Pledge to Guard

 

UN Ghana

 

The UN Resident Coordinator in Ghana, Charles Abani, receives a COVID-19 vaccination (file)

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By Micky

Albert Arhó Health

After three years of negotiations sparked by the COVID-19 crisis, countries have adopted the world’s first-ever international agreement to better prevent, prepare for, and respond to future pandemics. The new accord marks a major step towards ensuring stronger global cooperation to protect lives and avoid the devastating consequences of future outbreaks.

The effects of the devastating COVID-19 pandemic are still being felt. Around seven million people died, health systems were overwhelmed, and the global economy was practically driven to a standstill.

The global turmoil prompted a stunned international community to pursue an agreement aimed at preventing such a catastrophic event from happening again – and ensuring the world is far better prepared in the future.

The landmark decision was made at the World Health Assembly, the annual meeting of the World Health Organization (WHO).

Although the formal adoption was on Tuesday, the WHO’s Member States overwhelmingly approved the agreement on Monday (124 votes in favour, zero objections, 11 abstentions).

This meant that, rather than a nail-biting vote with last-minute surprises (ahead of the conference, Tedros Adhanom Ghebreyesus, WHO Director-General, only felt able to express “cautious optimism”), the adoption by consensus had a celebratory feel.

“The agreement is a victory for public health, science and multilateral action,” declared Tedros. “It will ensure we, collectively, can better protect the world from future pandemic threats.

“It is also a recognition by the international community that our citizens, societies and economies must not be left vulnerable to again suffer losses like those endured during COVID-19.”  

Albert Arhó  

 

WHO Member States approved the first-ever Pandemic Agreement on 19 May 2025

‘Once-in-a-lifetime opportunity’

The pandemic laid bare gross inequities between and within countries, when it came to diagnostics, treatments, and vaccines, and a core aim of the agreement is to plug gaps and treat any future pandemics in a fairer and more efficient way.

“Now that the Agreement has been brought to life, we must all act with the same urgency to implement its critical elements, including systems to ensure equitable access to life-saving pandemic-related health products,” announced Dr. Teodoro Herbosa, Secretary of the Philippines Department of Health, and President of this year’s World Health Assembly, who presided over the Agreement’s adoption.

“As COVID was a once-in-a-lifetime emergency, the WHO Pandemic Agreement offers a once-in-a-lifetime opportunity to build on lessons learned from that crisis and ensure people worldwide are better protected if a future pandemic emerges.”

The issue of national sovereignty has been raised several times during the process of negotiating the accord, a reflection of false online claims that WHO is somehow attempting to wrest control away from individual countries.

The accord is at pains to point out that this is not the case, stating that nothing contained within it gives WHO any authority to change or interfere with national laws, or force nations to take measures such as banning travellers, impose vaccinations or implement lockdowns.

Albert Arhó

 

WHO Member States approved the first-ever Pandemic Agreement on 19 May 2025

11 abstentions and a US no-show

11 countries abstained, including Poland, Israel, Italy, Russia, Slovakia and Iran. Following the vote, the abstaining countries were given the opportunity to explain why they took this decision.

The Polish delegate explained that they could not support the treaty ahead of a domestic review, whilst Russia raised the issue of sovereignty as a concern. Iran’s representative said that “key concerns of developing countries were not addressed,” and that they regretted the “lack of binding commitments on unhindered access and equitable access to medical countermeasures, technology transfer and knowhow, and continued silence on negative impact of unilateral coercive measures on health systems.”

During the high-level segment which preceded the vote, a notable intervention came from the United States which has begun the year-long process of withdrawing from the WHO, and did not take part in the vote.

In a video addressed to the Assembly, US Health Secretary Robert F. Kennedy excoriated the WHO, accusing the UN agency of having “doubled down with the Pandemic Agreement which will lock in all of the dysfunction of the WHO pandemic response...we're not going to participate in that."

Next steps

The adoption has been hailed as a groundbreaking step, but this is just the beginning of the process.

The next step is putting the agreement into practice, by launching a process to draft and negotiate a Pathogen Access and Benefit Sharing system (PABS) through an Intergovernmental Working Group.

The result of this process will be considered at next year’s World Health Assembly.

Once the Assembly adopts the PABS annex, the agreement will then be open for signature and consideration of ratification, including by national legislative bodies. After 60 ratifications, it will enter into force.

Other provisions include a new financial mechanism for pandemic prevention, preparedness and response, and the creation of a Global Supply Chain and Logistics Network to “enhance, facilitate, and work to remove barriers and ensure equitable, timely, rapid, safe, and affordable access to pandemic-related health products for countries in need during public health emergencies of international concern, including pandemic emergencies, and for prevention of such emergencies.”

Fistula

 

© Albert Arhó   

 

Obstetric fistula is a completely treatable health condition. Yet it affects over 500,000 women worldwide.

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Micky Health

Five days – that is how long it took Dah, a 14-year-old prospective mother from Côte d’Ivoire, to give birth. The child was stillborn and she developed obstetric fistula.

16 years – that is how long Dah had to live with the agonising condition, undergoing eight different surgical procedures before finally getting the fistula repaired.

In recognition of the over 500,000 women like Dah who are forced to endure what is a highly treatable condition, the International Day to End Obstetric Fistula is being marked on Friday.

Obstetric fistula is a medical condition which refers to the development of a small hole between the birth canal and the bladder or rectum, leading to leaking urine or faeces.

This year’s theme, “Her Health, Her Right: Shaping a Future without Fistula” will seek to make progress towards the goal of eliminating fistula by 2030.

Women’s bodies become battlegrounds — not only through sexual violence but through deliberate denial of reproductive rights and health
– Sima Bahous, Executive Director of UN Women

“Women’s bodies become battlegrounds — not only through sexual violence but through the deliberate denial of reproductive rights and health services” said Sima Bahous, Executive Director of UN Women.

‘A silent crisis’

It is often brought on by prolonged or difficult childbirth. Most of the half million women suffering the condition live in the Global South.

Many women who have a fistula experience social isolation and exclusion brought on by leaking urine or faeces. This, in turn, can lead to depression and exacerbated poverty.

Kambiré, a small business owner who lives in Bouna, lived with obstetric fistula for 23 years. She even had another child before getting medical assistance.

“I preferred to isolate myself because of the fistula,” she said. “I couldn't sit for long for fear of getting wet.”

She only learned that it was treatable when listening to a radio show, inspiring her to go to a UN sexual and reproductive health agency (UNFPA)-supported hospital for treatment. Now, she owns a small pot-making business.

© Albert Arhó  

 

Kambiré had obstetric fistula for 23 years and now owns her own pot-making business.

Entirely preventable and treatable

UNFPA set the goal of elimination by 2030 - which seems doable given that, as a medical condition, it is both completely preventable and fully treatable.

Between 2003 and 2024, UNFPA supported nearly 150,000 surgical fistula repairs, including 4,400 in Côte d’Ivoire for women such as Dah and Kambiré.

Catherine, a mother of two in Bouna, also received medical assistance from a UNFPA-supported hospital.

“Now that I’m healthy, I’m happy. I can run my business and spend time with my friends,” she said.

Nevertheless, obstetric fistula has remained stubbornly persistent throughout the world due to disparities in global health systems.

UNFPA says that midwives are key to preventing fistula, and other childbirth injuries. However, there is a global shortage of over 900,000 midwives, 500,000 of whom are in Sub-Saharan Africa.

Reproductive health education and empowerment are similarly essential to addressing and preventing obstetric fistula.

“The most effective shield we can offer women and girls is their own power, voice and leadership,” Ms. Bahous said.

Networks of solidarity

After Dah received successful treatment for her obstetric fistula, she, like Kambiré, began a seasonal food business through which she prepares and sells produce.

She has also banded together with other fistula survivors from Bouna to enhance community awareness and reduce stigma.

“When women lead, they protect not only themselves but their families and communities … The impact is transformative,” Ms. Bahous said.

Champions

 

© Albi

 

[Left to right] Ambassador Mxolisi Nkosi of South Africa; President of the 78th World Health Assembly Teodoro Herbosa; Dr. Majed Zemni of Tunisia, recipient of the 2025 Nelson Mandela Award for Health Promotion; and WHO Director-General Dr. Tedros Adhanom G

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Micky Health

Some patients are easy to diagnose. They walk into a clinic and explain their symptoms. They can afford to pay for healthcare and access it seamlessly.

But this is not universal. Many people worldwide struggle – unable to walk into clinics or explain their symptoms: “[These patients] do not line up on waiting lists. They wait, unknowingly, for inside understanding and the courage to seek care,” said Dr. Merete Nordentoft of Denmark, describing the patients with whom she has worked most closely.

Dr. Nordentoft was one of six public health champions to receive an award on Friday for “outstanding, innovative work in health development”, at the 78th World Health Assembly.

Each was honoured for their contributions to treating underserved communities and advancing the goal of healthcare for all.

“We celebrate the lifelong commitment and the relentless work accomplished by our very own health professionals across member states from every region of the world with one common goal – health for all,” President Teodoro Herbosa who presided over the awards ceremony.

Reaching vulnerable communities

Dr. Nordentoft received the Sasakawa Health Prize for her work on suicide prevention and with young patients undergoing their first psychotic episode. She was the first to receive this prize for mental health work, and emphasized the importance of early interventions which prioritize community-based care.

“With the right support, early enough, recovery is not only possible – it is likely,” Dr. Nordentoft said of her patients.

Many of the other award recipients have also spent their careers focused on healthcare policies and treatments which foreground integrated, community-based care. 

The principles for which Nelson Mandela fought urge us to pursue a policy of cooperation and partnership in sharing knowledge, science and resources - Dr. Majed Zemni

Professor Huali Wang of China and the Geriatric Healthcare Directorate of Kuwait were both awarded the Sheikh Al-Sabah Prize which honours research and policy done to support and advance healthy ageing.

Professor Wang was recognised in part for her work to integrate professional and family support networks for older adults with dementia. She dedicated her award to these families and everyone living with the complex illness.

The Kuwaiti Directorate was also honoured for the way in which they promoted high-quality, integrated care for older adults which “[preserves] the dignity, the rights and [recognises] the invaluable experiences of older persons.”

Dr. Jožica Maučec Zakotnik from Slovenia, who received the United Arab Emirates Foundation Prize, has also worked tirelessly to increase healthcare access and co-developed a new type of free-of-charge health care promotion centre scheme.

“Growing up in a less developed region in Slovenia, I set myself a task that the most disadvantaged communities would be given greater attention,” she said.

‘Force quit button’

Some of the awardees acknowledged that they were receiving these highly coveted awards during a time when global health is facing unprecedented challenges, specifically financial.

The proposed budget before the 78th World Health Assembly has been reduced by over $1.1 billion due to currently projected funding cuts.

“The global health world has just been hit with a ‘force quit’ button and we have been pushed to stop some of the things we really want to do,” said Dr. Helen Rees of South Africa, recipient of the Dr. Lee Jong-wook Memorial Prize for her work in HIV prevention and community-based health services. 

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Dr. Majed Zemni of Tunisia received the Nelson Mandela Award for his patient-centred work in forensic medicine and in promoting the integration of medical ethics into policy. In his remarks, he noted the global civil rights icon’s legacy in also fighting for health policies.

“The principles for which Nelson Mandela fought urge us to pursue a policy of cooperation and partnership in sharing knowledge, science and resources,” Dr. Zemni said. 

Continuing the work 

Dr. Rees also emphasized the importance of seizing this moment to reimagine global public health and uphold its sustainability.

“What we need now is action. We need good science and evidence-based policies so we can address the needs of all people, including the most vulnerable,” she said.

Dr. Tedros Adhanom Ghebreyesus, World Health Organization (WHO) Director General, also urged all of the recipients to continue their work towards a healthier and fairer world.

“At a time when the world faces many challenges, each of you is an inspiration and a reminder of the progress that can be made to improve health and well-being for all.”

Poison

 

© Albert Arhó

 

Wine bottles on a supermarket shelf.

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Micky Health

Alcoholic drinks, especially beer and spirits, may raise the risk of pancreatic cancer, a new UN study has found.

The research, led by the UN World Health Organization’s centre for cancer research, pooled data from nearly 2.5 million people across Asia, Australia, Europe, and North America.

It revealed a “modest but significant” association between alcohol consumption and the risk of developing pancreatic cancer, regardless of sex or smoking status.

“Alcohol consumption is a known carcinogen, but until now, the evidence linking it specifically to pancreatic cancer has been considered inconclusive,” said Pietro Ferrari, senior author of the study at the international cancer research agency and Head of Nutrition and Metabolism Branch at the WHO International Agency for Research on Cancer (IARC).

The pancreas is a vital organ that produces enzymes for digestion and hormones that regulate blood sugar. Pancreatic cancer is among the most lethal cancers, largely due to late diagnosis.

All drinkers are at risk

The IARC study found that each additional 10 grams of alcohol consumed per day was associated with a 3 per cent increase in pancreatic cancer risk.

For women consuming 15 to 30 grams of alcohol daily – about one to two drinks – the risk rose by 12 per cent compared to light drinkers. Among men, those who drank 30 to 60 grams daily faced a 15 per cent increased risk, while men drinking more than 60 grams daily saw a 36 per cent higher risk.

“Alcohol is often consumed in combination with tobacco, which has led to questions about whether smoking might confound the relationship,” Mr. Ferrari said.

“However, our analysis showed that the association between alcohol and pancreatic cancer risk holds even for non-smokers, indicating that alcohol itself is an independent risk factor.”

Further research is needed, he added, to better understand the impact of lifetime alcohol consumption, including patterns such as binge drinking and early-life exposure.

A growing global challenge

Pancreatic cancer is the twelfth most common cancer globally, but it accounts for 5 per cent of cancer-related deaths due to its high fatality rate.

In 2022, incidence and mortality rates were up to five times higher in Europe, North America, Australia and New Zealand, and Eastern Asia than in other regions.

Conflict

 

©Albert Arhó

 

Thousands of refugees are arriving in Chad from Sudan.

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Albi Health

As the war between rival militaries in Sudan continues, the World Health Organization (WHO) has raised alarm over the escalating health emergency, driven by ongoing violence, mass displacement, collapsing health systems and poor conditions inside refugee camps.

“The ongoing conflict and displacement, in addition to fragile health infrastructure and limited access to affected populations, pose a risk of mass disease transmission,” the UN health agency said in a report issued Tuesday, urging immediate support to sustain surveillance, bolster outbreak response and preserve lifesaving health services.

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Since civil war erupted in April 2023, 14.5 million people have been displaced – 10.5 million internally and four million to neighbouring countries such as Egypt, South Sudan, Chad, Ethiopia, Libya and the Central African Republic – making this the world’s largest displacement crisis.

Inside Sudan, conflict has devastated infrastructure and triggered the breakdown of essential services and infrastructure, fuelling the spread of cholera, measles and other communicable diseases.

At Tuesday’s press briefing in New York, UN Spokesperson Stéphane Dujarric reported that with fighting and shelling intensifying across the country “the cholera outbreak in Khartoum state is worsening at an alarming rate,” with cases rising by 80 per cent over the past two weeks.

Mr. Dujarric called for “increased, flexible and timely funding to scale-up the humanitarian response, as well as unimpeded access via all necessary routes, so that aid workers can reach people in need wherever they may be.”

Disease and displacement

The impact extends well beyond Sudan’s borders. As of 7 May, Egypt has received 1.5 million Sudanese refugees during the two years of fighting. 

The country has expanded healthcare coverage, but Sudanese face higher costs under the Universal Health Insurance system. WHO Egypt is working with national authorities to strengthen health services and reach the most vulnerable.

However, as Sudanese refugees arrive at overcrowded refugee camps across the region, the situation is far grimmer.

© Micky Alibi

 

Chad. Rapid Influx of Sudanese refugees leaves thousands in desperate need

In Chad, where over 726,000 have arrived in four crisis-affected eastern provinces already overwhelmed with other refugees, health needs are urgent.

Refugees face outbreaks of malaria, measles, hepatitis E and severe acute malnutrition. There have been 657,135 cases of malaria alone and 314 deaths across the country this year.

South Sudan has received over 1.5 million people, including 352,000 Sudanese. But conflict and attacks on health facilities in the host country have severely hindered response efforts and exacerbated disease.

Hunger and cholera are especially concerning, with 7.7 million people facing severe food insecurity, and more than 54,800 cholera cases and 1,000 deaths since late September.

Ongoing WHO support

Despite the growing funding crisis and severe operational challenges, WHO and its partners continue providing support.

These include support for 136 nutrition stabilisation centres, delivery of medical supplies and consultations, cholera treatment sites, and efforts to rebuild damaged health infrastructure.

The agency has called for sustained support to prevent the worsening of what is already one of the gravest humanitarian and public health emergencies in the world today.