country’s decision whether to outsource work to the agency.  “If this moves forward, PEPFAR is gone,” says Emily Bass, a public health specialist who first made the guidance public on her Substack …”

Emily Bass – America First Global Health Strategy Documents Pertaining to Plans for “State” Capture of Global Health

Emily Bass;  

“In this short sweet post, sharing all of the documents currently available from the Bureau of Global Health Security and Diplomacy related to implementation of the America First Global Health Strategy.” “ Each of these documents reinforces the extent to which the AFGHS roll out undermines American health security, moves away from evidence, undermines anyone’s ability to assess the impact of investments, and puts the Department of State in charge of the global CDC presence in many countries….”

E Bass – New GHSC-PSM Closeout Timeline Sets FY2026 End for Most Countries

Emily Bass; 

“No new funds for failsafes or everything else.”

(12 May) “The State Department Bureau of Global Health Security and Diplomacy is moving forward with plans to close out the massive contract known as Global Health Supply Chain – Procurement and Supply Chain Management contract by the end of US government fiscal year 2026. In a draft close out timeline dated May 5 2026, two-thirds of countries (24/37) will end technical activities on September 30 2026, the close of FY2026. Haiti’s technical activities are scheduled to end on January 31 2027; Democratic Republic of the Congo, Mozambique and Nigeria close on March 31, 2027….”

Trump 2.0

CNN – The Trump administration is trying to divert $2 billion in global health funding to pay for USAID shutdown

https://edition.cnn.com/2026/05/07/world/trump-administration-usaid-global-health-funding-intl

In case you missed this (from last week). “The Trump administration plans to redirect $2 billion in funding intended for global health programs to cover the cost of closing the US Agency for International Development (USAID), according to a copy of the notification obtained by CNN. The funds would be pulled from money that Congress appropriated for health programs tackling malaria, tuberculosis, maternal and child health, nutrition, global health security, HIV/AIDS and more, two federal health policy experts told CNN. Roughly $1.2 billion originally intended for foreign development assistance would also be redirected.” Instead, the administration aims to use those billions to pay for things like legal costs, pending invoices and asset sales in the wake of its abrupt dismantling of USAID….”

NYT – Kennedy Is Driving a Vast Inquiry Into Vaccines, Despite His Public Silence

https://www.nytimes.com/2026/05/11/health/kennedy-vaccine-safety.html

“Health Secretary Robert F. Kennedy Jr. has toned down his public criticism of vaccines, under orders from the White House. But inside his department, a sprawling research effort is a top priority.”

“Working behind the scenes, Mr. Kennedy is spearheading an intense push, across health agencies under his purview, for government scientists and federal data contractors to examine his long-held theory that vaccines are helping to fuel an epidemic of chronic disease, according to multiple people familiar with the effort.  They said the wide-ranging inquiry is a top priority for Mr. Kennedy, who sees vaccines as a “potential culprit” in various neurological and autoimmune disorders, including asthma and allergies. It resurrects research into a number of ideas Mr. Kennedy has espoused, including whether vaccines are linked to autism and whether thimerosal, a preservative that has largely been removed from vaccines in the United States but remains in some flu shots, is dangerous…. …. The effort is being led by Martin Kulldorff, a biostatistician and vaccine safety expert who rose in prominence during the pandemic as a critic of Covid restrictions and vaccine mandates, and is now the health department’s chief science and data officer. Career scientists at the Food and Drug Administration and the Centers for Disease Control and Prevention are conducting the research alongside contractors who provide statistical expertise and access to millions of patient medical records….”

KFF Health Tracking Poll: Public Views on Foreign Aid and Global Health Spending

https://www.kff.org/public-opinion/kff-health-tracking-poll-public-views-on-foreign-aid-and-global-health-spending/ 

(11 May) Including: “…. When it comes to assessing the impact of the changes the Trump administration has made to foreign aid and global health, majorities of the public say these changes have had a negative impact on “how people around the world view the U.S.” (64%) and on “the health of people in developing countries” (59%). Additionally, nearly half (46%) say “the ability to keep infectious disease from spreading to the U.S.” has been negatively impacted by the changes made by the Trump administration.  The public is more divided about the impact the Trump administration’s changes to foreign aid and global health have had on the U.S. budget deficit. …”

Science – Aiding peace or conflict? The impact of USAID cuts on violence

D Rohner et al; https://www.science.org/doi/10.1126/science.aed6802

“…The early, large-scale evidence found that abruptly ending aid triggered higher spikes of violence (armed battles, riots, and protests) in the same areas that previously received higher aid per capita. This suggests that sudden (rather than gradual) USAID cuts undermined democratic governance and precipitated civil unrest.”

“The abrupt withdrawal of USAID led to a significant and sustained increase in conflict across Africa’s most USAID-dependent regions. The findings demonstrate that large-scale, sudden aid cuts can destabilize fragile settings. A core mechanism that can explain this result is that the economic opportunity costs of violence drop faster than the rents over which groups compete….”

HIV

UN News – HIV prevention and treatment services faltering, warns UNAIDS

https://news.un.org/en/story/2026/05/1167515

“Decades of gains in the fight against AIDS are under growing threat as donor funding declines and community-based health services collapse in some of the world’s most vulnerable countries, the head of the joint UN programme on HIV/AIDS warned on Thursday.”

“The sudden funding decline is hitting the HIV response “like a shock wave,” said Winnie Byanyima, Executive Director of UNAIDS, adding that “the world is pulling back just when we need to push forward.”  Many countries are unprepared to sustain programmes previously supported by international funding, Ms. Byanyima told reporters at UN Headquarters in New York, noting that prevention and support services are already collapsing in several countries.  Today, 9.3 million people living with HIV are still waiting to begin treatment, while there were 1.3 million new infections worldwide in 2024….”

UHC & PHC

WHO – Measurement of self-reported forgone health care and its reasons: towards tackling unmet health care need

https://iris.who.int/items/3fdb4e08-33a0-4d51-bd8b-3909a90982d1

“Access to needed health services remains a central challenge for achieving universal health coverage, with unmet health care need reflecting gaps in service delivery, equity and health system performance. This working paper examines the measurement of self-reported forgone health care and its underlying reasons, contributing to WHO’s efforts to standardize approaches to measuring unmet health care need, in response to World Health Assembly resolution WHA76.4 and within the framework of the Fourteenth General Programme of Work (2025–2028)….”

Montreux Collaborative Blog – It’s 2026 – why can’t we accurately track health resources?

Tyler Smith, Cooper/Smith ;https://www.pfm4health.net/blog/its-2026-why-cant-we-accurately-track-health-resources-

“Country governments have had limited visibility into health resource flows for too long. These data are needed now more than ever, and technology can help. In this blog I review the evolving context and suggest some practical ways forward….”

“The blind spot: accurate and timely financial data Most countries cannot say with precision how much money is available for health in a given year, what was actually spent, or what services that money purchased….”

“Gaps in tracking is also concerning because so many financing models rely on the opposite assumption….”

“Shifting investments to enable next-generation resource tracking platforms If the Lusaka Agenda and Accra RESET are to be more than aspirational, Health Resource Tracking (HRT) needs to evolve from an episodic, donor-driven exercise into a systematic component of national planning and budgeting. Recognizing this need, in May 2025 the World Health Assembly adopted Resolution WHA78.12 on strengthening health financing globally, urging Member States to build “institutional capacities, as well as national data collection and reporting systems, for routine monitoring and reporting of domestic and external health resource tracking” — integrated with national PFM systems and leveraging digital technologies.”

“Achieving this vision requires a new lens on HRT that synthesizes best practices from PFM, economic evaluation, software engineering, and digital transformation. At minimum, a next-generation HRT system should focus on 6 imperatives…”

Hantavirus outbreak

With some updates, more or less chronologically.

Statement from the International Hantavirus Society and members of the international hantavirus research and clinical community regarding Andes virus transmission and the current outbreak investigation

P Maes et al; https://zenodo.org/records/20075274

“This statement summarizes current scientific evidence regarding Andes virus (ANDV) transmission dynamics, including documented person-to-person transmission, outbreak epidemiology, infection control considerations and implications for public health management during the ongoing cruise ship outbreak investigation in the South Atlantic. The document was prepared by members of the International Society for Hantaviruses (ISH) and the international hantavirus scientific and medical community.”

HPW – Hantavirus: Experts Question Claim that Only ‘Symptomatic’ People are Infectious

https://healthpolicy-watch.news/hantavirus-experts-question-claims-that-only-symptomatic-people-are-infectious/

Update as of Monday.

“The International Hantavirus Society and members of the international hantavirus research and clinical community have also warned against various “simplified conclusions”, including that the Andes virus (ANDV) has “minimal or negligible human-to-human transmission potential” and that only symptomatic patients are infectious…..”

“Are asymptomatic people infectious?  The experts warned in a statement last week that “the precise timing of infectiousness remains incompletely defined”.   “While symptomatic patients are likely to represent the highest-risk group, available outbreak reconstructions do not support overly categorical statements that transmission can occur only after clear symptom onset,” they said.  “Transmission potential during prodromal, early symptomatic or minimally symptomatic phases, should be considered when designing contact tracing, testing and quarantine strategies.” They stated that this is “particularly relevant in closed settings such as a cruise vessel where ANDV-exposed individuals may still be within the incubation period”. “

Geneva Health Files – The Hantavirus Briefing

https://newsletter.genevahealthfiles.com/the-hantavirus-briefing/?ref=geneva-health-files-newsletter

Briefing from last weekend. “In today’s edition, we bring you communications from top officials at the World Health Organization as they discuss the evolving developments from the outbreak of Hantavirus aboard a ship. At a press briefing earlier this week, officials responded to a range of questions from transmission, diagnostics, to treatment. The outbreak also brings into focus how countries currently share pathogen information. And most of all, the outbreak is a live illustration on the impact on global health security, also in light of withdrawal of the U.S. and Argentina from the WHO.

“Why is this important: Growing public concern about the Hantavirus outbreak; Stress-tests existing prevention, preparedness and response architecture for health emergencies; The current outbreak illustrates the strength of the amended International Health Regulations (2005); Draws focus on the feasibility of developing counter-measures for new outbreak from an already known pathogen; Shows the importance of solidarity of institutions across affected countries; Public memory brings inevitable comparisons to COVID-19; Underscores the importance of a global entity like the WHO to coordinate both the political and the logistical response to the outbreak; Raises questions on the politics of the withdrawal from the WHO by some member states; Outbreak comes two weeks ahead of the World Health Assembly putting “global health security” front and center. Revitalises the importance of, and urgency for, a new Pathogen Access Benefit Sharing system currently under negotiation…”

Guardian – ‘Empty and vapid’ CDC finally responds to hantavirus outbreak. But experts say it’s too little, too late

https://www.theguardian.com/world/2026/may/09/cdc-hantavirus-who-cruise-ship-outbreak-response

“World Health Organization – which the US left under Trump – has been leading the response to the cruise ship outbreak.”

·         See also  Devex Check-up: The hantavirus cruise ship outbreak reveals a US CDC adrift

“There is a sense among some experts that the CDC has been missing in action. Where the agency would normally be at the forefront of investigating and responding to this kind of outbreak, it took the CDC weeks after the first patient died to send a response team.  “This is not the CDC I knew or the CDC we need right now,” Dr. Jeanne Marrazzo, the head of the Infectious Diseases Society of America, tells Devex. Among her concerns is how CDC officials are monitoring U.S. citizens returning to the United States after potentially being exposed to the virus aboard the cruise ship. … .. Acting CDC Director Jay Bhattacharya has defended the agency’s response, telling CNN that the public “didn’t see what the CDC has been doing. … We don’t want to cause a public panic over this.””

“And WHO Director of Health Emergencies, Alert and Response Abdi Mahmoud told a news conference last week that the agency has collaborated with the CDC in its efforts to assess the outbreak and help countries repatriate their passengers.  … … But Marrazzo says it is WHO that has been leading “a very robust response. And not just WHO, but other health ministries and health agencies.”  At the same time, “the WHO is not built to do research,” she says. But the CDC is. And it is missing an opportunity “to be at the forefront of the emerging science and learning so much about the virus,” or to help coordinate high-level scientific collaboration investigating potential medical countermeasures, including vaccines and antivirals. That work, too, is going on without CDC leadership. There are no approved vaccines for Andes, the type of hantavirus circulating on the cruise ship. But the Coalition for Epidemic Preparedness Innovations is trying to fill that gap.  CEPI officials told my colleague Jenny Lei Ravelo they have created antigen designs for Andes and other types of hantaviruses, which are key building blocks in early vaccine development. Those antigen designs have already shown the capacity to trigger an immune response to the Andes virus in very early tests….”

Reuters – Experts race to write guidance to contain first ship-borne hantavirus outbreak

Reuters;

(from last weekend)  “WHO drafting protocols for nearly 150 passengers due to disembark in Tenerife. Monitoring and contact tracing prioritised, with guidance from Argentina’s 2018-19 Andes virus outbreak. … UK to repatriate citizens under strict controls, 45-day isolation required.”

HPW – Experts Call for Review of Global Outbreak Response as All Passengers Leave Hantavirus-hit Ship

https://healthpolicy-watch.news/review-of-global-outbreak-response-as-all-passengers-leave-hantavirus-hit-ship/

Update as of Wednesday morning.

“All passengers were evacuated from the cruise ship, Hondius, by Monday night – and a Spaniard taken to a military hospital in Madrid to quarantine has become the 11th person from the ship to test positive for hantavirus. The evacuation was completed 10 days after the World Health Organization (WHO) was notified about the outbreak – and experts have called for a review of the global response to identify and fix “gaps and vulnerabilities in the system”….”

Re the latter: “…Ellen Johnson Sirleaf and Helen Clark, co-chairs of The Independent Panel for Pandemic Preparedness and Response, which evaluated the global response to COVID-19, said that the hantavirus outbreak has “tested the international system”, ” demonstrating its strengths and gaps. The pair, who previously described the WHO response to COVID-19 as “analogue” in a digital age, commended the international response to the hantaviris outbreak from 2 May.  “The identification and communication of the hantavirus results from South Africa to the United Kingdom, its subsequent reporting to the WHO [on 2 May], and from WHO to countries worldwide demonstrated the importance of rapid application of the International Health Regulations,” they said.” “ “However, between the first death on board on 11 April and 2 May, “a series of events resulted in the growth of the hantavirus outbreak”, they noted.  “There were risks to passengers onboard, to people interacting with them on remote islands, and following the 24 April disembarkation in St Helena, to those who contacted them on land, in the air, and in their next destinations,” said Sirleaf and Clark.”  “A review should determine whether a more precautionary approach could have been applied pursuant to the guidelines in the WHO Handbook for Managing Public Health Events on Board Ships. …

““While sadly deaths on ships do occur, as more people embark on adventure travel to remote locations, the need to protect travellers and those in contact with them from potential exposure to pathogens will increase,” they said…. … The co-chairs appealed to governments to “review outbreak and pandemic planning to address vulnerabilities in the system, including in shipping, marine health and death-related protocols, port management, and protection of populations in remote locations”.  They also appealed to leaders to follow “all relevant protocols for contact tracing, infection control, reporting, isolation and supportive care” to break the chain of hantavirus transmission….”

PS: In September, the United Nations will convene a High-Level Meeting (HLM) on Pandemic Prevention, Preparedness and Response (PPPR).

TGH –  Hantavirus Outbreak Tests Global Health Law Amid WHO Crisis

A Phelan; https://www.thinkglobalhealth.org/article/hantavirus-outbreak-tests-global-health-law-amid-who-crisis

“As international negotiations stall around pathogen access and benefit sharing, the Andes virus outbreak exemplifies why the system is needed.”     A few excerpts:

“Cape Verde’s refusal to receive MV Hondius and the president of the Canary Island’s opposition to Spain’s agreement to permit the ship’s arrival have tested the international legal framework designed for precisely this scenario. In doing so, this incident has underscored the importance of international rules around public health emergencies—especially timely with international negotiations stalling around pathogen access and benefit sharing (PABS), the topic of an annex critical to the WHO Pandemic Agreement. Without the PABS annex, the Pandemic Agreement, adopted last year, cannot be opened for signature by WHO member states… the necessary first step before they become parties and it can enter into force….”

“… The MV Hondius incident demonstrates the need for a multilateral system that defines the obligations and terms for sharing samples, sequences, and benefits…”

But do continue the (very rich) read on IHR, travel restrictions and much more.

Telegraph – Blindsided: Why there are no vaccines or treatments for hantavirus

https://www.telegraph.co.uk/global-health/science-and-disease/why-there-are-no-vaccines-or-treatments-for-hantavirus/

“Unlike Covid 19, hantavirus is no mystery Disease X. So how is it that the world has seemingly been caught off-guard by the latest outbreak?”

·         But see also NYT –  Hantavirus Vaccines and Treatments Are in the Pipeline

“But it has been hard to attract interest in medical interventions for viruses that have not been considered a top public health priority, scientists say.”

“A handful of scientific teams around the world have been working — for decades, in some cases — to develop hantavirus treatments and vaccines. But it has not been easy to find funding or nurture commercial interest in medical interventions for a type of pathogen that does not infect humans often and does not spread easily between people. “It’s not an airborne, highly contagious viral threat, so it hasn’t been as high a priority for groups trying to prevent pandemics,” said Jay Hooper, a virologist at the United States Army Medical Research Institute of Infectious Diseases. But there are promising vaccines and treatments in development. And some of them, experts said, could be moved through the pipeline rapidly if hantavirus interventions became a priority…”

PS: “… Experts said that they hoped the current outbreak might help bring attention to a family of often-overlooked viruses….”

·         And a link:  BMJ – Hantavirus outbreak should reset WHO’s default approach to airborne risk  (by D K Milton, T Greenhalgh et al)

“The multinational outbreak of Andes hantavirus (ANDV) linked to cruise ship travel should prompt the World Health Organization (WHO) to change its default response to the risk of airborne transmission of the virus. Hantavirus is a pathogen with documented person-to-person transmission and high case fatality. Therefore, the starting point should not be to downplay the risk of airborne transmission until it is definitively proven. The starting point should be the immediate adoption of precautionary measures to reduce airborne transmission, such as respirator use by healthcare workers, cases, and close contacts; ventilation optimisation; avoidance of unfiltered air recirculation; and portable HEPA (high efficiency particulate air) filtration in all enclosed quarantine and transport settings….”

More on PPPR & GHS

Guardian Editorial – The Guardian view on the WHO pandemic treaty: the west’s fantasy negotiations have put the world at risk

https://www.theguardian.com/commentisfree/2026/may/10/the-guardian-view-on-the-who-pandemic-treaty-the-wests-fantasy-negotiations-have-put-the-world-at-risk

Nailing it. “After five years of deliberation the global south has forced the question that defined the Covid crisis: who will get the vaccines?”

This hard-hitting editorial concludes: “… Covid-19 prefigured and contributed to our current crises: “might makes right” and narrow national interest crowded out international cooperation. Avoiding a reckoning with that history suggests that the global north learned little from the Covid years, and has no serious plan for the future.”

Lancet Offline – Hantavirus—surprise, complacency, and peril

R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00963-3/fulltext

Horton on the hantavirus, PABS negotiations in Geneva (& WHA79), and the threat of Nipah and the threat of viral spillover events.

Yale Journal of International Affairs – How the WHO Can Improve Its 2025 Amendment: The Global Pandemic Patent Fund

Y Kim & J Shim; https://www.yalejournal.org/publications/global-pandemic-patent-fund

“… These (IHR) amendments demonstrate good intentions but remain limited by their reliance on voluntary mechanisms, failing to provide the economic incentives necessary to overcome the intellectual property barriers that fuel vaccine nationalism. To bridge this gap, this paper proposes the Global Pandemic Patent Fund (GPPF), a new structure that would rectify these market failures. Following an analysis of the amendments’ limitations, the paper details the GPPF framework using Gavi and the Medicines Patent Pool (MPP) as precedents, and proposes a “hub-and-spoke” model to ensure equitable global vaccine production….”

Lancet GH (Health Policy) – Rwanda’s lessons for strengthening Africa’s response to current Marburg virus disease outbreaks

C M Muvunyi et al ; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00112-9/fulltext

“… Using a narrative synthesis of published literature, reports, and field investigations, we identified crucial pillars underpinning Rwanda’s performance: a preventive One Health system that traced the outbreak to a single zoonotic spillover; innovative infection prevention and control measures; rapid nationwide expansion of molecular testing; early triage, active case finding, comprehensive supportive care, and access to investigational therapeutics; biomarkers for patient monitoring; and rapid workforce mobilisation and community engagement. Rwanda’s experience shows that high survival rates are achievable in low-resource settings, when early detection, laboratory systems, and integrated clinical and infection prevention and control strategies operate within coordinated multisectoral structures. Other countries facing Marburg virus disease outbreaks can adapt Rwanda’s model by institutionalising One Health surveillance, strengthening laboratory and biosafety systems, scaling emergency care readiness, integrating biomarker-guided protocols, and establishing pretrained rapid-deployment workforces.”

NCDs & Commercial determinants of health

UN News – When the UN Partners With the Harm It Is Meant to Prevent

Unni Karunakara  https://healthpolicy-watch.news/when-the-un-partners-with-the-harm-it-is-meant-to-prevent/

Focusing on two recent cases.

“The United Nations University Institute for Water, Environment and Health (UNU-INWEH) announced a “strategic partnership” with Nestlé to establish the World Food Academy 4 Sustainable Food Systems on 26 March.   The arrangement incorporates Nestlé’s science and technology seminars, which reached around 7,000 students across over 300 academic institutions in more than 90 countries last year, and will be extended through a joint symposium later in 2026.  The World Food Academy targets students, early-career researchers, and young professionals “particularly from priority regions in the Global South.””

“Within days, an open letter coordinated by the International Baby Food Action Network (IBFAN) and authored by Phillip Baker of the University of Sydney began circulating. It carries nearly 500 signatures from public health researchers, nutritionists, lawyers, and civil society organisations around the world. It calls on UNU-INWEH to terminate the partnership immediately. Its reasoning is grounded in the UN’s own published standards for engagement with the private sector.”

“… The case is not isolated. In late 2025, the Pan American Health Organization (PAHO), the WHO Regional Office for the Americas, signed a three-year Framework Agreement with Ferrero International to support initiatives for “children, adolescents, and families in vulnerable conditions.”   Researchers, civil society, and the BMJ raised the same concerns that the IBFAN letter raises now: a UN agency lending its name to a major ultra-processed food manufacturer in the very policy domain where the company’s interests run against the public health evidence. On 15 April 2026, PAHO terminated the agreement….”

“… two cases, two UN agencies. The pattern is not accidental. The UN’s financial architecture – assessed contributions are now a small proportion of operating budgets, with voluntary earmarked private funding filling the gap – rewards arrangements with well-resourced private partners and penalises institutes that decline them.   Reinforcing this is the multi-stakeholder model that the World Economic Forum and the World Health Summit have promoted for two decades as the standard architecture of global governance – framing corporations, philanthropies, and states as equivalent partners, weakening public responsibility and intergovernmental accountability. Without active central enforcement of the UN’s own frameworks, the pressure runs one way….”

Nature – Obesity rise plateaus in developed nations and accelerates in developing nations

https://www.nature.com/articles/s41586-026-10383-0

Check out the (worrying) findings.

·         Coverage via the Guardian – Obesity rates in some countries levelling off or potentially falling, study finds

“Researchers say rise not inevitable and it is important to unpick what is behind differences in obesity trends.”

“They found that the prevalence of obesity increased in almost all countries over the 45-year period. However, in most high-income countries, a rapid rise in the prevalence of obesity has been replaced by a slower increase, a plateau, or a potential decline….”

“Meanwhile, obesity among young people and adults in many low-income and middle-income countries continues to rise and in some cases this is accelerating. The team say it is important now to unpick what is behind the trends in different countries….”

Lancet GH (Viewpoint) – Time to confront the global health crisis hidden in plain sight: why traumatic brain injury belongs on the global health agenda

Global Coalition for TBI as a Notifiable Chronic Condition; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00063-X/fulltext

“Traumatic brain injury (TBI) is a growing global public health crisis that affects people in all regions of the world and across all age groups, with varied aetiology. Importantly, most of the TBI global disease burden affects those located in low-income and middle-income countries, where access to timely, safe, and quality care is more challenging. Improving care for TBI requires the synergistic efforts of multiple professional groups by coordinating prevention strategies, pre-hospital systems, emergency and acute care treatment, and support for chronic disease consequences. In 2022, WHO’s Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders focused new attention on neurological conditions, offering an opportunity for TBI advocates to use this framework to improve the care of TBI for all. In this Viewpoint, we highlight how strengthening TBI care requires addressing all phases of the care continuum, from coordinating surveillance efforts to develop targeted prevention strategies, to upscaling pre-hospital referral pathways and acute care infrastructure. Furthermore, the large chronic burden of TBI needs to be recognised globally, where rehabilitation and long-term support need to be expanded and adequately resourced.”

Release of the WHO global report on nicotine pouches

https://iris.who.int/items/9f5c2cb1-6c7c-46f9-afad-1b64f4bcd95b

The first WHO global report on nicotine pouches, Exposing marketing tactics and strategies driving the growth of nicotine pouches was launched on Thursday, 14 May. 

“It warns that these rapidly expanding products are being aggressively marketed to adolescents and young people while regulation in many countries remains limited or absent.   The report was released in the lead-up to World No Tobacco Day (31 May), which this year will focus on tobacco and nicotine addiction and the tactics used by industry to hook a new generation of users.”

Plos Med (Perspective) – Climate change and non-communicable diseases: An invisible syndemic

Gokul Parameswaran et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005082

“Climate change accelerates non-communicable diseases (NCDs) through cascading environmental disruptions and is attributed to driving increased NCD-related mortality. Yet this syndemic remains invisible and underfunded. We detail why addressing the climate-NCD intersection is critical for improving health.”

Guardian – ‘The mouth is a gateway into your body’: the fascinating, frightening links between our gums and our health

https://www.theguardian.com/society/2026/may/11/mouth-gateway-body-fascinating-frightening-links-between-gums-health

Horror story of the week.

“Scientists are discovering more and more associations between poor oral health and everything from heart disease to dementia. But can flossing and brushing properly guarantee a longer life?”

Wellcome Open Research – Bridging Aspirations and Reality: Challenges in Oral Health Policy Implementation in Karnataka, India

B R Rajeev et al ; https://wellcomeopenresearch.org/articles/11-241/v1

“Equitable access to and service provision for oral health in Karnataka, India, remains challenging despite several policy and program initiatives. It was unclear whether the formulation and implementation of the oral health policy were coordinated and involved all stakeholders and institutions. Therefore, this study aimed to explore the gaps and barriers in oral health policy formulation and implementation in Karnataka….”

SRHR

Guardian – ‘Unprecedented’ global effort gives new name to polycystic ovary syndrome – and new hope to millions of women

https://www.theguardian.com/society/ng-interactive/2026/may/12/polycystic-ovary-syndrome-pcos-new-name-polyendocrine-metabolic-ovarian-syndrome-pmos

“Decades-long campaign powered by patient perspectives results in switch from PCOS – a name that caused confusion and undue suffering – to PMOS.”

“After more than a decade of global consultation, polycystic ovary syndrome (PCOS) – a condition that affects one in eight women – has been renamed.  The hormonal disorder, estimated to impact 170 million women worldwide, will now be known as polyendocrine metabolic ovarian syndrome (PMOS).”

“The name change was published in the Lancet and announced at the European Congress of Endocrinology in Prague on Tuesday, after 14 years of collaboration between international societies and patient groups across six continents.”

“The renaming was spearheaded by the endocrinologist Prof Helena Teede, the director of Melbourne’s Monash Centre for Health Research & Implementation. For too long, experts including Teede say, the misleading nature of the term “polycystic” in PCOS contributed to delayed diagnosis and inadequate medical care.  PMOS is hoped to better reflect the condition’s complex nature – which affects not only the reproductive system in people assigned female at birth but also the metabolism and the risk of diabetes and cardiovascular disease…”

·         See the Lancet Health Policy article –   Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process  (by H J Teede et al)

“Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic ovary syndrome (PCOS), affects one in eight women. However, the term PCOS is inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma, while curtailing research and policy framing. Building on an international mandate for change, we outline an unprecedented, rigorous, multistep global consensus process for the name change….”

International Nurses Day (& more on HRH)

HPW – Nurses Are Not a Cost to Health Systems. They Are the Power Holding Them Together.

Howard Catton; https://healthpolicy-watch.news/nurses-are-not-a-cost-to-health-systems-they-are-the-power-holding-them-together/

“… ahead of this month’s World Health Assembly (WHA), the International Council of Nurses (ICN) has written to WHO Member States recommending concrete actions to address the escalating international recruitment that is deepening workforce shortages in lower-income countries and threatening global health system sustainability.   We are calling for coordinated co-investment by recruiting countries into nurse education, retention, and workforce and leadership development….

“… …. In our letter, we call for practical and collective action to strengthen the WHO Global Code of Practice on the International Recruitment of Health Personnel. … That includes coordinated co-investment by major recruiting countries into nurse education, employment, retention, leadership development, and workforce planning in source countries….”

“We are proposing practical mechanisms: proportionate reinvestment linked to recruitment, directing a share of education savings and tax revenues into source-country health systems, debt relief linked to workforce investment, and even a global fund to strengthen fragile health workforces….”

And this is why “…  this year’s International Nurses Day report from ICN, Our Nurses. Our Future. Empowered Nurses Save Lives is so important.  The report moves beyond outdated, one-dimensional images of nursing to show how nurses both save and improve lives at scale. For too long, nursing has too often been portrayed only through the language of compassion and sacrifice. Compassion matters enormously. But nursing is also power: economic power, clinical power, leadership power, workforce power, and social power.”

“Our report sets out seven key nursing powers that are transforming health systems around the world….”

Planetary Health

Arthur Wyns

(Via LinkedIn)

“Health will be a priority theme at COP31. The Turkish COP31 website was just updated – from 9 to 10 priorities – to now include health. People’s health and wellbeing is increasingly threatened by climate impacts, while the health systems that are meant to protect us are being overwhelmed and undercut. Some of the COP31 health priorities outlined by Turkiye include: – Climate-resilient, low-carbon health systems – Climate & health risk assessments and early warning – AI and digital health solutions – Preparing the health workforce to respond to climate impacts – Finance and international cooperation to build more climate-resilient and equitable health systems .”

Climate Change News – Scientists warn El Niño could intensify climate extremes in 2026

https://www.climatechangenews.com/2026/05/12/scientists-warn-el-nino-could-intensify-climate-extremes-in-2026/

“Climatologists say a particularly powerful weather pattern could amplify wildfire risk, heatwaves and flooding worldwide as global temperatures continue to rise.”

“El Niño meets global warming: Friederike Otto, professor in climate science at Imperial College London, said El Niño itself is “not the reason to freak out” but rather the fact that it is now happening on an increasingly warmer baseline. “El Niño is a natural phenomenon that comes and goes,” she told journalists this week. “What makes it so dramatic is not the event itself and whether it’s a ‘Super El Niño’ or not, but that it is happening in a dramatically changing climate.”

Devex -Developing country blocs push World Bank to extend climate plan

https://www.devex.com/news/scoop-developing-country-blocs-push-world-bank-to-extend-climate-plan-112486

“A bloc representing nearly 100 countries calls on the World Bank to extend its Climate Change Action Plan by one year amid U.S. pressure to scale it back or scrap it.”

“A bloc of developing-country shareholders at the World Bank has circulated a letter calling for the bank’s flagship climate plan to be extended for another year — a sign of mounting resistance to U.S. efforts to weaken the bank’s climate commitments, according to a document seen by Devex…. … The letter was signed by 12 group heads representing almost 100 countries and was reportedly organized by Brazil and China. Its backers include Saudi Arabia, China, and Russia, which could suggest that the U.S. is becoming increasingly isolated in opposing an extension of the climate plan, advocates say….”

Lancet GH – The hidden dimension of tuberculosis: non-human primate reservoirs and One Health strategies

Y Shah et al;  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00103-8/fulltext

“…  In their Health Policy paper (March, 2026), Coleman and colleagues help to explain why tuberculosis continues to impose such a heavy burden. The authors describe the tuberculogenic environment, emphasising how structural determinants—including poverty, housing, nutrition, education, employment, and health-care system capacity—influence vulnerability to infection, disease progression, and transmission. Infection with Mycobacterium tuberculosis is necessary but not sufficient for disease; social and environmental contexts largely determine individual and community outcomes….”

“However, an exclusively human-centred perspective overlooks a key dimension: the ecological and multispecies context of tuberculosis. The Mycobacterium tuberculosis complex (MTBC) comprises closely related pathogens capable of infecting humans and multiple animal species. Although host specificity exists, species such as M tuberculosis, M bovis, and M orygis can cross species barriers, enabling zoonotic and reverse zoonotic transmission. Emerging evidence suggests that zoonotic tuberculosis is more widespread than previously recognised, with MTBC detected in domestic animals, wildlife, and free-ranging populations, although cross-species transmission dynamics remain poorly characterised owing to fragmented surveillance and inadequate molecular integration. Non-human primates are increasingly recognised as important spillover hosts….”

Authors conclude: “… Reframing tuberculosis as a multispecies, socioecological disease transforms elimination strategies and underscores the need to address upstream social determinants, strengthen integrated surveillance across human and animal health systems, and map ecological hot spots of spillover and spillback. “

Access to medicines, vaccines & other health technologies

Stat – Colombia wins a key court ruling over a compulsory license issued for an HIV medicine

https://www.statnews.com/pharmalot/2026/05/11/colombia-dolutegravir-court-case-patent-cost/

“Consumer advocates called it an “historic” decision with regional implications in the battle over access to medicines.”

“A South American court upheld the steps taken by the Colombian government when it issued a compulsory license two years ago for an HIV medicine, a move that confirmed the legal framework for using such an approach in the future.  The Court of Justice of the Andean Community — a tribunal that settles trade, intellectual property, and labor disputes for Bolivia, Colombia, Ecuador, and Peru — also ruled that the Colombian government had properly justified the reasons for issuing a license and appropriately set an expiration date for its license. “The court concluded that Colombia did not incur a breach of Andean regulations, since such measures are valid when there are reasons of public interest,” the health ministry said in a statement. “Colombia adequately complied with the obligation to determine the duration of the compulsory license” for the medicine, which is sold by ViiV Healthcare….”

Africa CDC – Africa CDC Announces Results of African Pooled Procurement Mechanism (APPM) Tender for Essential RMNCH Medicines

https://africacdc.org/news-item/africa-cdc-announces-results-of-african-pooled-procurement-mechanism-appm-tender-for-essential-rmnch-medicines/

“The (Africa CDC) is pleased to announce the successful conclusion of its first African Pooled Procurement Mechanism (APPM) tender for essential medicines for Reproductive, Maternal, and Newborn Health (RMNCH), covering 10 priority products across 10 African Union Member States. This milestone marks a significant step in transforming access to life-saving maternal and newborn health commodities, while advancing Africa’s broader agenda of health security, affordability, and market shaping.”

“The tender process, conducted through an open international competitive process, achieved:

Substantial cost savings, with pooled procurement delivering 30–90% lower prices compared with Member State benchmarks; Improved supply security through the establishment of non-exclusive framework agreements with multiple qualified suppliers; Strong competition, with 13 bids received and evaluated through a transparent, multi-stage process; Participation of African manufacturers, with 5 of the 10 RMNCH products involving African manufacturers.”

HPW – BioNTech Factory Closures Spark Concerns Over EU Supplies Amid Trade Tensions

https://healthpolicy-watch.news/biontech-factory-closures/

“This week’s announcement of BioNTech factory closures in Germany marks an end to the country’s pandemic-era COVID-19 vaccine production boom. The Mainz-based pioneer announced that it will manufacture its final batches of the vaccine domestically later this year, transferring all future production to its American partner, Pfizer….” “ This strategic retreat from Germany – which includes the shuttering of facilities in Marburg, Idar-Oberstein, and the recently acquired CureVac site in Tübingen – is scheduled for completion by the end of 2027, according to German media reports. In total, the company plans to cut up to 1,860 jobs across production sites in Germany, as well as in Singapore. … The company’s leadership attributed the restructuring to plummeting global demand for pandemic products and a necessary pivot toward funding a high-stakes oncology pipeline.”

PS: “… Economic experts warn that relying on volatile corporate and geopolitical developments to maintain vaccine supplies threatens European health security….”

“…  foreign manufacturers are stepping in to fill the void, with US pharma company Pfizer likely to utilise its established manufacturing facilities in Europe to absorb BioNTech’s production in the EU. Further underscoring this transatlantic market shift, European regulators recently authorised mCombriax, a new messenger RNA vaccine produced by US rival Moderna that protects adults aged 50 and older against both COVID-19 and seasonal influenza….”

CGD – A Prize for Repurposing Drugs for Neglected Diseases

S Chethik et al;  https://www.cgdev.org/blog/prize-repurposing-drugs-neglected-diseases

“More than one billion people are affected by poverty-related and neglected diseases (PRNDs), including the 21 recognized neglected tropical diseases, as well as HIV/AIDS, tuberculosis, and malaria. These diseases cause avoidable illness and death, reduce schooling and labor productivity, and impose large economic costs. Yet funding for PRND research and development (R&D) remains far below need. In 2024, R&D funding was still more than $1 billion below its 2018 peak. At the same time, thousands of FDA-approved drugs already exist and some may hold promise as treatments for PRNDs. But without a viable commercial market, no one has a strong financial incentive to find out. One solution is to create the missing incentive. A prize could reward innovators that discover and prove an existing drug can treat a PRND. …”

Conflict/War & Health

Guardian –  Internal displacements caused by violence or conflict at record high in 2025

https://www.theguardian.com/world/2026/may/12/internal-displacements-violence-conflict-record-high-2025

“The 32.3m surpasses those caused by disasters for the first time, as 82.2m people displaced in total around world.”

“The number of internal displacements triggered by conflict or violence around the world reached a record high in 2025, surpassing the number of disaster-driven internal displacements for the first time. A report published by the Internal Displacement Monitoring Centre (IDMC) shows that by the end of 2025 there were 32.3m conflict-driven internal displacements. That is 60% higher than those recorded the previous year, and – for the first time since data collection began in 2008 – above displacements driven by natural disasters, which reached 29.9m in 2025.”

“Jan Egeland, the secretary general of the Norwegian Refugee Council, described the figures as a “sign of a global collapse” in basic protection of civilians.”

AI & health

Gates Foundation – Making AI work for more people: A new partnership with Anthropic to build AI tools in global health, education and agriculture

https://www.gatesfoundation.org/ideas/media-center/press-releases/2026/05/ai-anthropic-partnership 

“A new, multi-year partnership between the Gates Foundation and Anthropic aims to apply this approach in practice.”  “The partnership brings together each organization’s resources and expertise toward shared goals, and includes commitments of $200 million over four years in grant funding, API credits, and technical support to develop AI tools and shared public goods — freely available resources — across health, education, and agriculture.”

“In health, the partnership will focus on applying AI to accelerate the development of vaccines and other critical innovations, while making large, complex datasets more accessible, interactive, and actionable for researchers and decision-makers. Initial efforts will center on systems that help scientists analyze data, generate insights, and move more quickly toward new breakthroughs. Early applications include life-saving childhood vaccines, as well as new prevention and treatment approaches for cervical cancer and preeclampsia. In parallel, the partnership will modernize the data systems that track disease and health trends, connecting information across sources so public health leaders have sharper insights at their fingertips. This includes work with the Institute for Health Metrics and Evaluation (IHME) on the Global Burden of Disease study well as partnerships with governments to help public health leaders make more informed decisions.”

Some reports, series of the week

Lancet Global Health – Energy and health in low-income and middle-income countries

https://www.thelancet.com/series-do/energy-health-2026

“Reliable and affordable clean energy is essential for modern living and powering economies. Access to clean energy has increased substantially in low-income and middle-income countries over the past three decades. However, millions still lack reliable and affordable access to electricity and clean cooking fuels. This new Series—an update to the Series published in The Lancet in 2007—outlines the burden of disease associated with energy production and consumption; the drivers of and barriers to clean energy adoption; and how reliable, affordable, sustainable, and equitable electricity access in health-care facilities is necessary for achieving universal health coverage.”

Lancet Regional Health Africa – May issue

https://www.thelancet.com/issue/S3050-5011(26)X2003-X

·         Start with the Editorial: Is WASH a pipe dream for Africa?

“Ensuring the availability and sustainable management of water and sanitation for all by 2030 is the aim of Sustainable Development Goal 6. However, this is looking unattainable in Africa–the most water insecure region, with the lowest levels of water, sanitation and hygiene (WASH) access. Less than a third of people have access to safe drinking water in Africa. The impacts of the state of WASH in Africa already has far reaching consequences on the health, wellbeing, education, and employment of its people. Without urgent intersectoral action to improve water security, these impacts will become ever more devastating….”

“…While barriers to WASH seem to far outweigh success stories in Africa, there are positive signs that regional leadership is stepping up. The African Union has declared 2026 as the year of “Assuring Sustainable Water Availability and Safe Sanitation Systems to Achieve the Goals of Agenda 2063”. Their call-to-action acknowledges the need for intersectoral action, highlighting water as a human right, water security for economic transformation, climate resilience and adaptation, Pan-African solidarity, the role of innovation, and equity and inclusion….”

Miscellaneous

Science Politics – Visa Apartheid in an Age of Populism

S O Aremu et al; https://sciencepolitics.org/2026/05/13/visa-apartheid-in-an-age-of-populism/

“Border regimes are a structural threat to global health.”

“When mobility is restricted unequally across populations, it creates what many scholars now describe as “visa apartheid.” Visa apartheid is a system in which the right to move, and by extension, the right to health, is stratified along lines of nationality, race, and geopolitical power….”

“Visa apartheid is not simply a bureaucratic inconvenience; it is a structural determinant of global health. …”

The authors give 5 recommendations. Including:  “Reframing mobility as a global public good.”

Nature News – Goodbye GDP? 31 ways to replace the world’s favourite measure of economic health

https://www.nature.com/articles/d41586-026-01511-x

“Proposed UN progress indicators include greenhouse gas emissions, life expectancy and children’s performance in reading and maths.”

“The United Nations is considering 31 new indicators to “complement and go beyond” the world’s main measure of economic growth, gross domestic product (GDP).  The proposed new annual indicators include economic metrics such as household disposable income per person, and environmental data such as a country’s greenhouse gas emissions and levels of particulate matter in the air. Also included are health and education indicators such as life expectancy and children’s performance in reading and maths; as well as measures of wellbeing such as the proportion of women and girls subjected to physical and/or sexual violence. Fifteen of the 31 proposed indicators are already part of indicators for the UN’s Sustainable Development Goals (SDGs)….”

“The new indicators are in a report, Counting What Counts, written by a multidisciplinary committee of researchers and policymakers, co- chaired by economists Kaushik Basu, based at Cornell University in Ithaca, New York, and Nora Lustig at Tulane University in New Orleans. The group was assembled last year by UN Secretary General António Guterres….”

·         See also   UN News – United Nations proposes new global dashboard to measure progress beyond GDP

“Secretary–General’s High–Level Expert Group sets out a set of indicators to put people and planet at the centre of decision–making.”

·         And a Nature Editorial – Science can take the lead in making better measures of economic growth

“The United Nations wants scientists to help design indicators of progress that go beyond GDP. Researchers should seize the chance and be aware of past failures.”

Coming back among others on the Human Development Index (HDI), which was created in a previous attempt to dethrone GDP more than three decades ago, and some other indices.

“… the use of these indicators hasn’t changed most governments’ focus on maximizing GDP. One reason is that GDP has its own rules, called the System of National Accounts, which are set by the UN Statistical Commission (UNSC), a decision-making body comprising the chiefs of national statistics offices. This group is extraordinarily influential, but historically it is not used to engaging with other organizations, even within the UN system. If a new indicator is to have at least the same importance as GDP, then the UNSC must put its weight behind it….”

New WHO health inequality country profiles to track progress on achieving health equity

https://www.who.int/news/item/12-05-2026-new-who-health-inequality-country-profiles-to-track-progress-on-achieving-health-equity

“The World Health Organization (WHO) has released interactive health inequality country profiles showing the state of health inequality in countries based on the Organization’s principal global health strategy, the Fourteenth General Programme of Work (GPW 14)….”

Global health governance & Governance of Health

PMNCH – PMNCH appoints Monica Geingos as Board Chair to champion a new era of leadership for women’s, children’s and adolescents’ health

PMNCH;

“Former First Lady of Namibia, lawyer, entrepreneur and global advocate Monica Geingos to lead the world’s largest alliance for women’s, children’s and adolescents’ health and well-being at a pivotal moment for sexual and reproductive health and rights, gender equality and health financing.”

Succeeding Helen Clark (who ends her tenue in November 2026).

CGD (blog) – The EU’s Global Europe Instrument: Ambition, Tension, and What Needs to Change

M Gavas;  https://www.cgdev.org/blog/eus-global-europe-instrument-ambition-tension-and-what-needs-change

“The European Union (EU) is redesigning how it finances development around the world. The proposed Global Europe Instrument will shape where EU money goes, who benefits, and what strings, if any, are attached. With the Foreign Affairs Council meeting on 18 May, this is the moment to ask whether the proposal is fit for purpose.”

“There is a lot to like within the proposal. It rightly recognises that development cooperation must engage with infrastructure, private investment, and geopolitical realities. Its flexibility provisions respond to a genuinely more unpredictable world. But these strengths sit alongside some serious structural problems, as well as the disappearance of historic commitments in the proposal that have long protected the EU’s most vulnerable partners. Ministers meeting on 18 May should push to fix both. These concerns are increasingly being voiced within the European Parliament….”

Excerpt:

“A historic benchmark at risk: human development:  A significant loss in the proposal is the disappearance of the longstanding human development benchmark which previously ring-fenced at least 20 percent of EU development funding for health, education, nutrition, and social protection. They are the foundations on which everything else, including infrastructure, trade, resilience, stability, depends.  The European Parliament’s draft report flags this, and proposes reinstating the commitment, particularly for the most marginalised.”

“The EU’s Global Gateway has become one of the few large-scale public finance instruments still expanding in Africa, particularly as bilateral ODA to sub-Saharan Africa fell 26 percent in a single year. Yet our analysis of flagship projects shows that the bulk of investments appear directed toward EU strategic corridors for critical minerals, and not necessarily aligned with African partners’ own development priorities. Less than 10 percent of flagship projects are in education and research; only slightly more than 10 percent are in health. The European Parliament’s draft report also underlines that strategic investment initiatives must remain responsive to partner-country priorities, not shaped primarily by European geopolitical interests…”

Plos GPH – From pilots to partnerships: Why African-Nordic collaboration can help reshape global health

Steven L. B. Jensen et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006329

Re the inaugural African–Nordic Health Summit in Stockholm in January 2026.

“Convening policymakers, researchers, implementers, financiers, civil society and private sector actors from across both regions, the summit was founded on a simple premise: lasting health improvements require partnerships that move beyond isolated interventions toward integrated health systems capable of delivering impact at scale. The summit represented not simply another global health convening, but a wider response to systemic challenges that have come to define the current global health landscape. The emerging African-Nordic partnership offers a promising model for how global health cooperation can evolve to address these challenges. The Stockholm summit deliberately focused on women’s health, including maternal health….”

“… The African-Nordic Health Summit was conceived not as a one-off event but as the beginning of a sustained platform for collaboration. The next convening, scheduled for Kigali in 2027, aims to learn from impactful partnerships and inspire concrete initiatives across the regions. Participants highlighted the importance of moving from broad commitments toward focused collaboration on a limited set of priorities where African-Nordic partnerships can demonstrate measurable progress. Such partnerships could include joint initiatives to strengthen midwifery and maternal care, expand digital tools for frontline health workers, integrate non-communicable disease screening into maternal health services, and support regional health manufacturing and supply chains…”

CGD – Donors Are Increasingly Focusing on “Systems Strengthening”: How Can They Do It Well?

R Glennerster; https://www.cgdev.org/blog/donors-are-increasingly-focusing-systems-strengthening-how-can-they-do-it-well

“Published strategies and private conversations with bilateral donors suggest systems strengthening is becoming a much bigger focus….”

Glennerster then wonders, “… What should (evidence-based) systems strengthening be?…

“… To strengthen a system, therefore, is to help it move to be more in line with the evidence on what is cost-effective and scalable. This can be done in three ways:…”

“… This means systems strengthening should involve evidence-based prioritization of country-level resources, based on local needs and cost-effectiveness; supporting the transition to more cost-effective policies; and generating evidence which often directly leads to systems strengthening.”

Global health financing

Economist Impact – Tuberculosis proves that investment in health pays off

M Pai; https://impact.economist.com/health-society/tuberculosis-proves-that-investment-in-health-pays-off

« Madhukar Pai of McGill University says tuberculosis kills on a vast scale, but as foreign aid shrinks, countries with a high burden of TB stand to gain a lot by investing more to curb the disease and its heavy social cost.”

UHC & PHC

HP&P –  Assessing intervention effects on healthcare-related financial protection in low and middle-income countries: a rapid evidence review

https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czag065/8677080?searchresult=1

By K Kruja, S Witter et al.

Pandemic preparedness & response/ Global Health Security

Nature – AI can design viruses, toxins and other bioweapons. How worried should we be?

https://www.nature.com/articles/d41586-026-01476-x

“Scientists are debating whether to limit biological AI software to ward off threats.”

Planetary health

Nature Health (Comment) – GDP alone cannot measure human progress and well-being

Klaus Prettner, David Bloom et al; https://www.nature.com/articles/s44360-026-00137-7

“Gross domestic product remains the dominant metric of progress, but new measures such as healthy lifetime income offer policymakers a clearer and more relevant view of well-being.”

Lancet Planetary Health – Inequalities in health-care carbon footprints and implications for demand-side interventions: a global assessment across population groups

Han Zhao et al; https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(26)00029-X/fulltext

“Reducing emissions from health care is now recognised as an urgent priority on the climate–health agenda. Although studies have quantified the environmental impacts of health systems at national and global scales, inequalities in health-care carbon footprints (HCFs) across population groups (both between and within countries) and their trajectories remain unexplored. This study quantified these disparities and evaluated the potential of targeted demand-side interventions to achieve equitable, low-carbon health care while expanding delivery of care.”

Interpretation of the findings: “… Our study moves beyond cross-country comparisons based on national averages or totals by examining HCFs across different population groups within countries. The highest-spending populations were found to contribute disproportionately to health-care carbon emissions, thus highlighting that achieving equitable, low-carbon health-care transitions requires attention to within-country population disparities to target interventions. Our findings provide quantitative evidence for pathways to meet fair health-care emission-reduction targets while maintaining care quality.”

Covid

Nature – At last, a pill that can prevent COVID after exposure to infected people

https://www.nature.com/articles/d41586-026-01546-0

“Drug arrives years after pandemic’s peak, but could still offer protection to vulnerable populations.”

“An antiviral pill has, for the first time, been shown to prevent COVID-19 in people exposed to the SARS-CoV-2 virus at home, according to trial results published today in the New England Journal of Medicine…”

Science – Virologist accused of starting COVID-19 will fight U.S. ban on funding

https://www.science.org/content/article/virologist-accused-starting-covid-19-will-fight-u-s-ban-funding

“HHS memo says Ralph Baric had a “pattern of deception” in describing virus studies long before pandemic.”

“Alleging a “pattern of deception” in virus studies done more than a decade ago, the U.S. government has proposed a ban on federal funding to a prominent coronavirus researcher whose more recent work has incited unproven accusations that he helped start the COVID-19 pandemic. The Department of Health and Human Services (HHS) has already suspended Ralph Baric, a tenured professor at the University of North Carolina (UNC) at Chapel Hill and a member of the National Academy of Sciences, from receiving further money for his virology studies. Now it has begun formal debarment proceedings, which could cut off his funding for 3 years or more. As Science finalized this story, UNC announced that Baric,72, was retiring, but he told Science he plans to appeal the recommended debarment, likely with legal help from the school….”

Mpox 

BMC Global and Public health – Mpox vaccine acceptance and uptake in Africa: a systematic review and meta-analysis

https://link.springer.com/article/10.1186/s44263-026-00277-8

By F Z L Cheuyem et al.

Infectious diseases & NTDs

NYT – A Single Infusion Could Suppress H.I.V. for Years, Study Suggests

https://www.nytimes.com/2026/05/11/health/hiv-infusion-immunotherapy.html

“A study of a few patients, to be presented this week, showed promise for a type of therapy that has already cured some blood cancers.”

“For about a decade, scientists have had remarkable success curing some blood cancers by modifying a patient’s own immune cells to recognize and kill the malignant cells. That same approach may help control H.I.V., among the wiliest of viruses, scientists will report on Tuesday. After a single infusion of immune cells engineered to recognize the virus, two people in a new study have suppressed their H.I.V. to undetectable levels, one of them for nearly two years. The data is scheduled to be presented at a gene therapy conference in Boston, but the researchers shared an early copy with The New York Times.”

“The treatment is years, if not decades, from being widely available, but the study offers what scientists call “proof of concept,” and the tantalizing hope that a single shot could one day offer lifelong relief from H.I.V….”

Cidrap News – RTS,S malaria vaccine averted 1 in 8 deaths among eligible kids in 3 African nations over 4 years

https://www.cidrap.umn.edu/malaria/rtss-malaria-vaccine-averted-1-8-deaths-among-eligible-kids-3-african-nations-over-4-years

“An international group of researchers estimates that, despite only moderate uptake of three doses and low uptake of the fourth, the RTS,S/AS01_E malaria vaccine saved the lives of one in eight eligible children in the first three African nations to offer the vaccine from 2019 to 2023. For the observational study, published late last week in The Lancet, the research team randomly assigned 158 administrative-unit clusters, each with a birth cohort of roughly 4,000 children, in Ghana, Kenya, and Malawi to either roll out the RTS,S malaria vaccine in 2019 (79 implementation areas) or to implement it later (79 comparison [control] areas)….”

Independent – Drones now key to fighting malaria as the climate crisis fuels ‘catastrophic’ rise in cases

https://www.independent.co.uk/climate-change/malaria-climate-crisis-africa-floods-tanzania-b2972378.html

“In Tanzania’s captial Dar es Salaam, researchers are using drone mapping to track malaria’s changing spread after years of declining cases. Nick Ferris reports.”

Nature Medicine – Brazil’s big bet on mosquitos

https://www.nature.com/articles/s41591-026-04388-5

“As Brazil takes its modified mosquito program from pilot to practice at national scale, what will it take to beat dengue?”

Lancet Global Health (Comment) – Undernutrition and tuberculosis: time to recalibrate the global response

Vineet K Chadha et al;  https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00091-4/fulltext

“The relationship between undernutrition and tuberculosis is one of the oldest observations in infectious disease epidemiology, yet its precise quantification has remained elusive. In The Lancet Global Health, Matthew J Saunders and colleagues present the findings of a modelling study estimating that eliminating all undernutrition (BMI <18·5 kg/m2) among adults globally could avert 23·7% of adult tuberculosis incidence worldwide. This estimate is approximately two and a half times higher than the current WHO population attributable fraction of 8·9%,  a difference that warrants attention. The major methodological contribution of this study lies in treating BMI as a continuous concept rather than WHO’s approach of classifying individuals as either having undernutrition or not, applying a single relative risk estimate…..

·         The study in  the Lancet GH – Global, regional, and national estimates of tuberculosis incidence averted by eliminating undernutrition in adults: a modelling study  (by M J Saunders et al)

Nature Africa – Fourteen days to recovery from kala-azar

https://www.nature.com/articles/d44148-026-00118-8

“A shorter regimen has been tested in Eastern Africa, but Amudat patients are still waiting.”

NCDs

Nature Health – Environmental and lifestyle drivers of early-onset cancer

https://www.nature.com/articles/s44360-026-00122-0

“Early-onset cancer of many body sites and organ systems is increasing world wide. This Review outlines the potential causes. “

Lancet Regional Health Africa – Survivorship burden of lip and oral cavity cancer in Sub-Saharan Africa, 1990–2023: an analysis of the Global Burden of Disease 2023 Study

https://www.thelancet.com/journals/lanafr/article/PIIS3050-5011(26)00041-6/fulltext

By Chukwuemeka L. Anyikwa et al.

Guardian – Arts and cultural engagement ‘linked to slower pace of biological ageing’

https://www.theguardian.com/science/2026/may/12/arts-cultural-engagement-linked-slower-pace-biological-ageing-ucl-research

“Research from UCL suggests visiting art galleries or museums, singing and painting can help improve health outcomes…”  The results are published in the journal Innovation in Aging.

Nature (News) – Sleep linked to slower ageing: huge study pinpoints the right amount

https://www.nature.com/articles/d41586-026-01506-8?utm_source=bluesky&utm_medium=social&utm_campaign=nature&linkId=61859149

“Health outcomes were better in people who slept between about six and eight hours a day.”

Science – Most dementia patients have multiple brain diseases. How should they be treated?

https://www.science.org/content/article/most-dementia-patients-have-multiple-brain-diseases-how-should-they-be-treated

“Growing awareness of “copathology” inspires new diagnostic tests and clinical trials.”

Sexual & Reproductive health rights

HPW – More Girls Will Finish School if India’s Supreme Court Ruling on Menstrual Health is Implemented

D Shetty; https://healthpolicy-watch.news/more-girls-will-finish-school-if-indias-supreme-court-ruling-on-menstrual-health-is-implemented/

“In January, India’s Supreme Court has ruled that menstrual health is a fundamental right, directing states and schools to take measures to facilitate menstrual health and sanitation. The laws of the world’s most populous country are now in line with the United Nations (UN) stand on menstrual health taken in 2024, and one that is also echoed by the World Health Organization. …”

Global Public Health – From emergency relief to system strengthening: Stakeholder perspectives on official development assistance for reproductive, maternal, neonatal and child health in Guinea-Bissau

Anaxore Casimiro et al; https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2672821

« Guinea-Bissau, a politically fragile West African nation, relies heavily on official development assistance (ODA) to sustain reproductive, maternal, neonatal and child health (RMNCH) services. This study explored how national and international stakeholders perceive the role, evolution and effectiveness of RMNCH-related ODA and how these perspectives compare with donor strategies…”

Lancet (clinical) series – Schistosomiasis in women and adolescent girls

https://www.thelancet.com/series-do/schistosomiasis-in-women-and-adolescent-girls

“Female genital schistosomiasis (FGS) is a chronic genital disease caused by the deposition of Schistosoma haematobium eggs, affecting at least 40 million women and girls worldwide, primarily in sub-Saharan Africa. Women and girls living with FGS face numerous intersecting challenges and health complications, ultimately contributing to urogenital dysfunction and adverse sexual and reproductive health outcomes.   In this four-paper Series, we examine sex-specific aspects of Schistosoma infections in women and girls, diagnostic techniques and treatment strategies, barriers to diagnosis and treatment, management during pregnancy and implications for offspring, and the interactions with other genital infections and their clinical implications.”

Neonatal and child health

Lancet Child & Adolescent Health – Global variation in injury patterns, interventions, and post-operative outcomes for children and adolescents undergoing trauma laparotomy: an international cohort study

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(26)00069-6/fulltext

“… Kids in poorer countries with severe abdominal injuries were six times more likely to die after receiving emergency surgery than their counterparts in richer countries…..”

UN News – From childhood to university, economic inequality shapes life chances worldwide

https://news.un.org/en/story/2026/05/1167492

“Economic inequality is leaving a deep mark on children’s health, learning and future opportunities – with effects felt well beyond the classroom, the UN Children’s Fund UNICEF and the UN education agency UNESCO warned on Tuesday.   Independent studies by the agencies paint a picture of widening disparities that begin in childhood and continue into higher education, despite decades of global progress in school and university enrolment….”

Access to medicines & health technology

FT – EU to stockpile key drugs to avoid repeat of pandemic-era panic buying

https://www.ft.com/content/7c07683d-6b41-4213-859e-6e1d8e96ff32

“Member states agree on Critical Medicines Act that aims to incentivise domestic production.”

·         See also Stat –  European Union inks a draft deal to boost local production of medicines and avoid shortages

“The initiative seeks to avoid the kinds of withering shortages seen during the Covid-19 pandemic.”

“The European Union reached a provisional deal to strengthen the supply of essential medicines — such as antibiotics, insulin, vaccines, and painkillers — and avoid shortages by ‌boosting domestic production and reducing reliance on imports.  Known as the Critical Medicines Act, the initiative seeks to avoid the kinds of withering drug shortages that were seen during the Covid-19 pandemic. Specifically, the proposal targets supply-chain weaknesses for more than 200 medicines that are considered critical ​to the region’s health security, including treatments for rare diseases….”

Human resources for health

Human Resources for Health – Can financial retention incentives slow health worker migration? PPP-adjusted salary differentials in Zimbabwe’s donor-dependent health system

https://link.springer.com/article/10.1186/s12960-026-01074-y

By G George et al.

Conflict/War & Health

SSM Health Systems – Health systems strengthening and resilience-building in fragile and conflict-affected settings: experiences and operational perspectives of international NGOs

M Paola Bertone a, S Witter et al; https://www.sciencedirect.com/science/article/pii/S2949856226000735

“The study offers insights into HSS, grounded in the experiential perspectives of those engaged in HSS programming.  Early attention to HSS is essential, also in relation to resilience as HSS can support building of resilience capacities. HSS programming must be intentional, with clear incentives and supportive structures for NGOs. Funding cuts risk shifting attention to narrow humanitarian approaches, which may jeopardize the very systems that will save lives in the future.”

International Health (Editorial) – Neglected tropical diseases in conflict zones: devastating consequences of a lack of inclusion 

Margriet den Boer  et al; https://academic.oup.com/inthealth/article/18/3/313/8672946?searchresult=1

Editorial of International Health’s Special Issue on neglected tropical diseases (NTDs) in conflict settings.   “… we reflect on a year of remarkable successes in NTD control amidst fierce global health challenges…”

Papers & reports

Plos GPH – Temporal trends in African healthcare system capacities in prevention, detection, response, and sustainability between 2010 and 2023

Pratik Sharma et al; https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005285

“This analysis evaluated self-reported national capacities for prevention, detection, response, and sustainability in 54 African countries from 2013 to 2023 using data from WHO State Party Annual Report (SPAR) submissions. …”

Among the findings: “… Between 2013 and 2023, African regions showed incremental gains across all capacity domains, with the largest post-pandemic improvement in response capacity. However, persistent performance gaps remain, especially in Middle Sub-Saharan Africa. …”

Global Public Health –  Social medicine beyond the medical curriculum: A Latin American historical perspective

Gabriel Abarca-Brown et al; https://www.tandfonline.com/doi/full/10.1080/17441692.2026.2671502

« Current debates in social medicine and global health have emphasized the medical curriculum as a means to foster awareness, reflexivity, and sensitivity among medical students and practitioners. Yet, this curricular focus may come at a cost, risking a narrowing of the scope of social medicine by neglecting broader historical, political, and ideological forces. This article argues for a reorientation that situates contemporary social medicine within longer histories of geopolitical struggle, using Latin American social medicine (LASM) since the mid-twentieth century as a critical lens. LASM illustrates how political regimes, international institutions, and social movements have influenced medical training, the scalability of health initiatives, and community-engaged activism. By integrating historical, ideological, and political analysis, this perspective positions LASM not merely as a regional case study but as a site of theoretical production, offering insights for social medicine, global health, and decolonial approaches to training, infrastructure, and activism. »

Health Research Policy & Systems – Citation and policy influence of research using demographic and health survey data: a bibliometric analysis

https://link.springer.com/article/10.1186/s12961-026-01487-0

By E Omondi et al.

Tweets  (via X & Bluesky)

Andrew Harmer

“ Most people will not have heard of Simeon Bennet but he’s the Senior Speechwriter to WHO’s DG Dr Tedros. His Ted Talk from a couple of years ago is really good. www.youtube.com/watch?v=Jgen… “

Moritz Piatti-Fünfkirchen  (WB)

(via LinkedIn)

“A significant milestone for the PFM for Health agenda.  At the G7 Development Ministers’ Meeting in Paris on 29-30 April, G7 members endorsed a renewed approach to development built around four principles: resilience, sovereignty, effectiveness, and coherence.”

“Notably for those of us working at the intersection of public finance and health, the communiqué includes an explicit commitment to sovereign health financing — supporting domestic resource mobilization, strengthening national development banks, and better coordinating health funding with country-led strategies. This reflects a growing recognition that increasing health budgets alone is not enough. How public money for health is planned, allocated, and executed determines whether those resources actually reach people.  This is meaningful validation for the PFM for Health agenda — and a timely one, as many countries face tightening fiscal space and declining external aid. The path to Universal Health Coverage runs through finance ministries as much as health ministries.  With the Évian Summit in June, there is a real opportunity to translate this political commitment into concrete country-level action. Much work remains, but this is an encouraging step in the right direction.”

Seye Abimbola

“There is a class of “global health” people who warmed to (even sought to lead) discussions on “decolonisation” when it began to catch fire in the field, but who has over time come to see that they are the people, their interests are the interests, and their practices are the practices, from which the field would need to be, is being called to be decolonised. It’s been fascinating to watch their retreat, even antagonism.”

On Monday, the long awaited 79^th World Health Assembly starts in Geneva, and boy, do I have FOMO : ) Fortunately, a few of my colleagues will be present – stay tuned for their updates! Ps: hope they’ll also find the time for some early morning “slow jogging” around the Lake in Geneva, which I much enjoyed last year (#WalktheTalk).  One consolation for missing the Geneva global health week: the “Sleepless Ape” (which I tend to be after a few days at the WHA) might get some more rest than usual next week : )

As you can imagine, this pre-WHA issue features a bunch of“primers” and other pre-analyses related to #WHA79. Speaking of one of these,  “ Global health reformcannot wait for a new world order. Middle powers must act now” (by I Kickbusch) is a nice read. I certainly agree global health reform can’t wait for a new world order. But I have somewhat less faith in many of these ‘middle powers’ (certainly most European ones, given their current leadership) – keeping in mindtheir track record of the past years on vaccine equity (during the Covid pandemic), the Gaza genocide, their stance in the pandemic agreement   (& PABS) negotiations, and let’s not forget their overall right-wing policies which tend to facilitate the radical-right in our countries, instead of doing the opposite.

I have my doubts whether  the European Commission’s new ( & naturally ‘bold’ )Global Health Resilience Initiative can change this. Paraphrasing K Seitz in a neat  HPW analysis, the initiative predominantly features right-wing recipes, to “boost global health resilience”. Good luck with that.

Onwards to other agenda items and issues then in Geneva. The WHO DG race will clearly get some attention in Geneva, even if it’s early days. As Priti Patnaik put it,  ❝The next WHO leader will need to be a multitasking political acrobat” . Some of the more paranoid ‘DG wannabes’ are probably already humming that first line of the U2 song, ‘Acrobat’: “Don’t believe what you hear, don’t believe what you see. If you just close your eyes, you can feel the enemy….”   

But there’s a a lot more on the agenda in Geneva, as the primers make abundantly clear. On Wednesday, the  World Health Statistics report 2026  already set the scene for #WHA79: “…while global health efforts are delivering results, progress is fragile and insufficient.” Put differently, “There’s a real threat of reversal. “  

Elsewhere, and part of the broader backdrop of the global health architecture reform discussions, there are increasing calls for a thorough development cooperation & partnerships “reset”, with a flurry of related events these weeks. In this issue, we pay some attention to an OECD meeting on the Future of Development co-operation in Paris (11-12 May)  (ahead of an OECD flagship report, scheduled for October). Next week (19-20 May) the  Global Partnerships Conference  takes place in the UK. And of course we also come back on this week’s “Africa Forward” Summit in Nairobi, Kenya (with Macron & Ruto as some of the protagonists). The Nairobi declaration will also inspire the G7 summit in Evian, France (in June).

On Tuesday International Nurses day was celebrated. As  Howard Catton put it in a HPW op-ed,  “Nurses Are Not a Cost to Health Systems. They Are the Power Holding Them Together”.   With 2 nurses among my siblings, I can only concur.

And oh yes, before I forget, on the Planetary Health front, we seem to be heading for a year in which “El Niño meets global warming”.  Better be ‘resilient’  this year : )

Enjoy your reading.

Kristof Decoster

·         A few reads of the week

·         PABS negotiations extension

·         Hantavirus on cruise

·         More on GHS

·         Global health reform & reimagining (& the future of development cooperation)

·         Run-up to the 79^th WHA

·         More on Global Health Governance & Financing/Funding

·         Tax Justice & debt crisis

·         Bilateral health agreements & US Global health strategy

·         Trump 2.0

·         UHC & PHC

·         Social & Commercial Determinants of Health

·         International Midwife Day & more on SRHR

·         2nd Africa Health Workforce Investment Forum  (6-8 May, Accra)

·         More on Human Resources for Health

·         Decolonize Global Health

·         Planetary Health

·         Access to Medicines, Vaccines & other health technologies

·         AI & digital health

·         Conflict/War & Health

A few reads of the week

African Journal of Health Economics, Systems and Policy: inaugural issue

https://www.africanjhesp.org/

Brand new & important new journal. “African Journal of Health Economics, Systems and Policy (AJHESP) is a peer-reviewed, Open Access journal dedicated to advancing rigorous, policy-relevant scholarship at the intersection of health economics, health policy, and health systems. AJHESP provides a home for applied research that bridges the persistent gap between evidence production and financing reform. AJHESP fills a gap no indexed journal currently occupies: a dedicated platform for scholarship that treats African health financing, policy, and systems problems as the primary intellectual agenda. The journal operates in English and French — a commitment to the linguistic reality of the African….”

For more from this (fabulous) inaugural issue (Editorial, Comments, …), see further in the newsletter.

Lancet Global Health – How (not) to organise a panel at a global health conference

Afifah Rahman-Shepherd et al; https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00101-4/fulltext

Lovely read from last weekend that quickly went viral.

“Although guidance on how to organise a global health conference exists, most stop short at organising panels. Inspired by Desmond Jumbam’s satire on writing about global health, here is how (not) to organise a panel at a global health conference….”

Quote: “…Recycle panellists. If you are flying most of your panellists in from the Global North (as you should), make sure they sit on more than one panel. Of course they can talk about pandemics, ageing, artificial intelligence, conflict, and climate change. This is what expertise looks like in an ‘era of polycrises’….”

PABS negotiations extension

Coverage & analysis from end of last week (and over the weekend).

WHO Member States agree to extend negotiations on Pathogen Access and Benefit Sharing annex

https://www.who.int/news/item/01-05-2026-who-member-states-agree-to-extend-negotiations-on-pathogen-access-and-benefit-sharing-annex

WHO press release after the round last week in Geneva (27 April-1 May).

“Member States of the World Health Organization (WHO) have progressed work on the Pathogen Access and Benefit Sharing (PABS) annex, a key part of the WHO Pandemic Agreement, and today agreed additional time was needed to finalize the framework for ensuring a better, more equitable, response to future pandemics.”

“Countries today ended the resumed session of the sixth meeting of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement in Geneva, focused on the PABS system. The outcome of this work will be presented to the Seventy-ninth World Health Assembly (WHA) later this month. Given the need for further negotiations, the Assembly will be asked to consider continuing IGWG’s work as mandated in Resolution WHA78.1 and submit the outcome to the next Assembly in May 2027, or earlier by a special session of WHA in 2026.”

PS: “… The IGWG will hold its seventh meeting from 6 to 17 July 2026.”

Geneva Health Files – Countries Negotiate More Time, Ward Off Pressure to Rush Consensus on the WHO Pathogen Access Benefit Sharing System

P Patnaik; Geneva Health Files;

Must-read analysis from Monday morning. “ Multilateralism is important, but cannot be an end in itself: this seems to be the message that WHO member states sent out this week.”

“The open-ended Intergovernmental Working Group has sought more time to negotiate the  Pathogen Access Benefit Sharing System at the WHO. The work of the member-states led body is expected to continue for another year in a bid to reach consensus. In doing so, countries exercised pragmatism, and gave the process more oxygen in a bid to build a considered system to access the information on pathogens, and find ways to share benefits during health emergencies including pandemics and Public Health Emergencies of International Concern (PHEICs). While there was disappointment among many quarters, this was near-choiceless given the lack of convergence on key “foundational matters”….”

“The PABS negotiations are arguably the most important multilateral negotiations currently underway, some experts are of the view. They touch not only key areas of global health, but also on matters of trade and security. The negotiations will now run for another year till May 2027, unless countries reach consensus on PABS earlier in which case a special session of the World Health Assembly is not ruled out…. “ “In this story, we capture the dynamics as they evolved in the meeting last week during April 27th-May 1st. “

A few excerpts:

“The week saw a combination of structured informal meetings and discussions in the formal plenary sessions. The progress made during the intersessional period in a series of informal sessions led by France and South Africa, was also formally presented at the meeting. …  …. … a range of bilateral consultations between groups of countries, and within regions. We learned that there were informal consultations between the Africa Group and the European Union discussing proposals from either sides in a bid to find initial landing zones, diplomatic sources told us. It is understood that these proposals were not formally tabled at the IGWG this week. “While it was helpful to understand positions better, we were unable to find landing zones,” a developed country negotiator told us.”

“… While the obligations on benefit sharing are front and centre for many countries, the conditions on access are emerging to be a decisive factor on the success of these negotiations…. It appears that attaching conditionalities on the access to information is a priority not only for middle-income countries but for many developing countries, sources tell us.  …. So although the access to medical products during health emergencies is a priority for many countries, they take the new legal obligations on the access to information seriously.”

“… The meeting also saw in-depth discussions on benefit sharing obligations. Sources told us that there was increasing convergence on the idea of setting aside a minimum floor (percentage) of the access to medical products during Public Health Emergencies of International Concern (PHEICs). Many said this was progress compared to previous meetings on this matter….” “… For some developing countries, the access to licenses and technology transfer, both during PHEICs and pandemic emergencies is a part of preparedness and prevention. …”

…Countries warded off pressure from various quarters to conclude negotiations this week, given the sheer distance to consensus on several areas in the PABS system. … “ “… One of the concerns of countries dominating the dilemma on the extension of the time frame, included the future of these negotiations in light of the leadership transition at the WHO. The term of the current DG comes to an end in August 2027. Given that DG Tedros has championed the Pandemic Agreement, many fear that a new DG may not have the same level of commitment to see this through. But not all shared this view. “This is a member state led process. I do not see any DG candidate who would say they will not support this,” a developing country diplomat said. It is interesting that countries hope, and fear for a further politicization of these negotiations. “We should have finished these discussions to reach consensus. Having this alongside an election process, will make this more political,” a developed country negotiator said. “We want these negotiations to be a part of the elections discussion. People would like to know where candidates stand on this,” a developing country negotiator told us, adding that the PABS negotiations were “deeply political”.”

HPW – Pandemic Talks Extended – But Colombia Appeals for New ‘Method’ to Settle Differences

https://healthpolicy-watch.news/pandemic-talks-extended-but-colombia-appeals-for-new-method-to-settle-differences/

“Colombia has appealed for a new “method” to settle the outstanding annex of the Pandemic Agreement, after World Health Organization (WHO) member states failed to reach agreement last week after almost a year of talks.” “… “There is one fundamental point that we request be included in the resolution: extending the negotiating period makes no sense unless the negotiating method is changed,” Colombian  Ambassador Germán Velásquez told the Intergovernmental Working Group (IGWG) shortly before the meeting closed last Friday evening.  “It is not possible to continue seeking consensus in the same way. Why not introduce the concept of ‘progressive consensus’? Once a majority has been reached on specific points, a vote should be held if necessary, and negotiations should continue.”…”

“Colombia is part of the Group for Equity, a large cross-regional alliance of countries that has been pushing for a PABS annex that ensures the inequity of the COVID-19 pandemic, where wealthy countries commandeered all the scarce vaccines, is not repeated.  The proposal for voting also has the support of some civil society groups, notably Pedro Villardi, from Public Services International, a trade union federation with over 30 million members.  …”

PS: “The Group for Equity and the Africa Group – which represent the vast majority of member states – have become increasingly frustrated by what they see as developed countries protecting the interests of their pharmaceutical companies instead of levelling the playing field ahead of future pandemics…..”

PS: “Helen Clark and Ellen Johnson Sirleaf, co-chairs of The Independent Panel for Pandemic Preparedness and Response, said that “a lack of action to prevent and prepare for the next pandemic threat is a disservice to humanity”.  They called on governments to do more on pandemic prevention, preparedness, and response (PPPR): “All countries must be able to detect and rapidly report outbreaks which may pose an international threat.” However, they also acknowledged that many low- and middle-income countries are impacted by high debt levels, and a sharp decline in development assistance.   “Leaders have an opportunity to demonstrate their commitment to protect humanity at the upcoming UN High-Level Meeting on PPPR in New York in September. “ ““There, they must make progress to fill enduring gaps in PPPR including on co-ordination, financing, equity, and accountability. They should also make it clear that the PABS Annex must be finalised to enable the WHO Pandemic Agreement to proceed.”

·         See also Devex –  Pandemic treaty annex to miss World Health Assembly submission

“Delays in the adoption of the PABS Annex also defer countries’ ratification of the pandemic agreement, which outlines how countries can best prepare for and respond to the next pandemic. The pandemic agreement needs at least 60 countries to ratify it to come into effect.”

Medicines Law & Policy – World Health Organization Members ask for more time to solve difficult negotiations on access and benefit sharing

K Mara & Ellen ‘t Hoen ; https://medicineslawandpolicy.org/2026/05/world-health-organization-members-ask-for-more-time-to-solve-difficult-negotiations-on-access-and-benefit-sharing/

With their take on the state of play in the PABS negotiations.   With among others an overview of key unresolved issues.

Hantavirus on (haunted) cruise

UN News – Hantavirus outbreak on cruise ship not ‘another COVID’, WHO says

https://news.un.org/en/story/2026/05/1167458

“A deadly hantavirus outbreak aboard a cruise ship in the Atlantic Ocean poses a low global public health risk and is “not the start of another COVID pandemic”, the World Health Organization (WHO) said on Thursday.”   (Key messages Tedros from the media briefing on Thursday)

·         See also HPW – First Person Outside Cruise Ship is Suspected of Hantavirus Infection 

With coverage of a related WHO media briefing on Thursday.

PS: “Collaboration with US: Dr Abdi Mahamud, WHO’s infection control specialist, said that each country is responsible for repatriating citizens from the ship and tracing any citizens who may have had contact with those exposed to the virus. Although the US decided to leave the WHO, it has citizens on board the ship and Mahamud said that collaboration with the US CDC is “going very well on a technical level”. US CDC officials have joined meetings of the Global Outbreak Alert and Response Network (GOARN) “so the information flow is there, transparent and frank, and information sharing”, he added. The US remains party to the International Health Regulations (IHR), which stipulates the conduct of countries in the event of disease outbreaks, and was receiving formal communication on the outbreak through that….”

·         See also Stat –  Key takeaways from WHO briefing on hantavirus cruise ship outbreak  

“The U.S. and Argentina, both recent WHO dropouts, are cooperating in the response.”

“Some of the information exchanges are occurring through the International Health Regulations, a treaty aimed at protecting the world from disease outbreaks that can cross borders. The U.S. is still a party to the IHR.  Anaïs Legand, WHO’s technical lead on viral hemorrhagic fevers, said she has had excellent collaboration with her counterpart at the Centers for Disease Control and Prevention. “We have very positive, regular interactions almost every single day.” Tedros said that the WHO is sharing information with the U.S. in the way it always has, and is getting information in return through IHR channels. He said he hoped the U.S. and Argentina would reconsider withdrawing from the global health agency.”

·         And via RANI’s newsletter: “As WHO’s Dr. Tedros noted in today’s media briefing, the outbreak is a real-time stress test of international systems, including the amended International Health Regulations (IHRs) and the legal architecture of a future PABS…”

Nature News – Hantavirus crops up on a cruise ship — what scientists are watching

https://www.nature.com/articles/d41586-026-01450-7

“The group of rodent viruses can cause disease in humans, but cases are rare.”

·         See also  Science – Cruise ship’s hantavirus outbreak puts researchers in uncharted territory

From earlier this week. “Questions about the culprit virus and its route of spread remain as health officials make plans for stranded passengers.”

PS: “…. All the researchers involved stress the challenge of investigating an outbreak on a ship in international waters with so many countries involved. “I think the response has been a wonderful global collaborative effort,” Blumberg says. “It shows the value of networks and people speaking to each other.”

HPW – Cruise Ship Hit by ‘Uncommon’ Human-to-Human Transmission of Hantavirus

https://healthpolicy-watch.news/cruise-ship-hit-by-uncommon-human-to-human-transmission-of-hantavirus/

Cfr a WHO media briefing from Tuesday.

“The cruise ship Hondius, at the centre of a hantavirus outbreak, is likely to dock in the Canary Islands where Spanish authorities will assess passengers, disinfect the ship and conduct a full epidemiological investigation. This is according to Maria van Kerkhove, director of the World Health Organization’s (WHO) Department of Epidemic and Pandemic Preparedness and Prevention, at a media briefing in Geneva on Tuesday….”

“… The WHO has deemed the global threat posed by the outbreak to be “low”, based on how the virus spreads…. … … The WHO was informed of “a cluster of severe acute respiratory illness” aboard the ship by the UK on 2 May, in terms of the International Health Regulations…..”

HPW – Two More Reported Cases of Hantavirus Linked to Cruise Ship Hit by ‘Uncommon’ Human-to-Human Transmission

https://healthpolicy-watch.news/cruise-ship-hit-by-uncommon-human-to-human-transmission-of-hantavirus/

Update as of Thursday morning.

·         And via the Guardian –  Argentina races to find origins of cruise ship hantavirus outbreak, amid reports some passengers have returned to US

Ps: “The health emergency aboard the MV Hondius comes as local public health researchers in Argentina point to climate change accelerating the risk of the spread of hantavirus.”

“Public health experts say that higher temperatures expand the virus’ range because, in part, as it gets warmer and ecosystems change, rodents that carry the hantavirus can thrive in more places. People typically contract the virus from exposure to rodent droppings, urine or saliva.  “Argentina has become more tropical because of climate change, and that has brought disruptions, like dengue and yellow fever, but also new tropical plants that produce seeds for mice to proliferate,” said Hugo Pizzi, a prominent Argentine infectious disease specialist. “There is no doubt that as time goes by, the hantavirus is spreading more and more….”

Stat Opinion – Not being part of the WHO, especially ahead of the World Cup, is a dangerous position

K Kuppali; https://www.statnews.com/2026/05/05/hantavirus-cruise-ship-outbreak-who-world-cup/?utm_campaign=twitter_organic&utm_source=twitter&utm_medium=social

“The cruise ship hantavirus outbreak is a warning sign to the U.S.”

“…. Within hours of confirming the suspected diagnosis, WHO activated a coordinated international response under the International Health Regulations (IHR) — epidemiological investigation, laboratory testing, logistics support, clinical management and medical evacuation of symptomatic passengers, all moving in parallel. That is the system working as designed: a pathogen moving faster than borders, in an unexpected place, requiring rapid simultaneous action across multiple countries and jurisdictions before the full picture was even clear.   …. The United States, having withdrawn from WHO in January 2025, received none of that notification….”

“That isolation from global health governance will matter far more in six weeks, when the FIFA World Cup 2026 opens across 11 American cities…..”

NYT – Hantavirus Outbreaks Are Rare, but They Aren’t Going Away and There’s No Cure

https://www.nytimes.com/2026/05/05/health/hantavirus-outbreaks-disease-history.html

(gated) “Since the family of rodent-borne infections were identified in the 1950s, they have turned up all over the world.”

Stat – Public health experts are worried about the cruise ship hantavirus outbreak, but not for the reason you might think

https://www.statnews.com/2026/05/07/hantavirus-cruise-ship-outbreak-scientists-say-not-new-pandemic/

“It’s not the start of a pandemic, they say, but we need to learn more about these viruses.”

“Scientists and public health experts are gripped by the hantavirus situation too, but for different reasons. They are worried that hantaviruses haven’t been as well studied as they ought to be. They have some concern that more passengers could fall ill. They are not fearful that the MV Hondius is ground zero for the next big one….”

More on Global Health Security

Telegraph – The African Medicines Agency is the missing link in global health security

DM Darko (DG of AMA) https://www.telegraph.co.uk/global-health/science-and-disease/the-african-medicines-agency-will-transform-global-health/

View by the current DG of the African Medicines Agency.

Global Health reform & re-imagining (& future of development cooperation)

WHO – Reform of the global health architecture and the UN80 Initiative – A joint process to support reforms – Report by the Director-General 

https://apps.who.int/gb/ebwha/pdf_files/WHA79/A79_24-en.pdf

Preparatory document online already.

See eg @thirugeneva.bsky.social:

“@who.int   Reform of the global health architecture and the UN80 Initiative – “The joint task force will have 25 members, of whom 14 will be representatives of WHO Member States, two from each WHO region and, as well as two additional members from the regions providing the co-Chairs.” #WHA79.”

+ “There will be five representatives of global health initiatives (Gavi, the Vaccine Alliance; Global Fund to Fight AIDS, Tuberculosis and Malaria; the Coalition for Epidemic Preparedness Innovations; Unitaid; and the Pandemic Fund); up to four representatives of United Nations entities, including WHO; one representative each of the World Bank and a regional health organization.”

Andrew Harmer – A WHO worth fighting for?

https://andrewharmer.org/2026/05/05/a-who-worth-fighting-for/

Hard-hitting (& hilarious) read on a WHO related Comment from last week by A Nordström et al.  A few paragraphs from the introduction to provide you with a flavour:

“ (A) Nordstrom can write about the WHO because of what he used to do. He also floats in stellar company, as you can see from the list of collaborators in a recent Comment he wrote in the Lancet – A WHO worth fighting for: the case for focused, ambitious reform. They are so important that it took them almost 400 words to summarise all their accomplishments – sometimes, a list of email addresses just isn’t enough. Why, why, you might be asking, does it require eight people to write a Comment in the Lancet – can’t Nordstrom write it himself? Well, he probably did, maybe with a bit of help from Kazatchkine (who is the last author in the Comment in the Lancet) – just enough to get him the second best placing in the list of authors. The others are just the padding – Nkengasong, Piot, Robalo Correia e Silva, Alwan, Maciel, and Minghui’s – whose primary function is to add gravity to the position Nordstrom is taking. And to guarantee publication of a Comment in the Lancet, of course.

Note that Nordstrom is taking a position; he is not making an argument. There is nothing in his Comment in the Lancet that hasn’t been said by him and his cronies before (you will know them well: Nordstrom, Piot, Clarke, Rottingen, Kazatchkine, Kickbusch, Dybul, et al – the Geneva Gliterati), but he’s repeating it again in his Comment in the Lancet to keep the pressure up, to maintain the narrative he is trying to push so that his words become a reality. If you say something often enough, people will accept it just to shut you up. This is what power looks like – a bunch of pals using their collective mass to get their views down on paper and into policy. It happens all. the. time. If you don’t have guns and bombs, network instead and write a Comment in the Lancet.”

Harmer then dissects the 6 reforms they advocate for.

And concludes: “Much like capitalism and the end of the world, currently it seems easier to imagine the end of WHO than imagine Member States paying more to save it.”

That’s exactly right.

BMJ Opinion – In an uncertain world, investment in health is crucial for security

https://www.bmj.com/content/393/bmj.s853

“Investing in health worldwide is a collective security strategy, write Martin McKee, Michel Kazatchkine, and Stefano Vella.”

“The Munich Security Conference’s 2026 report on international security policy barely mentions health. Yet, if there was one fundamental lesson to be learnt from the covid-19 pandemic, it was that health is a fundamental pillar of national and regional security. Unless health is fully recognised and embedded as a strategic security priority, the world will remain dangerously exposed to shocks that can rapidly escalate into broader instability….”

“… Health influences security through several interconnected mechanisms…”

“… Despite the clear security implications, global health financing is collapsing. … Disinvestment in health is a direct threat to national and international security. Reframing health as a strategic investment rather than just a social cost is essential…”

They conclude: “… Recasting health as a pillar of security requires action well beyond the health sector. Governments must embed health system resilience in national security strategies. Finance ministries must accept long term health investment as a national asset rather than a discretionary cost. Organisations concerned with security should treat health threats alongside geopolitical risks. Multilateral agencies and global health actors must frame their work in terms of security and stability, while safeguarding equity and rights. Finally, academia, civil society, and professional bodies should translate evidence into narratives that resonate with security, diplomatic, and economic audiences. Ultimately, safeguarding health is safeguarding global stability, a lesson the international community cannot afford to forget.”

Global Policy –  The New U.S. Development Doctrine: Business Deals

S Klingebiel & A Sumner; https://www.globalpolicyjournal.com/blog/07/05/2026/new-us-development-doctrine-business-deals

“The Trump administration has not simply cut aid. It is seeking to replace the traditional development cooperation model with a transactional, interest-driven doctrine in which development institutions serve as instruments of “America First” business deals.”

Ps: “The first meeting of the Future of Development Cooperation Coalition (FDCC) took place on the sidelines of the World Bank/IMF Spring Meetings a few days ago. The OECD is bringing together participants from around the world for the conference “The Future of Development Co-operation” on 11–12 May. The UK FCDO will hold a “Global Partnerships Conference to build new international coalitions to tackle shared challenges” a week later, and the German government has started preparation for the launch of a new “North-South Commission”…..”

CGD (blog) – The New Flexi-Lateralism: Five Building Blocks for Development Cooperation in a Fractured World

A Sumner et al; https://www.cgdev.org/blog/new-flexi-lateralism-five-building-blocks-development-cooperation-fractured-world

“The OECD Conference on the Future of International Development Co-operation (which is set to take place in Paris on 11-12 May 2026) comes at a moment of acute strain. …. The question confronting delegates in Paris is not whether cooperation is changing. It is how any new configuration will work in practice.”

“In a new CGD policy paper, we argue that a “new flexi-lateralism” is emerging as a pragmatic response to these conditions. We define this new flexi-lateralism as international cooperation—which happens through flexible, practical tools and selective coalitions, anchored in UN norms—that proceeds even when universal commitments are openly contested and attacked. We draw from evidence of debt-servicing initiatives launched at the Fourth International Conference on Financing for Development (FfD4) in Sevilla in July 2025. …”

“Our paper identifies five defining characteristics of the new flexi-lateralism evident in the Sevilla initiatives…”

Run-up to the 79^th World Health Assembly (18-23 May)

Starting in ten days from now.

·         With already lots of preparatory Documents now: https://apps.who.int/gb/e/e_wha79.html

Do check out for example Voluntary contributions by fund and by contributor, 2025. Rather informative.    

Related, see Devex Check-up: WHO else? 

“In 2025, WHO was forced to restructure, cut staff, and reduce its budget. That is despite some donors stepping up. Digging through WHO’s latest audited financial statement, I found that Saudi Arabia contributed a total of $92 million to the agency’s program budget in 2025, placing it among WHO’s top 10 donors, alongside Germany, the United Kingdom, China, and the Gates Foundation, which is now WHO’s largest funder.”

“Experts tell me they welcome the country’s increased contribution, but they remain concerned about the agency’s finances. WHO’s expenses exceeded its revenue in 2025, resulting in a deficit of $39 million. And for 2026-2027, Director-General Tedros Adhanom Ghebreyesus said in January that they still face a funding gap of $660 million.”

“There’s also WHO’s long-standing reliance on earmarked donor contributions. Anders Nordström, senior adviser for international politics and diplomacy for health at Karolinska Institutet, was among a group of prominent global health experts calling for WHO to reform its financing, arguing it should only accept flexible funding to maintain its independence and integrity. He said earmarked funding also hampers the organization’s ability to recruit and retain top talent, which is crucial for WHO to improve the quality of its technical work.”

Geneva Health Files – What The Creative Ambiguity Around The Withdrawal From The World Health Organization Means

V Penmetsa (legal scholar); https://newsletter.genevahealthfiles.com/what-the-creative-ambiguity-around-the-withdrawal-from-the-world-health-organization-means/?ref=geneva-health-files-newsletter

“In this edition, we bring you an exploration of what the withdrawal of a member state from the World Health Organization means for the institution. As we worked on this, it became plainly obvious that this is a topic that is deeply sensitive and political. My colleague, Vineeth Penmetsa has worked on this careful analysis, ahead of the World Health Assembly later this month, when the matter will be taken up by member states. Senior diplomats told us that “no one has the guts to talk about this,” also alluding to the withdrawal of the U.S. To be sure, this has implications for countries in general, and for the United Nations system, experts caution. It is also a question that will inevitably need to be addressed by a new Director General of the WHO, going forward.”

“Vineeth argues that the silence that built WHO may also be the silence that may unbuild it. The question of withdrawal should be addressed by member states in a way that balances universality considerations with sovereignty.”

“An organization designed on the premise that no one would ever want to leave is discovering that the absence of an exit clause is not the same thing as the absence of an exit – and that the real cost of the ambiguity is not legal, but operational. The Constitution’s drafters treated universal participation as a functional precondition for the Organization’s mandate; the questions raised over the last sixteen months touch directly on that premise.”

PS: “….The deeper risk is not outright departure but selective participation: states exiting the global body while retaining access to the regional benefits without equivalent obligations. Argentina is the case that exposes how this works in practice…”

Excerpt:      “The 79th World Health Assembly, 18–23 May 2026, will be asked to take a position on both exits. The likely outcome is the one the Executive Board rehearsed: acknowledgement of Argentina’s withdrawal, deference on the United States, no constitutional amendment, and no recourse to the dispute-settlement pathway available under Article 75 of the WHO Constitution, which permits referral of constitutional questions to International Court of Justice.

By declining to challenge either departure, the Assembly will in effect have endorsed a de facto withdrawal right for all Member States, without ever amending the Constitution to create one. The reform conversation has been absorbed into the joint Global Health Architecture and UN80 process – procedurally ambitious, but vague so far.  The deeper question of whether any Member State can lawfully leave WHO is therefore being answered not in treaty text but in institutional muscle memory. Legally, the answer remains: no, except for the United States, and only where the cumulative conditions of the 1948 reservation, including settlement of outstanding financial obligations, are satisfied. Practically, the answer is becoming: perhaps yes, whenever you want, and the practical answer is now available to any Member State, regardless of whether it holds a reservation, because the system has shown it may not enforce the rule….”

More on Global Health Governance & Financing/Funding

Devex -Africa looks inward as global health funding dries up

https://www.devex.com/news/africa-looks-inward-as-global-health-funding-dries-up-112438

With some more coverage from the Nairobi regional WHS last week. “At the World Health Summit regional meeting in Nairobi, leaders and experts outlined how domestic financing — from taxation to insurance — could reshape Africa’s health systems as donor aid declines.”

WB  – Western and Central African Leaders Launch a Roadmap to Tackle Health Crisis in the Region

https://www.worldbank.org/en/news/press-release/2026/05/05/western-and-central-african-leaders-launch-a-roadmap-to-tackle-health-crisis-in-the-region

“A dozen ministers of health and finance, alongside representatives of development partners, the private sector, civil society, regional institutions and youth leaders from Western and Central Africa concluded a one-day meeting in Accra on May 4^th to advance the health, nutrition and population agenda and deliver better access to quality health care for communities across the region.”

“During the event, the World Bank Group (WBG) launched its regional health strategy “Fit to Prosper: Investing in Health for Jobs and Development in Western and Central Africa”, a country‑driven roadmap anchored in the principle of health sovereignty. The strategy provides a roadmap to accelerate progress toward universal health coverage (UHC), while underscoring that health investments are essential not only for saving lives but also for economic growth driven by quality jobs both today and tomorrow. The Fit to Prosper strategy is built on three strategic priorities: Frontlines First (strengthening service delivery with a focus on primary care), Fixing Finance (ensuring sustainable investment), and Future Fit (building health system resilience). “

AJHESP (Commentary) – Transition from dependence to self-reliance: financing and governing health systems in Africa

O Adeyi, E Barasa et al ; https://www.africanjhesp.org/content/article/1/3/full/

From the new AJHESP journal.

“Recent cuts in development assistance for health (DAH) have caused reactions that range from apocalyptic forecasts of doom for health in Africa to political declarations of sovereignty for health systems on the continent. Amidst the upheavals and proclamations, many African countries face a practical challenge of transitioning their health systems from chronic dependence on DAH to self-reliance in financing and governance. Viable transitions depend on recognizing the crisis of legitimacy for governments that do not ensure basic health services for their populations and deploying levers of public policy to execute two concurrent transitions-quantitative and qualitative. Policy makers have four levers at their disposal: legislation and policy; regulations and institutions; financing, including generation, allocation, purchasing, and incentives; and learning, monitoring, and evaluation. By deploying these levers to bear upon challenges in the quantitative and qualitative dimensions of transition, African countries can achieve self-reliance in financing and governing their health systems.”

·         Also from the inaugural issue:  Navigating Africa´s health financing in the post-aid era (by Angela Esi Apeagyei (IHME))

“…. I propose a framework consisting of three pillars that recognize the diverse economic landscape on the continent and that could ensure that the most vulnerable are not left behind. The three pillars are fiscal capacity, outcome-based targets, and strategic efficiency. Fiscal capacity covers the mechanisms of revenue mobilization. Outcome-based targets emphasize tangible health metrics of success and strategic efficiency encourages learning from the best performers on the continent…..”

Cidrap News – US lawmakers seek answers on blocked funding for Gavi

https://www.cidrap.umn.edu/childhood-vaccines/us-lawmakers-seek-answers-blocked-funding-gavi

“A bipartisan group of US lawmakers is calling on the Trump administration to restore US funding for Gavi, the Vaccine Alliance.”

“In a letter sent earlier this week, members of the Senate appropriations committee urged Secretary of State Marco Rubio to restore the $600 million appropriated by Congress in fiscal years 2025 and 2026 for the public-private partnership, which help poor countries purchase and administer vaccines that protect children against 20 infectious diseases. The funding expires on September 30 if it’s not released…..”

·         See also Devex – US lawmakers push back as Trump administration blocks $600M for Gavi

“ The standoff over vaccine funding is a proxy for the battle between Congress and the administration over who holds the power of the purse.”

PS: “… The Gavi spokesperson said releasing U.S. funds will help accelerate the rollout of two new vaccines that offer greater protection against multiple diseases and do not contain thimerosal. This includes the hexavalent vaccine — a single vaccine that protects against six diseases, including polio — and the multiconjugate meningococcal vaccine…..”

Devex Pro – At Finance in Common, development banks face a harsher era

Devex Pro;  

Update on “Finance in Common”. “Finance in Common, or FiCS, was launched in 2020 with the goal of aligning 500 public development banks, or PBDs, that controlled trillions of dollars in assets. Six years later, things are very different for both FiCS and PDBs.”

“FiCS, led by Rémy Rioux — outgoing president of the French development agency AFD — wants to move from forging partnerships and writing reports to measurable outcomes on efficiency and mobilization.  Meanwhile, PDBs — national banks owned by a government — need to move from being flush with assets to doing more with a whole lot less.”

“Doing more with less. Attracting private capital. Mobilizing domestic resources. Let’s face it — these are the new (and already tired) slogans in a world where traditional donor assistance is no longer a given. Behind the slogans, however, lies a real slog to shift the development model so that it can actually raise serious money.   Karim Karaki of ECDPM told my colleague Jesse Chase-Lubitz on the sidelines of the meetings that PDBs “may show ambition in mobilizing private capital at scale, but this also partly depends on their shareholders — governments — and their engagement in tackling regulatory issues.”   It will also require government funding, “in a context where [official development assistance] has been cut by 23%,” said Karaki. These are commitments that G7 countries — all of which cut aid in the last year — are hard-pressed to make.  “This puts limits not only on what PDBs can do, but on the motto ‘do more with less,’” he said. “We are entering times where we should be real on the fact that we’ll have to do less with less, but this should also be seen as an opportunity to be more strategic in the way we spend resources, and on the objectives we could/should prioritize.”

Devex – Money Matters: Who funds global health — and by how much?

https://www.devex.com/news/money-matters-who-funds-global-health-and-by-how-much-112429

“Before the cuts and the chaos, global health funding was one of the largest pots of money in development. The world’s biggest donors spent $18.1 billion on the sector in 2024, and the United States accounted for two-thirds of that money. That era is over — but with the U.S. now rolling out multimillion-dollar health agreements across the world, it’s not yet clear by how much. A new Devex analysis offers a baseline, and a measure of just how much the world needs to reshuffle to adapt.”

“.. To understand what’s at stake, Devex’s Miguel Antonio Tamonan and Alecsondra Kieren Si took stock of where global health financing stood in 2024, the last full year before the U.S. began its dramatic retreat and ongoing rebuild. They found that in that year, the world’s biggest donors spent $18.1 billion in official development assistance, or ODA, on health, with U.S. cash amounting for 67% of that total. The second-largest donor — the United Kingdom — made up just a sliver of that spend, contributing $1.2 billion in 2024.”

“Nigeria — the country that also holds the largest bilateral health agreement with the U.S. as of today — received the lion’s share of the health ODA in 2024, followed by Mozambique, Tanzania, Uganda, and South Africa.”

“Miguel and Alecsondra also surveyed the biggest organizational players, with the Gates Foundation coming out as by far the most influential: In 2024, the organization disbursed $8.2 billion charitable support, of which $5 billion, or just over 60%, went to health programs.”

G7 Financing for Development: Framework for promoting Health Sovereignty Financing and Self Reliance

https://www.diplomatie.gouv.fr/files/files/presse-et-ressources/actualites/-ok-g7-framework-for-promoting-health-sovereignty-financing-and-self-reliance.pdf

5-pager. Outcome from last week’s G7 Development ministers meeting.   Must-read.

With a number of commitments to action on increased mobilization of financing mechanisms for health; medical countermeasures (MCM) surge financing for health emergencies, effective and efficient mobilization of domestic resources for health, & national health compacts.

·         Do also check out the  reaction and overall assessment by Global Health Advocates :  

“G7 Development 2026: A framework for health sovereignty, but equity remains unfinished. G7 Development Ministers, meeting in Paris, have put forward a new approach focused on resilience, coordination, and sovereignty. While these signals are encouraging in a fragmented geopolitical landscape, they fall short of ensuring universal access to health…. “ “… We welcome the fact that a specific deliverable was conceived to address the current issues related to global health financing. In a geopolitical landscape marked by a questioning of multilateralism, this is an encouraging sign that G7 members agreed to rightfully recognise health as a driver of mutual development. However, the resulting Framework for Promoting Health Sovereignty Financing and Self-Reliance risks failing equity requirements if international public financing flows’ trajectory is not meant as a comprehensive response to the current crisis of global health financing….”

We welcome the commitment to making health a driver of mutual development, notably through the involvement of public development banks and the strengthening of surge financing. The call to align solutions with national priorities, including meaningful civil society participation, is an essential step forward.  However, while the framework establishes principles of sovereignty, it fails to guarantee equity due to a lack of firm financial commitments and indispensable structural reforms, such as debt suspension during health crises. Without equitable access requirements and genuine technology transfers for local innovation, these intentions risk failing to bridge global health inequalities….”

Cidrap News – TB costs in poor countries exceed those of HIV, estimates suggest

https://www.cidrap.umn.edu/tuberculosis/tb-costs-poor-countries-exceed-those-hiv-estimates-suggest

“Active cases of tuberculosis (TB) cost low- and middle-income countries (LMICs) with heavy TB burdens $3.5 billion more in current annual and future lost earnings and medical expenses than HIV, yet receives substantially less funding, researchers in Peru and the United States write in a new study published in BMJ Global Health.”

“The researchers used a model to estimate the economic costs of TB and HIV to households and the economy, including factors such as the effects of parental disability or death on children’s future earnings, in 25 LMICs. The analysis was based on data from sources such as the World Health Organization (WHO) Global Tuberculosis Report, the Institute for Health Metrics and Evaluation’s Global Burden of Disease dataset, and Demographic Household Surveys….”

·         Cfr the BMJ GH study – Economic costs of TB and HIV in high-TB-burden countries

“The findings indicate that active TB cases result in significant economic losses, with US$13.7 billion in current annual losses, US$17.2 billion in future losses and US$5.7 billion in medical expenses, for a total of US$36.6 billion. In contrast, HIV causes US$5.5 billion in current losses, US$20.9 billion in future losses and leads to medical expenses of US$6.1 billion for a total of US$32.5 billion. … …. The economic impacts of TB are at least as large as those of HIV, with higher returns on investment in TB prevention. These results advocate for increased funding for TB relative to funding for HIV in these countries because the returns to incremental funding for TB are greater than those for HIV at current funding levels.”

Habib Benzian & Ikenna Ebiri-Okoro  – Complexity and Consolation

Substack; 

“Two responses to global health’s three-body problem.”

“In a recent OpEd, Ilona Kickbusch and Vinh-Kim Nguyen draw on the three-body problem in physics – a formally defined phenomenon in which three interacting gravitational bodies produce dynamics that cannot be predicted or solved in general terms – to describe global health governance as defined by complexity, instability, and radical uncertainty. It is an elegant argument. It may also be a convenient one.”

“The two essays that follow take that possibility seriously, from different positions and in deliberately different registers. The first, written from a global health systems perspective, examines what the language of complexity clarifies and, more importantly, what it risks obscuring. The second, by Ikenna Ebiri-Okoro, first published on International Health Policies, speaks from a vantage point closer to the ground – not from Geneva, but from inside a health system that is expected to actually function under the conditions being theorized. They do not say the same thing. But they share a question: when global health is framed as inherently unpredictable, whose interests does that framing serve?”

Sustainability Starts with What We Are Building – Why fixing financing is not fixing the system

E S Koum Besson ;  https://www.linkedin.com/pulse/sustainability-starts-what-we-building-why-fixing-koum-besson-oftve/

“Sustainability is not a financing question. It is about knowing where we are going, and what we are building.”                       Excerpts:

“… A recent article by Stephanie Nolen on Zambia (in the NYT) illustrates this starkly. She describes how, after donor funding ended, health workers were left without access to digital tools—because internet subscriptions had been financed externally, but nothing had been built to sustain their use. When the money disappeared, so did the system. In some cases, staff had never even been trained to use the tools effectively. This is not an isolated failure. It is a pattern. And it becomes visible when inputs are mistaken for systems rather than components of them….”

“… The Core Problem Is Not Financing: These are not financing problems. They are service delivery and system design problems….”

“… Expanding Fiscal Space Is Not The Same As Building Systems: The same type of “confusion” appears in broader financing debates. We often hear calls to expand fiscal space through : health taxes; pooled procurement; innovative financing mechanisms such as debt swap… These are important and necessary, but they are not sufficient. Because the question is not only how much fiscal space is created, but: How that space is structured, used, and integrated into systems….”

See for example  debt swaps.  “The question is not whether we use debt swaps but whether they reinforce systems—or bypass them. If designed differently, debt swaps for health could: support a steady increase in domestic health budgets; be anchored in public financial management systems; reinforce system-wide reforms rather than fragmented activities….”

“What Sustainability Actually Requires: This changes how we should think about sustainable health financing. Sustainability is not about: securing more funding; choosing better instruments; optimising inputs. It is about: building systems that countries own, operate, and sustain over time.

The most effective work I have seen did not start with financing. It started with a clear vision of the system to be built. Everything else followed — because the tools were chosen to serve the system, not define it….”

Plos GPH – Measuring health financing vulnerability due to reductions in official development assistance: A conceptual framework with empirical application across 47 African countries

J A Asamani et al ;  https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006282

By some WHO Afro authors.  “…This paper proposes an approach to assess country’s vulnerability to external aid cuts, considering dynamic health financing and macro-fiscal risk factors….”

Tax justice (1^st of May) & debt crisis

Oxfam/ITUC – Top CEO pay increased 20 times faster than workers’ pay in 2025

https://www.oxfam.org/en/press-releases/top-ceo-pay-increased-20-times-faster-workers-pay-2025

Released ahead of May 1^st.  “Global real worker pay fell 12 percent while real CEO pay surged 54 percent between 2019 and 2025.   At least four CEOs of major corporations each pocketed over $100 million in pay and bonuses last year. …   Billionaires were paid $2,500 per second in dividends in 2025. The International Trade Union Confederation (ITUC) and Oxfam are calling for urgent action to rein in extreme wealth, including higher, fairer taxes on the richest and binding limits on CEO pay.”

CESR  – New resource: Ensuring institutional capacity for taxing wealth

https://www.cesr.org/institutional-capacities/

“A new resource from CESR and the New Economics Foundation, From Design to Capacity: an Institutional Capacity Framework for Taxing the Wealthiest, argues that the real challenge isn’t just what to tax, but whether governments have the institutional capacity to make it work in practice.”

“Extreme wealth is often hidden behind offshore structures, complex ownership arrangements, and legal loopholes that present huge challenges to identifying, valuing, and taxing wealth. States also face fragmented data systems, legal constraints, and intense political pressure from well-resourced elites. The result? Persistent enforcement gaps and reforms that stall, weaken, or fail to come to fruition. This report is designed to help activists, policymakers, and practitioners diagnose these challenges and push for reforms that are not only ambitious but durable. Drawing on experiences from Argentina and Brazil, it shows that capacity isn’t fixed: it can be built through strategic action….”

Guardian – Women in developing countries hardest hit by rising debt burden, UN research finds

https://www.theguardian.com/world/2026/may/04/women-in-developing-countries-hardest-hit-by-rising-debt-burden-un-research-finds

“Study warns women face job losses and increased unpaid care duties as debt and conflict-driven turbulence force spending cuts.”

“Women are hit hardest when the debt burden in developing countries rises, a trend expected to worsen as the war in the Middle East continues, UN research shows.  A report by experts from the UN Development Programme (UNDP), based on data from 85 countries gathered across three decades, shows women are disproportionately affected when debt repayments increase significantly….”   “As governments cut back public spending to accommodate rising debt costs, women, who are overrepresented in sectors such as education and care, are more likely to lose their jobs – and then to shoulder additional caring duties as the state retreats.”

“… The report finds that, between the early 2010s and 2022, debt-servicing burdens in the 85 developing countries studied almost doubled. It estimates this led to the loss of 22 million women’s jobs in the short-term, and more than 38 million in the long term.  In general, moving from a moderate to a high debt-servicing burden – measured as a share of a country’s exports – causes on average a 17% decline in women’s income per capita, the report finds, while men’s income is unchanged. Life expectancy tends to decline for women and men.”

“Achieving gender equality is one of the UN’s 17 sustainable development goals. De Croo suggested creditor countries could consider linking debt relief to commitments to avoid spending cuts that disproportionately hit women.”

Guardian – Cut borrowing costs for poorer countries to free up $900bn for development – report

https://www.theguardian.com/global-development/2026/may/06/cut-borrowing-costs-for-poorer-countries-to-free-up-900bn-for-development-report

“G77 nations spend $8tn a year servicing debts, but analysis shows how comprehensive relief could benefit social spending.”

“Cutting debt servicing costs for the world’s poorest countries could free up $900bn (£660bn) a year for development, a new report to the UN secretary general has claimed.  Prepared by advocacy group Development Finance International (DFI) with the support of the Norwegian government and launched in Oslo today, the analysis warned that the world is facing “the worst ever debt-provoked development crisis”.   The G77 developing countries spend a total of $8tn a year servicing their debts, the report showed – equating to an average of 35% of government spending. Six billion people are living in countries where spending on debt service is higher than the annual health budget….”

Bilateral health agreements & US global health policy

Devex Check-up – Even as some bilateral health deals stall, it’s still ‘America First’

Devex;

Overall update from Tuesday.  

“Meanwhile, the deals that are in place are not on schedule. Uganda and Rwanda were among the first countries to strike agreements back in late 2025, setting April 1 as a start date for the new funding model. This includes direct U.S. financing to partner governments to buttress a range of health activities, including disease surveillance and HIV programs. Civil society groups say they are still discussing how to implement the new strategy more than a month after that deadline, leaving the U.S. State Department scrambling to cover programs in the meantime. These setbacks don’t mean U.S. officials are getting ready to write off the America First Global Health Strategy that is the basis for these new agreements.  “Just because countries are not wanting to negotiate on the MoUs or not coming to an agreement doesn’t mean that the U.S. is going to change its policy,” Frieda Arenos, the director of U.S. government relations at advocacy organization the ONE Campaign, tells me….”

“While countries such as Ghana and Zimbabwe make the headlines when they walk away from negotiations, more than 30 countries have already reached agreements, and the number continues to rise. And while it is taking longer than anticipated to operationalize the plans, countries understand that this will be the path to secure ongoing U.S. health financing — at least so long as the Trump administration is in office.   “

“And countries need that support. Even though part of the U.S. strategy is to push partners to take more ownership of their health services, an abrupt withdrawal would be catastrophic.

“The U.S. has really taken on a role in addressing disease burdens, so that’s highly specialized healthcare workers and individuals who know how to care for those populations,” Arenos says. “There will be gaps in care, even if the government steps in.”   That might explain why Zimbabwe’s talks have quietly resumed, according to sources, and why, in Zambia, civil society groups feel the pressure to reach some kind of agreement, despite their outrage at the transactional nature of the leaked drafts.”

Reuters – US criticises Zambia for lack of engagement as $1 billion health deal stalls

Reuters;  

(May 1) “The United States has criticised Zambia for failing to engage on a new health aid agreement governing more than $1 billion in U.S. funding, saying ​repeated outreach from Washington had been ignored as an April 30 deadline ‌passed without a deal.”

“Outgoing U.S. ambassador Michael Gonzales said the failure to finalise the memorandum of understanding (MOU) had left funding continuing on an ad hoc basis, without a coherent implementation plan ​for programmes covering HIV, malaria, maternal and child health and disease preparedness….” ““… Gonzales said ​Washington had faced “effectively zero substantive engagement” from Zambian officials since ​January, with ⁠calls going unanswered and meetings cancelled, preventing meaningful negotiations on future cooperation…..”

PS: “Zambia’s ​presidential spokesperson Clayson Hamasaka said the government would engage with Washington through diplomatic ​channels….”

Reuters – Zambia says US health deal must be uncoupled from minerals access

Reuters;  

(4 May) “Zambia says health and minerals deals should be separate; Both proposed US agreements are under negotiation; Other countries rejected US health deals on data privacy concerns.”

“Zambia’s government said on Monday that it opposed a U.S. attempt ‌to tie health funding to access to critical minerals, giving details for the first time about why negotiations with Washington over two proposed agreements have stalled…. Zambia’s Foreign Minister Mulambo Haimbe said ​the United States had offered support of up to $2 billion over ​the next five years in a proposed health agreement, but that some ⁠of the terms regarding data sharing would violate Zambians’ right to privacy…..”

·         See also Bloomberg – Zambia says privacy, minerals concerns stall US Health aid. 

Emily Bass – Is the Department of State Setting Up the Supply Chain Transition to Fail?

Emily Bass;  

“Hey. What’s going on?” 

“In recent days, the Bureau of Global Health Security and Diplomacy at the Department of State made a series of move that could be taken for elements of an orderly transition plan to wind down the Global Health Supply Chain Procurement and Supply Management (GHSC PSM) contract managed by Chemonics International, which had previously been reported to be headed for an emergency closure as soon as this month…..”

“… I’ve spent the last week or so working on a detailed analysis of (i) the US government’s own assessment of the timing required for contract handover, (ii) the available resources for GHSC Task Order 1, which covers HIV commodities, technical assistance, forecasting, storage and delivery, and (iii) the gaps between Global Fund procurement functions and GHSC PSM functions. What I’ve learned strongly suggests the steps the State Department are not, in fact, part of an orderly, appropriately resourced, and harm-mitigating plan, but rather an approach that sets countries and systems up to fail so effectively, it is hard to imagine there is no deliberate intent….”

Bass concludes: “… To recap: GHSD has chucked the timeline for orderly transition from GHSC-PSM to a different system out the window; the fund that must support these enormous changes at the last minute is wildly under-capitalized; and the one entity identified to pick up where GHSC-PSM leaves off  (i.e. Global Fund) can only cover a portion of the work that needs to be done.  I would love to be wrong about this analysis. Unfortunately the memo is real, and so is the gap between what GHSC PSM does and what the Global Fund can, at this point, do…”

And ending on a really ominous note: “… In my last post, I wrote of a growing crisis of confidence in Team AFGHS to deliver the results and accountability that Congress and taxpayers have come to expect from US government global health funding. Based on this analysis, that skepticism should sharpen into cynicism. The strategy may not just be sketchy on the details, it may be designed to deliver disappointment. The AFGHS may not be even be the strategy it says it is. It may be a strategy seeking to fail.”

Emily Bass – America First Global Health Guidance Launches Fee-for-Service Coup Against CDC

Substack;  

“Bonus: it comes with a menu.”

“The Department of State is turning the US Centers for Disease Control and Prevention’s global HIV program into a disempowered, McKinsey consulting firm-esque entity that will receive resources at the whim of politically appointed Department of State leadership. Released to government staff yesterday, the new “Guidance for U.S. Government Operations Under the America First Global Health Strategy” (I’ve included JPGS of the whole thing at the end of the document) lays out a plan for placing every aspect of global health foreign assistance funding and decision making in Department of State control, including the public health agendas and activities of the CDC, the nation’s bulwark against infectious disease threats…..”

“Historically, CDC received roughly USD two billion a year from the State Department, via a transfer of foreign assistance funds from the State Department-held Global Health Programs account. The new guidance swaps in a fee-for-service model, in which CDC’s global health program will receive payments based on technical assistance services that countries select and prioritize, along with a minimum package of services required by almost all countries receiving funding under the America First Global Health Strategy…..”

“By setting the minimum package, insisting on the fee-for-service model (an approach State Department advisor Brad Smith has been promoting for months now), and effectively ending predictable funding for CDC, the Department of State is positioning itself to influence, if not set, US global health security strategy at a scientific and public health level for which it has neither the expertise nor the statutory mandate….”

PS: “… Historically, the Department of State has been responsible for global health diplomacy—an important field centered on the government-to-government and global arrangements that support health in an interconnected world. The US government’s foreign policy shop has not exercised control over budgets, staffing, agendas and activities related to public health, epidemiology, disease surveillance and outbreak response. Multiple laws establish that the Department of Health and Human Services, CDC, the Administration for Strategic Preparedness and Response (ASPR), and other government entities are the scientific leads. The new guidance changes the status quo not by rewriting laws but by establishing State Department control over funding. Whether it’s choking off funding for the supply chain contract, CDC or Department of Defense, control of the Global Health Programs budget is a primary tactic for the State Department’s expansionist agenda. …”

“Fortunately, there is a remedy. Congress gives the State Department its Global Health Program money, and Congress can, and must, use its legislative powers to direct State to transfer a minimum portion of the GHP budget to CDC. This wording can go into House and Senate appropriations bills; there is also a clear need for new legislation that establishes the roles, mandates and responsibilities of the government agencies and departments involved in foreign assistance for global health now that the Department of State has a conflict of interest it clearly will not manage on its own.”

TGH –   As Defunded HIV Programs Thin, Uneven Resilience Emerges

M Reid & J Ratevosian; https://www.thinkglobalhealth.org/article/as-defunded-hiv-programs-thin-uneven-resilience-emerges

“The latest data for the President’s Emergency Plan for AIDS Relief shows how HIV programs are scaling back on epidemic control.”

“Together the trends signal a system that has shifted into preservation mode—protecting treatment while scaling back the functions that sustain epidemic control, with fewer community and facility-based testing campaigns, reduced outreach to populations at highest risk of HIV acquisition, and slower initiation of new patients onto treatment, weakening the pipeline that identifies and links people to care.”

They also discuss “What Bilateral Health Agreements Mean for PEPFAR’s Next Phase”.  And lay out three priorities for the future:    “First, protect the front end of the response—testing, prevention, and community systems—during transition…. … Second, realign the financing assumptions behind the bilateral health agreements’ architecture with the realities of service delivery…. … Third, preserve visibility—through robust, transparent, and fit-for-purpose data systems. Without reliable data, the public and stakeholders will lose the ability to identify risk, target interventions, and course-correct in real time….”

The New Humanitarian – “We are going to die”: The frontline costs of Uganda’s new US health agreement

S K Wekuphulu;  https://www.thenewhumanitarian.org/news-feature/2026/05/06/frontline-costs-uganda-new-us-health-agreement

““We are fighting political and cultural wars. Wars that are not ours.””

“…. Post-abortion care services (PAC) are legal in Uganda, secured through years of advocacy and government-NGO collaboration, some under US-supported programmes. But health workers, activists, and patients told The New Humanitarian that in recent months, post-abortion care and critical HIV/AIDS services are increasingly caught in the fallout of a new $2.3 billion health agreement between Uganda and the United States, one that is integrating donor-funded programmes into Uganda’s public health system while reducing reliance on NGOs.”

PS: “… According to Betty Balisalamu, executive director of Women with a Mission in eastern Mbale, the effects of a health model cutting out civil society are already visible in how local officials engage with marginalised communities.  “It sends a message,” she said. “The officials say if even our funders are stepping back, then the government should too.” At Rukoki General Hospital in Kasese, in western Uganda, a laboratory technician described what that looks like in practice. Key population focal persons, like staff trained to support groups such as sex workers and LGBTIQ individuals, are no longer present. “There is more stigma now,” the technician said. “People are afraid to come.”….”

Trump 2.0

NYT – Kennedy Starts a Push to Help Americans Quit Antidepressants

https://www.nytimes.com/2026/05/04/science/rfk-antidepressants-ssris-hhs-maha.html

“The health secretary has long complained that Americans overuse psychiatric medications. New policies he is introducing aim to change that.”

“The initiative focuses on the most widely prescribed class of psychiatric medications, first-line treatments for depression and anxiety that include Zoloft, Lexapro, Paxil and Prozac. In 2026, 16.6 percent of U.S. adults, or roughly one in six, reported currently taking an S.S.R.I…. …. … The changes — new trainings, reimbursement mechanisms and clinical guidelines — nudge clinicians to help patients getting off medications, and to consider nonpharmaceutical interventions, like therapy, nutrition and exercise….”

·         Related: Guardian – ‘Christofascism’ is here: inside the slow demolition of US public health

“ From prescribing spiritual warfare to demonizing health experts, RFK Jr’s health empire has become a dangerous vehicle for a Christian nationalist worldview.”

Science – CDC leader calls for new journal to ‘elevate scientific rigor’

https://www.science.org/content/article/cdc-leader-calls-new-journal-elevate-scientific-rigor

“Bhattacharya publicly slams vaccine study he pulled from agency’s flagship publication.”

The flagship publication is CDC’s Morbidity and Mortality Weekly Report (MMWR).  “….he questioned the peer-review process at MMWR—for 65 years a mainstay for CDC to convey urgent public health data. After saying MMWR needed revamping, Bhattacharya pivoted and called for a new, externally reviewed CDC journal…..”

UHC & PHC

AJHESP – The cost of not knowing: evidence gaps and Africa´s Universal Health Coverage financing journey

B S Kamara;  https://www.africanjhesp.org/content/article/1/2/full/

“African governments routinely make consequential health financing decisions with insufficient analytical support. Drawing on direct experience as Deputy Governor of the Central Bank of Liberia, twice Minister of Finance and Development Planning, and Senior Health Financing Advisor at Africa CDC, this commentary argues that Africa’s persistent Universal Health Coverage (UHC) financing failures are as much an evidence problem as a resource problem. The evidence that finance ministries and central banks need, granular, domestically grounded, politically legible, is largely absent. The uncharted relationship between ECOWAS monetary convergence criteria and health fiscal space illustrates one such critical gap. The African Journal of Health Economics, Systems and Policy (AJHESP) is positioned to build the analytical infrastructure this continent urgently needs.”

Lancet Primary Care (Viewpoint) – 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

“In this Viewpoint, we draw on expert consensus from professionals across 19 countries using the nominal group technique and Delphi-style rounds. Experts were organised into thematic “policy laboratories” focusing on primary care, hospitals, and oversight. …. Three key constructs from a five-day workshop 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. …”

Lancet Primary Care (Viewpoint) – Palliative care integration in primary health care across the life course: a global health imperative

W E Rosa et al ; https://www.thelancet.com/journals/lanprc/article/PIIS3050-5143(26)00001-4/fulltext

“Annually, more than 70 million people worldwide have health-related suffering amenable to palliative care. However, this need remains unmet for more than 85% of cases, predominantly in low-income and middle-income countries. Because most people with serious illness live in community settings and wish to remain there through the end of life, integration of palliative care into primary health care (PHC) is crucial. Primary care teams are well positioned to deliver generalist palliative care but often face insufficient training, weak PHC infrastructure, and poor policy support, among other barriers. In this Viewpoint, we provide an evidence-based rationale for improved integration of palliative care into PHC and share best practice exemplars that show feasible pathways to strengthen integration through training, mentorship, service development, international collaboration, and system adaptation. Informed by lessons learned and recommendations, our international and interprofessional team emphasises that successful integration of palliative care into PHC will require evidence-based advocacy, community partnerships, context-specific implementation, sustainable resourcing, and coordination between generalist and specialist teams to strengthen community-based, person-centred services across the life course.”

Guardian – Flaws in Kenya’s AI-driven health reforms driving up costs for the poorest

https://www.theguardian.com/global-development/2026/may/04/kenya-ai-healthcare-reforms-driving-up-costs-for-poor

“Amid unrest, President William Ruto promised to give all Kenyans access to healthcare. But the algorithm favours the rich, an investigation has found.”     Excerpts:

“An AI system used to predict how much Kenyans can afford to pay for access to healthcare, has systemically driven up costs for the poor, an investigation has found.  “No Kenyan will be left behind,” Ruto told a crowded stadium in Kericho during his 2023 presidential campaign, announcing that every citizen would soon have access to affordable healthcare. But his solution has instead sparked protests and anger, as healthcare contributions for millions of people are now calculated via a formula described as “flawed” and which sources have said has almost no transparency. That solution, which Ruto has described as AI-powered, does not rely on the recent advances in artificial intelligence which underpin large language models such as ChatGPT – instead it uses a predictive machine learning algorithm. It now  determines healthcare contributions for millions of people through a means-testing process described as “flawed”, and which sources have described as having almost no transparency.”

“Through months of investigation, reporters at Africa Uncensored, in collaboration with Lighthouse Reports and the Guardian, were able to obtain key details of this system and audit how it worked. The findings reveal how, from the start, it was systematically overcharging the poorest Kenyans, overestimating their incomes, while undercharging the wealthiest by underestimating their incomes.”

“… Since its launch, the Social Health Authority (SHA) has been met with a barrage of criticism for misclassifying people, and setting unaffordable or incomprehensible premiums.”

PS: “Kenya’s algorithmic healthcare system is structured on a decades-old World Bank bugbear: proxy means testing (PMT), a way of estimating the incomes of the poor based on their possessions and other life circumstances, such as how many children they have or whether they live alone.  PMT has been used in World Bank-funded programmes “all over Africa, all over Asia and the Pacific”, said Stephen Kidd, a development economist. It has often been set as a condition for a government to receive a loan.”

“… Across Africa, Asia and Latin America, PMT algorithms have become popular in determining which households are “poor enough” to receive cash transfers, food subsidies and other benefits. These systems aim to expand the services of the state to people who have historically gone uncounted; the informal workforce whose inconsistent earnings do not fit neatly into income-based healthcare schemes.  But Kidd and other researchers have found that these systems simply do not work. In attempting to categorise a population as “poor” or “not poor”, most make significant errors…”

Montreux Collaborative Blog –  Should I Stay or Should I Go? Reflecting on the Institutional Positioning of Free Care Programmes in relation to National Health Insurance

Helene Barroy, WHO; https://www.pfm4health.net/blog/should-i-stay-or-should-i-go-reflecting-on-the-institutional-positioning-of-free-care-programmes-in-relation-to-national-health-insurance

“Across many sub-Saharan African countries, the institutional positioning of “free care programmes” has become an urgent question. Nearly two decades ago, governments introduced subsidized maternal, neonatal, and child health services—often the first tangible step toward Universal Health Coverage (UHC) through the removal of user fees. Today, many of these same countries are establishing national health insurance (NHI) funds to expand coverage and financial protection. This dual movement raises a core question: Should free care programmes be integrated into NHI structures as part of broader pooling reforms, or remain within existing institutional arrangements while NHI capacities and population coverage gradually expand? This blog explores the issue through two contrasting examples: Burkina Faso, where the free care programme is integrated on-budget within the government’s public financial management (PFM) system, and the Democratic Republic of Congo (DRC), where it operates off-budget through a dedicated purchasing agency (Fonds de Solidarité en Santé, FSS). Together, these cases illustrate divergent but instructive pathways for countries navigating similar reforms on the continent, including Benin, Côte d’Ivoire, Mali, Niger, Nigeria, Sierra Leone, or Togo.”

Barroy concludes: “… The overarching lesson is that pooling choices must be grounded in context and institutional capacity. In some settings, integrating free care programmes into a purchasing agency may be appropriate, particularly where regular PFM processes are not yet conducive to strategic purchasing. In others, maintaining the free care programme within the regular budget system may be preferable, especially where that system can support purchasing reforms and benefit expansion. Ultimately, as countries scale up free care programmes while building NHI institutions, the priority is not to identify a single “right” model but to make deliberate governance choices based on trade‑offs, institutional maturity, and financial management capacity—distinguishing between short‑term practical arrangements and the longer‑term pooling pathway toward UHC.”

Social and Commercial Determinants of Health

UN News – As housing insecurity grows, global leaders push for action

https://news.un.org/en/story/2026/05/1167452

“With nearly three billion people lacking access to adequate housing worldwide, the global housing crisis has become one of the most urgent human rights challenges, according to UN-Habitat, the UN agency focused on sustainable urban development and housing. “

“More than one billion people live in informal settlements, while over 300 million people experience homelessness across the Global South and North. In Africa, 62 per cent of urban dwellings are informal. In the Asia-Pacific region, over 500 million people lack access to basic water services, and more than a billion live without adequate sanitation….”

“… The issue will take center stage at the thirteenth session of the World Urban Forum (WUF13), the UN’s premier global conference on sustainable urbanization, due to take place in Baku, Azerbaijan. “

HPW – Big Tobacco is No Longer Selling Cigarettes – It Is Engineering Addiction

H Kluge; https://healthpolicy-watch.news/big-tobacco-is-no-longer-selling-cigarettes-it-is-engineering-addiction/

“Europe needs a more precise focus to address the tobacco industry’s “engineered architecture of addiction”, featuring flavoured tobacco and nicotine products with ever more sleek designs. As an early champion of global tobacco legislation, the region can reposition itself to lead again – including through updated European Union directives on tobacco product regulation, advertising and taxation.”

The Milbank Quarterly – The Political Economy of Wellness: Commercial Determinants of a Burgeoning Industry

N Karreman et al ; https://onlinelibrary.wiley.com/doi/10.1111/1468-0009.70088

“This article examines how the wellness industry operates as a commercial, social, and political determinant of health…..”

International Day of the midwife & more on SRHR

HPW – Investing in Midwives is Essential to Improve Sexual and Reproductive Health 

T Guerma ; https://healthpolicy-watch.news/investing-in-midwives-is-essential-to-improve-sexual-and-reproductive-health/ 

« The International Day of the Midwife (May 5) reminds us that safe birth is not a stand-alone event, but part of the broader continuum of sexual and reproductive health and rights….”

Guardian – Zambia cancels world’s largest human rights and tech summit days before start

https://www.theguardian.com/global-development/2026/may/02/zambia-cancels-rightscon-summit-largest-human-rights-technology-conference

“Government blocks RightsCon 2026 conference saying it did not ‘align with national values’.”

“… Rights campaigners have called the decision a blatant act of censorship and part of a broader pattern of suppression of legitimate debate.  …. Zambian news reports have suggested pressure from China could be behind the surprise move – several Taiwanese delegates had been due to attend and the conference was being held in a venue donated by China. The conference, now in its 14th year, was held in Taipei last year….”

PS: “A significant number of speakers were lined up to address issues around the online censorship of sexual and reproductive health rights (SRHR).  … Luca Stevenson, of the International Planned Parenthood Federation, said RightsCon was a “critical” space for communities already pushed to the margins, “including sex workers, LGBTQIA+ people, and those seeking sexual and reproductive healthcare”….”

Devex – OCHA chief says he’ll refuse US money if new restrictions attached

https://www.devex.com/news/ocha-chief-says-he-ll-refuse-us-money-if-new-restrictions-attached-112443

“Tom Fletcher, the head of U.N. OCHA, said that he would forgo American dollars rather than accept conditions tied to abortion, gender identity, and diversity, equity, and inclusion.”

Devex Pro – ‘An entirely new animal’: A look inside the new Mexico City Policy

https://www.devex.com/news/an-entirely-new-animal-a-look-inside-the-new-mexico-city-policy-112454

(gated) “The Promoting Human Flourishing in Foreign Assistance policy now extends far beyond abortion and is set to reshape how organizations receive U.S. funding in countries across the world.”

“The Trump administration’s sweeping expansion of the Mexico City Policy is still coming into focus — but with three areas of restriction instead of one, the rule is poised to reshape U.S. foreign assistance.  …”

Guardian – Can promises on gender equality made in Australia help a 16-year-old Indian cigarette maker with no toilet?

https://www.theguardian.com/global-development/2026/may/06/can-promises-gender-equality-made-in-australia-help-a-16-year-old-cigarette-maker-with-no-toilet-india

“The Melbourne declaration aims to direct funding and power to those most overlooked and affected by injustice. But for many its promise is a distant one.”

“Last week…  world leaders and advocates came together in Australia to launch the Melbourne declaration for gender equality, a framework that promises gender-responsive funding, policy reform and a fundamental shift in how power and resources flow towards those most affected by injustice.”

2nd Africa Health Workforce Investment Forum  (6-8 May, Accra)

https://www.afro.who.int/media-centre/events/2nd-africa-health-workforce-investment-forum-6-8-may-2026-accra-ghana?s=09

Ahead of the Forum: “The 2nd Africa Health Workforce Investment Forum (AHWIF) [will] take place from 6 to 8 May 2026 in Accra, Ghana, bringing together heads of state, ministers, global health leaders, development partners, and private sector stakeholders. Organized by the World Health Organization (WHO) in collaboration with the Government of Ghana and key partners, this high-level forum aims to accelerate implementation of the Africa Health Workforce Investment Charter, adopted at the 1st Forum in May 2024.  The Forum provides a critical platform to transition from commitments to concrete investments in Africa’s health workforce — addressing the continent’s most pressing health system challenge….”

WHO Afro – Africa’s health workforce expands but shortages, unemployment and migration intensify: WHO report

https://www.afro.who.int/news/africas-health-workforce-expands-shortages-unemployment-and-migration-intensify-who-rpt?s=09

“Africa is producing more health workers than ever before, yet millions of people still lack access to care; hundreds of thousands of trained health professionals are unable to find jobs; and many of them are migrating. A deliberate shift linking education, employment, retention, quality, productivity and investment is needed to alter the paradox of growing health personnel numbers and unmet needs, a new report by the World Health Organization (WHO) finds.”

“Launched on 6 May 2026 at the Second Africa Health Workforce Investment Forum in Accra, the State of the Health Workforce in Africa 2026: Plan. Train. Retain. highlights a deepening crisis driven not by a lack of training alone, but by systemic failures in health worker employment, distribution and retention.  …”

“… Africa’s health workforce has grown to 5.72 million in 2024, up from 4.3 million in 2018. Yet this progress is not keeping pace with demand. The African region currently has only 46% of the health workers it needs….”

“A defining challenge is the persistence of a dangerous paradox: severe shortages alongside high unemployment. In 2024, an estimated 943 000 trained health workers were unemployed, even as health systems remain understaffed.  … …. WHO has revised the projected health workforce shortage in the African Region by 2030 from 6.1 million to 5.85 million. This is an important signal that progress is being made. However, the reduction is marginal and fragile. It does not yet represent a structural transformation of the health labour market, and it could easily be reversed if countries do not accelerate investment in education, employment, and retention.”

“… Retention pressures are intensifying. Nearly 46% of health workers report intentions to migrate, driven by poor working conditions and limited career opportunities, while absenteeism continues to erode system capacity, with losses estimated at up to 20% of the wage bill.  …”

“Despite these challenges, the report presents a strong investment case. Every US$ 1 invested in the health workforce can generate up to 10 times in financial returns and more than 30 times in broader social and economic benefits. Yet current investment levels remain insufficient. Countries would need to increase spending by approximately US$ 4 per capita per year, or expand workforce budgets by about 15% annually, to close the gap.    ….”

PS: “Participants are expected to review progress under the Africa Health Workforce Investment Charter and mobilize new commitments to accelerate reforms and financing. The forum will also introduce the Africa Health Workforce Agenda 2026–2035, a new regional strategy to drive coordinated action to plan, train and retain health workers at scale….”

More on Human Resources for Health

Stat – The ‘brain drain’ narrative about health professionals misses half of the story

M Chankseliani;  https://www.statnews.com/2026/05/05/brain-drain-doctors-returning-home-systems/?utm_campaign=twitter_organic&utm_source=twitter&utm_medium=social

“Returning to a home country to practice medicine brings surprising challenges, opportunities.”

“I have spent the past several years studying internationally educated professionals who return to their countries of origin, examining what they attempt, what they contribute, and what stands in their way. The study I led interviewed 52 health professionals across 43 countries, alongside 14 domestically educated peers working in the same health systems. Most were from low- and middle-income countries, though the study also includes professionals from higher-income settings, who had studied abroad before returning to work in their home systems. … What emerged challenges the story global health policy tends to tell about mobility.”

“The dominant frame remains “brain drain”: who leaves, in what numbers, from which countries, and how to slow the flow or compensate for the loss. The WHO Global Code of Practice on the International Recruitment of Health Personnel, now under significant review, is structured around this logic. So are most bilateral agreements, most return incentive schemes, and much of the research. The analytic gaze is fixed on departure….”

She then points to “… an uncomfortable truth: While global policy has invested heavily in tracking mobility and managing recruitment, it has invested far less in creating institutional conditions that allow returning professionals to exercise influence. … Ministries of health and international funders need to shift attention from managing exit to enabling consequential return. That entails recognizing comparative knowledge as an asset rather than an irritation, addressing legal and policy gaps that immobilize reform, and cultivating institutional cultures capable of absorbing challenge….”

·         For more, see the study in  Global Public Health: Internationally educated health professionals and health-system change: A global qualitative study

Decolonize Global Health

Africa Launches Continent-Led, First Bilingual Open-Access Journal in Health Economics, Systems &..

http://www.businessghana.com/site/news/general/348073/Africa-Launches-Continent-Led,-First-Bilingual-Open-Access-Journal-in-Health-Economics,-Systems-&..-

See the intro (and reads of the week).  “Eleven of Africa’s most distinguished health economics, systems and policy researchers have joined forces to launch the African Journal of Health Economics, Systems and Policy (AJHESP), the continent’s first bilingual, fully open-access, peer-reviewed journal dedicated to health economics, health systems and health policy. The journal launches on May 4, 2026, with submissions now open. …  AJHESP positions itself as a platform for the policy-relevant, Africa-rooted evidence that this moment demands.”

·         Do read the Editorial of the inaugural issue-  The African Journal of Health Economics, Systems and Policy: origins, commitments, and the work ahead  (by A O Ajagba, S Abimbola, J Nonvignon et al).

“This founding editorial traces the origins of the African Journal of Health Economics, Systems and Policy (AJHESP), describes the editorial commitments that govern it, and introduces the three commentaries that open the inaugural issue. African Journal of Health Economics, Systems and Policy launches in May 2026 as a fully open-access, bilingual, peer-reviewed journal, the first indexed journal in this field to publish in both English and French, governed by a founding editorial board of eleven researchers from across Africa and the diaspora. We describe the gap the journal addresses, the principles guiding its editorial decisions, and the three commentaries that launch it.”

Planetary Health

IPS – How Santa Marta Finally Made Fossil Fuel Phase-Out Politically Discussable

U M Shah; https://www.ipsnews.net/2026/05/how-santa-marta-finally-made-fossil-fuel-phase-out-politically-discussable/

“The First Conference on Transitioning Away from Fossil Fuels in Santa Marta, Colombia, may eventually be remembered as a defining moment in global climate politics, not because it produced a treaty or a formal negotiation outcome, but because it changed the tone, structure, and ambition of the conversation itself.  For decades, international climate diplomacy has been about managing emissions, not addressing the source of those emissions: fossil fuels….”

Santa Marta ended that, ànd started focusing on solutions.

PIK – Deforestation lowers threshold for Amazon degradation to below 2°C warming

https://www.pik-potsdam.de/en/news/latest-news/deforestation-lowers-threshold-for-amazon-degradation-to-below-2degc-warming

“Around two-thirds of the Amazon rainforest could shift into degraded forest or savannah-like ecosystems at 1.5-1.9°C of global warming if deforestation increases to roughly 22-28 percent of the Amazon, according to a new study from the Potsdam Institute for Climate Impact Research (PIK) published in Nature. Without additional deforestation, by contrast, such large-scale changes would likely occur only at much higher warming levels of around 3.7–4°C.”

WRI & Rockefeller Foundation: Early Climate Health Investments Generate 68-Fold Gains in Low- and Middle-Income Countries

https://www.rockefellerfoundation.org/news/wri-rockefeller-foundation-early-climate-health-investments-generate-68-fold-gains-in-low-and-middle-income-countries/

“New World Resources Institute analysis, supported by The Rockefeller Foundation, reveals that every $1 invested in preparing for climate-caused health risks can yield up to $68 in benefits for communities in Africa, Asia, Latin America and the Caribbean, and the Middle East. Research shows how tools and services like early warning systems and disease surveillance significantly reduce deaths and illness, helping more communities in low- and middle-income countries become more resilient.”

HPW – Methane Emissions From Fossil Fuels Near Record Highs

https://healthpolicy-watch.news/methane-emissions-from-fossil-fuels-near-record-highs/

“Methane emissions from fossil fuels stayed near record highs in 2025, with no sign of decline despite proven, low-cost ways to reduce them, the International Energy Agency (IEA) said on Monday.” “  “Methane emissions from the energy sector plateaued near record highs,” the IEA found in its annual Global Methane Tracker. “There is still no sign that methane emissions from fossil fuel operations are falling, despite well-known and proven mitigation pathways.” ….”

WEF – Methane emissions are accelerating warming. Scientists say this plan can help

https://www.weforum.org/stories/2026/05/scientists-issued-plan-cutting-methane-emissions/?utm_source=x&utm_medium=social

“An international meeting under the G7 Presidency will address methane emissions reduction, while a group of more than 250 scientists have also recently published a 10-point plan to accelerate methane science and policy….”

Equinet (Editorial) – Let’s not repeat the ‘curse of oil’: Health is a central marker of equitable benefit-sharing from critical minerals in the green transition.

TARSC/EQUINET and the AEGT Research teams, East and Southern Africa; https://www.equinetafrica.org/

Excerpts:

“… There is no doubt that the current excessive and inequitable consumption of the fossil fuel-reliant goods and services has to end. It is a major driver of climate change and ill health. Fossil fuel-linked air pollution alone is reported by the Global Climate and Health Alliance to be causing over 5.1 million deaths annually.  But in extracting critical minerals to replace fossil fuels, are we replicating the same harmful political economy and choices made by powerful corporations and policymakers? Are we replicating the ‘curse of oil’ in the critical mineral sector, with a disproportionate benefit for wealthy countries and transnationals and with ecological degradation, conflict and displacement in zones of extraction?”

“Globally, African countries, particularly in East and Southern Africa (ESA), are reported to hold high shares of the global reserves of the ’critical’ or ’strategic’ minerals extracted for low-carbon technologies, that is copper, lithium, nickel, cobalt, graphite, manganese and rare earth elements. They are extracted in a range of ways by transnational corporation operations through to artisanal small-scale mines (ASM). While exports of these minerals are increasing, value-added processing is not. Several ESA countries have banned or taxed the export of the raw minerals, and some are introducing processes to increase the concentrations of the minerals exported. But these measures have been slow to translate into meaningful increases in value-added local processing in the region, given constraints in accessing the capital investments for this. ….”    “… A clear marker of the inequity in who benefits from this new version of the ‘gold rush’ in Africa is in their public health consequences. These public health impacts are most felt by mine-workers and by communities living around mines. ….”

“… Critical minerals have been linked in various studies and surveys to silicosis, tuberculosis and toxic metal poisoning from copper; lung disease, bronchitis, impotence and psychiatric symptoms from manganese; kidney, liver, heart disease and cancers from lithium and nickel; and to genetic damage and newborn malformations from cobalt. The economic insecurity and hazardous settings of informal and small-scale miners and surrounding communities combine to intensify these risks.
These social, environmental and health impacts take place in remote rural areas, making them invisible to the urban and high-income country users of the technologies they enable, and to some policy actors. The under-reporting of the health impacts in ESA countries externalises the burdens to workers and to adjacent and displaced communities and their children; groups who are already struggling with social and economic insecurity.   The energy transition that climate change is driving can neither can neither be “just” nor “green” if these health and well-being impacts are ignored….”

“The G20 Johannesburg Summit hosted under the South Africa presidency in November last year, reflecting the prior Social Summit, called for a more holistic global framework for equitable benefit-sharing in critical mineral value chains, “integrating economic, social, and environmental dimensions across the value chain – from extraction to processing, manufacturing, disposal and recycling”.”

Lancet Correspondence – Broadening metrics in the Lancet Countdown on health and climate change – Authors’ reply

M Romanello et al; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00742-7/fulltext

A number of letters (and this authors’ reply) in today’s Lancet issue.  Re the metrics in the Lancet Countdown on health and climate change.

Access to Medicines, Vaccines & other Health Technologies

BMJ Editorial – Restoring certainty to global health regulation

Y Tony Yang et al ; https://www.bmj.com/content/393/bmj.s814

“Resilient systems for drug and vaccine regulation are needed to guard against political volatility and technical fragmentation.”   New article in the BMJ series ‘Geopolitics of Global Health’.

Telegraph – Nigeria wages war on the deadly fake drug trade

https://www.telegraph.co.uk/global-health/science-and-disease/crackdown-nigeria-counterfeit-substandard-drug-medicine/

“The country’s crackdown could be a blueprint for other countries grappling with a global crisis of counterfeit and substandard medicines.”

On the work done by Nigeria’s National Agency for Food and Drug Administration and Control.

Stat – China’s strict new supply chain regulations could create massive problems for Western biopharma companies

https://www.statnews.com/2026/05/04/china-biotech-pharmaceuticals-supply-chain-regulations/

“Just as it did with rare earth minerals, China is tightening control.”

“….  on April 7, China’s State Council issued Decree No. 834, the Regulations on Industrial and Supply Chain Security, effective immediately, with no transition period. Its 18 articles give Beijing sweeping new powers to investigate and sanction any foreign company whose commercial decisions are deemed to harm China’s industrial chain security. China’s 15th five-year plan has explicitly designated biotechnology and pharmaceuticals as the centerpiece of its next phase of industrial development. Decree No. 834 is the legal infrastructure through which Beijing intends to protect and leverage that ambition….”

GAVI – IRC, through Gavi’s ZIP programme, surpass 30 million vaccine doses, reaching over 1 million zero-dose children in crisis settings

https://www.gavi.org/news/media-room/irc-through-gavis-zip-programme-surpass-30-million-vaccine-doses-reaching-over-1

“Marking World Immunization Week 2026, the International Rescue Committee (IRC) announced that, together with partners in the Gavi-funded REACH consortium, it has delivered more than 30 million life-saving vaccine doses in some of the world’s most fragile and conflict-affected settings – reaching over 1 million zero-dose children who had never received a single vaccine….”

MSF Access – MSF Access welcomes Kris Torgeson as incoming Executive Director

https://msfaccess.org/msf-access-welcomes-kris-torgeson-incoming-executive-director

Starting from 1 September.

AI  & digital health

Nature News – Machine learning improves health-care access in Sierra Leone

https://www.nature.com/articles/d41586-026-01152-0

“A machine-learning tool that allocates scarce medicines to meet demand and reduce waste is providing millions with better health care as it rolls out nationwide.”

Conflict/War & Health

Joint call by the President of the International Committee of the Red Cross, the DG of WHO and the International President of MSF – States should uphold and strengthen the protection of medical care in armed conflict on the 10th Anniversary of UN Security Council Resolution 2286

https://www.icrc.org/en/statement/icrc-who-msf-health-care-must-never-be-casualty-war-resolution-2286

“Ten years ago, the UN Security Council unanimously adopted Resolution 2286 on health care in armed conflicts. The situation is even worse compared to 10 years ago. Today, we mark not an achievement – we mark a failure.  “

Lancet World Report – Lebanon’s health system: a silent casualty of war

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00907-4/fulltext

“Lebanon’s already weakened health system is overwhelmed, under-resourced, and increasingly attacked by the Israeli army. Amelie David reports from Lebanon.”

Global health governance & Governance of Health

South Centre – Input for the Special Rapporteur on the Right to Development: For the 2026 thematic reports to the Human Rights Council on “Participation in development” and to the United Nations General Assembly on “Peace for development”

https://www.southcentre.int/south-centre-input-for-sr-on-rtd-17-april-2026/

“The South Centre has submitted its latest input to the UN Special Rapporteur on the Right to Development for the 2026 thematic reports on “Participation in Development” and “Peace for Development”. Our report underscores that development is not a charitable concession but an inalienable human right. To overcome the structural violence of the current international order, we advocate for:…

“Reforming the Global Architecture: Democratising the Bretton Woods institutions and the UN Security Council to rectify the historical underrepresentation of Africa, Latin America, and Asia.

A “Human Rights Economy”: Transitioning from voluntary corporate “tick-box” exercises to a Legally Binding Instrument (LBI) that ensures extraterritorial accountability for transnational corporations.

Dismantling “Regulatory Chill”: Reforming the Investor-State Dispute Settlement (ISDS) system, which currently prioritizes corporate profits over the policy space needed for development and climate justice.

A Paradigm Shift to “Positive Peace”: Redirecting a portion of the $2.7 trillion global military expenditure toward the SDGs and grant-based climate reparations.

Substantive Justice: Recognising traditional and indigenous knowledge as valid evidence in policy-making and ensuring reparative justice for historical dispossessions.”

Devex Pro Insider: The ODA identity crisis

(gated) https://www.devex.com/news/devex-pro-insider-the-oda-identity-crisis-112022

“Global development is searching for a new “meta story” after record cuts, while African leaders pivot toward sovereign, investment-ready systems.”

Devex – Mark Green to become next president and CEO of the ONE Campaign

https://www.devex.com/news/mark-green-to-become-next-president-and-ceo-of-the-one-campaign-112445

“The former USAID administrator under the first Trump presidency will take over from Ndidi Okonkwo Nwuneli, who will remain on ONE’s board of directors while becoming chair of a new committee to support ONE’s growing presence in Africa.”

“In the development community, he’s perhaps best known as head of USAID during President Donald Trump’s first term, during which time Green advocated for a “journey to self-reliance,” country-led ownership model, while also pushing for greater private sector investment over traditional foreign assistance….”

Devex Pro – Germany, the world’s top aid donor, proposes development cuts

https://www.devex.com/news/germany-the-world-s-top-aid-donor-proposes-development-cuts-112423

“Germany’s development ministry faces €582 million in cuts as Berlin reshapes aid around geopolitical priorities, shifts toward loans, and narrows its global footprint despite remaining the world’s largest donor.”

“The German government agreed to general preliminary cuts for the country’s 2027 federal budget proposal last week. The development ministry, or BMZ, took an expected €582 million ($680 million) cut, just weeks after the Organisation for Economic Co-operation and Development numbers showed that Germany has now replaced the United States as the world’s largest provider of official development assistance, or ODA.   …  Germany’s strategy is to replace grants with more loans…”

PS: “Overall, just 1% of the government’s total spending currently goes to development, but a recent poll showed that the German public dramatically overestimates the figure, believing on average that 12% of the federal budget is spent on development cooperation.

Global Policy – Globalization Rewired: Trump, the IMF, and the Return of Power Politics

J Yue; https://www.globalpolicyjournal.com/blog/05/05/2026/globalization-rewired-trump-imf-and-return-power-politics

« Globalization is not retreating but being reconfigured: as institutions such as the IMF and World Bank become increasingly aligned with major power interests, policymakers face a growing challenge—how to prevent globalization from devolving into a tool of power politics and instead sustain a viable balance between power and rules.”

“Recent reporting has revealed a striking and somewhat paradoxical shift: institutions once derided by the Trump camp as bastions of “globalism”—notably the International Monetary Fund (IMF) and the World Bank—have quietly regained favor in Washington. This change in tone does not signal a renewed commitment to multilateralism. Rather, it reflects a more pragmatic recalibration: when international institutions align with U.S. strategic priorities, their utility—and thus their legitimacy—are reassessed…..”

Devex – Save the Children, like others, tries to suss out US foreign aid policies

https://www.devex.com/news/save-the-children-like-others-tries-to-suss-out-us-foreign-aid-policies-112440

(gated) “Christy Gleason sees hope in the congressional budget and the administration’s health agreements, though questions remain.”

“….  That has left organizations such as Save the Children in a wait-and-see mode.  … … “This is a very, very different model for approaching global health than we have seen in most of my career that I can think of,” said Christy Gleason, chief policy officer at Save the Children US. “And so we are paying a lot of attention to … what does it mean in terms of the agreements? What does it mean in terms of the trade-offs? What will it mean … as they move from agreement to implementation?”…”

Public Health Challenges – Health Diplomacy in Africa: Prospects, Obstacles, and the Way Ahead

M Edward; https://onlinelibrary.wiley.com/doi/pdf/10.1002/puh2.70245

“This review examines the prospects and obstacles of health diplomacy in Africa and proposes strategic directions to enhance its effectiveness in achieving equitable and sustainable health outcomes….”

Development Today – Capital nation: the Norwegian oil fund’s discreet role in international aid

https://www.development-today.com/archive/2026/dt-3–2026/capital-nation-the-norwegian-oil-funds-discreet-role-in-international-aid

“The Norwegian oil fund has invested NOK 88 billion in fixed-income securities issued by international organisations. Many of these bonds finance development programmes initiated by institutions like the World Bank, the African Development Bank, and the vaccine alliance GAVI. The fund has not incurred losses on these bonds, and its largest investments are in EU institutions, where further exposure is expected in the years ahead.”

Global health financing

Global Policy – The 2026 Forum on Financing for Development: Progress or paralysis?

Bodo Ellmers; https://www.globalpolicy.org/en/publication/2026-forum-financing-development-progress-or-paralysis

“The international community convened at the United Nations (UN) headquarters in New York from 20-24 April for the first Financing for Development (FfD) Forum since the Fourth International Conference on Financing for Development (FfD4) in Sevilla last summer. … … This briefing assesses the outcomes of the 2026 UN Financing for Development Forum, examining whether it delivered meaningful progress on implementing the Sevilla commitments or reflected broader paralysis in global economic governance. It finds that the forum largely failed to advance implementation, with weak outcomes, misplaced priorities in the agenda, and growing divergence among Member States limiting progress. Progress only took place at the margins of the forum, where new initiatives were launched.”

Plos GPH – The impact of US Government Stop Work Order on HIV epidemic trajectory in Zimbabwe

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006288

By Isaac Taramus et al.

UHC & PHC

TGH – Argentina’s Vital Statistics Show Health Backslides

https://www.thinkglobalhealth.org/article/argentinas-vital-statistics-show-health-backslides

“Argentina’s uneven progress on mortality indicators could hide deeper health-care failures.”

Lancet Primary Care (Viewpoint) – Reviving the promise of primary care: redesigning service delivery to promote core functions

M Peters et al ; https://www.thelancet.com/journals/lanprc/article/PIIS3050-5143(26)00037-3/fulltext

“Although primary care can reduce morbidity, increase lifespans, and improve health equity, it is underperforming globally. As health systems adapt with evolving funding, technology, and demographic conditions, the role of primary care in achieving health for all needs to be clearly explained. Redesigning primary care around four main functions (ie, being the first choice for most health needs; detecting illnesses and risks; providing high-quality care across the life course; and linking to advanced care and social systems) can optimise its benefits within broader systems. In this Viewpoint, we reassert the core functions of primary care, describe design features that promote the core functions, and introduce models that effectively leverage these functions to address emerging health-system challenges…..”

NYT – Since Congress Let Obamacare Subsidies Expire, Millions Are Dropping Coverage

https://www.nytimes.com/2026/05/01/business/obamacare-enrollment-decline.html

“Americans can’t afford the higher health insurance premiums that resulted from Congress’s refusal to extend federal tax credits.  Millions of Americans appear to be dropping Obamacare coverage in the months since Congress failed to extend the generous subsidies that had become a defining feature of the Affordable Care Act…..”

“Initial sign-ups had already fallen by about 1.2 million people. But insurance companies, state officials and industry analysts are reporting that many more have lost Obamacare coverage now that people are facing long-term higher costs. The federal government has yet to report current enrollment data. Many insurers and analysts are estimating overall declines of about 20 percent, dropping to around 19 million from the 24 million who were covered under the A.C.A. last year. Other indications suggest there could be even larger potential losses by the end of the year, a deep retrenchment for Obamacare coverage and a reversal of significant gains in the last several years.”

“The rising cost of health care has shown up as a top concern among Americans in several public opinion polls….”  “ … Though health care has faded somewhat as a priority for the Republican-controlled Congress since lawmakers hit a stalemate over the subsidies at the end of 2025, it is likely to figure prominently in the midterm elections this year….”

Independent –  The ability to afford healthcare is at ‘crisis point’ doctors warn – and will consume 20% of America’s GDP in next decade

https://www.independent.co.uk/news/health/us-healthcare-system-costs-cardiovascular-disease-b2968096.html

“The average American pays over $15,000 a year in healthcare costs.”

SS&M – Understanding public opposition to negative reimbursement decisions in healthcare: A systematic review

V Reckers-Droog et al ; https://www.sciencedirect.com/science/article/pii/S0277953626004004?via%3Dihub

Negative reimbursement decisions in healthcare often evoke public opposition. We mapped the scientific literature to decompose public opposition.  Public opposition involves multiple actors and complex dynamics. Opposition is fueled by distrust, high expectations, and selective media framing. Understanding these dynamics may aid the acceptability and legitimacy of decisions.”

SS&M – Equity of financial protection for health care in high-income countries: A systematic scoping review

By E C Xie et al.  https://www.sciencedirect.com/science/article/pii/S0277953626003825

« This review provides the first systematic synthesis of evidence on the equity of health system financial protection in high-income countries…”

Planetary health

Global Policy –Climate Negotiations Under Scrutiny: Are UNFCCC COPs Up To the Challenge?

Franziska Petri et al; https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.70172

“This article provides an integrative assessment of the existing reform options of the COP in terms of their implications for both democracy and effectiveness. We find that the most concrete reform options often involve practical difficulties or trade-offs. Moreover, although some smaller reforms (such as capacity building or agenda streamlining) are achievable, larger reforms such as increasing meaningful nonparty stakeholder engagement remain difficult to achieve. The biggest stumbling block for any significant reform lies in the UNFCCC decision-making procedures, namely the consensus requirement….”

Nature (Worldview) – To move beyond GDP, don’t ignore environmental economists

P Kumar;  https://www.nature.com/articles/d41586-026-01299-w

“Sustainable development will only be achieved when governments base decisions on human skills and natural resources, not just gross domestic product.”

“The world seems ready to move beyond gross domestic product (GDP), a measure of economic growth, and towards metrics that are more representative of sustainability and people’s well-being. United Nation member states ratified this move in 2024, and the World Bank concurs. A UN group, tasked last year with recommending how this transition should work, released a draft of its interim report in November last year. A final report is expected on 7 May. The proposed framework has drawn strong reactions from many experts in beyond-GDP metrics, few of whom were part of the group. In short, the report is vastly complicated and untethered from the substantial body of work that has been gathered over many decades in this field….”

“The framework for the transition aims to cover all bases of well-being — including health, education and ‘subjective well-being’. It rests on three foundations (peace, respect for the planet and human rights). But it fails to recognize the core dependence of human needs on nature. And because it isn’t firmly grounded in economic and ecological sciences, the proposal lacks robustness and credibility. Without solid backing from environmental economists, the UN will struggle to provide an authoritative pathway to move governments beyond GDP….”

Health Affairs – From Crisis To Strategy: Mainstreaming Climate Risk In Health Systems Planning

C Sorensen, J Borghi et al; https://www.healthaffairs.org/doi/10.1377/hlthaff.2025.01641

“… We propose a risk-based framework that integrates insights from disaster risk management and health systems thinking to identify adaptation strategies. Our approach emphasizes understanding and addressing the upstream determinants of climate risk, including the intersectoral operating environment and social and environmental vulnerabilities that amplify health impacts. This perspective links climate risk reduction to the broader agenda of health equity. ..”

ODI (Briefing paper) – Supporting just transitions through social protection: key roles for philanthropy

A McCord et al;

https://odi.org/en/publications/supporting-just-transitions-through-social-protection/

“This briefing paper by Global Risks and Resilience looks at how philanthropies can contribute to ensuring a just transition to net zero, through the extension of social protection to address poverty and income security.”

Lancet Offline – Climate and health—time to step up our activism

R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00867-6/fulltext

Horton’s Offline from this week, starting from the assessment that climate change is accelerating.

Covid

Cidrap News – New research chips away at COVID-19 blood clot mystery

https://www.cidrap.umn.edu/covid-19/new-research-chips-away-covid-19-blood-clot-mystery

“Doctors and scientists are still working to understand why COVID-19 can cause fatal damage to so many different organs. A potentially major piece of that puzzle was revealed today in research published in the Journal of the American Heart Association.”

Scientists find that human embryos are vulnerable to COVID

https://www.news-medical.net/news/20260504/Scientists-find-that-human-embryos-are-vulnerable-to-COVID.aspx

“A University of California, Riverside study reports that cells in the earliest stages of human development could be susceptible to infection by SARS-CoV-2, which causes COVID-19, offering new insight into how the virus interacts with developing human tissues and why that may matter for pregnancy research….”

Infectious diseases & NTDs

Nature Medicine – Brazilian elimination of mother-to-child HIV transmission: lessons for large-scale global health systems

https://www.nature.com/articles/s41591-026-04373-y

Concluding: “In summary, Brazil has demonstrated that eliminating MTCT of HIV is achievable even in large, complex settings. Its success reflects the combined effect of universal health coverage, integrated surveillance systems, sustained public financing, and strong community participation. As the global community continues to pursue the elimination of MTCT of HIV, Brazil offers a powerful reminder that elimination depends not only on biomedical advances but also on resilient health systems, sustained public financing, and inclusive public health strategies.”

Plos Med – Trends in HIV self-testing uptake in Africa: A modeling study of population-based surveys and HIV testing program data

Aishi Aratrika et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004771

“HIVST uptake has increased in Africa, with wide variation between countries. HIVST is more likely to engage 25–34-year-olds and men, who have historically been less likely to be aware of their HIV status…..”

BMJ – How climate change is reshaping India’s snakebite crisis

https://www.bmj.com/content/393/bmj.s620

“Nearly half the world’s snakebite deaths happen in India. Now, climate change is pushing a neglected crisis into a dangerous new phase. Rupsa Chakraborty reports.”

NCDs

Lancet Viewpoint – The role of community-based blood pressure screening in improving hypertension care

M R Poulter et al ;  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00379-X/abstract

« In their recent Viewpoint, Frieden and colleagues argue that mass blood pressure screening diverts resources from improving hypertension care. We present a counterargument that community-based blood pressure screening can complement health-care services by increasing hypertension detection, particularly in populations with limited access to health care. Opportunistic community-based screening can be delivered at relatively low cost and reach individuals who might not otherwise engage with health-care systems. In settings where access to health-care facilities is constrained, such approaches provide an additional route to identifying raised blood pressure and initiating further assessment… …. Community-based screening, alongside strengthened primary care, could form part of a broader strategy to address the global burden of hypertension….”

Plos Med – Investment in preventive health needs to be seen as a driver of economic development

Francesca Colombo et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005074

“Prevention delivers major gains in health and productivity but remains underfunded due to governance and technical barriers. Strategic investment in prevention is critical to reduce health system costs, boost productivity and sustain long-term prosperity.”

With focus on the OECD countries.

Plos Med – Multimorbidity, health service use, and health insurance by socioeconomic groups in 31 countries: A multi-cohort study

Yanshang Wang et al; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005087

“The prevalence of physical, psychological, and cognitive multimorbidity is characterised by marked socioeconomic status (SES) inequalities. However, the relationships between multimorbidity patterns—particularly those involving cognitive conditions—and healthcare utilisation, as well as the role of health insurance, remain poorly understood. This study aims to explore healthcare-seeking behaviour among individuals with multimorbidity and assess whether these associations vary by SES and health insurance coverage.”

Conclusions: “… Cognitive disorders further complicate the relationship between multimorbidity and health service use, indicating potential unmet healthcare needs, especially among individuals with lower SES. Our study highlights the potential role of health insurance in reducing socioeconomic disparities in healthcare utilisation associated with multimorbidity.”

Cell (Review) – Exercise as a therapeutic intervention for long-lasting and chronic diseases

https://www.cell.com/cell-metabolism/abstract/S1550-4131(26)00086-0

“In a little over 100 years, global life expectancy has increased by ∼60%. Paradoxically, it has been estimated that we now exercise five times less than we did 100 years ago. Despite a marked increase in life expectancy, the prevalence of non-contagious diseases (NCDs), otherwise known as “chronic lifestyle diseases,” such as cardiovascular disease, type 2 diabetes, cognitive diseases, and cancer, has increased. Here, we discuss the concept of “exercise as medicine” for the treatment of NCD and provide evidence for the direct mechanisms by which regular physical activity can either prevent the onset or slow the progression of these diseases.”

Mental health & psycho-social wellbeing

Plos Med  – Health system use and experience among people with poor mental health: A cross-sectional analysis of the People’s Voice Survey in 18 countries

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004745

By Margaret E. Kruk et al.

Neonatal and child health

Nature Health (Comment) – Understanding environmental exposures in early life for lifelong health

Martine Vrijheid; https://www.nature.com/articles/s44360-026-00130-0

“Understanding early-life environmental exposures is crucial for protecting lifelong health and should be prioritized in developing exposomics studies and infrastructures worldwide.”

Nature Medicine – Rethinking triage for febrile children in low-resource settings

Mihir R. Atreya et al; https://www.nature.com/articles/s41591-026-04387-6

« Integrating clinical data with simple physiological measures or biomarkers improves triage of febrile children and could reshape frontline care in resource-limited settings. »

Access to medicines & health technology

Guardian – First malaria drug for babies is approved in ‘major public health milestone’

https://www.theguardian.com/global-development/2026/may/02/new-drug-coartem-baby-babies-malaria-who-treatment

See also a previous IHP newsletter issue. “WHO prequalification of Coartem Baby means newborns can be safely treated rather than using medication for older children.”