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( 07 November 2025)
The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium.
Dear Colleagues,
This week in global health has been full of movement. COP30 deliberations on climate hope, the G20 meeting on global priorities, and the WHO’s unveiling of its new financing strategy. Across the news, there is renewed attention on vaccines, sexual and reproductive health, and pandemic preparedness, despite the urgent need for action on climate change, non-communicable diseases, and reminders of how deeply interconnected our challenges remain.
Yet, amid all this, one pattern stands out. Even as many say we are entering a post-U.S. world order in health, its influence still quietly shapes much of the agenda. Whether in funding frameworks, health security narratives, or development priorities, the U.S. continues to set the tone even when it is not in the room.
Perhaps this is less a drift and more a transition, one where new voices are emerging, but the old echoes still linger.
Enjoy your reading.
Rajeev B R
(P.S.: Kristof will take over the coming week onwards)
There will not be translated versions and the AI summary of this newsletter this week.
Global Health Governance & Financing
More on Reimagining global health & development
More on global tax & debt justice
Health Emergencies
Trump 2.0
SRHR
Planetary Health
Access to Medicines, vaccines & other health technologies
….
The World Health Organization (WHO) today released new guidance for countries on ways to counter the immediate and long-term effects of sudden and severe cuts to external funding, which are disrupting the delivery of essential health services in many countries.
The new guidance, called “Responding to the health financing emergency: immediate measures and longer-term shifts”, provides a suite of policy options for countries to cope with the sudden financing shocks, and bolster efforts to mobilize and implement sufficient and sustainable financing for national health systems.
External health aid is projected to drop by 30% to 40% in 2025 compared with 2023, causing immediate and severe disruption to health services in low- and middle-income countries (LMICs). WHO survey data from 108 LMICs collected in March 2025 indicate that funding cuts have reduced critical services – including maternal care, vaccination, health emergency preparedness and response, and disease surveillance – by up to 70% in some countries. More than 50 countries have reported job losses among health and care workers, along with major disruptions to health worker training programmes.
See- Responding to the health financing emergency: immediate measures and longer-term shifts
Sarkar, Swarup et al.; https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(25)00155-6/fulltext
Recent events at the World Health Organization's (WHO) South-East Asia Regional Office (SEARO) laid bare weaknesses in governance that go beyond a single change in leadership. This includes an outdated leadership selection process, its Director being placed ‘on leave,’ and the second most populous country departing the WHO Regional Committee for another.1,2 This tests both WHO's credibility and SEARO's capacity to protect and advance the health of the region's population.
The Independent Panel for Pandemic Preparedness and Response3 identified structural tensions in WHO governance, with Regional Directors accountable both to the Director-General and to the member states that elect them. The Panel proposed two options: align with other UN agencies and appoint regional directors from headquarters, or retain the current system but strengthen accountability.
SEARO's most recent leadership contest illustrates why reform is urgent. Questions over the process governing Regional Director selection across all WHO regions were raised by over 100 experts prior to the SEARO election.4 The case of SEARO was particularly alarming with concerns about one family-based nomination, inadequate vetting, inappropriate campaigning, and political maneuvering.
See also-
The WHO regional director elections must be reformed
Kennedy J, Thakrar R.; https://gh.bmj.com/content/10/10/e015343?utm_source=alert&utm_medium=email&utm_campaign=bmjgh&utm_content=latest&utm_term=02112025
The Bill and Melinda Gates Foundation (BMGF) is the World Health Organization’s (WHO) second biggest source of funding, contributing 9.5% of WHO’s revenues between 2010 and 2023. BMGF made 640 grants worth $5.5 billion to WHO between 2000 and 2024. This amounts to 6.4% of all money disbursed by BMGF in the period. $4.5 billion or 82.6% of all BMGF contributions to WHO went to infectious diseases, of which $3.2 billion (58.9%) went to polio – despite polio accounting for an insignificant proportion of the global burden of disease.
A small proportion of the money BMGF gave to WHO goes to strengthening health systems, non-communicable diseases, and broader determinants of health, despite their importance to WHO’s strategy and global health more generally. Our study emphasises an important point for global health practice and policy: without flexible and sustainable sources of funding WHO will struggle to achieve its strategic aims.
As the Productivity Commission finalises its reports to Government on reform priorities, researchers have put forward four suggestions for how the Commission could advance planetary health equity.
“However well intentioned, business as usual approaches to economic policy simply won’t work on a warming planet,” write Professor Sharon Friel and Chelsea Hunnisett below, as part of their ongoing #PlanetaryHealthEquity series.
Since its re-election in May 2025, the Albanese Government has been focused on economic reform. Treasurer Dr Jim Chalmers announced that the first step was to take a hard look at productivity growth in light of the ongoing productivity slump.
Treasurer Chalmers told the National Press Club in June this year: “Too often it’s seen as a cold, almost soulless, concept – when it’s really the best way of making people better off over time, creating more opportunities, making our economy and our society more dynamic.”
Latest research from Dr Nicholas Frankand colleagues at the Planetary Health Equity Hothouse shows domestic demand and consumption have been key sources of economic growth over the past decade, even outweighing exports.
In Denmark, leaders agreed to eradicate poverty, expand employment, and build more inclusive societies — ultimately signing the Copenhagen Declaration on Social Development, a set of commitments. Thirty years later, they’ve arrived at the summit’s second iteration to do the same — now in Qatar’s gleaming capital, and amid an entirely different world.
For the United Nations, the Second World Summit for Social Development — and the corresponding Doha Political Declaration, which was formally endorsed by delegates on Tuesday morning — is an attempt to renew the commitments world leaders made in 1995, and re-anchor promises made three decades ago….
“This Second World Summit for Social Development opens at a moment of high global uncertainty, divisions, conflicts and widespread human suffering,” said U.N. Secretary-General António Guterres, speaking at the summit’s opening on Tuesday. “The Doha Political Declaration represents a booster shot for development.”
The United Nations’ decision to relocate key agency offices to Nairobi is more than logistical — it’s a chance to decolonize global governance and center Africa, where it already plays an operational lead.
Earlier this year, it was announced by U.N. Secretary-General António Guterres and the government of Kenya that the global offices of UNICEF, UNFPA, and UN Women will be relocated — either in part or in full — to Nairobi by 2026. Some observers have framed the move narrowly as cost-saving, especially given a widespread spate of aid cuts across the world.
However, this narrative downplays the most significant aspect of the move — that it could well mark an encouraging step toward localizing the U.N., through redistributing decision-making power, leadership, and institutional presence to regions where its agencies operate most actively. Indeed, Guterres himself has emphasized that Africa is a priority and that investing in the continent is a duty for the U.N. It’s crucial.
The fact is, for decades, the U.N. has remained rigid in its headquarters and leadership distribution, with decision-making power overwhelmingly concentrated in Europe and the United States. The U.N.’s overall structure today — not just its Security Council — continues to reflect a post-World War II order, dominated by the victors with outdated power dynamics.
The financial dominance of the U.S. and Europe heavily influences U.N. policy and decision-making. As the largest donor, the U.S. contributes billions annually, translating into disproportionate influence. U.N. agencies openly acknowledge this donor-driven dynamic.
Next week, delegates from across the world will converge on Nairobi, Kenya, for two weeks of negotiations on the new UN Tax Convention.
This is potentially a landmark treaty that could finally make it possible to tax the super-rich and global corporations fairly. If successful, the convention would mark the beginning of a new era of international tax justice – one where wealth is no longer hoarded by a tiny elite while billions go without the basics.
The UN Tax Convention offers a way out of this broken system. It could bring measures for real transparency – such as public country-by-country reporting of corporate profits – and coordination to tackle tax avoidance. Likewise, it could fix the deeply unjust rules that allow multinationals to shift profits across borders to minimise their tax bills.
Instead of taxing profits where companies are headquartered (usually in the global North), a fairer system would tax global profits and allocate taxing rights based on where companies actually do business – reflecting real economic activity. That’s the kind of change that could transform global revenues and start to level the playing field between rich and poor nations.
The leading UN-backed international authority on hunger crises described the situation as a ‘man-made emergency’
Famine has gripped two more war-torn regions of Sudan as fighting intensifies and thousands edge closer to starvation, the UN-backed global hunger monitor warned on Monday.
The latest declaration covers two towns in Sudan: El Fasher in North Darfur and Kadugli in South Kordofan province.
Twenty other areas across Darfur and Kordofan are also at heightened risk of famine, the report says.
“This is a man-made emergency, and the steps needed to prevent further catastrophe are clear,” said the IPC’s Famine Review Committee (FRC), the independent body that verifies famine findings. “Only a ceasefire and unimpeded humanitarian access can prevent further deterioration and save lives.”
About 77% of Jamaica remains without power, while 50 people in Haiti, the Dominican Republic, and Jamaica are reported dead as of this publication. And as organizations race to support affected communities, they’re doing so largely without what was once the biggest player in the game: the U.S. Agency for International Development. By late March, the Trump administration canceled 73% of USAID programs in Jamaica and half of those in Haiti, according to an early analysis from the D.C.-based Center for Global Development. And today, only a few hundred staff members have migrated from USAID to the U.S. Department of State.
But typically, USAID would have deployed DART teams before a hurricane made landfall, explained Konyndyk and two other former senior USAID and State Department officials. They and another former senior USAID official were also encouraged by the fact that the U.S. government’s regional disaster assistance program, or RDAP, in Latin America and the Caribbean was saved from the U.S. aid cull — a move that preserved a roster of in-country expertise across the region.
My American Public Health Association membership was revoked after over 20 years because I protested for Palestine. As authoritarian norms spread in government, they are metastasizing into civil society institutions that should be resisting them.
My offense? In November 2024, I participated in a protest at APHA’s Minneapolis meeting. Three dozen of us donned red latex gloves — signifying “blood on our hands” — and walked through the exhibit hall. We were protesting the executive board’s unanimous decision to block the governing council from even considering a resolution on Palestinian health justice, despite 90% of the council having approved a Gaza ceasefire statement the previous year.
An anonymous complaint deemed our protest “antisemitic and intimidating to Jewish members.” A three-person subcommittee held a 40-minute Zoom meeting with me — no written charges, no investigation, no witnesses interviewed, no appeal process — and issued my expulsion.
The next decade could be marked by more preventable pandemics, rising health inequalities, and a world where the U.S. no longer sets the standard for science,” said Dr. Jirair Ratevosian, Hock fellow at the Duke Global Health Institute.
“We’re concentrating power in one single person — that’s against our constitutional traditions. That whole idea of checks and balances has really been collapsing.” — Lawrence Gostin, founding director, O’Neill Institute for National and Global Health Law
One focus of the strategy is to “promote American companies and American innovations abroad, including continuing to procure goods from American companies,” but experts are concerned programs tasked with product delivery — many built upon decades of developing partnerships, implementation arrangements, and trust with communities — were either eliminated or weakened.
An “America First” strategy is an oxymoron, given that the backbone of global health is international cooperation as opposed to populist agendas, according to Gostin.
Africa’s development hinges on the health and rights of its women, children, and adolescents.
Too often, these groups are treated as peripheral in policy and investment decisions. Yet, they are the very foundation of the continent’s future.
In our latest opinion piece for Jeune Afrique, Prof. Mohamed Janabi and I argue that health is not a cost—it is a catalyst for development. When women and children are healthy, educated, and empowered, societies thrive. Economies grow. Peace and stability become more attainable.
But today, millions of women still die from preventable causes during pregnancy and childbirth. Children lack access to basic health services. Adolescents face barriers to sexual and reproductive health. These are not just health issues—they are failures of policy and political will.
We call on African leaders and global partners to:
-Prioritize universal health coverage with a focus on primary care and sexual and reproductive health.
-Invest in data systems that make women and children visible in national planning.
-Ensure accountability for commitments made under the Sustainable Development Goals and the African Union’s Agenda 2063.
The time to act is now. Let’s not allow the health of women and children to remain the blind spot of development.
Read the full piece here: https://lnkd.in/efKFrphr
The United States will not send any high-level federal officials to the 30th United Nations Climate Change Conference, or COP30, in Brazil — which officially starts next week — but dozens of governors, mayors, and other local leaders say they will attend to represent U.S. interests at the subnational level.
The decision comes as President Donald Trump, who has called climate change a hoax, moves forward with plans to withdraw the U.S. from the Paris Agreement for a second time. The administration notified the United Nations of its intent to leave, and the withdrawal will take legal effect on Jan. 27, 2026.
While parties to the Paris Agreement are in the midst of submitting their updated nationally determined contributions, or NDCs — their 10-year plans for cutting greenhouse gas emissions — the U.S. is not expected to do so. The lack of a federal plan from one of the world’s top emitters complicates global efforts to stay on track to limit warming, but there is still hope that emissions cuts from climate-focused states and cities, which account for a large share of U.S. emissions, can make a meaningful difference.
Professor Jane Hirst, Chair in Global Women’s Health, from The George Institute for Global Health, featured in the Financial Times discussing the growing risks rising global temperatures can pose to maternal and newborn health.
The article highlights emerging evidence on how rising temperatures can affect pregnancy outcomes, reinforcing the importance of understanding the intersection between climate and health.
In the face of “climate urgency,” the Brazilian presidency of the 30th United Nations Climate Change Conference, or COP30, called for a focus on implementing climate action in the lead-up to the summit in Belém this November.
“The international community should investigate how climate cooperation could become better equipped to accelerate the implementation of the Paris Agreement and of COP decisions by aggregating efforts that are currently fragmented,” the presidency wrote in its second letter to the public, published Thursday at the end of the Copenhagen Climate Ministerial — the second in a series of gatherings to galvanize consensus ahead of COP30. The first was the Petersberg Climate Dialogue, which took place in March in Berlin.
One of the primary criticisms of annual COP meetings is that they produce big promises but don’t create clear pathways for implementing them.
“The UNFCCC and the Paris Agreement don't have the strength or mandate to take this forward, so we're proposing to reconsider how we can institutionally strengthen implementation,” COP30 President André Corrêa do Lago told journalists Wednesday.
Brazil outlined its concept of the global mutirão, a term that is being used ahead of COP30 to symbolize a joint effort across national and subnational governments, societies, Indigenous communities, and economic players.
This isn’t the first time Brazil has fought to emphasize implementation over pledges and promises. Brazilian President Luiz Inácio Lula da Silva made similar comments last November during the G20 summit in Rio de Janeiro.
“There’s no point in negotiating new commitments if we don’t have an effective mechanism to accelerate the implementation of the Paris Agreement,” he said then. “We need stronger climate governance.”
The World Health Organisation (WHO) and the German pharmaceutical company, Bayer AG, have renewed a longstanding collaboration to support endemic countries in scaling up free-of-charge treatment against three deadly neglected tropical diseases (NTDs).
Donated medicines include suramin and different formulations of nifurtimox for the treatment of human African trypanosomiasis and Chagas disease, as well as niclosamide for the treatment of taeniasis. The donation amounts to 18 million tablets and vials, and its estimated value is US$ 15.5 million.
The agreement, which was signed by WHO on 26 August 2025 and by Bayer AG on 2 October 2025, also stipulates that Bayer AG provide US$ 9.45 million in support of WHO’s programmatic work and operations on these three conditions at global, regional and country levels during the crucial years between 2025 and 2030. This will enable Member States and partners to accelerate progress towards the 2030 targets set in the NTD road map 2021–2030.