The big story of the week is still Ebola and we know we told you last week that the chances of it becoming a pandemic are slim-to-none. We still don’t think it is likely to become a pandemic but the chances now are slightly better than slim. It is already the second-largest outbreak ever, with over 900 suspected cases. The Africa CDC’s latest situation report had 904 suspected cases, 106 confirmed cases, 204 suspected deaths, and 11 confirmed deaths. However, case counts are growing exponentially. Just days after that report, the agency had a briefing in which suspected cases had already gone past a thousand - a four-fold increase in two weeks since the first notification.

The WHO has convened a panel to recommend candidate drugs and vaccines for the disease for which none exist at present even though Russia claimed to have developed a vaccine that could even work against the Bundibugyo strain. The WHO panel recommended evaluating monoclonal antibodies (mABs) MBP134 and Maftivimab and the antiviral remdesivir for treatment and a combination of an mAB with remdesivir. For post-exposure prevention, the panel suggested using the oral antiviral obeldesivir but this strategy depends on contact tracing, which in the DRC especially, is... well.

Ebola outbreaks are not new for Africa, and for DRC. But as the Africa CDC chief Dr Jean Kaseya made brutally clear in his latest briefing, if Ebola outbreaks were happening with this frequency in Europe or North America, we would’ve had vaccines and drugs long ago. In the same briefing, he also bemoaned the lack of actual funding, noting that there were pledges of over $500 million, but actual funds received amounted to barely half of that. The WHO asked for a ceasefire to contain the outbreak (as if), an outbreak that the agency said is fast outpacing the response to it.

Elsewhere, the US had an innovative idea to combat Ebola on its soil... relocate exposed Americans to Kenya, a plan that the Kenyan government even okayed before the courts put a temporary kibosh on it. Multiple countries have imposed travel restrictions on several African nations, another point that drew the Africa CDC’s ire, as it should. As for spread outside Africa, there was some concern over two suspected cases in India, one in Bangalore, and another one in Ahmedabad. Both of them later tested negative. In Austria, one person has been hospitalised with possible symptoms. Although initial tests returned negative, a second test is still pending.

In very good news though, the WHO also announced that the first person in this outbreak has been successfully treated and discharged from the hospital.

We will end our Ebola briefing for today with one final word. The WHO is on the ground, and they’ve arranged emergency supplies, etc. However, in this case, it might be better for the WHO to take the backseat and let the Africa CDC run the show, with the WHO’s support. Honestly, at the moment, the WHO may not be best equipped to lead the response anyway. Take their hantavirus response, for example. They couldn’t even come up with an efficient and effective tracking, testing and containment strategy with just 23 countries to coordinate with.

Speaking of hantavirus, it is still trying to make its presence felt, with cases rising by 1 to thirteen. This was probably made easier by the fact that all Spanish passengers on the “hantavirus cruise” were quarantining together. What is funnier still is that authorities are not extending the quarantine period. So hantavirus can still spread further. Go, you little virus, go!

Elsewhere in Africa, the resurrected pharma firm in Malawi that we told you about a little over a month ago, the one that was selling expired insulin to the hospitals it stole them from, has got a new government contract - worth K1.6 billion - to sell extremely overpriced gloves to hospitals.

In Uganda, Quality Chemical Industries (QCIL) launched locally manufactured Hydroxyurea capsules. The drug is used to treat sickle cell disease, and continues QCIL’s often-underrated journey in local manufacturing in Africa.

In Kenya, regulators have issued a public safety alert after detecting a falsified batch of Phesgo, a breast cancer treatment, circulating within the Kenyan pharmaceutical market.

There was some more left-over wishy-washiness from the World Health Assembly, including the adoption of an action plan to counter AMR, a meeting to commit to strengthening collaboration to end malaria and other NTDs, and other meetings involving other words like reaffirming and ratifying and endorsing and corroborative.

The WHO also agreed to convene a conference for donors on a way to “rehabilitate” Gaza. The same Gaza that Israel says it wants to eventually take over 100% of, beginning with 70% now. The same Gaza where Israel says it has made plans for ‘voluntary emigration’ for the people staying there. The same Gaza where Israel continues to kill people every single day, and destroy whatever buildings are still left standing. The fact that Israel is still part of the UN is staggering beyond belief, considering they’ve attacked every UN body and every UN principle.

And Gaza is not all. They’re still at it in Lebanon too.

Amid all this, some relief comes from the fact that some things simply never change. One of those is Indian drugmakers love of quality control and adherence. In the latest instalment of that story, the US FDA highlighted data integrity and maintenance issues at a Dabur India plant and issued a warning letter to Intas Pharma after deeming their response to a previous Form 483 not quite there. Also jumping into the fray were the All India Institute of Medical Sciences, Bhubaneswar along with Ashirwad Hospital & Research Centre, Ulhasnagar who both received identical letters for not following agreed protocol during a clinical study testing a new treatment for ovarian cancer.

And finally, every time we have a new vaccine, like clockwork, misinformation follows. This time, it is coming for the new HIV jab. Bhekisisa has a reckoner on how to get ahead of it.

Stories Of The Week

Oh, it’s hot now, is it? Wait for the future, why don’t you? Because the climate story has officially become annual programming. The WMO’s latest warning says there is now an 86% chance that at least one year between 2026 and 2030 will surpass 2024 as the hottest year ever recorded. And that is not even the scary part. The scary part is that temperature breaches that we once - even maybe up to three years ago - treated as political red lines, have become completely normalised now.

The Paris Agreement’s 1.5°C threshold was supposed to function as a guardrail. The world “temporarily” crossed it in 2024. Now, the WMO says there is a 91% chance annual temperatures will exceed that level again within the next five years, and a 75% chance the entire 2026–2030 average will stay above it.

The timing is awkwardly symbolic. Britain just recorded its hottest May day ever at 35°C, while parts of France and Spain are running as much as 10°C hotter than normal. Europe’s latest heatwave has already turned airports, rail systems and city centres into stress tests for infrastructure built for a different climate.

Meanwhile, in the Arctic, temperatures are rising more than three times faster than the global average, with further sea-ice decline expected across the Barents, Bering and Okhotsk seas. The knock-on effects are no longer confined to polar scientists and satellite maps. Changing rainfall patterns are already reshaping agricultural and economic risk across the Sahel, Amazon and parts of the subtropics.

The uncomfortable reality is that climate adaptation is quietly becoming a development issue as much as an environmental one. Countries least responsible for emissions remain among the most exposed to heat stress, crop volatility, flooding and rising sea levels. Which brings us to the recurring policy contradiction at the centre of global climate politics: everyone agrees the temperature targets matter, while simultaneously behaving as though overshooting them is manageable.

The WMO is careful to note that a single year above 1.5°C does not mean the Paris goals are permanently dead which is technically true. But technically, we might even achieve all of the UN SDGs. Fact is temporary breaches have a habit of becoming permanent negotiating positions. Look at where the Pandemic Pact talks are as a case in point.

At this point, there is no debate on whether warming is accelerating. Are governments, food systems and urban infrastructure moving quickly enough to keep up with a world that is heating faster than the institutions designed to manage it, that’s the question? The answer, unfortunately for all of us, is no.(WMO)

Progress? Not in this life! For decades, global development operated on the assumption that progress, while uneven, was broadly inevitable. The World Bank’s Atlas of Global Development 2026 suggests that assumption is now breaking down. According to the report, global development is advancing at its weakest pace in 75 years. The slowdown is not abstract macroeconomic drift. It is showing up in lives shortened, opportunities delayed and poverty reduction losing momentum. Funnily enough, all of this happening at a time when global inequality was supposed to be narrowing.

One statistic alone captures the scale of this reversal best. Had global development maintained its earlier trajectory, 150 million fewer people would be living in extreme poverty today. The report also estimates that global life expectancy would be nearly a year higher had previous development trends continued. Women’s empowerment indicators, meanwhile, would have advanced further than they have.

The world is still improving in several areas, but at a pace too slow to keep up with the scale of demographic, economic and climate pressures now colliding simultaneously. Part of the problem is that the old engines of development are weakening all at once. Debt burdens are climbing across low- and middle-income economies. Climate shocks are repeatedly wiping out infrastructure and agricultural gains. Aid budgets are under pressure. Trade fragmentation is growing. And geopolitical competition is increasingly crowding out long-term development planning in favour of short-cycle strategic interests.

The result is a development environment where countries are expected to grow, industrialise and build resilience while facing higher borrowing costs, more volatile weather and weaker external support than previous generations experienced.

Africa sits directly at the centre of this tension. The continent remains one of the few regions with significant demographic momentum, urban expansion potential and untapped industrial capacity. Yet many African economies are also navigating rising debt servicing costs, currency instability, food insecurity and shrinking fiscal room at the same time. That combination makes development slower, more expensive and politically harder to sustain.

The Atlas does not argue that progress has stopped. Extreme poverty rates have still declined over the long term. Health and education outcomes continue improving in many regions. Digital access has expanded dramatically. But the report’s broader message is harder to ignore: progress is no longer compounding fast enough to offset the pressures accumulating underneath it.
(World Bank)

Breakthroughs

Say no to drugs. Yet another of those breakthroughs which is not happy. Scientists have now discovered that beta blockers, the heart medication prescribed almost automatically after heart attacks for roughly four decades, may be doing very little for millions of patients with otherwise normal heart function. In some women, the drugs may even increase the risk of death, repeat heart attacks or heart failure. Which is awkward, considering beta blockers have been handed out ever since cardiology collectively decided in the 1980s that more medication must obviously mean more medicine. The broader lesson here is less about one drug and more about how modern healthcare quietly accumulates standard practice. It’s like being at a large corporate firm with legacy software that nobody wants to audit because the system still works. Medicine is excellent at celebrating new therapies, but spectacularly less enthusiastic about revisiting old ones once they become institutional muscle memory. This is true for drugs, and this is true for practices and protocols as well.
(New England Journal of Medicine, European Heart Journal)

Bottom line

Wrap it before you tap it. Governments around the world are fretting over falling birth rates and lowering fertility rates and plummeting replacement rates of populations. They’re even offering rewards for people birthing more children. Yet, none of them has stopped to consider if Earth can afford more children. The answer is no. Not for a long, long, long time. Maybe never. Because humanity is already living far beyond what Earth can sustainably support, with a new study estimating the planet’s “comfortable” long-term carrying capacity being closer to 2.5 billion people rather than the current 8.3 billion casually stress-testing the biosphere every day. Which is unfortunate timing, given the global economy is still built on the assumption that infinite consumption, permanent growth and same-day delivery are all basic human rights. The researchers argue fossil fuels effectively allowed humanity to borrow ecological capacity from the future, which sounds remarkably similar to how modern finance handles almost everything else.

Naturally, this does not mean civilisation collapses tomorrow. It simply means there is a reason why we’re noticing the planet’s support systems beginning to wither. Food systems are under strain, water security is worsening, biodiversity is collapsing and climate disasters are becoming recurring line items instead of “once-in-a-generation” events. The genuinely awkward part is that the study also found population size explained environmental damage more strongly than per-capita consumption alone, reopening one of those debates policymakers prefer to approach with kid gloves. Because while everyone agrees sustainability matters, far fewer people enjoy discussing what sustainability actually requires in a world where every government simultaneously wants higher consumption, more industrial output and rising birth rates.
(Science Advances)

No river, no cry. Speaking of support systems collapsing, scientists have found that rivers around the world are quietly losing oxygen, with nearly 80% of more than 21,000 river systems showing steady deoxygenation over the past four decades. Tropical rivers, including those in India, are being hit hardest, which is deeply inconvenient considering billions of people already depend on these waterways for drinking water, agriculture, fisheries and the occasional government promise about sustainability. Yes, climate change is the main culprit, with rising temperatures reducing oxygen solubility in water and heatwaves accelerating the process further.

Unlike hurricanes and wildfires or collapsing glaciers and other photogenic disasters though, rivers losing oxygen is an invisible crisis. Fish simply disappear gradually, biodiversity quietly erodes and ecosystems begin malfunctioning. Slowly at first, then all at once. The study also found that dams and altered river flows complicate oxygen dynamics further, proving once again that every large-scale intervention in nature eventually comes back with giant teeth to bite us in the butt.
(Science Advances)

Under my Salmonella, ella, ella, eh! Climate change isn’t done nipping at our arses. Scientists have now found that it is also helping fuel the rise of antibiotic-resistant Salmonella, because melting glaciers and destabilising food systems is not enough payback. This study in The Lancet Planetary Health, which analysed more than 480,000 Salmonella genomes across 139 countries, found that warming temperatures and changing rainfall patterns are linked to a significant rise in antimicrobial-resistance genes. Higher heat speeds up bacterial growth and gene exchange, floods spread resistant microbes through water systems and droughts conveniently concentrate them into shrinking water supplies.

The particularly grim detail is where the strongest climate-linked increases are happening: West Asia, North Africa, South Asia and Sub-Saharan Africa, regions already carrying heavy infectious disease burdens alongside fragile healthcare infrastructure. Globally, antibiotic resistance genes in Salmonella have risen 38% over the study period, with climate change accounting for roughly a tenth of that increase. Which may not sound catastrophic until one remembers humanity is already losing the antibiotic arms race largely through overprescription, weak regulation and the agricultural industry’s commitment to treating antibiotics like seasoning. Climate change is now acting as an accelerant on top of that dysfunction. Over the course of curating The Kable, especially this year, we’ve come to believe that the future of public health is like a group project where every global crisis has decided to collaborate. Either that or Israel.
(The Lancet Planetary Health)

Typhoid Mary, come to me. Dust, it turns out, is not just dead skin, cat dander, insect skeletons and regret. Scientists at Ohio State vacuumed schools, dorms and offices and found genetic traces of 54 different viruses lurking in the fluff, including Covid, flu and norovirus. The particles themselves are harmless by then. What remains is essentially the forensic residue of everyone who coughed, sneezed or simply existed in the building. Which means your office carpet now doubles as an epidemiological archive. Somewhere inside every neglected corner is a complete historical record of who brought the plague in after that long weekend.

The researchers think dust surveillance could become a middle ground between individual testing and wastewater monitoring: less invasive than swabbing people, more precise than analysing an entire city’s sewage. Schools, hospitals and workplaces might eventually detect outbreaks before anyone notices half the staff sounding like honking ducks. The only obstacle is standardising how to collect the stuff. If AI takes over all the lab tech jobs, they can apply for janitorial positions the world over to save humanity.
(Building and Environment)

Long reads

Learn from Africa. Only one long read again. Fittingly, it is a lesson from Africa on how to manage climate volatility. The continent only has decades of experience picking up everybody else’s slack.
(The Conversation)

Oh, and Gopal Nair doesn’t want you to see this.

Before moving on to talking about ills of the world and other things, have you realised that there seems to be more disease around lately? Cholera, malaria, TB, flu, RSV, mpox, measles, dengue... all seem to be on the rise. Heck, true-blue, card-carrying meat-eaters in the US are turning vegan thanks to tick bites. Even “tiny” outbreaks that you rarely heard about previously are becoming more and frequent. Rare diseases are becoming increasingly less rare. Not a week goes by when some kind of fungal, or bacterial, or viral disease doesn’t affect some part of Africa. Sure, climate change has a part to play. As does air pollution. Even ultra-processed foods. Smoking and tobacco, for some. Alcohol. Sedentary lifestyles. But what is really at play here is Covid. A disease that is proven to cause immune dysfunction. A disease that affects your immune system so thoroughly that it leaves your body wide open for any other disease that wants to walk in. And it is the collective failure of our health authorities, our medical fraternity, our governments, our corporations, our return to work and school, our back to normal approach that has landed us in this place. Even in the face of growing evidence that we need clean air to mitigate this disease (and pollution but that’s a separate discussion), we’re doing nothing to implement clean air protocols in our schools and offices and indoor environments. And masking, hey, that’s for sheep. I’m free-spirited and can think for myself. I don’t follow the herd of maskers. I stand free, along with my 7 billion like-minded, free-spirited rebels. Not too long ago Ignaz Semmelweiss was forced out of medicine and shunted to a mental asylum because he insisted that doctors should practise the unheard-of custom of washing their hands before treating children in hospitals. Would the anti-maskers be okay with surgeons working on them in hospitals without disinfecting themselves today? Because rebels. Anyway, change is unlikely, but in the hope it does, some reading: Covid and a 49% higher risk of new-onset autoimmune-related diseases, the myth of “immunity debt,” increased risk of chronic pulmonary disease, cardiovascular disease, diabetes, kidney disease, mental health conditions, increased risk tolerance leading to more automobile accidents, and, ooh, flight issues. But buckle that seat belt tight, eh!

So yeah, poor hantavirus, relegated so quickly to the back pages. The UK is not sitting by though, having already secured for itself supplies of an experimental drug from Japan. Might the world have had more treatments for hantavirus, specifically the Andes hantavirus, by now? Possibly, if not for one of the scourges of the modern world, Donald Trump, and his administration that cut funding for a study on it. One last thing to add about hantavirus before we move on: it spreads primarily through contact with infected rodents, not via bites necessarily, but by inhaling aerosolised particles from rodent urine, droppings, or saliva. Touching contaminated surfaces and then touching the mouth, nose, or eyes is another way of exposure. And yet another means of contracting it is by consuming food or water contaminated with rodent excreta. All of these situations have been created, and enforced, by Israel in Gaza over the past three years. Sewage systems, water networks, buildings have all been destroyed. Combined with uncollected waste, rubble, and stagnant water across displacement camps, this has created optimal conditions for rapid proliferation of rodents and insects. And there is no capacity for pest control, sanitation, or healthcare in Gaza because Israel has ensured that. Since the beginning of 2026 alone, there have been more than 70,000 cases of ectoparasite infections and rodent-borne illnesses recorded in Gaza, with rodents contaminating food supplies, chewing through tents, and raising the risk of diseases including hantavirus pulmonary syndrome, leptospirosis, and rickettsial infections. And children who have lost the ability to dream. Israel still keeps weaponising even the barest of bare resources left in Gaza to breed more infectious diseases.

So, on to Ebola then. We began last week’s issue with the news about the outbreak of Ebola in Democratic Republic of Congo (DRC). And immediately thereafter, the Africa CDC declared it a pan-continental health emergency, the agency’s second-such declaration. The WHO stepped in too, declaring the Ebola outbreak a public health emergency of international concern, the third-such declaration in the last 6 years. Someone said something about escalating disease outbreaks post-Covid? Anyhoo, this is the 17th Ebola outbreak in DRC. Testing over the weekend confirmed that it is the Bundibugyo virus, which has had two reported outbreaks before: one in Uganda in 2007, and one in DRC (of course) in 2012. And the Bundibugyo virus doesn’t have any vaccines or treatments, just like the Sudan virus. When it comes to Ebola, only the Zaire virus has approved vaccines and drugs. But might we have had a treatment though? Possibly. But the world’s “smartest” man put paid to that. Here anyway is a list of treatments under development with no Musk involvement. There is a lot to unpack with this present outbreak, which within three days of being reported was already the third largest Ebola outbreak ever, and is well on its way to becoming the largest ever. The outbreak was first reported on April 24, but given the spread and the number of cases, researchers believe the disease has been circulating for weeks, maybe even months, and either went unnoticed or misdiagnosed. Easy to misdiagnose because there are no tests either for the Bundibugyo virus. Cases have also been reported in Uganda. Genomic sequencing of the outbreak reveals a more complex transmission pattern than a straightforward single-source outbreak. Instead of one linear chain, the viral genomes show branching transmission - multiple distinct clusters with geographic spread across Bunia, Katwa, and Uganda. This could indicate either multiple independent spillover events from the animal reservoir or a single introduction that went undetected long enough to establish several separate human-to-human transmission chains spreading in parallel. The pattern matters operationally: Ebola containment depends on contact tracing and ring vaccination, both of which become substantially harder with multiple active transmission hotspots. A dispersed, multi-focal outbreak suggests more locations requiring surveillance, possible undetected community transmission, and an outbreak potentially larger or older than initial assessments indicated. And we’re already seeing that in play on the ground. So, do we think Ebola is what the next pandemic will be? Just like we said with hantavirus, unlikely. We do think Ebola will cost us way more lives, and possibly take much, much longer to contain. But thankfully, there have been no reports of asymptomatic spread so far, or even in the past. At the moment, case counts, and deaths, are on a steep upward trajectory but Africa has shown several times in the past that she knows how to handle an Ebola outbreak even with very limited resources. And this time, the Africa CDC is fully present, and has support from the WHO, with CEPI, Gavi et al hopefully ready to jump in. So no, we don’t think this will become a pandemic.

Ebola isn’t the only thing rampant in DRC though. This year, there have been over 25,000 suspected cholera cases, over 71,000 suspected measles cases, and over 2,300 cases of bacterial meningitis. Not even counting mpox which is still doing the rounds across Africa with more than 250 confirmed cases, and one death, in the last three weeks. In Nigeria, an ongoing Lassa fever outbreak has seen the death toll rise to 191.

But enough with the disease. Let’s look at what else has been happening. The Africa CDC partnered with the Global Fund to strengthen health systems across Africa and further the continent’s self-reliance plan. The agency also launched a report demonstrating the investment potential for health R&D in Africa. How much is it, you ask? $668 billion in additional GDP over the next 20 years. Both of these announcements came on the sidelines of the ongoing World Health Assembly (WHA), at which the Pandemic Pact was not discussed or presented.

What did happen at the WHA though? Well, they agreed to discuss the Pandemic Pact later. Sometime later. They agreed to suspend the US’ voting rights if outstanding dues didn’t get paid, although considering the US has exited the WHO, why should they have voting rights anyway? They also condemned Iran’s attacks on Gulf states, while saying nothing about the attacks on Iran which necessitated Iran’s response. China, and to some degree South Africa, were the only countries to call out the US attack on Iran.

On the sidelines of the WHA, the African Medicines Agency (AMA) took a couple of large strides too: a partnership with the US Pharmacopeia (USP) for regulatory collaboration, and a collaboration agreement with the WHO to advance regulatory harmonisation in Africa.

Elsewhere PAHO partnered with Google “to expand access to trusted health information.” Hehehe. Google. One of the biggest purveyors of misinformation in the online space alongside Meta and whatever Space Karen wants to call his venture is what PAHO thinks will credibly disseminate reliable health information “while countering the spread of misinformation online.” Meanwhile, this is the kind of shit on YouTube that proliferates in the name of science.

There was stuff happening at the UN Security Council too. Bahrain continued again to try and get support to force an intervention in the Strait of Hormuz. And the UK said Iran should halt all attacks. The UK didn’t ask anybody to stop attacking Iran though. The best statement, with not even a hint of irony though, came from France who said the Council has a duty to protect civilians. Okay, nothing ironical in that but in the same statement France said “the Council must support efforts aimed at holding perpetrators of war crimes to account, including by the International Criminal Court.” Okay, the ICC did issue warrants against Benjamin Netanyahu and Yoav Gallant in November 2024. Initially, a French foreign ministry spokesperson said the country would act “in line with the ICC’s statutes.” Then, the French foreign ministry said that provisions for immunity from prosecution apply to Netanyahu and other Israeli leaders. The International Federation for Human Rights (FIDH) said France is lying because when the ICC issued a warrant against Vladimir Putin, France didn’t have any such diplomatic qualms. So, yeah, offer rhetorical support when it is politically cost-free, then retreat from it at every point when it requires something concrete. Then grab a Security Council pulpit and preach. Nous sommes très honorables.

In other news, Roche has partnered with the Medicines Patent Pool to increase access to its influenza antiviral medicine Xofluza in 129 countries. The deal will allow selected generic manufacturers to develop and supply lower-cost versions of the treatment.

Speaking of partnerships, Gilead also expanded its collab with the WHO to supply roughly 400,000 more doses of its treatment for visceral leishmaniasis. Gilead also inked yet another deal, this one worth $140 million, with South Korean API maker Yuhan. Gilead also continued to ignore MSF’s plea to sell HIV meds directly to them.

And we’re not done with death and other mysteries yet. In the US, four people died and emergency responders had to be quarantined because of exposure to “an unknown substance.”

China has denied entry visas to pigs and wild boar from the Philippines because of swine flu.

And for the last three years, we have been talking about the disease most likely to cause the next pandemic: bird flu. It has now been found for the first time in a polar bear on Svalbard, the same place that hosts the world’s seed vault, in case of world-ending apocalypse. And bird flu isn’t done changing form yet. A new study has found a reassortment of Eurasian, North American, and South American genes. Unfortunately, we have not been paying any heed on the scale we should be to bird flu. If a pandemic were to hit, we are not prepared. And unlike Ebola, unlike hantavirus, unlike Covid even, a bird flu pandemic would be pretty much disastrous. For humans, and for all kinds of animal and avian life.

And finally, for what it is worth, the UN General Assembly adopted a resolution saying countries are obligated to protect the environment from greenhouse gas emissions. The resolution has no legal bearing but at least it is a good moral victory to end this section with.

Stories Of The Week

Are we ready yet? Ready for what, the next pandemic? Hell, no! A new Global Preparedness Monitoring Board report says the world is not getting safer from pandemics. In fact, pandemic risk is rising faster than preparedness investment, leaving countries more exposed than they were after Covid.

The report, A World on the Edge: Priorities for a Pandemic-Resilient Future, tracks a decade of Public Health Emergencies of International Concern, from Ebola to Covid to mpox. Its verdict is blunt: outbreaks are becoming more frequent, more damaging, and harder to recover from. Health systems are under strain, economies are more fragile, societies are more polarised, and development assistance has fallen to levels not seen since 2009.

One of the sharpest warnings is around equity. Access to diagnostics, vaccines and treatments is not improving fast enough. Mpox vaccines reached affected low-income countries almost two years after the outbreak began, slower than the 17 months it took for Covid vaccines to arrive. Of course, there was only approved manufacturer who was more interested in selling to countries in the Global North who wanted stockpiles, so there’s that.

Ebola outbreaks, and Covid especially, also weakened trust in government, civil liberties and democratic norms, while politicised responses and attacks on scientific institutions have left societies less resilient for the next crisis.

AI and digital tools could help monitor threats and strengthen preparedness, but the report warns that without governance and safeguards, they could also deepen access gaps and weaken health security.

The GPMB sets out three priorities: create a permanent independent mechanism to monitor pandemic risk, finalise the Pandemic Pact (hehe), and secure financing for both preparedness and early response.

Simple then. Build trust. Manufacture equity. Work on following through. But first, a Pandemic Pact. Maybe before the next pandemic.
(GPMB)

Bottom line

Divided by borders, united by weather. Millions of people across India and Pakistan are sharing the same truth: pre-monsoon heat is becoming longer, earlier and deadlier. A new analysis by World Weather Attribution finds that human-caused climate change made the heatwave across northwestern India and Pakistan last month roughly three times more likely, and about 1°C hotter than it would have been in a pre-industrial climate.

The event is no longer rare. The study estimates that a 15-day April heatwave like this now has about a 20% chance of occurring in any given April. In plainer terms: this is becoming a one-in-five-year problem, not an exceptional weather anomaly.

The heat was brutal on the ground. From mid-April into May, several Indian cities crossed 46°C, with at least 37 heat-related deaths reported in India and 10 in Karachi. The heat also pushed electricity demand to record levels and compounded agricultural drought conditions across more than 1 million sq km.

The more worrying signal is timing. Extreme April heat is intensifying faster than May heat, which means South Asia is facing a longer danger window before the monsoon. Dry heat is arriving earlier, humid heat is compounding the risk later, and the season of survivable discomfort is turning into a season of serious public-health stress.

Heat Action Plans are helping, but the report says implementation remains uneven and too focused on emergency response. Outdoor workers, daily-wage earners, older adults, people in poor-quality housing and informal workers remain the most exposed. The funding problem is also basic: because heatwaves are not formally declared disasters in India and Pakistan, they are often excluded from disaster relief support.

The climate crisis of the future is already here for South Asia. Hospitals, farms, power grids, streets, homes are all now relics from the future.
(World Weather Attribution)

Glass half-full? Doesn’t matter even if it’s half-empty. Coz whatever is in it is gonna boil, baby, boil. But let’s begin with good news. Climate scientists are revising the old climate scenario playbook. The very worst-case pathway, the coal-heavy future that projected around 4.5°C of warming by 2100, now looks less likely. That is progress. Unfortunately, the best-case pathway is also slipping away, with even the most optimistic scenarios now expected to overshoot the Paris Agreement’s 1.5°C limit. The new proposed worst-case scenario sits closer to 3.5°C by the end of the century, while the “middle” path, roughly where the world is currently headed, lands near 3°C of warming. The planet is already about 1.3°C warmer than pre-industrial levels, and every extra tenth of a degree sharpens risks around heat, floods, water scarcity and ecosystem loss.

The grim bit: 1.5°C is now considered implausible without first overshooting it, then somehow pulling warming back down later through large-scale carbon removal. In the best-case scenario described by scientists, warming peaks around 1.7°C and may stay there for decades before any theoretical cooling happens.

Doesn’t mean the apocalypse has been cancelled. Emissions are still rising, action is still too slow, and climate feedbacks, from ocean heat release to forest carbon loss and cloud changes, could add further warming beyond human-controlled emissions. The window has narrowed, but the danger has not disappeared. Not that it matters much because by 2100, one pandemic or the other would’ve taken care of pretty much all of us. If not, there’s always Israel.
(Copernicus)

Long reads

It’s getting smoggy in here. Only one story here this week but wear a mask while reading this. Because it is about air pollution in India and how it is years of political denial that has brought it to the state it is in where redemption seems almost impossible.
(Drilled)

Oh, and Gopal Nair doesn’t want you to see this.

In regular programming for The Kable, there has been (yet) another outbreak of Ebola in the Democratic Republic of Congo (DRC), not even 6 months after the last one was declared over. 246 suspected cases with 65 deaths have been reported already. Preliminary lab tests indicate that it is not the Zaire ebolavirus, which means no vaccine. Cases have been reported from Mongwalu, Rwampara and Bunia, and the Africa CDC believes proximity of these regions to Uganda and South Sudan are cause for concern about cross-border spread too. For all the conflict and strife everywhere else in the world, we believe DRC has had it the worst. Ever since a frustrated Belgian “king”, in cahoots with a cartel of European colonisers decided that they could divvy up African land among themselves, it has been nearly 150 years since the people of what is now DRC have been able to enjoy the fruit of their bountiful land in peace.

Such a pity that a week that had so much good news otherwise for Africa had to end on such a sad note. What good news, you ask? Well, for starters, the Africa CDC is looking for a long-term collaboration with South Africa’s Aspen to bulk up vaccine manufacturing on the continent, with an initial focus on priority vaccine antigens, looking to scale supply up to 100s of millions of annual doses over time. Elsewhere, Biovac, fresh from receiving funding to set up a vaccine manufacturing hub, has now received new funding (via a loan) from France to get that hub off the ground. In Kenya, Kenya BioVax, which was set up in 2021 to localise vaccine manufacturing, took the curtains off its facility in Embakasi during a visit for a French ministerial delegation. The facility is planned to be operational next year, so it’s a good time now to showcase capabilities.

Doctors Without Borders have been asking Gilead to sell its HIV wonderdrug directly to them. Why? SciDevNet is telling you why. In Eswatini, the country where at 23.4% of the population, HIV prevalence is the highest in the world, the Global Fund program has managed to deliver 3,000 doses. Gilead believes this is enough while they scale up. Eswatini only has some 220,000 HIV patients, after all. This is pretty much the demand-supply gap across all places covered by the existing program. But hey, if you can’t afford $28k per dose, why get HIV?

PAHO has signed an agreement with CSL Seqirus to earmark a supply of the flu vaccine, in case of a pandemic, for countries in Latin America and the Caribbean. Excellent news but if there indeed were a pandemic, we remember what happened with COVAX, right? It delivered 120 million doses of the agreed upon 994 million doses from J&J, Moderna, AstraZeneca, and Pfizer/BioNTech, who, at the same time, delivered 1.8 billion doses in bilateral deals. Heck, the UK and Canada even took from COVAX, in spite of having a stockpile already. India banned Serum Institute from exporting contractually-obligated vaccine doses. Yeah, good agreement, PAHO.

In India, a storm in the country’s most populous state saw over 100 people dying, and lots of damage to property. Obviously, Indian media was all over it. Especially after the Russian president sent a condolence message.

The Gates Foundation continues to present AI as the solution for all the woes of those without wealth and privilege. This time, it comes in the shape of a new $200 million partnership with Anthropic for low- and middle-income countries (LMICs) and underserved communities in the US who will be able to use AI for better health, education, and agriculture outcomes.

Some announcements from the US. A partnership with the Global Fund for an innovative mosquito repellent, made by an American company, of course. In this case though, thankfully, the product itself will be made in Kenya. The deal will see it being made available across sub-Saharan Africa and other malaria-endemic regions. The US has also put up a new funding announcement for food for seven countries - DRC, El Salvador, Ethiopia, Guatemala, Haiti, Kenya and Rwanda. Conditions? Well, this is the US. Of course, they have conditions. The food has to come from the US, screw the shipping costs. Some others too. The resistance to the US continues to gather steam though. At the World Bank, nearly 100 countries have banded together, asking the World Bank to extend its climate plan by a year, against American wishes.

Africa carries an outsized share of the world’s disease burden. Stands to reason that Africa’s representation in clinical trials would be outsized too. But alas, bias exists there too.

And finally, as always, coffee is what brings good cheer to end this section with. So, what’s with coffee today? Well, drink two to three cups a day, and keep dementia at bay.

Stories Of The Week

Let them eat cake. The Horn of Africa and Central Africa are experiencing some of the world’s most severe hunger crises, with millions facing acute food insecurity and famine conditions.

Sudan remains one of the worst humanitarian crises globally, with 19.5 million people - 41% of the population, facing high levels of acute food insecurity. 135,000 people are classified in catastrophic levels, with 14 areas at risk of famine if conditions deteriorate further. Drone warfare has become a leading mode of conflict, targeting civilian infrastructure and exacerbating the crisis.

Somalia is experiencing rapidly worsening conditions, with 6 million people facing high levels of acute food insecurity. The Burhakaba district has reached malnutrition levels not seen since 2022, with famine conditions emerging under a plausible worst-case scenario. Global aid cuts have reduced humanitarian funding from $2.38 billion in 2022 to just $160 million in 2026, leaving only 1 in 7 Somalis who need food assistance actually receiving it.

The DRC continues to face one of the world’s largest hunger crises, with 26.5 million people struggling to meet basic food needs, nearly one in four Congolese. More than 3.6 million are in emergency conditions, while 4.18 million children require treatment for acute malnutrition.

And in South Sudan, the conflict in Jonglei state is witnessing alarming escalation, with 200,000 people displaced from Akobo County and potentially thrust into catastrophic malnutrition levels as healthcare systems collapse and humanitarian access becomes increasingly restricted.

The crises are interconnected through climate change, conflict, collapsing global aid, and rising food prices linked to geopolitical tensions. Without urgent cessation of hostilities, improved humanitarian access, and massive funding increases, these regions face catastrophic levels of starvation and death.

Mpox, Ebolavirus, cholera, malaria, hantavirus... all of these pale into oblivion when you haven’t had a square meal in days or even enough water to get by.
(IPC, IPC, IPC, DWB, IRC)

Rule of law. Israel, meanwhile, continues doing what it does best: killing children. According to UNICEF, since the “ceasefire” in Lebanon began on April 17, at least 23 children have been killed and 93 injured, bringing the total to 200 children killed and 806 injured since March 2, nearly 14 children killed or injured every single day. The latest victims include two children from the same family who were killed this morning alongside their mother in a strike that hit their car.

Beyond the immediate carnage, an estimated 770,000 children are experiencing heightened distress from repeated exposure to violence, with 72% of caregivers reporting their children are anxious or nervous and 62% depressed or sad. The psychological trauma is so severe that UNICEF warns these children risk developing chronic or lifelong mental health issues without urgent support.
(UNICEF)

A rose by any other name smells just as sweet. By that same token, calling a terrorist a settler doesn’t make them any less of a terrorist. When not killing kids, Israel is busy destroying schools, and childhoods. This is what UNICEF says. Violence against Palestinian children in the occupied West Bank, including East Jerusalem, has escalated sharply, with at least 70 children killed since January 2025 and around 850 injured, most by live ammunition. The crisis is no longer confined to direct attacks: homes are being demolished, schools damaged or made inaccessible, water and sanitation systems vandalised, movement increasingly restricted, and more families displaced in the first four months of 2026 than in all of 2025. With education disrupted, basic services harder to reach, and child detention reportedly at an eight-year high, the pattern points to a broader dismantling of the conditions children need to survive, learn and grow. This can’t be true. Maybe UNICEF is the UN’s Hamas wing.
(UNICEF)

Lies, damn lies, and statistics. We have a World Health Assembly coming up next week. And the WHO has presented a global health scorecard in advance of the assembly. And no, there is no update on the pandemic pact. And yet, the check-in makes for grim reading. Progress towards 2030 health goals is slowing, falling short, or in some areas moving backwards. Malaria incidence is rising, maternal and child mortality gains are losing pace, measles vaccine coverage remains below the level needed to prevent outbreaks, and the pandemic wiped out nearly a decade of gains in life expectancy before a partial, uneven rebound. Data for this report is only till 2024 so all this is before factoring in everything the new US dispensation has managed to do to world health for the short, chaotic time it has been around. Till 2024, there were some bright spots though, including lower alcohol and tobacco use, fewer new HIV infections, and progress against neglected tropical diseases, but the wider picture is fragile, thanks to incomplete data, weakened surveillance systems, and funding cuts yet to fully show up in the numbers. Also, fewer HIV infections is already a thing of the past. Unlike many things, global health gains are not something that can achieve critical momentum and then continue self-sustaining. Neglect catches up, and fast.
(WHO)

Thou shall not covet. Oh lookee here. Israel’s favourite UN agency is back again, this time talking about children in wealthy countries for a change. The kids aren’t alright there either, thanks to economic inequality. It is doing more than widening bank balances. It is showing up in children’s bodies, classrooms and basic chances in life. A new analysis across 44 OECD and high-income countries finds that child poverty remains stubbornly high, with almost one in five children living in income poverty and top-earning households taking home over five times more than the bottom fifth. The consequences are measurable: children in more unequal countries are more likely to be overweight, less likely to report very good health, and significantly more likely to leave school without basic reading and mathematics proficiency. And then, the cycle just keeps on repeating. And then Space Karen says billionaire shouldn’t be used as a pejorative.
(UNICEF)

I am the danger. And finally, a fascinating investigation from AFP about an illegal opioid supply chain originating in, well, India, that is helping feed a deadly drug crisis in West Africa. Millions of tapentadol tablets are being shipped from India into countries where the drug is not permitted. The pills are cheap, potent and, in many cases, far stronger than approved medical formulations anywhere in the world. Some consignments were allegedly declared as harmless medicines, while seizure records and shipment data point to continued exports even after India announced a crackdown on certain opioid combinations.

Tapentadol is being misused as a painkiller, stimulant and survival tool by people doing punishing physical work, but it is also being mixed into kush, the synthetic street drug already devastating parts of the region. Authorities and researchers link the trade to rising addiction, informal detention-style detoxes, bodies being recovered from public spaces, and growing use among young people, including schoolchildren. In some countries, officials say the drug is unauthorised or illegal, yet it is still reaching streets, ports, informal markets and vulnerable communities.

One of the Indian companies listed in the report has a director whose father controlled Maiden Pharma, the company behind cough syrup deaths in the Gambia not too long ago. India’s drug regulator said it had no record of issuing export clearances for the consignments listed in the report but the drug makers association in India said the trade is legal and stopping misuse of the drug is a “shared responsibility of all key stakeholders.”

The world’s pharmacy has some murky depths to it.
(France24)

Breakthroughs

Go Corona, go. We spoke about the Covid conscious community in the very beginning of this issue. Here’s some good news for them. For the first time, an antiviral pill has been shown in a major household-exposure trial to reduce the risk of developing symptomatic Covid after close contact with an infected person. Given within 72 hours of symptoms appearing in a household member, a five-day course cut symptomatic illness from about 9% in the placebo group to about 3%, while also reducing confirmed infections overall. It arrives long after the pandemic’s peak, so this is not a mass-market miracle moment, but it could matter enormously for the people still living with real risk: older adults, immunocompromised patients, care-home residents, healthcare workers, and those who have built their lives around avoiding infection. We are not done with Covid yet. And finally, there may just be a pill that helps stop an unavoidable exposure from becoming an infection.
(NEJM)

Bottom line

The heat is on. For those not in the loop, we have a football World Cup coming up next month. Honestly though, with the way the FIFA head honcho has been behaving around Israel and the first-ever FIFA peace prize winning orange top, we should cancel the World Cup. And considering it is being held in the US, all the more reason to cancel it. Italy has already boycotted the event. And climate change might actually put paid to it, after all. A new analysis suggests roughly a quarter of the tournament’s 104 matches could be played in conditions where heat strain becomes a real risk, with around five games potentially crossing the threshold where postponement would be advised. Climate change has made these hazardous conditions substantially more likely than when the tournament was last held in the US in 1994, and while air-conditioned stadiums may protect some players and spectators, the wider event ecosystem remains exposed: public screenings, outdoor celebrations, fan travel, volunteers, workers, and cities trying to host a summer mega-event in a hotter world.
(World Weather Attribution)

Long reads

Move, child! Everything else about The Kable today has been distressing. No reason for this section to be different. The Internal Displacement Monitoring Centre (IDMC) has released new data. 35,000 child displacements are happening every single day. All this and more fun reading.
(IDMC)

Oh, and Gopal Nair doesn’t want you to see this.

First things first, when we signed off last week, we had plans for what we would write about in The Kable this week, apart from summarising the stories that met us during the week. Those plans involved putting together the words blue and carbon, and separately putting together the words green and water and India. But life comes at you fast. This week, life came in the shape of a cruise liner, carrying hantavirus on board. And not just any ole hantavirus but the Andes virus which actually is known to spread from human to human. We’ll have a little more to say about that a little further down but we’ll end this bit here by saying we don’t believe this hantavirus outbreak on this cruise liner will result in another pandemic, or even a minidemic. But will it result in more people dying/falling ill than avoidable? Oh, our “health authorities” are certainly trying their best. And in serendipitous news, world leaders met last week, for the 6-and-a-halfth, and final, final, time, to flesh out a pandemic agreement. And they decided to meet again for a seventh time in July. Hopefully, for a final, final, final time.

In regular Kable programming, we doubt it was because saner heads prevailed but the US didn’t go through with their threat to pull funding for HIV meds for Zambia. And Zambia officially stated that the proposed bilateral health deal with the US was not about aid but access to minerals and data.

Over in Sudan, drones attacked the airport at Khartoum, an attack that Sudan explicitly called the UAE out for, while also asking Ethiopia to not let warmongers use their space. Ethiopia responded by calling the allegations baseless. This is exactly what Zecharias Zelalem explained while talking about Ethiopia and Eritrea last week. It is not African nations fighting each other. It is armourers sitting elsewhere creating strife, because that unrest is where they see the biggest gains for themselves.

A week doesn’t go by lately when we don’t hear about Africa’s path to achieving self-sufficiency by 2040. And we need more talking. We need more doing too. A new assessment by the WHO says Africa’s qualified health workforce is on the rise, growing from 4.3 million in 2018 to 5.72 million in 2024. However, the rate of unemployment among these qualified healthcare workers is rising too. In 2024 alone, nearly a million of them were without jobs. And not because Africa has all the health workers it needs. That department is still only staffed at 46%. It is because countries still haven’t invested enough in health budgets. A real chicken-and-egg situation here which, if not solved, will see Africa dealing with a projected shortage of 5.85 million healthcare workers by 2030.

ARILAC. That’s the acronym of the week for the Africa CDC. And it stands for Advancing Regional Integrated Laboratory Capacity for AMR Control, an initiative the agency is launching alongwith the the African Society for Laboratory Medicine (ASLM) and the EU to strengthen microbiology laboratory systems, AMR surveillance, and the integration of One Health data across the continent.

Dr Delese Mimi Darko, the Director General of the African Medicines Agency (AMA) has written an op-ed on the progress the agency has made so far in its mission to achieve regulatory harmonisation across Africa. 31 countries have so far signed on to the AMA. Let’s hope all the others sign on soon too.

In UN news, Bahrain and the US, without even the remotest trace of irony, have passed a security council resolution asking Iran to stop its attacks in the Strait of Hormuz. Ignorance, they say, is bliss. Delusion must be blissest.

Elsewhere, Israel has had enough of the pretend ceasefire and attacked Beirut earlier this week, while also indulging in one of its favourite “double-tap” tactics targeted at paramedics.

Many years ago, when we’d just begun The Kable, there were weeks on end when the news was endlessly about Novartis laying off people here, there and everywhere. Feels like déjà vu to see that not much has changed. BioNTech, too, is saying buh-bye to people and places, because the Covid boom didn’t last long enough for them, we guess.

A little earlier this year, boosted by the US’ declining share in international aid, Germany became the world’s largest aid donor. Apparently petrified by the thought, German lawmakers are scaling down their aid budget.

One bad coffee news day is just the exception that proves the rule about all coffee news being good news. And proving the rule is this study that says coffee not only improves focus, it also reduces anxiety. Heck, even decaf helps with learning and memory. Now, that is a magical bean, Jack!

A standard preventive measure in most “developed” countries, and one of the drugs on the WHO’s list of essential medicines for newborns is a Vitamin K shot which protects them from internal bleeding, brain damage, or death by jumpstarting the clotting process. Except, in the US, thanks to conspiracy theorists and health authorities (yes, we know, they’re now one and the same), parents are increasingly not giving their babies these shots, and more and more babies are dying.

And finally, everybody’s heard of Alcatraz, right? That infamous prison that was so difficult to break out of that when people did do that, they made movies out of it? Anyway, these are modern times, and nobody is trying to break out of Alcatraz anymore. But a coyote swam two miles or more to break into Alcatraz. Wily!

Stories Of The Week

A requiem for malaria? Mosquitoes have ruled the planet for far too long. But in recent times, we have hope that the tide may be beginning to turn. Evidence? Here it is. A rigorous evaluation published in The Lancet confirms what public health officials have been waiting to hear: the RTS,S malaria vaccine is saving children’s lives across Africa. Over four years in Ghana, Kenya and Malawi, approximately one in eight child deaths were averted among those eligible to receive it. In 2024 alone, malaria killed an estimated 438,000 African children. If similar coverage could be achieved across the 25 endemic African countries now offering malaria vaccines, tens of thousands of additional lives could be saved annually.

The evaluation, which tracked outcomes from the WHO’s Malaria Vaccine Implementation Programme between 2019 and 2023, found something else worth noting: introducing malaria vaccines didn’t cannibalise uptake of other childhood vaccines or erode the use of insecticide-treated nets. In fact, the vaccine schedule created opportunities to deliver measles and meningitis vaccines simultaneously, alongside vitamin A supplementation and bed nets. Children who hadn’t previously accessed any malaria prevention suddenly had at least one layer of protection.

So, the vaccine works. Supply exists. Demand is there. What’s missing? Money. Funding constraints are preventing countries from scaling vaccination to their national targets or sustaining the coverage they’ve already achieved.The urgency to accelerate deployment is real, the obstacles are financial, and the window for action is narrow. To put things into a little more perspective, to vaccinate all children currently aged five to 36 months in malaria-endemic areas of Africa would cost approximately $1.4 billion, with an ongoing annual cost of $592 million to vaccinate new cohorts. The US alone has spent, at a lowball estimate, $25 billion in the first 60 days of attacking Iran. Space Karen spent $40-odd billion buying Twitter and turning it into a circle jerk for conspiracy theorists and hatemongers and ragebaiters. In India, a billionaire spent gazillions on a wedding for his son, and then gazillions more on a private “zoo.” Yet, we can’t defeat malaria.
(WHO, The Lancet)

Refugees of the Nile. Roughly 850,000 Sudanese are now living in Egypt, having fled a conflict entering its fourth year. The UN refugee agency, UNHCR, provides registration, protection services, health, education, and cash assistance to these arrivals. But the system is collapsing from underfunding.

In 2025, funding levels remained almost unchanged from 2022, before the Sudan crisis erupted. Yet the refugee population in Egypt has nearly quadrupled, from 300,000 to more than 1.1 million.

The cash assistance programme, which allows refugees dignity by letting them choose whether to pay rent, buy food, or fund education, has received only 2% of required funding. More than half the intended beneficiary families are no longer supported. UNHCR warns the entire programme faces closure within weeks without additional funding.

The impact is acute. Most families receiving cash assistance are headed by women with school-aged children. When support ends, mothers face an impossible choice: feed their children or send them to school. A single breadwinner cannot sustain a family of that size.

There are, however, faint signs of progress. Private companies have begun offering training and job opportunities to refugees through corporate social responsibility programmes. This could equip people with skills transferable when they eventually return home safely. But without basic survival support, these opportunities remain out of reach.
(UN News)

Cruise control. So, hantavirus has been dominating the newsfeed this week, eh? Well, at least ours. So, a quick catch-up. The ship in question, the MV Hondius, is a Dutch-flagged expedition cruise liner, that left Ushuaia, Argentina, on April 1, with plans to visit remote parts of the South Atlantic and Antarctica. Stops included Antarctica, South Georgia, Tristan da Cunha, St Helena, Ascension Island, and others. The first person to be infected, who died on arrival at St Helena, was a Dutch passenger who boarded the ship in Argentina on April 1, along with his wife, who also fell ill and died in South Africa, after having”briefly boarded” a KLM flight to Amsterdam. Now, hantavirus generally doesn’t spread from human to human, and is more often spread from from rodents to people. It also has an incubation period between one and eight weeks. So, it is likely the index patients caught the illness in Argentina, where they even visited landfills among other touristy things to do. However, one type of hantavirus does spread from person to person - the Andes virus. And authorities in South Africa confirmed that, in this case, it was indeed the Andes virus at play. At the moment, there are five suspected cases, two deaths, and one infection on the MV Hondius. And four suspected cases, one infection, and one death in South Africa. And one confirmed case in Israel (tender mercies). One confirmed case in Switzerland. And suspected cases in Germany, the Netherlands, France, Spain, the US, Canada, and Singapore. Did our health authorities learn lessons from Covid? On first evidence, no. And we believe that warrants an independent Kable of its own, which we might release mid-week next week. Maybe along with all the wonderful things that cruises can offer you besides. But, even with a 30%+ mortality rate and an R number of 2, we’re pretty certain the Andes virus won’t bring us to the next pandemic. Won’t hurt to buy a few fit-tested N95 masks nevertheless.

Bottom line

The mosquito migration. A new study says mosquitoes have been running human affairs since before we even knew what running meant. Malaria didn’t just kill our ancestors. It herded them around like particularly fragile livestock, fragmenting populations across Africa over 74,000 years and fundamentally shaping which humans ended up next to which other humans. Yeah, so you didn’t choose your neighbours. Bloody mosquitoes chose them for you.

Climate mattered, sure, but a parasitic disease transmitted by an insect the size of a full stop proved equally bossy. The research, which combined mosquito distribution models with paleoclimate data, found that early human populations consistently sidestepped high-malaria zones, creating genetic divisions that ripple through our DNA today. So while we like to imagine our ancestors conquering landscapes through sheer grit and ingenuity, they were actually just trying not to die of fever in swampy bits of Africa.

So far, history has credited climate and geography with sculpting human evolution, but malaria, an organism so ancient and persistent that it makes human civilisation look like a weekend hobby, deserves equal billing. We might have opened with good news on the malaria vaccine front but boy, this story might make us eat our words if a mosquito doesn’t put paid to us first.
(Science Advances)

What do humans need for life? Air, water, food, love, humour? Clothes optional. Everything else is either comfort or luxury, not a need. The one common denominator in air, water and food is plant life. And without air, water, and food, there is bound to be no love or humour either. Funnily (haha), it is plants that we’re not factoring in the extinction numbers. Plants are dying out by the tens of thousands and absolutely no one is losing sleep over it. Between 35,000 and 50,000 plant species will effectively vanish by century’s end. That’s between 7% and 16% of all plant species on Earth, stripped of 90% of their habitat in the next 55 to 75 years.

Climate change is the culprit: warmer temperatures and shifted rainfall patterns are carving up the world into unlivable zones faster than plants can relocate. Even if plants could somehow sprint towards the poles and higher altitudes on pure determination alone, it wouldn’t matter. In places like the Arctic, Mediterranean, and Australia (unsurprisingly), the extinction crisis is already catastrophic.

Yes, we’re about to torch our own survival in the process. Nearly 10,000 flowering plant species are already teetering on extinction, including some that have been around for hundreds of millions of years with no close relatives to pick up the slack. The vanilla orchid is going. The titan arum, the world’s smelliest plant, is going. Species that represent vast swaths of evolutionary history are vanishing because conservation bodies don’t prioritise plants the way they do animals. Which is rather inconvenient given that plants are, technically, how humans eat and survive. When plant futures become unstable, food security collapses. Maintaining the conditions that support human life requires urgent action. But we’re too busy looking elsewhere.
(Science)

Long reads

The art of the steal. The New Humanitarian talks about how Uganda’s new health deal with the US is already seeing lives being impacted on the ground, even though the deal hasn’t even kicked in yet.
(The New Humanitarian)

Have the cows stopped farting, Clarice? Health Policy Watch on the rise and rise of methane emissions from fossil fuels. Hey, records are there to be broken, right?
(Health Policy Watch)

Oh, and Gopal Nair doesn’t want you to see this.

Because it is Labour Day, we will try not to use any extra words in today’s extra-long issue. Nothing superfluous. No chaff. Except for this paragraph which we could’ve totally avoided.

Continuing from last week’s World Malaria Day coverage, some news that came in just a tad too late to be included in last week’s Kable. The first-ever malaria treatment for newborns and infants was prequalified by the WHO late last week. Developed by the Medicines for Malaria Venture and Novartis in partnership with organisations and partners across Africa and Europe, this approval from the WHO follows on from a nod by Swiss health authorities last year.

And Oxford University and India’s Serum Institute, who are already partnered up to deliver the world’s 2nd malaria vaccine, struck a new deal for a new multi-stage vaccine, R78C.

Before moving on to some important updates from Africa, a quick recap of the UN Security Council meeting this week, where Lebanon and Syria had to explicitly state that Israel is an occupying entity, bent on occupation, with Norway, and Tony Blair (???) and Israel saying Hamas, Hamas, Hamas in return. Bahrain also chimed in with a but, but Strait of Hormuz, while the US said Trump is god. We feel so much more secure already.

Ghana became the latest country to reject the US’ America-first bilateral health aid deal. Not surprisingly, it was concerns over data sharing that tanked the deal. Zimbabwe, Zambia, and Kenya too have previously said no to similar deals, although Kenya’s no was because of a court’s intervention. Unlike Zimbabwe and, to an extent, Kenya, Zambia has a lot of minerals that the US was drooling at the prospect of getting its hands on. So much so that Zambia was threatened, deal or no deal, to hand over access to minerals by April 30, or HIV medicines stop. Doesn’t mean this threat won’t extend to Zimbabwe or Ghana. There is gold and chrome and diamonds and lithium and bauxite and manganese to be looted here. And Kenya has titanium and gold and garnets. At the time of writing, the threat to Zambia hadn’t materialised into action thankfully.

We’d written two months ago about Senegal and Ghana’s shameful regression in law on LGBTQ relations. The real-life harm of that is now becoming apparent in Senegal where HIV patients are skipping treatment, fearing arrest.

Burundi became the newest country to introduce the HPV vaccine into its routine immunisation schedule.

In this excellent video explainer, Zecharias Zelalem talks about the potential for conflict between Ethiopia and Eritrea again, and how this is being fomented by the same countries responsible for the destruction in Sudan and the Democratic Republic of Congo (DRC). For a change, the US and Israel are secondary here.

Speaking of the DRC, yeah, they did sign a bilateral health deal with the US. We don’t see how they had too many options. First, they suffered forever under Belgium’s cruel, and cruelly extractionary, colonial rule. Then, when they did get independence, their first democratically elected leader was executed, and his body dissolved in acid so a memorial wouldn’t come up. Unfortunately for the DRC, in the 1990s, coltan suddenly became the thing because the world needed tantalum for everything... computers, cellphones, airplanes, microwaves. And the DRC had the world’s largest deposits. Since then, the country has been in a permanent state of conflict, with disease and displacement naturally following. Then, there is neighbouring Rwanda whose coltan exports don’t always tally with expected production numbers. A bilateral health deal that allowed the DRC to monetise some of its mineral resources might seem like the lesser of two evils, even if it means parting with health data. And now, they have US and UAE money to guard their mines too.

It’s acronym time for the Africa CDC once again. This week’s acronym is AHLMC - the African High-Level Ministerial Committee on Global Health Architecture Reform. Launched on the sidelines of the World Health Summit meeting in Kenya, this acronymcommittee will act as Africa’s voice on the global health platform, including in pandemic pact talks. At the same event, the Africa CDC also entered into another pact, this time with Africa Frontline First (AFF), and without any acronym, to deploy 200,000 community health workers across the continent. Harking back to the AHLMC, final talks for the pandemic pact began this week and were supposed to have concluded by now. But there is absolutely no information on what happened after the opening session of these talks.

In Sudan, measles continues to run riot, with over 9,000 cases now in South Darfur. In North Darfur meanwhile, drones are laying waste to aid vehicles.

Doctors Without Borders (MSF) released a report about how Israel is using water as a weapon of collective punishment in Gaza, asking the international community to pressure Israel into acting like they’re human. Like Israel cares. They went and approved a school on stolen land. And appointed a fanatical fanatic to continue ethnic cleansing of Palestine as part of the “Peace Plan.” Israeli pirates even went way out of their way to kidnap activists from the Global Sumud Flotilla and their boats. Oh but you can’t paint all of Israel with the same brush! Well, they have a “comedy” show called Eretz Nehederet which set up a hidden camera to ask Israelis what they think of executing Palestinians. Well.

And it’s not limited to Palestine. Their looting, occupying ways are now firmly entrenched in Lebanon too. A Lebanese gas field is now Israeli apparently. Ceasefire? Pah! IDF leaders say they don’t believe in all that bullshit. “’The only mission is to continue the destruction,’ one officer said. ‘There is no other mission.’ The IDF believes this systematic destruction of Shi’ite villages will prevent villagers from returning home.” As per tradition, Israeli soldiers are also looting property from homes in Lebanon. Despite indulging in the basest of base fantasies though, what is surprising is that suicides are going up in the Israeli army. Only 10 in recent weeks but well-begun is half-done, as they say.

In other “big” news from West Asia, the UAE has decided to exit OPEC. Must suck to have their productivity rationed by other members of a cartel. Now the UAE can pump up to 5 million barrels per day. Yay. If only the Strait of Hormuz was open.

Elsewhere, the WHO now has a new network of regional training centers for biomanufacturing: the Institut Pasteur de Dakar, Senegal; the Council for Scientific and Industrial Research, South Africa; Oswaldo Cruz Foundation (Fiocruz), Brazil; Translational Health Science and Technology Institute, India; National Institute for Bioprocessing Research and Training, Ireland; Center for Continuing Professional Development, Egyptian Drug Authority, Egypt; Peking University, China. These centers will (hopefully) work with industry and institutions to build biomanufacturing capacity in their respective regions.

MSF is once again asking Gilead to sell its HIV drug to it. This time, asking shareholders to step in. Persistence doesn’t always pay.

In France, they lifted bird flu restrictions, et voilà, they reported two bird flu outbreaks.

In Pakistan, a story we missed earlier, a BBC investigation about a hospital that was the epicenter of a child HIV outbreak two years ago, that still continues to reuse needles and syringes and play foolhardy with children’s lives. 331 kids got HIV because the hospital couldn’t care less about basic medical practices.

Prompted by the war on Iran, and the “sudden realisation” of how dependent we are on fossil fuels, a bunch of countries met in Colombia earlier this week to plan a transition away from fossil fuels. They ended the meeting saying yes, we need to phase out fossil fuels, but where will the money come from?

Meanwhile in India, human lives continue to matter next to nothing. In India’s IT capital, unseasonal rainfall saw a hospital wall collapse, leading to seven people dying. The same rains saw 750 homes getting submerged, and two people getting electrocuted, and another person dying inside their house after a brick crashed through their roof. In India’s financial capital, four people from a family died after eating watermelons. Health authorities couldn’t attribute the deaths to the watermelons because immediately after, there were no watermelons to be found anywhere in the market. Elsewhere, in the state of Madhya Pradesh (MP), nine people died when a cruise boat sank. Lifejackets existed only in regulations. In the same state, 16 labourers died after their van collided with an SUV. In another state, Odisha, four people died when a bus ran into a truck. In Gujarat, six people in a van died when their vehicle was hit by a speeding bus. The good thing is there’s no dignity in death either. A man in Odisha had to dig up his sister’s skeleton and take it to the bank which refused to let him withdraw the measly Rs. 19,000 lying in her account. And in MP, a woman was forced to clean the ambulance that took her relative to the hospital because the relative was in an accident and bled in the ambulance. All this in only the past few days. There is far too much disrespect for human life in India to cover in one weekly newsletter focussed on other topics. We’ll, however, try and showcase as much as possible from hereon.

And finally, they say, if you wait by the banks of a river long enough, the bodies of all your enemies will float past. And if they don’t, make like elephants in Gabon do and crush them to death.

Stories Of The Week

Twenty years of regression. Twenty years after Darfur first entered the global conscience, UNICEF is sounding the same alarm. Children are being killed and maimed, schools and hospitals destroyed, families displaced, often repeatedly, often with nothing. Since April 2024, more than 1,300 children have been killed or maimed in Al Fasher alone, many by explosive weapons and drones. Across Sudan, the UN has verified over 5,700 grave violations against children since the current war began. In the first three months of 2026, the rate accelerated.

The scale is larger than it was in 2005. The funding is not. UNICEF’s 2026 humanitarian appeal for Sudan is 16% funded. More than 3 million of Darfur’s 4 million school-aged children are out of school. Famine conditions were confirmed in Al Fasher in November 2025, with acute malnutrition rates exceeding 50% in some locations. Humanitarian access remains obstructed by insecurity and bureaucratic impediment. The world, UNICEF notes, has not responded with anything close to the outrage of two decades ago.
(UNICEF)

The hunger next door. The crisis in Darfur does not stop at Sudan’s borders. Across them, South Sudan is deep in a catastrophe of its own. Some 7.8 million people - 56% of the population - are facing acute food insecurity between now and July 2026. Of these, 73,300 are at catastrophic levels, a 160% increase from the last estimate. The drivers are familiar: escalating conflict, mass displacement, economic collapse, climate shocks, and agricultural systems that have largely ceased to function.

Children and women are bearing the weight of it. Some 700,000 children under five are projected to face severe acute malnutrition through July - the deadliest form - up by 100,000 cases in six months. In Jonglei alone, nearly 300,000 people have been displaced, cutting communities off from what little humanitarian assistance exists. Disease outbreaks - cholera, malaria, measles - are compounding malnutrition among children already critically weakened. The UN warns of a credible risk of famine in four counties across Upper Nile and Jonglei states.

Women and girls account for nearly 60% of those displaced since the start of the year, an average of 104 every hour. Health facilities have been destroyed or looted. Women are giving birth without medical care in a country that already carries one of the highest maternal mortality rates in the world. Some are going days without food, eating wild plants to survive. An additional 2.4 million Sudanese refugees and returnees have crossed into South Sudan from the war next door, arriving into a country that has no capacity to absorb them.
(UNICEF, UN Women)

Wherever they go, hunger follows. If we’re talking about crises, displacements, conflicts, hunger, destruction of health facilities, then we can’t avoid talking about Israel, can we? This time in the context of Lebanon where the already fragile food security has deteriorated sharply. Nearly 1.24 million people, close to one in four of the population analysed, are projected to face acute food insecurity between April and August 2026, up from 874,000 in the preceding period. The reversal has been swift. Families who had managed to stabilise are being pushed back into crisis as conflict, displacement, and rising costs converge. The sharpest deterioration is in the southern districts - Bent Jbeil, Marjeyoun, Sour, and Nabatiyeh - where displacement and market disruption are most severe.

The crisis cuts across population groups, but falls hardest on the most exposed. 36% of Syrian refugees and 45% of Palestinian refugees are classified at Crisis level or worse. Among Syrians who arrived after 2024, the figure reaches 52%. Agriculture, already damaged by the 2024 conflict, has yet to recover, and the spring planting window is closing without the support needed to use it. Without sustained humanitarian assistance and some measure of security stabilisation, UN agencies warn the situation is likely to deepen further in the months ahead.
(IPC)

Hunger is the new trending. A new report released by UN agencies - the Global Report on Food Crises 2026 finds that acute hunger has doubled over the past decade, with 266 million people across 47 countries facing high levels of acute food insecurity in 2025. For the first time in the report’s ten-year history, famine was confirmed in two separate contexts in the same year: Gaza and parts of Sudan. The number of people facing catastrophic hunger is now nine times higher than it was in 2016. Ten countries account for two-thirds of all cases: Afghanistan, Bangladesh, the DRC, Myanmar, Nigeria, Pakistan, South Sudan, Sudan, Syria, and Yemen. Conflict is the primary driver across nearly all of them.

The report carries an additional warning that the numbers may understate reality. Funding for food crisis response has fallen back to levels last seen a decade ago, and data collection has deteriorated with it. Eighteen countries and territories, including Burkina Faso and Ethiopia, which alone accounted for over 27 million acutely food-insecure people in 2024, lacked comparable data this year. The apparent stabilisation in overall figures reflects missing information, not improved conditions. The outlook for 2026, the report states, remains bleak. Duh!
(GNAFC)

Hunger ascendant in Africa. If the stories earlier in the section didn’t make it explicit enough, hunger in Africa is on the rise. In fact, it has risen for the eighth consecutive year. 306 million people are undernourished across the continent - more than 45% of the global total, and 892 million face moderate or severe food insecurity, more than double the global average. Over one billion people in Africa could not afford a healthy diet in 2024. A healthy diet now costs the equivalent of $4.41 per person per day, against an extreme poverty threshold of $2.15.

A new joint report by FAO, WFP, the UN Economic Commission for Africa, and the African Union Commission identifies the central problem as a financing gap that successive frameworks have failed to close. Government spending on agriculture has grown modestly since 2018 but remains insufficient. Bank credit to agriculture accounts for less than 4% of total lending. Foreign direct investment in food and agriculture runs below $2 billion annually. Climate finance reached $44 billion in 2021-22 — against a target of $250 billion. Africa, the report notes, is off track on every measurable hunger goal. And it has been off track for eight years.
(FAO)

A bang for a buck. The US says it is ready to pay its UN dues, well at least some of them. Provided the UN agrees to a list of only nine reforms it has helpfully described as “quick wins.” Washington currently owes $4 billion across regular and peacekeeping budgets, a figure it has accumulated partly by capping its own contributions below the rate it is legally assessed for.

What are the quick-win conditions then? Cut senior staff, end business class travel below a certain grade, overhaul the pension system, deploy AI interpreters, and reduce peacekeeping missions by a further 10%. The last demand is particularly instructive. The US has spent thirty years neither resolving nor abandoning the crises those missions exist to contain. In fact, a lot, if not all, of those crises were created by the US.

The UN has already cut its administrative budget by 15%, eliminated up to 3,000 posts, reduced troop levels by 25%, and repatriated underperforming units. But none of this is sufficient for the US. We dunno. But if we were $4 billion in arrears, we would at least show some humility.
(Devex)

Bottom line

How green is my transition? The minerals powering the world’s clean energy future - lithium, cobalt, nickel, graphite, rare earth elements - have been called the oil of the 21st century. The comparison is more apt than its proponents intend. A new report by the UN’s water think tank finds that the extraction of these materials is replicating, with considerable precision, the extractive injustices of the fossil fuel era. The costs fall on the poorest communities while the benefits accumulate elsewhere.

In the DRC, which accounts for more than 60% of global cobalt production, over 80% of mineral output is controlled by foreign industrial mines. Nearly three quarters of the population lives on less than $2.15 a day. Two thirds lack access to basic drinking water, in a country that holds more than half of Africa’s freshwater reserves. In communities near mining sites, 72% of residents report skin diseases. More than half of women and girls report gynaecological problems. Birth defect rates in maternal wards near mining areas are markedly elevated. Approximately 30% of DRC mining sites employ children, some as young as seven, without protective equipment.

The numbers scale globally. In 2024, lithium extraction consumed an estimated 456 billion litres of water, equivalent to the annual domestic water needs of 62 million people in sub-Saharan Africa. Producing one tonne of rare earth minerals generates approximately 2,000 tonnes of toxic waste. Demand for these materials is projected to quadruple by 2050. The report does not argue against the green transition. It says that a transition which moves environmental harm from rich to poor, and from one generation to the next, is not a transition at all.
(INWEH)

Climate change: the great equaliser. As we noted last week, Europe is beginning to experience what it spent centuries exporting. The World Meteorological Organization’s 2025 State of the European Climate report confirms the direction of travel. 95% of the continent recorded above-average temperatures last year. A record 1,034,000 hectares burned in wildfires, an area larger than Cyprus. Iceland recorded its second-largest glacier loss on record. The Greenland Ice Sheet lost 139 billion tonnes of ice. Europe is now warming twice as fast as the global average, a distinction it has done everything to cause.

The silver lining, such as it is, comes in the energy figures: renewables supplied 46.4% of Europe’s electricity in 2025, with solar hitting a regional record. Policymakers are framing the energy transition as a national security matter, which appears to be a more effective motivator than several decades of climate science. Unfortunately, the glaciers don’t seem to be waiting for the reframing to take hold.
(WMO)

Free press? You oughta be dreaming. The 2026 Reporters Without Borders World Press Freedom Index has recorded its bleakest picture in 25 years. For the first time since the Index began, more than half the world’s countries fall into the “difficult” or “very serious” categories. In 2002, that figure was 13.7%. The share of the global population living in a country rated “good” for press freedom has collapsed from 20% to less than 1% in the same period. The legal indicator - tracking how governments use law to restrict journalism - deteriorated in over 60% of all assessed states between 2025 and 2026. The preferred instrument, deployed with bipartisan enthusiasm across democracies and dictatorships alike, is national security legislation.

The roll call is long and geographically eclectic. India sits at 157th, explicitly named for the sharpest legal deterioration. Russia holds 48 journalists in prison. Saudi Arabia executed a journalist, and not in a Turkish consulate, and fell 14 places. More than 220 journalists have been killed in Gaza since October 2023, at least 70 while actively working. The United States dropped seven places to 64th, as systematic attacks on the press became settled policy, Voice of America was shuttered, and a Salvadoran journalist was detained and deported. Argentina and El Salvador, governed by two of Washington’s more enthusiastic regional admirers, recorded significant declines of their own. Ecuador fell 31 places after two journalists were murdered. Peru fell 14 after four were. Nicaragua’s media landscape, the report notes with admirable understatement, lies in ruins.

The one unambiguous bright spot is Syria, which climbed 36 places following the fall of Assad’s government - the largest single-year improvement in the Index’s history. Norway holds first place for the tenth consecutive year. Eritrea comes last for the third. In more than 80% of all countries assessed, protection mechanisms for journalists are rated as non-existent or ineffective. The Index has been running for a quarter of a century. The trend line has never pointed in a more consistent direction.
(RSF)

Long reads

The waste... it keeps on piling up. UNEP has this wonderful interactive page that shows how, and how much, waste is piling up with your daily usage. Production, consumption, production, consumption, death. Vicious, bloody cycle.
(UNEP)

In his own voice. In 2024, there were quite a few campus protests in the US against Israel’s ongoing genocide and ethnic cleansing in Palestine. One of these was at Columbia University, where one of the organisers of the Gaza solidarity encampment was Mahmoud Khalil, a Palestinian-American graduate student. He was arrested, threatened with deportation, couldn’t attend his own graduation, or even the birth of his child. He has written a moving, and powerful, piece in NY Mag about all of this, and much, much more.
(NY Mag)

Oh, and Gopal Nair doesn’t want you to see this.

Without further ado, on with this week’s Kable then.

Oh wait, there is a little more ado. Sorry. It seems we don’t run out of invented days to celebrate/commemorate things. Like February 14 for Valentines’ Day, and April 1 for right-wing days, or November 19 for International Men’s Day, which also happens to be World Toilet Day, so that tracks at least. Adding to that list is April 25, World Malaria Day. And no, we don’t need a special reminder for a disease that has been killing us and our children since time immemorial, not least because it might give those mosquitoes visions of glory.

But because it is World Malaria Day, let us begin with some related news. In Brazil, indigenous kids are the first to receive a paediatric malaria treatment, developed by Medicines for Malaria Venture (MMV) and GSK, for relapsing malaria. Unlike older, once-a-day weekly doses, this new paediatric tafenoquine is a single-dose treatment, which they’re trialling in the Yanomami Indigenous Territory (TIY) of northern Brazil.

In more good news on the malaria front, well, there is none. But there are a series of reports on the scenario in Africa, where inspite of new vaccines and therapeutics, malaria continues to dominate the child-killing space. The Conversation with more reading on what the continent has gained and the challenges she still faces in the fight against malaria, SciDevNet talking about the absolute imperative for local research when it comes to fighting the good malaria fight in Africa, and Health Policy Watch on the need for urgent policy interventions to ensure the new breed of malaria drugs can avoid AMR for as long as possible.

In case anyone has any doubts about the persistent threat posed by malaria, look no further than Zimbabwe, where, in the year so far, cases and deaths have been twice last year’s number for the same period and four times that of 2024. Even otherwise, as this UNICEF report on child mortality published last month shows, 1 in 6 children over one-month old are dying of malaria.

We’re pretty sure mosquitoes and the parasites they breed that cause a whole lot of human diseases, even other than malaria, aren’t done evolving. If nothing, these parasites are still developing resistance to frontline treatments. Which could possibly mean new pathogens. At least, new forms of pathogens. As a reminder, for the past many years, our leaders have been sitting together in various locations, at various fora, trying to hammer together a deal for a new pandemic pact, a deal that is hinging on access to pathogen data. The next round of these discussions begin next week in Geneva. Hopefully, these will be the final, final round. Again, as history is our witness, countries in the Global South that share critical pathogen data very rarely benefit from the health outcomes developed using that data. This pandemic pact is the only theoretical thing that precludes that from happening again.

In a further boost for African health systems, the African Union and the European Commission have launched three new initiatives, totalling over €100 million, under the Global Gateway strategy, all operationally managed by the Africa CDC. One strengthens national public health institutes across ten African countries, covering disease surveillance, early warning, emergency response, and laboratory services. Another targets antimicrobial resistance through a One Health workforce trained to detect threats across animals, humans, and the environment. The third rolls out digital health solutions for pandemic preparedness and primary care in six African countries.

In an even more impressive achievement for African manufacturing, South Africa’s Biovac has secured funding of over $100 million to build Africa’s first end-to-end multi-vaccine manufacturing hub. Expected to be operational in 2028, the plant will make vaccines for cholera, polio, meningitis and pneumonia, and also supply to UNICEF and Gavi. UTANO has a wonderful read on why this is such a huge deal for Africa. And regulatory oversight features prominently as one of the reasons. We aren’t surprised.

In Kenya, the country’s largest hospital chain, Mediheal, has been in the news around this time of the year consistently for the past three years. In 2024, it was because the group was close to financial collapse. In 2025, it was because the group was under investigation for organ trafficking. And this year, the group has been cleared of organ trafficking charges.

The last of our stories from Africa today... this study about this house that can prevent many fatal illnesses in African children. In Tanzania, researchers built 110 of these simple two-story structures and they proved effective in protecting children from diarrhoea, malaria, and respiratory illnesses.

In other news, CEPI has partnered with the Pasteur Network to work on localising regional vaccine R&D capacity, including trials and manufacturing, all in the name of pandemic preparedness. As an aside (couldn’t resist), they signed this agreement in a closed room with no masks on. Anyway, we’re pretty sure this agreement excludes the Pasteur lab in Tehran because that lab exists only in name and legend now, thanks to Israel.

In fact, of all the over 2,800 buildings that Israel (and the US) hit in Iran till last week, less than a third were military installations. The rest? Industrial locations, residential buildings, cultural locations, commercial facilities, medical facilities, and Israel’s favourite targets, hospitals and schools.

In Gaza, Israel killed two water truck drivers, and UNICEF is outraged, we tell you, outraged. In Lebanon, UN aid workers were able to finally go into south Lebanon and, well, Israel has done what Israel does.

Coming up soon, on May 3, is World Press Freedom Day. UNESCO commemorates this every year. UNESCO also has section on their website where they pay homage to killed journalists. For the past many months, it has mostly been Palestinian journalists. This year, many journalists from Lebanon have joined the list. According to the Committee to Protect Journalists (CPJ), last year 129 journalists were killed worldwide, officially. 84 of them were killed by Israel. This year, in Palestine and Lebanon alone, Israel has already killed 18 journalists, 10 of them from Lebanon. One of the journalists Israel killed this week was Lebanon’s Amal Khalil. And the details of her death... it was stone-cold murder. It was bad enough for the Lebanese PM to call Israel out for war crimes. All this amid a “ceasefire.” Western media has been running cover for Israel’s crimes for a long time, often twisting itself into knots to avoid using direct terms, like calling five-year-old Hind Rajab a young woman. But when even western media, like The Guardian in this case, begins to carry exposés, on how Israeli prisons are just rape-torture camps to force people out of the West Bank (and Gaza) (and Palestine), maybe one can hope that the tide is turning.

Elsewhere, the WHO has released a new AI-powered tool to help you with facts about sexual and reproductive health. Which reminds us, about two years ago, the WHO had released an AI health influencer called S.A.R.A.H. We decided to check up on S.A.R.A.H. Isn’t doing much influencing anymore. And the company that developed that tool, Soul Machines, is going out of business. Maybe that’s why the WHO hasn’t mentioned who has developed their new AI tool.

Moderna is launching a trial for its bird flu vaccine, with first volunteers in the UK already dosed. Surprisingly, the trial is also hoping to find volunteers in the US.

The same US where their secretary of war says military personnel no longer need flu shots. Because a sick soldier can at least infect the enemy, right? Anyway, vaccines don’t work. Which is why US authorities aren’t releasing a report that shows that Covid vaccines did, in fact, work, and minimised hospital stays.

Gallstones, vision changes, postpartum thyroiditis and pre-eclampsia, and blood clots. Just some of the adverse health conditions mothers can develop after giving birth. And then, if all goes well, the kids even grow up and reach teenage.

In India, business as usual. Drug makers receive critical observations after US FDA facility inspections, while elsewhere authorities bust a racket of fake Mounjaro pens.

A new survey says at least 70% of people believe at least one false or unproven health claim. Claims like childhood vaccinations cause autism, raw milk good, vaccines are for birth control, and so on. The survey covered 16,000 people across 16 countries, with representation from all continents, so it is fairly accurate, we’d say.

Thankfully, survey or no survey, The Big Catch-Up, the immunisation initiative launched by the WHO in partnership with Gavi in 2023, seems to have done its job. Since its launch, the initiative delivered over 100 million vaccine doses to 18.3 million children across 36 countries, targeting those aged one to five. It wrapped up in March, having reached 12.3 million children who had never previously received a vaccine, immunising them against diseases including diphtheria and polio. Final figures are still being tallied, but the program looks set to hit its target of reaching at least 21 million under- or unimmunised children.

A look at the climate and environment then, shall we? What’s the forecast like? WMO predicts El Niño, and as early as next month. And it’ll be pretty bad.

In Mozambique, they discovered four new species of chameleons. And they’re already endangered, thanks to forest loss.

But our leaders are on top of things. In fact, France is hosting the G7 environment ministers this week in Paris for an, well, environment summit. And they will not be discussing climate change at this summit so the US won’t feel bad. Oh well, maybe they can discuss how to watch TV when there is no wind.

And finally, if you still think plastic is not destructive, scientists created a plastic that kills viruses on contact. Not just kills, physically rips them viruses apart. Yeah, and that is what you store your lunch in?

Stories Of The Week

A revival unforeseen. A stunning work of investigative journalism from the Platform for Investigative Journalism, Malawi reveals how one of Malawi’s largest pharmaceutical suppliers came back from the dead without anyone even noticing, and got up to nefarious deeds en route.

In 2013, Galaxy Pharmaceutical and Surgical Logistics Ltd was found supplying faulty antibiotics to hospitals, which resulted in infant deaths, an issue that came to the fore when doctors at Mzimba District Hospital reported deaths among newborns whose mothers had been treated with Chloramphenicol, supplied by Galaxy. Authorities at the time found the company guilty of supplying faulty medication and revoked the operating licenses of both the company and its owner, leading to the company’s closure. However, the antibiotic stock itself could not be checked because they conveniently disappeared before investigators could arrive. Immediately thereafter, case files from the infant deaths inquiry were stolen from the regulator’s offices.

Just like the kids, the case died. And in 2019, the company came back to life, but as GPSL Wholesale Ltd. So innovative. And it was back in business, with, among other things, supplying insulin to public hospitals. The only thing is the insulin in question was expired and stolen from government hospital’s poorly secured storeroom and moved through an illicit broker before landing back in state facilities, including the very hospital it was stolen from. Clinicians only caught on when the insulin stopped working and labels began peeling off refrigerated vials to reveal the originals underneath. Following the insulin scandal, the regulatory body’s own disciplinary committee recommended revoking its licence again. The board issued a warning instead. The company continues to supply state hospitals.

Allegations of political interference and attempted bribery during the disciplinary process have never been investigated. The criminal prosecution over the insulin has stalled, partly due to the death of a central suspect.

Sounds a lot like a Bollywood movie, eh? Well, the promoters of Galaxy/GPSL are of Indian origin.
(PIJ Malawi)

$71 billion, and counting. A joint EU-UN assessment, conducted with the World Bank, puts the cost of rebuilding Gaza at $71.4 billion over the next decade, with $26.3 billion needed in the first eighteen months alone. Physical infrastructure damage stands at $35.2 billion; economic and social losses at $22.7 billion. Housing, health, education, commerce, and agriculture are the hardest-hit sectors. Over 371,000 housing units have been destroyed or damaged, more than half of all hospitals are non-functional, and the economy has contracted by 84%.

The human toll is harder to quantify, though the report tries: Gaza’s human development has been set back by an estimated 77 years. 1.9 million people have been displaced, many more than once, and over 60% of the population has lost their homes.

The assessment calls for Palestinian-led reconstruction, a ceasefire, unimpeded humanitarian access, and a credible pathway to Palestinian statehood. The assessment also calls for a two-state solution, to which we have unparliamentary words as a response because you can’t give your home over to settler-terrorists.
(UN)

Home is where the rubble is. Gaza, Lebanon, Congo, Sudan. Everywhere, people who once had homes now have ruins. Nearly four million people have returned to Sudan since the conflict, with the heaviest flows into Khartoum and Aj Jazirah. The IOM, which is tracking the movements, says what they’re returning to is destroyed services, damaged homes, and infrastructure that has no likelihood of recovering anytime soon. At the height of the conflict, nearly 12 million people fled affected areas; nine million remain internally displaced, and over four million are still in neighbouring countries.

It’s not like people are returning because conditions have improved. But a combination of economic pressure, family separation, and the deteriorating situation in host countries is making this forced return happen. Home, a place you don’t willingly go to, but a place you’re forced to return to because staying anywhere else is no longer an option. The gap between what’s needed and what’s available is, at this point, a recurring feature of every Sudan story.
(IOM)

SDGs? More like who gives a damn! We didn’t want to include this story here but the UN likes to pretend that the SDGs still matter so, here we are. A new UN report - Financing for Sustainable Development Report 2026 (FSDR) - finds that with four years left until the 2030 deadline, progress on the SDGs has stalled, and in some cases reversed. One quarter of developing countries still have lower per capita incomes than before the pandemic. Around 3.4 billion people live in countries spending more on debt interest than on health or education. Official development assistance has fallen sharply, foreign investment is declining, and the least developed countries are now absorbing the additional blow of global trade tensions and rising tariffs. The financing gap for developing countries stands at up to $4 trillion annually. The report points, somewhat optimistically, to renewable energy investment hitting a record $2.2 trillion in 2024 and expanded South-South trade as signs of resilience, before noting that none of it will matter without urgent global cooperation and political will, two things that are, at present, in notably short supply.
(UN)

Your food, pre-cooked. A joint FAO-WMO report finds that extreme heat is becoming the defining operating condition for global food systems, threatening the livelihoods and health of over a billion people. Heatwaves are growing more frequent, intense, and prolonged, hitting crops, livestock, fisheries, and forests simultaneously. 2025 ranked among the three hottest years on record, and in that same year, more than 90% of the world’s oceans experienced at least one marine heatwave, depleting oxygen levels and pushing fish stocks into decline.

The numbers are unambiguous: every one-degree rise in average global temperatures cuts yields of maize, rice, soya, and wheat by around 6%. Yield declines for most major crops begin above 30°C; for chickens and pigs, heat stress sets in at 25°C. The intensity of extreme heat events is expected to double at 2°C of warming and quadruple at 3°C. In parts of South Asia, tropical Sub-Saharan Africa, and Central and South America, the number of days too hot to work outdoors could reach 250 per year by the end of the century.

The report calls for early warning systems, heat-resistant crop development, and better financial protection for agricultural workers. It also notes, with the weariness of an institution that has said this before, that adaptation alone will not be enough, and that the only lasting solution is cutting emissions. Coordinated global political will, as ever, is left as an exercise for the reader.
(FAO)

When doing a lot isn’t nearly enough. The WHO released its 2025 Results Report this week with roughly half of all output targets unmet amid a whole lot of flux, yet the organisation still managed to extend essential health coverage to 567 million additional people, bolster emergency preparedness for 698 million more, and improve health outcomes for 1.75 billion. None of this hit the “Triple Billion” targets set in 2018, but the WHO is used to not hitting targets anyway.

Highlights from the report include emergency mental health coverage rising from 28% to 48% of countries, HPV vaccine coverage nearly doubling from 17% to 31% since 2019, and the WHO responding to 66 emergencies across 88 countries, including 33 million medical consultations delivered through health partners in Gaza, although this number seems a little sus to us. The newly adopted Pandemic Agreement and revised International Health Regulations provided some structural scaffolding for emergency preparedness gains. Again, the Pandemic Agreement is not “adopted” yet because the PABS deal is still pending. This is more self-congratulatory than actual fact.

As much as the highlights, the gaps are just as telling: diabetes management, measles surveillance, polio eradication, and financial protection all remain unresolved. A large share of WHO’s budget stays earmarked for specific thematic areas, leaving the organisation with limited room to manoeuvre. And yes, the world remains off track for the health-related SDGs by 2030, which, given the previous story in this issue, will surprise no one.
(WHO)

Karma comes calling. For a while now, a lot of rabid and virulent voices across Europe have been rabidly and virulently complaining about the influx of migrants destroying the fabric of their very society. Which is very rich coming from a society that spent centuries invading, colonising and impoverishing the people they colonised. Anyway, the Lancet Countdown Europe has released its 2026 report on health and climate change in the region, and whatever the rabid rabble-rousers may think, Europe better plan for what the Global South has had experience of for a while. Heat is on the way up with 99.6% of the continent seeing rising deaths due to heat. Dengue, chikungunya, and Zika are finding Europe way too comfy. Daily heat health warnings of extreme heat in Europe increased by 318%.
(Lancet Countdown Europe)

Breakthroughs

Serum? More like superbugfighter! Korean skincare aficionados (and who among us isn’t eh?) have been slathering Centella asiatica extract on their faces for years, swearing by its calming, anti-inflammatory properties, and honestly, fair enough, it works. But researchers at the University of Kent and UCL have now found that madecassic acid, one of Centella’s star compounds and a fixture in the glass-skin industrial complex, may have a considerably more consequential application than keeping pores tightened: it can stop antibiotic-resistant E. coli from growing.

The compound works by binding to the cytochrome bd complex, a protein system bacteria rely on for respiration during infection, and one that doesn’t exist in humans or animals, making it a clean target. Researchers also created three modified versions of madecassic acid, all of which successfully blocked bacterial growth, with one variant capable of killing E. coli outright at higher concentrations. Given that antimicrobial resistance is projected to cause 39 million deaths between 2025 and 2050, a hero ingredient that moonlights as an antibiotic precursor is, to put it mildly, a welcome development.

The skincare industry will presumably find a way to put “now with AMR-fighting properties” on a sheet mask within the next year.
(RSC Medicinal Chemistry)

Bottom line

Hot and Dry, and coming for you. By the 2090s, nearly 2.6 billion people, about 28% of the projected global population, could face compound hot-dry extremes, simultaneous heatwaves and droughts, five times more often than today. A study combining 152 climate simulations across eight models finds that on current emissions trajectories, implying a 2.7°C rise by 2100, these events will affect nearly a third of humanity with dramatically increased frequency, and will last up to three times longer than they do now.

The compounding is the point. Heat and drought together are considerably more destructive than either alone, amplifying wildfire risk, agricultural losses, heat-related deaths, and socioeconomic instability simultaneously. And as with every climate story in The Kable, the burden falls hardest on tropical nations and low-income countries, which have contributed the least to the emissions driving the problem and have the least capacity to absorb the consequences.

The study does offer a number rather than just a warning: full implementation of Paris Agreement commitments (hehe) and additional binding pledges could reduce the exposed population from 28% to 18%, which would mean nearly 900 million fewer people in the crosshairs. Whether that constitutes hope or simply a less catastrophic version of the same outcome is, at this point, a matter of perspective.

Honestly though, 2090 is too far now. None of us is gonna make it till then. The planet itself will be a dry, smoking husk with a few scattered survivors being feasted upon by mosquitoes. So, don’t sweat it. Or do.
(Geophysical Research Letters)

First world problems. This is a story about a small town in Texas, America. You might wonder how and why it fits into The Kable. But as with Europe and heat and disease above, this is an indication that the Global North, that so far thought of itself as insulated from the problems of the “Third World,” will soon be dealing with the same issues.

Corpus Christi, population 500,000, home to some of the largest petrochemical facilities in the United States, is on track to run out of water by next year. Absent significant rainfall, its reservoirs will dry up completely. No modern American city has ever experienced this. There is, as the city manager put it, no manual for what comes next.

The city has mandated 25% water cuts across the board from September. But city data shows that 70% of households already use less water than the new restrictions require. The residents have, in other words, been squeezed dry. Figuratively, for now. The cuts will have to come almost entirely from the industrial users who account for more than half of the city’s water consumption: ExxonMobil, Valero, Occidental, and others, whose plants consume tens of millions of gallons daily. A single Exxon plastics facility uses 13 million gallons per day. None of these companies have publicly explained how, or whether, they intend to comply.

If industry shuts down, the economic collapse of the city follows. If it doesn’t, the reservoirs empty. Schools are exploring drilling their own wells. Hospitals want exemptions. The mayor has balked at cutting off household water supply to those who can’t comply. Nobody, including the city’s own legal team, is sure what authority the city actually has to enforce any of this on its industrial customers.
(KUT News)

Long reads

The press looked away. Again. Media coverage of violence against women and girls has hit a nine-year low, accounting for just 1.3% of global online news in 2025, down from a peak of 2.2% at the height of the #MeToo movement in 2018. This is in spite of rising AI-assisted abuse and widespread sexual violence in active conflict zones. A new report - The Global Misogyny News Coverage Tracker - hopes to change that.
(AKAS)

The mosquito menace. A piece in Nature about how new vaccines mean malaria deaths should be on the way down. Why then, it wonders, are they rising still?
(Nature)

Smile, you’re on camera. And finally, to end what even we think is a dystopically dark issue, a look at some cute wildlife and stunning nature pics. Winners of the World Nature Photography Awards 2026. Go on, you deserve it for making it all the way here.
(World Nature Photography Awards)

Oh, and Gopal Nair doesn’t want you to see this.

As of midnight yesterday, a 10-day ceasefire has apparently been agreed between Lebanon and Israel. Let us not get into the nitty-gritties of how two sides can agree to a ceasefire when only one side is doing the firing but let us instead place odds on how long before Israel violates this ceasefire, unless they’ve already done so by the time you’re reading this. Because there are still some schools and hospitals standing. The Israeli “defence” minister has already said they will continue occupying all the land they’ve seized in Lebanon. Because that is just the Israeli way. A history lesson is called for here. In 1978, the UN set up a peacekeeping mission in Lebanon, called United Nations Interim Force In Lebanon (UNIFIL). The interim in the name might lead you to believe UNIFIL would’ve ceased operations nearly 50 years later. But it is still around. And it is still being attackedterrorised by Israel.

Attacking schools is the number one rule of conflict zones around the world. Proof? Here, this report from the Democratic Republic of Congo (DRC) that shows a 300% rise in attacks on schools in the past year.

In neighbouring Burundi, it is illness of the mystery kind that is attacking kids and adults, with 35 people ill and five already dead. Disease symptoms include fever, vomiting, diarrhoea, and blood in urine, and severe cases have also reported jaundice and anaemia. Authorities have already ruled out Rift Valley fever, yellow fever, Crimean-Congo haemorrhagic fever (CCHF), Ebola and Marburg.

If you’re looking to visit Nigeria this year, especially between July and September, be prepared to swim a lot. Because the Nigeria Hydrological Services Agency (NiHSA) just released its annual flood outlook for the country, and it’s gonna be a really, really wet year. The outlook predicts widespread flooding across 33 ‌of Nigeria’s 36 states, and also capital Abuja, with a peak between July and September.

In Haiti, water, health, education, sleep, safety, and childhood are all at risk, both due to continually escalating violence and continued unavailability of everything needed to ensure all of these.

In Rajasthan, India, one more mystery illness has taken root, claiming the lives of seven children this past week alone.

India also saw three huge fires near its capital this week. One in Lucknow, Uttar Pradesh. Another in Ghaziabad, Uttar Pradesh. And the third at a landfill site not too far from the capital. The visuals look like scenes from the aftermath of a war zone. Were there lives lost? Yes. How many? Who cares? Poor people don’t count for shit here. Case in point: In this same week, there was a boiler explosion at a power plant killed at least 14 people in Chhattisgarh state. The compensation for the families of those who died? Rs 500,000 from the state government and Rs. 200,000 from the central government. That’s it. That’s how much a life is worth, in case you wondered. In this particular case, there might be sentencing and punitive verdicts but we will come to that when it happens because there is some backstory there.

In good news, Indian drug regulators have made it easier, and faster, for drug manufacturers hit the market. Good news for the manufacturers. But since Indian drugmakers are known the world over for being the quality standard to aspire to, we guess this is good news for the end user too.

Bird flu is refusing to fly off anywhere. The newest entrant to the list is Côte D’Ivoire who reported an outbreak of H5N1 no less at a farm, resulting in 95,000 birds crossing over to the other side.

The Global Fund, in partnership with the US, is ramping up access to Gilead’s HIV drug Lenacapavir by a whopping 1 million doses. With the US being involved, it is very likely this delivery might be through the newly-signed bilateral deals, and might even be contingent on the beneficiary nations agreeing to US’ terms on sexual and reproductive health. But 1 million doses is a fantastic number, right? Especially when we have 1.3 million new cases of HIV every year? Oh! Maybe Doctors Without Borders has a point when they call this inadequate. In another timeline, Gilead cares.

After making bank with diabetes and obesity, Novo Nordisk is now looking to cash in on AI in a new partnership with OpenAI to “bring new and better treatment options to patients faster.” Yeah, AI will certainly do that. At least the new part. As for better, well, it’s subjective, ain’t it?

Speaking of AI in healthcare, Amazon too is getting into the game, with Amazon Bio Discovery a research tool to speed up early-stage drug discovery.

And finally, with AI, Amazon won’t have to worry about workers and the clock anymore, we guess. Because human workers sometimes faint. And other workers sometimes show empathy for the ones who’ve fainted. And then, Amazon has to instruct managers to tell workers to ignore their passed out colleagues and continue working coz those packages aren’t gonna pack themselves. Colleagues might die today. It’s okay. You’ll get new ones tomorrow. But delivery? That has to happen today. Coz it’s Prime time, baby!

Stories Of The Week

People without a home. Three years into the conflict, Sudan has become the world’s largest humanitarian and displacement crisis. Nearly 34 million people - two thirds of the population, now need assistance, while close to 14 million have been forced to flee their homes. Around 4.5 million have crossed into neighbouring countries, with Chad, South Sudan, Egypt and Uganda among those bearing the heaviest burden on already fragile systems. Inside Sudan, nearly 9 million remain internally displaced, and those who have returned to areas like Khartoum find homes damaged, services absent, and livelihoods destroyed. Climate shocks - flooding, extreme heat, and disease outbreaks - compound what conflict has already broken.

The human cost to children is staggering. Since the conflict began, over 5.6 million babies have been born into war, many to displaced mothers in under-resourced facilities without electricity or skilled medical staff. Sudan’s maternal mortality rate has risen by more than 11% since 2022, and the infant mortality rate stands at 42.9%. An estimated 70–80% of health facilities in conflict-affected areas are non-functional, and WHO has verified over 200 attacks on healthcare since April 2023, killing nearly 2,000 people. In just the first three months of this year, at least 245 children were killed or maimed, a 50% increase on the same period last year.

“After three devastating years of war, children in Sudan continue to bear the heaviest toll, with drones responsible for nearly 80 per cent of all reported child killings and injuries. As this conflict enters its fourth year, the reality for children in Sudan is growing darker hour by hour.”
Eva Hinds, UNICEF Chief of Communication in Sudan.

Famine, once considered a risk, is now a stark reality. Over 28.9 million people are acutely food insecure, with famine already confirmed in El Fasher and Kadugli and spreading risk across more than 20 localities in Darfur and Kordofan. Families in besieged areas are surviving on one meal a day or less, with some turning to leaves and animal feed. Agriculture, which employed two thirds of the population before the war, has been decimated and supply routes are now controlled by armed actors who extract bribes and food at checkpoints. The approach of the main planting season makes the window for agricultural recovery narrower by the day. Sexual violence has further compounded the food crisis: women and girls face heightened risk of assault in the course of routine activities needed to access food, making female-headed households three times more likely to experience food insecurity.

The third International Conference on Sudan, held in Berlin, brought together foreign ministers and representatives from 55 countries and resulted in pledges totalling €1.5 billion in humanitarian aid. Germany committed €232 million, the EU and its member states €811 million, and Saudi Arabia $145 million. Despite broad agreement on the urgent need for a ceasefire, the conference produced no truce and no cessation of hostilities. Critically, the countries funding and arming the warring parties were not named at the conference, nor were the warring parties themselves invited to attend. Senior UN officials described Sudan as an atrocities laboratory, citing sieges, the deliberate use of starvation as a weapon of war, sexual violence, and sustained attacks on civilian infrastructure. The overall humanitarian response plan requires $2.9 billion and is currently only 16% funded. Without a ceasefire and sustained international pressure, the pledges made in Berlin risk being absorbed into a crisis that continues to outpace the world’s willingness to confront it.

Despite all this doom though, the human spirit still finds a way to shine through. Away from the headlines and the funding gaps, in a camp on the outskirts of the Ugandan town of Biale, nearly 600,000 Sudanese refugees are quietly rebuilding what war took from them. A civil engineer who once worked with the UN in Darfur now leads his refugee community from inside a tent. A former trader from South Darfur runs one of twenty community kitchens that sprang up after food rations were cut, feeding neighbours he describes as his own flesh and blood. A university professor who fled Khartoum under bombardment now travels regularly from Kampala to the camp to support those who arrived after her. A Sudanese doctor practices medicine in a Ugandan hospital, contributing to a country that received him without discrimination. And a man who arrived in Uganda in 2008, long before this latest wave of displacement, built a hotel he named The White Heart, chosen as an invitation, he says, to overcome the bitterness of repeated wars. In Sudan’s darkest chapter, its people continue to find ways to show up for one another. Bless our collective hearts!
(IOM, ReliefWeb, UNICEF, UNICEF, FAO, NRC, UN, Dabanga Sudan, UN)

Water? We’ve a plan for it! Recently, we all read about how the world is now entering a water bankruptcy phase. The World Bank has a solution. Water Forward. An initiative it is launching with a coalition of multilateral development lenders to deliver water security to one billion people by 2030. How? By mobilising private, public and philanthropic capital across 14 water-stressed countries in Africa, the Middle East and South Asia to target urban leakage and to modernise irrigation and to reuse wastewater and, of course, for data-driven planning.

Global freshwater demand is projected to outstrip supply by up to 40% before the decade is out. Over two billion people currently lack safe drinking water, and water-related shocks are already carving several percentage points off annual economic growth in vulnerable nations. So we can understand coming up with plans to deliver water security in four years. But seriously, how is this anything but a fool’s quest? We didn’t fix anything in 10 years since the SDGs were implemented and in four years, it’ll all be hunky-dory? Especially when the agency that came up with the plan spent over $2 billion on consultants last year alone?

That reminds us: there is a tower in Paris that The Kable owns and we’d like to sell cheap. Maybe, say, $2 million?
(World Bank, Devex)

Bottom line

Here we go, again. Not that we needed reminding but here is a reminder nevertheless that global wildlife trade is the best pipeline for animal pathogens to find their way into human bodies. A new analysis published in Science found that traded mammals are 1.5 times more likely to share pathogens with humans than their untraded counterparts, and that the longer a species spends in trade, the more pathogens it contributes to the exchange: roughly one additional pathogen per decade on the market. Live-animal markets are worse than product trade, illegal trade is worse than legal, and the entire supply chain from poaching to pet shop is essentially an extended networking event between human immune systems and diseases they have never met before. HIV, Ebola and Covid have all been linked to traded wildlife, and researchers are now flagging that as new species enter the trade, new pathogens will follow. Four in five scientists recommend reducing the volume of trade overall. But the fifth fellow... that fellow has historically come down on the supply side when it comes to demand for exotic pets, ivory trinkets, pangolin scales, and donkey balls.
(Science)

Long reads

A resurrection unrivalled. People say media in India is sold out and no longer reliable. Which is true. Except for independent media which is still doing a fantastic job of reporting stories that would otherwise not see the light of the day. Two examples this week are part one and part two of this three-piece investigative series on Indian pharma companies that killed children and suffered no consequences. Reported by News Laundry and The News Minute, with their reporting supported by the Thakur Foundation, incidentally founded by India’s most-famous pharma whistleblower. We’ve linked only to News Laundry because we have issues with the public backing that one of The News Minute‘s founders displayed for one of the aforementioned sold-out media in India and that is something they’ve never addressed adequately enough for us.
(News Laundry, News Laundry)

Yes all men. A new report on CNN found a chat group documenting ways of raping and sexually assaulting their wives and partners, with 62 million visits in one month alone. Don’t let anybody ever say not all men.
(CNN)

Inferius. Inferius. Inferius. And finally, since we began with Israel, it is fitting that we round off this depressing week with Israel and testimony about rape and sexual violence of the worst possible kind inside Israeli prisons. Just when you think Israel can’t sink any lower, they lower the bar even more. If you have the fortitude, EuroMed also has a Twitter thread documenting this abuse.
(EuroMed Monitor)

Oh, and Gopal Nair doesn’t want you to see this.

If you’ve been with us from the very beginning, you may have noticed our various evolutions - from a daily newsletter, focussed primarily in the pharma space, to a weekly format, still mainly focussed on pharma but from a Global South perspective, to a latter expansion into One Health keeping the Global South, mainly Africa, rooted at the centre. Over the last year or so, we’ve ourselves noticed that The Kable, while still maintaining life sciences and One Health at its core, has taken on more of a geopolitical voice. We’d like to say the evolution is organic and also, we’d argue, inevitable because haven’t events in the past, say, 30 months confirmed that everything in the world is indeed political? Art, trade, business, technology, economy, global affairs, aid, diplomacy, health, climate... everything is political.

The unfortunate truth is the people most affected by global politics, or even local politics, also have the least agency in the outcome. At The Kable, we are under no illusion that we can ever change that. However, what we can do is bear witness. We will continue to do so. And we hope you will continue to be with us here, almost every Friday, till there is nothing left to witness.

On with The Kable then.

A week that began with an orange idiot with access to both social media and nuclear weapons threatening nuclear annihilation over the weekend, followed by a UN Security Council vote, vetoed by China and Russia, that sought to open the Strait of Hormuz by force, and then, a ceasefire declaration between Iran and the US, with mediation from Pakistan, who strangely abstained from the UN vote.

Unfortunately, Israel has never met a ceasefire it couldn’t violate. Why would this one be any different? Within hours of the announcement, Israel bombed Lebanon. Again. And again. And again. Over 10 times in less than 10 minutes, with hundreds of people dead and thousands injured. Among the places Israel bombed: a mosque, a cafe, a grocery shop, a bakery, a shop, a house, a car wash, another grocery shop, a pharmacy, many civilian buildings, and a funeral. Yup, a goddamned funeral. Also, entire villages, and their forever favourite targets, hospitals. There are far too many horrifying reports from far too many witnesses and survivors to carry here but we will leave you with this fairly-sanitised testimony from a Doctors Without Borders staff member. May April 8 be a date that forever lives in infamy and is forever associated with the horrors perpetrated by a rogue state.

With all the atrocities that Israel is, and has been, inflicting on Lebanon, one would think the situation in Gaza and Palestine wouldn’t have worsened, no? But evil wears many faces. The attack on Iran has been on for 40 days, and Gaza has been bombed by Israel for 36 of those days. In that time, only 8% of medical evacuations have been allowed, and only 20% of aid trucks have been let in. Even MSF is not able to get aid in. Repeatedly. The WHO is kinda stopping work because Israel killed their contractor. And Israeli settlers are ramping up violence too. The Israeli cabinet has even approved a record number of settlements in the West Bank. Fun fact: like most things Israeli, this too is illegal under international law. But so is spraying chemical agents to stop vegetation from growing. Didn’t stop Israel from doing that in Syria and Lebanon earlier this year “to prevent terrorists from hiding.” Nor has international law stopped Israel from committing ecocide in Palestine in all these decades. Also, olive trees are native to the Levant, not pines. Not even Aleppo pines.

Over on the hellsite formerly known as Twitter somebody asked for the UAE to be permanently banned from all of Africa.

If you’re wondering why, here is more reason from The Middle East Eye on how the UAE is using Ethiopia as a staging point to route arms to the RSF to continue the genocide in Darfur.

Measles has found its way to Bangladesh, with an outbreak killing more than 100 children. In response, authorities have launched emergency vaccinations but they really need to close their borders to unvaccinated Americans.

How about some good news for a change? We do cover those too in The Kable, you know? The good news today is that IAVI has launched a clinical trial for a single-dose Marburg virus vaccine. Our only grouse with this trial is that considering pretty much all Marburg outbreaks have been in Africa, why is this in-human trial happening in the US?

This week also saw the G7 One Health Summit in France. And the summit had a lot to say. But what the summit said most of all was that aerosol transmission of respiratory infections is a myth. And they said it without saying a thing, if you looked at any of the pictures coming out of the event. But, that’s a rant for another day. So what did come out of the summit? First, a nothingburger declaration on reforming global health architecture. If the voices with the most agency in global health architecture remain the ones with the deepest pockets, there is no change forthcoming. The summit did see a whole lot of pledges pledged though. The EU and the World Bank both got in on the act. The Gavi director said they’ll be talking to the board to sanction some more funding for African vaccine manufacturing. As a summit, it was most fruitful for the Africa CDC who secured more than $250 million in funding for various programs. And if there are summits and announcements, you can always count the WHO in. This time, in the form of a set of R&D roadmaps for pathogens that could trigger the next pandemic, obviously as long as they aren’t airborne, which going by the picture that accompanied the WHO release, won’t be the case.

Just last week, MSF was moaning about how Gilead won’t sell HIV drugs to them. How could they? They have acquisitions to make-make and shareholders to please-please.

The US has expanded its bilateral health deal agenda to Asia now, signing its first such deal with Cambodia. Cambodia gets a little under $31 million, for the same loss of public health data as the 27 other countries that have signed similar deals. And the US wants reciprocity.

And the current US dispensation, apparently blessed by Christ himself, has threatened the Vatican to take its side, or else. In any case, the Pope, the first American-born Pope, has cancelled plans to visit the US later this year.

And finally, do you have bixonimania? If you look at a screen far too much in a day, (and face it, we all do, those Instagram reels aren’t gonna watch themselves, are they?) you probably have already developed bixonimania. AI insists. And if ChatGPT and Gemini say it’s true, it bloody well better be true.

Stories Of The Week

Families uprooted. Three years since the war in Sudan erupted, repeated displacement is pushing families across Sudan, South Sudan and Chad into collapse, with most households reporting nearly four major losses including homes, livelihoods and personal belongings. A survey by the Norwegian Refugee Council (NRC) of refugee- and displaced households shows that solidarity among communities is reaching breaking point as over 90% of families in South Sudan, 80% in Sudan, 75% in Egypt and 70% in Chad are reducing or skipping meals, with nearly universal hunger across the region.

The crisis has caused a collapse in coping capacity, with 74% of households in Sudan, South Sudan and Chad having no income whatsoever. In Chad, 9 in 10 women-headed households have no income, while basic needs continue to deteriorate - 20% of women in Sudan, Chad and South Sudan have no access to any toilet or latrine, three times more than men. Children are particularly vulnerable, with 18% of households compelled to send children to work, and family separation tripling the risk of child marriage in Chad and nearly doubling child labour. Across the wider region, only 45% of children in displacement have regular access to education, with nearly one in five having none at all. Despite the extreme conditions, in Sudan and Chad, nearly 1 in 3 people receiving aid are still sharing what they have with others, though mutual solidarity built on food-sharing among people going hungry themselves has reached its limits.

But as long as there is gold in Darfur, and tall, glitzy towers to be built in far-off desert capitals, people of Sudan and their neighbours won’t know peace.
(NRC)

Lives upended. Preliminary estimates from the International Rescue Committee (IRC) show that of the more than 1 million people internally displaced in Lebanon’s current crisis, approximately 350,000 are children, with over 45,000 currently living in overcrowded collective shelters across the country. An IRC report says that repeated displacement is having compounding effects on children’s emotional wellbeing, behaviour and development. Well, duh!

Caregivers report that maintaining routine has become nearly impossible as daily structure breaks down in chaotic shelter environments, with children constantly surrounded by noise and activity. The instability is manifesting in visible behavioural changes, including a rise in violent behaviour, aggressive language, and emotional outbursts, with children now playing war-related games instead of peaceful, simple play. Psychological distress is deepening, with children showing increased anxiety, constant fear of losing loved ones, and unusual clinginess, while older children are internalising loss of hope for the future due to repeated disruptions to education. But hey, what is one traumatised child when Israel is finding Hezbollah in hospitals and graveyards?
(IRC)

Planet overloaded. A new study says humanity, no, humankind has already exceeded Earth’s carrying capacity, with our current counted population of 8.3 billion far, far, far beyond sustainable levels. Using more than 200 years of population data, researchers differentiated between maximum carrying capacity (estimated at 12 billion) and optimum carrying capacity (a measly 2.5 billion), finding that our current consumption levels make us well beyond what the planet can support long-term.

According to the study, human population growth shifted from increasing rates to a negative demographic phase in the early 1960s, where adding more people no longer means faster growth. Global population is projected to peak between 11.7 and 12.4 billion by the late 2060s or 2070s, if current trends hold. But the gap between the sustainable optimum of 2.5 billion and our current population itself is causing water and food shortages, animal population crashes, and climate disruption. Can’t even begin to imagine what it will be like when we add half as many more people.

Study authors also said that meaningful change is still achievable if nations work together to overhaul socio-cultural practices for using land, water, energy, biodiversity, and other resources. In other words, we’re up poop creek without a paddle.
(Environmental Research Letters)

Bottom line

Water ain’t gonna wash these away. Drugs in India positions itself as the pharmacy of the world. And it does rank as one of the world’s most prolific drugmakers. But India is also well known for rampant antibiotic consumption, and completely random disposal. And the truth of both is evident in India’s wastewater, as SciDevNet points out. Researchers analysing wastewater samples across four Indian cities - Delhi, Mumbai, Kolkata and Chennai - found urban waste teeming with resistance genes. And yes, the microbes themselves may vary from city to city but the mechanics of drug resistance are pretty much the same. It is precisely India’s predominant position in the drugmaking and antibiotic-manufacturing spaces why this is not just an India-specific public health concern, but something that affects all of us everywhere. Also read what Gopal Nair doesn’t want you to read today for a corollary piece.
(SciDevNet)

Long reads

Make local but import more. As more or less is the norm now, this section kicks off with The Conversation Africa. This time talking about how local manufacturing in Nigeria doesn’t stop the country from still importing over 70% of its medicines.
(The Conversation)

Make local but how? And now, it is Devex talking about how making in Africa is not as easy as it sounds because the incentives aren’t doing the job they ought to.
(Devex)

AI to the fore. And finally, a look at pharma’s increasing tilt towards AI and who stands to gain the most. Hint: won’t be Africa or the Global South.
(Devex)

Oh, and Gopal Nair doesn’t want you to see this.

Something new did happen this week, though. Humanity planned a trip back to the moon for the first time in over five decades, but we’re still no closer to sending Space Karen on a one-way shuttle to Mars.

In Africa, the Africa CDC is getting back into the acronyms game and making up for lost time with a mouthful this time. Spark-NCDs, or to fully spell it out, Strengthening Public Health Surveillance and Resilient Knowledge for Non-Communicable Diseases in Africa. Launched in Tanzania early in the week, this program, yet another flagship one, will enhance disease surveillance systems, generate comprehensive NCD data, develop healthcare workforce capacity, and implement integrated, people-centred care across the continent. If it works as intended, we will forgive the mealy-mouthedness of the name.

Speaking of acronyms, how about BRIGHT then? That’s what the International Vaccine Institute (IVI) and the Brazilian government have named their joint fund, looking to boost research in Global South health innovation. In case you’re wondering, BRIGHT as in Bridging Research Investment in Global Health Technology.

Talking about Global South cooperation, one bit of news that we missed, and one that thankfully isn’t an acronym, is the announcement by FIOCRUZ about the launch of the Global Coalition for Local and Regional Production, Innovation and Equitable Access. HQ-ed in Brazil, this, umm, coalition, will work on vaccines, therapeutics, diagnostics, and health technologies. And it has a bucketload of partners on board already.

There will be a couple of mentions of Sudan in today’s Kable. And with good reason. The country has the world’s largest population of internally displaced people only because the land is rich in agriculture, livestock, mineral, and gold resources, which certain states in other parts of the world are looking to corner. In a teeny-tiny bit of good news, the Global Fund has approved emergency TB funding to support diagnosis and treatment for displaced people and host communities. A small amount - a little over $1.5 million - but the Fund is hoping this will cover 10 states that are less conflict-ridden.

The Pandemic Agreement that we wrote about so eloquently last week (pat, pat)... well, the delegates debating the agreement didn’t close it out. Instead, they agreed to negotiate for five more days from April 27 to May 1.

If you looked at the Pasteur Institute’s network website for a list of their members across the world, you will see 32 members, with 7 in Africa and 9 in Asia. One of the 9 in Asia is Tehran’s institute, set up in 1920, which also serves as a biobank and cell bank and stores malaria vectors and has BSL-2 and BSL-3 labs where research on arboviruses and AIDS and TB and hepatitis and other conditions happens. Thanks to Israel and the US, though, now there are only 8 Pasteur Institutes in Asia. Well, it’s okay. Pasteurisation is overrated anyway. Ask the US. Raw milk is all the rage there. Raw milk and E.coli.

We couldn’t resist this. Sorry. The Medicines for Malaria Venture is taking AIm at malaria in a partnership with deepmirror, with the launch of Drug Design for Global Health (dd4gh) (yeah, yeah another acronym, we dgaf). dd4gh (can’t even key that in without making typos) is an AI platform that will speed up drug discovery for researchers working on new malaria drugs. Hopefully, faster than those blasted mosquitoes can adapt.

Elsewhere, the Pandemic Fund has announced its fourth call for proposals with a new targeted approach. Instead of open competition, this round focuses on 15 countries facing the highest pandemic risks and capacity needs that have never received multilateral country grants: Afghanistan, Benin, the Central African Republic, the Republic of Congo, Eritrea, Guinea, Haiti, Liberia, Madagascar, Mali, Mozambique, Niger, Nigeria, Sudan, and Uganda. With $244 million total available, each country receives a preset allocation or maximum request amount, plus a full year to develop proposals.

The MSF has written an open letter to Gilead, once again asking Gilead to sell them their HIV drug Lenacapavir, instead of asking them to only wait for Global Fund supplies. Once again, Gilead has said no. Not because they can’t give. But because they won’t. Even a cursory look at Gilead’s history would’ve been enough for MSF to know that doing the right thing isn’t what Gilead is about.

A timely study in The Lancet Neurology that says 2023 saw more than 250,000 people die of meningitis. Somebody send this to health authorities in the UK and to whoever is in charge of the meningitis page at the WHO. Don’t bother sending it to health authorities in the US, though, because there are no health authorities there anymore. ‘Murrrica.

In Hong Kong, online retailer HKTVmall’s parent company, Hong Kong Technology Venture Company, released its annual report. And in the report was this: “The team is dedicated to developing and refining equipment designed to maintain the viability of detached body organs, such as limbs and heads. The team has conducted 38 experiments in which the animals’ limbs or heads were separated from their bodies.“ Yup, there was blowback. And the company issued a clarification saying the only animals involved were pigs and sheep. Glad that’s all sorted then.

The WFP this week issued a statement that “global disruptions to supply chains” are why people will be hungry tomorrow. The “global disruptions to supply chains” is the “closure” of the Strait of Hormuz to forces hostile to the territory that governs said Strait.

And the UN Security Council this week actually voted, on a resolution brought by Bahrain, to authorise armed force to open the Strait of Hormuz. None of the speakers at the Council said anything about Iran being attacked, but had lots to say about Iran doing the attacking. The US even spoke at the Council, and the only representative who even mentioned Israel was Pakistan. After the first vote failed, thanks to a veto by Russia, China, and France, Bahrain re-drafted the resolution to make it defensive intervention. The Security Council was scheduled to vote again today, but it has been deferred to next week.

Moving on to our favourite subject: disease. Taiwan has reported its first case of human bird flu and 33 close contacts have been identified already. Singapore has reported its first local case of the new mpox strain. And in Germany, the mpox clade 1b strain is quietly becoming a clusterrhymeswithbuck. In the US though, the CDC is on top of things. The agency has paused or stopped testing for dozens of infectious diseases. Testing is so third-world, baby! In India, in Etah in Uttar Pradesh, a mystery viral fever is once again raging. This seems to happen in this same place like clockwork every 4 to 5 months.

We won’t even tell you about the theft of viral samples from a BSL-3 lab in Brazil, some of which were later found discarded in a public trash bin. Some of the known samples included H1N1 and H3N2 flu viruses - both human and swine variants, and the rest are still being tested. And here, we’re thinking BSL-3 facilities are all super-secure.

Apropos of nothing, we recently discovered there is an association in India that works towards dissemination of awareness about heart strokes, and also research on the subject. Unfortunately, they’ve named themselves Indian Stroke Association. And their website is... umm, take a look.

And finally, groundbreaking scanning technology has revealed a mysterious structure hidden beneath ancient city ruins in Egypt’s northwest Nile Delta. No news yet on whether they found an ancient book with it, but we know what happens next.

Stories Of The Week

No safe country for women. In war and conflict, the first group of people to pay the price are always children and women. And they’re also the ones who pay the price for the longest time. We hear about soldiers, mostly men, who went to war and got PTSD and had movies made about them, but never about the children and women who became victims of conflict they didn’t seek or make. However, we’ve all seen news and reports of what happens to children and women. Child soldiers beaten and abused into soldiering, women abused, sold, traded across war zones around the world. Horrifying testimony after testimony about abuse of the worst kind. And it never ends. (Disclaimer: we aren’t including transpeople here simply because of lack of data and no other reason)

This time, it is from Sudan via a new report from MSF. Between January 2024 and November 2025, at least 3,396 victims and survivors of sexual violence sought treatment in MSF-supported facilities across North and South Darfur, though MSF warns this represents only a fraction of the true scale, as many cannot safely reach care. Women and girls accounted for 97% of victims treated in MSF programmes. Following the RSF’s capture of El Fasher, the capital of North Darfur, on 26 October 2025, MSF treated more than 140 victims who reached Tawila in November, with 94% of these attacked by armed men along escape routes. In just one month between December 2025 and January 2026, MSF identified a further 732 victims in displacement camps around Tawila, where women reported attacks both during their journeys and within the camps.

The violence extends far beyond active conflict zones. In South Darfur, hundreds of kilometres from active ground fighting, 34% of victims were assaulted while farming or travelling to farmland, and 22% while collecting firewood, water or food. Children are also among the victims, with one in five survivors in South Darfur under 18 years of age, including 41 children younger than five.

MSF data shows patterns of systematic abuse, with armed men responsible for most assaults - over 95% in North Darfur, while nearly 60% in South Darfur involved multiple perpetrators. Survivors face significant barriers to care including insecurity, stigma and limited protection services, while sexual violence is being used as a weapon of war and a systematic means of controlling civilians, in violation of international humanitarian law.
(MSF)

Immigrants, they get the job done. Increasingly around the world, we’re becoming more insular as people. Insular to the point of xenophobic, even. Not just among countries but even within countries. Within states, even. And this insularity is coming at a time when increasingly people are migrating because opportunities are condensing into ever-smaller pockets around the world. Every sociological survey for the longest time has been saying that we will be a planet of migrants and refugees in no time at all, thanks to conflict, climate, cash, and commerce. Yet, the words migrants and refugees invoke derision more than shared empathy no matter where you go. Is there hope around the corner though?

More than 60 countries now include refugees and migrants in their national health policies, according to a new WHO report tracking progress on 2019 World Health Assembly commitments. The survey of 93 member states finds two-thirds include these populations in health plans, with 16 countries reporting refugees can access services on par with host populations, 14 extending that to documented migrant workers, and 11 to asylum seekers.

However, no country surveyed provides equal access to migrants in irregular situations - those living without legal status or documentation. While Belgium and Chile are presented as positive examples with intercultural mediation programs and migrant community representatives in health councils, the report reveals significant gaps: only 37% of countries routinely collect migration-related health data, fewer than 40% train health workers in culturally responsive care, and just 30% run campaigns to counter discrimination.

The situation is particularly dire in emergency planning, with only 42% of countries including refugees and migrants in disaster risk reduction frameworks, and irregular migrants entirely absent from those plans. Oh and, wealthy nations? They’re actively restricting access. Not even talking about openly xenophobic places like the US. Canada plans to start charging refugees for essential services in May. Germany extended emergency-only care restrictions to 36 months because when you come to a new land with no resources and no support and no people, three years is all the time you need to stand entirely on your feet.
(WHO)

Exodus in motion. If you want to look at how refugees are made, there is a refugee crisis unfolding in real-time right now in Lebanon, thanks to those decades-old experts in dispossessing and displacing people. More than one in every five children in Lebanon has been forced to flee their homes in just one month, as Israeli airstrikes and displacement orders have displaced 1.2 million people - 20% of the population - since early March, including 350,000 children. Families are forced to leave everything behind, with many relying wholly on humanitarian aid after years and years of living in crisis mode already. If that wasn’t proof enough, here UNICEF is piling it on, saying that in just three weeks, 370,000 children have been forced out of their homes at an average of at least 19,000 children displaced every single day. The UN’s top humanitarian official told the Security Council that Lebanon is facing one of its most dangerous moments in years, with over 1,240 people killed and 3,500 injured in the past four weeks. The situation is particularly dire in Syria, where UNHCR reports more than 200,000 people have crossed the border from Lebanon since March 2, with the vast majority being Syrian refugees who had fled Syria previously and are now forced to flee again. The IOM has called for increased international support, saying the scale of displacement is pushing the country to its limits. With only $94 million received of a $308 million emergency appeal, humanitarian agencies are struggling to meet needs as displaced families crowd into 660 collective shelters - including 470 schools turned into temporary housing - with many sleeping on streets or sharing classrooms without privacy, heating, or adequate hygiene. Even places - historical and cultural monuments - are under threat, with UNESCO taking 39 of them under its protective wing. Like that will stop Israel.
(Save The Children, UNICEF, UN, UN, IOM, UNESCO)

Don’t forget Somalia either. Nearly 2 million children across Somalia are at risk of acute malnutrition as the country faces a deepening emergency driven by drought and the same old combo of conflict, displacement and funding cuts. The attack on Iran and the subsequent stress on global supply chains, with transport costs for food, medicines, fuel and water becoming more expensive, is only making things worse.

With Somalia’s heavy reliance on imports, prices are climbing fast. In drought-affected areas, water costs have more than doubled as scarcity grows and fuel for delivery becomes unaffordable. UNICEF has $15.7 million worth of supplies in transit for Somalia, including nutritional treatments, vaccines and insecticide-treated bednets, but these shipments risk delays or added costs if the situation in Iran remains unresolved. Over the past year, more than 400 health and nutrition facilities have already shut down due to insufficient financing, including 125 sites offering vital nutrition assistance. Without immediate support, more may be forced to shut down in districts experiencing the highest levels of food and nutrition insecurity. And worsening drought could push 6.5 million Somalis into crisis and emergency levels of food insecurity by the end of this month. What UNICEF needs is $121 million for this year and what they’ve raised so far is less than $20 million.
(UNICEF)

Huff and puff and turn yourself around. A large study finds that just a few minutes of vigorous physical activity each day could dramatically cut your risk of major diseases, including a 63% lower risk of dementia, 60% lower risk of type 2 diabetes, and 46% lower risk of death. The research, published in the European Heart Journal, shows it’s not just how much you move, but how intensely you move that matters, with short bursts of vigorous activity like rushing for a bus or climbing stairs quickly linked to striking reductions in disease risk. The study even found that intensity played a larger role for certain diseases. For inflammatory conditions like arthritis and psoriasis, intensity was the key factor, while for diabetes and liver disease, both duration and intensity mattered. Now, if only jumping to conclusions was considered vigorous activity, we’d be in peak physical form right now.
(European Heart Journal)

Breakthroughs

Go to bed whenever but wake up early as heck! A new clinical trial found that solriamfetol can significantly boost alertness in early morning shift workers struggling with shift work disorder. The study included 78 workers who typically start shifts between 3 AM and 7 AM - a time when the brain is biologically programmed to sleep. Participants taking the drug showed clear improvements, staying less sleepy and remaining awake longer during simulated work hours, with both participants and clinicians noting better overall functioning, improved work performance, and greater ability to manage daily tasks throughout full eight-hour shifts. The research addresses a major gap in shift work disorder treatment, as previous medications have mainly been studied in overnight workers and can interfere with later sleep. This drug, though promotes alertness for extended periods without significantly disrupting later rest. The study has only been funded by two pharma companies, so it’s highly unlikely if the trial resulted in market approvals, it would be sold to your corporate overlords to get you to come in to work early. Nope. Nor will it be given to you as a bonus.
(NEJM Evidence)

Bottom line

Is it hot or is it just us? If you’re talking rural Africa, then it’s definitely not us. Not that we aren’t hot. But rural Africa is hotter. And getting even more so. A new study using 10 global climate models reveals that rural African communities are facing dangerous heatwave exposure nearly twice as much as urban residents, and the heat gap is growing. While everyone assumes cities trap heat the worst, the research shows rural populations across Africa are already recording between 20 and 1,000 person-days of heatwave exposure per year, compared to urban residents’ fewer than 20 person-days. Under a future with meaningful emissions action, rural exposure in south-east Africa will reach over 200 million person-days by century’s end, versus roughly 100 million for urban dwellers. In high-emission scenarios, climate change becomes the dominant force, driving rural heatwave exposure to roughly 70 million person-days in south and west Africa combined, compared to just 5 million for urban populations. The danger isn’t just how hot it gets but how hot it gets in places with no way to escape it, where farmers can’t stop working when temperatures spike and pregnant women face heat exposure linked to premature births with no nearby clinics to intervene.
(The Conversation)

Bug free and fantastic. Who even likes insects, right? Sure, there will be the odd, quirky nephew here and there who is an avid insectologist or whatever but people in general prefer seeing as little as possible of them as they can. Thankfully, climate change may make it so that we don’t have to see them at all. At least some to begin with. A new study measuring heat tolerance of over 2,000 insect species in Kenya and Peru reveals that many tropical insects are already living close to their thermal limits and may struggle to survive further warming. The research shows that insects from lowland areas are already very close to their critical thermal maximum - the temperature at which they lose motor control due to heat stress - while flies are particularly vulnerable with lower tolerance and less stable proteins. The study used mountains as natural laboratories, collecting insects from hot lowland savannas to cooler highland forests and gradually increasing temperature until each insect entered heat coma. Results showed that lowland insects have little to no capacity to temporarily increase heat tolerance through physiological responses like producing heat shock proteins, while insects from higher elevations could slightly adjust to more heat. This suggests heat limits may be constrained by fundamental protein architecture, meaning many species may not be able to evolve fast enough to keep pace with rapid climate change. Study authors posit that with insects making up 90% of all animal species and being essential to ecosystems through pollination, waste recycling, and forming food webs, the loss of tropical insect species would have far-reaching consequences for ecosystems, agriculture and human well-being. Pollination, smollination! Bah! It’s not like we’ll even have oxygen to breathe. What is with all this pollination nonsense? Kill the butterflies and kill the bees too. We don’t need honey, we’ll have whiskey. Hic!
(The Conversation)

Who drank all the coffee? We’ve only been sharing good news on the coffee front for a long time now. Finally, the law of averages has caught up with our favourite brew. A new Rabobank report reveals that climate change could make 20% of land currently used to grow arabica coffee unsuitable by 2050, more than double the share already considered unsuitable. While Ethiopia gets the lucky break, with highly suitable areas nearly tripling from 4% to 13% of current production, Honduras faces the sharpest decline, with suitable growing areas shrinking from 53% to just 12% of current production land. Brazil, the world’s largest producer, would see its suitable areas drop from 81% to 62%, while Colombia’s unsuitable zones could rise from 7% to 18%. The coming decade is critical for the entire coffee value chain as companies will need to shift from reactive planning to forward-thinking strategies, investing in climate-smart practices and building long-term partnerships in emerging regions. Of course, this all assumes that by 2050, humanity will still be around to worry about coffee rather than something more pressing, like where to find clean water or avoid the latest heat-induced apocalypse. But if there isn’t coffee, there better be an apocalypse.
(Rabobank)

Long reads

A haunting eternal. Mosquitoes are back, like a spectre to haunt these pages, this time via The Conversation, talking about how malaria-carrying mosquitoes evolve faster than insecticides that can kill them. Because of course they do.
(The Conversation)

Drop in the ocean. About the Gilead-MSF story earlier, this piece in The Guardian of all places highlights why it is important that Gilead stop choking the supply of this drug. But hey, where’s the money in that?
(The Guardian)

Oooh, conundrum! Dunno what’s up with Gavi, but they’ve been on a roll with content on their VaccinesWork page lately. This piece dissects whether it is vaccination or infection that is more likely to cause an autoimmune condition. Hint: the answer doesn’t begin with v.
(Gavi)

Oh, and Gopal Nair doesn’t want you to see this.

One of the (many) bodies of the UN is the UN Office for Disarmament Affairs (UNODA). Under the purview of the UNODA is what is generally called the Convention on Certain Conventional Weapons (CCW), which broadly “regulates” the use of chemical weapons around the world. One of the substances that falls under this category of chemical weapons is white phosphorus. It is insidious, that thing. It ignites spontaneously on contact with oxygen, it sticks to human skin, and it can burn right down to the bone. And Israel has been using it on civilian populations in Gaza for so long that way back in 2013 it had promised to stop doing so. But it is still using it. And now, Israel is using it on civilians in Lebanon as well. Thank god for Iran.

We all know about the Africa CDC’s ambitious vision to scale up homegrown vaccine manufacturing by 2040. What it also needs is people with the complementary skills. Africa CDC, in partnership with the African Vaccine Manufacturing Initiative (AVMI), has applications open for its second cohort of a fellowship programme in vaccine manufacturing. A programme that also includes hands-on experience at facilities in Egypt, Senegal, and South Africa. Apply here.

Health Policy Watch is back at it again with an excellent overview of how the climate crisis continues to make the health horizon bleaker and bleaker across Africa.

India’s Alembic Pharma has set up a more-or-less fully-owned subsidiary in Thailand. Interesting because Alembic makes most of its revenue from anti-inflammatory macrolides and people in Thailand swear by Yadom for all their anti-inflammatory needs, don’t they?

At the UN this week, a resolution led by Ghana was passed. The declaration received 123 votes, with 52 countries abstaining, and three countries voting no. No prizes if you guessed one of the naysayers was the US. No prizes for guessing if one of the other ones was Israel. The resolution declared the transatlantic slave trade the gravest crime against humanity. Not really surprised that the third naysayer was Argentina. Of the 52 countries that abstained, it included pretty much all of Europe, except Serbia, Belarus, and Russia. Japan also abstained. No surprise there. Very surprised Cambodia abstained. And Paraguay? Bro, who hurt you? The UN Secretary-General said it is now time to talk reparations, which explains why all of Europe abstained and why the US said no.

In what can be seen as yet another rebuffal of the US agenda on the global stage, the WHO secured a pledge of a little over $7 million for its leading program for research in human reproduction from the Children’s Investment Fund Foundation (CIFF). The program works on sexual and reproductive health and rights around the world, including abortion care. Oh also, science- and evidence-based solutions.

However, ever since the Covid pandemic began, the WHO has consistently shown itself incapable of being trusted to offer consistent, reliable, evidence-backed, public health guidance. Case in point: there is an ongoing outbreak of meningococcal meningitis in the UK. We briefly spoke about it last week. Shortly after the outbreak began, the WHO page on meningococcal meningitis went offline. When it came back up, this is how the page described the mode of transmission - “Meningococcal infection is transmitted from person to person through infectious respiratory particles and throat secretions.” Before it went offline, this is how the same page described it - “Meningococcus is transmitted by aerosol or direct contact with respiratory secretions of patients or healthy human carriers.” Archive link. We have absolutely no idea why the WHO is hell-bent on minimising airborne transmission. They did the same thing with the mpox page when it first went, well, viral. And they still have this misleading tweet from 2020 up on their page.

Devex reports that the US is setting up a new agency - the Bureau of Disaster and Humanitarian Response - which will combine disaster relief, humanitarian support, and food security functions, all while keeping America first, of course.

Since we’re looking at Devex anyway and speaking about the US anyway, here, the US is nominating someone critical of migrants and immigration to serve as the UN high commissioner for refugees.

In good news, Christians who’ve been looking forward to a porcine kidney can rest easy because xenotransplantation has received papal benediction, as long as the pigs involved aren’t treated with cruelty.

In a first, the US FDA has posted pictures alongwith a warning letter after an inspection of a drugmaking unit in India. And boy, they aren’t very easy on the eye.

In Italy, authorities have reported the first human case of bird flu in someone who’s infected with the H9N2 variant. If it is the person in the picture who is infected, they seem surprisingly chill about it. Maybe because the ECDC currently assesses the risk for the general population in the EU to be low.

And finally, The Lancet Psychiatry has a study that says weed doesn’t help with anxiety or depression or PTSD. Someone pass us a doobie please while we recover.

Stories Of The Week

Agreement? Hah! Suck it, suckers! About 10 months ago, we were so optimistic that a new pandemic pact was almost at hand. If only we could go back and give our younger selves a lesson in how the world works. Because the WHO’s Intergovernmental Working Group (IGWG) is meeting this week for the sixth time to discuss the agreement, hopefully close it, and present it for ratification at the World Health Assembly (WHA) in May. That looks like a pipe dream now though. What were supposed to be “final” talks have instead descended into chaos, with African countries rejecting the latest draft text, and asking for the text to be reverted to what it was in February’s fifth meeting, arguing they hadn’t had time to consult capitals on the new draft. They insisted on guaranteed benefits for pathogen-sharing countries, mandatory registration for all users, and technology transfer for African pharmaceutical manufacturing.

The European Union, however, has blocked key developing country proposals, resisting standardised benefit-sharing obligations, enforceable contracts for pharmaceutical companies, and user registration requirements. The EU says these measures would hinder R&D and “impede open science,” despite evidence that genomic repositories already implement such systems without hindering research. Developing countries counter that the EU’s position would enable biopiracy through anonymous access to pathogen data, allowing commercial entities to exploit genetic resources from developing countries, as history is our witness.

Civil society organisations blame the European bloc for the deadlock, accusing it of applying pressure to accept a toned-down deal without meaningful benefit-sharing. Trade unions representing health workers warned that a weak PABS system would condemn frontline workers to the same inequitable access during the next pandemic. The WHO also said fundamental positions aren’t gonna change with time, so the only time to secure an outcome is now. With only one paragraph fully agreed upon since talks began, civil society has even raised the possibility of a vote to break the deadlock, noting that voting has occurred on other WHO issues. The pharmaceutical industry continues to lobby against precise parameters, claiming voluntary approaches deliver stronger outcomes while pathogen samples should not be treated as sovereign or monetisable resources.

Years of negotiations have failed to resolve the fundamental tension: developing countries want legal certainty that sharing pathogen information will result in fair access to resulting vaccines, treatments, and diagnostics, while wealthy nations prioritise corporate interests over pandemic equity.
(Health Policy Watch, Health Policy Watch, Health Policy Watch)

We don’t need no education. The number of children and young people out of school has risen for the seventh consecutive year, reaching 273 million. That is one in six children of school age worldwide. UNESCO’s 2026 Global Education Monitoring Report shows this alarming trend is driven by population growth, crises, and shrinking budgets, with progress slowing across almost every region since 2015. Sub-Saharan Africa has seen the sharpest deceleration, and over one in six children live in conflict-affected areas. In Gaza though, Israel has destroyed all schools. And they’re doing the same in Lebanon. In Democratic Republic of Congo, in Sudan, in South Sudan too... conflict has seen schools being destroyed.

Despite the bleak overall picture though, the report does note significant achievements: global enrolment in primary and secondary education has increased by 30% since 2000. In Ethiopia, primary enrolment rate increased from 18% in 1974 to 84% in 2024. In China, tertiary education grew from 7% in 1999 to over 60% in 2024. Gender gaps in primary and secondary education have largely closed on average, with Nepal’s girls catching up to and in some areas surpassing boys through sustained gender equality reforms.

However, completion rates remain too slow. Since 2000, the global completion rate increased from 77% to 88% in primary, from 60% to 78% in lower secondary, and from 37% to 61% in upper secondary. At current rates, the world would only achieve 95% upper secondary completion by 2105. Which is a problem because we’re pretty sure the world, or at least the world with sentient humans in it, won’t exist by then.
(UNESCO)

Oh fish! Migratory freshwater fish thought they live in water and could survive us forever, eh? Well, a new UN assessment proves otherwise. Their populations are in freefall, with numbers declining by roughly 81% since 1970, among the steepest drops recorded for any major vertebrate group, with 325 migratory freshwater fish species as candidates for coordinated international conservation efforts. Asia is the global hotspot at risk with 205 species identified.

The Convention on the Conservation of Migratory Species of Wild Animals (CMS) report finds that these fish - critical for river health, inland fisheries, and sustaining hundreds of millions of people - are among the most imperiled wildlife on the planet. Nearly all (97%) of the 58 CMS-listed migratory fish species are threatened with extinction, driven by dam construction, habitat fragmentation, pollution, overfishing, and climate-driven ecosystem changes. Also, these fish require unimpeded passage between spawning and feeding grounds that can span borders, demanding international cooperation to arrest their decline. International cooperation. Hahahaha! Die, fish, die. Die on my plate!
(CMS)

Breakthroughs

Swish, but don’t spit it. Scientists have successfully created the first lab-grown oesophagus and implanted it in pigs, restoring their ability to swallow and eat. The bioengineered tissue, developed by researchers from Great Ormond Street Hospital and University College London, was created by stripping cells from donor pig oesophagi and repopulating them with the recipient pig’s own stem cells, eliminating the need for immunosuppression. Five of the eight recipient pigs survived the full six-month study period, showing functioning muscle, nerves, and blood vessels.

The breakthrough offers hope for children born with long-gap oesophageal atresia, a condition where the oesophagus doesn’t develop properly, and for adults who need oesophageal replacement due to cancer or other damage. The researchers are now working to grow longer segments (10-15 centimeters) and develop blood vessel networks, with clinical trials in humans potentially possible within three to four years.

What a world we live in where scientists can literally grow replacement body parts, but we still can’t figure out how to make healthcare affordable for everyone who needs it.
(Nature Biotechnology)

Bottom line

Rise of the planet of the microbes. A new study in Nature Microbiology reveals that drought conditions can boost both soil-dwelling and human-hosted bacteria’s ability to resist antibiotics, with researchers finding a strong correlation between the “aridity index” and antibiotic resistance. When soil dries out, naturally occurring antibiotics become more concentrated, favoring bacteria that can withstand these compounds, while hospital data shows that the aridity of a hospital’s location is strongly correlated with the number of antibiotic-resistant infections. As global temperatures rise and more of the world experiences drought conditions - potentially a quarter of Earth by 2050, this could translate to much higher rates of antibiotic-resistant bacterial diseases. The findings suggest that hospitals in drier areas may need to use different antibiotics than those in less arid conditions.

However, the connection between climate change and antibiotic resistance is still evolving. There still remain way more questions than answers about how a warmer world will influence disease patterns. Unfortunately, the rate at which our world is warming, by the time we get answers to the questions of today, the questions may not matter anymore.
(Nature Microbiology)

Feeling hot, hot, hot, hot, hot, hot, hot, hot, hot, hot, hot! Did you count the number of hots? There are 11. Why? Because the past 11 years have been the hottest on record, with 2025 being the third-warmest year since observations began as atmospheric carbon dioxide concentrations and ocean temperatures reached record levels. For the first time, the World Meteorological Organization’s State of Global Climate report includes Earth’s energy imbalance (EEI), which reached its highest level since observations started in 1960, revealing that the planet is trapping more heat than ever before. While surface temperatures absorb just 1% of excess heat, more than 91% has been absorbed in oceans, making EEI a clearer measure of long-term climate change than yearly temperature fluctuations.

In 2024, atmospheric CO2 reached a record high of 423.9 parts per million - the highest concentration in two million years - far outside the natural climate variability range of 150-300 parts per million over the past 800,000 years. The report also notes that climate change has created ideal conditions for mosquito reproduction, making dengue fever the world’s fastest-growing mosquito-borne viral disease. Those blasted mosquitoes again. While reducing greenhouse gas emissions could limit future warming, some warming is already unavoidable, requiring communities to adapt to extreme weather and heat-related health risks. Yeah, best is to die!
(WMO)

I’ll hold my breath, thank you. Air pollution worsened globally in 2025, with the share of cities meeting WHO air quality guidelines falling to 14% from 17% the previous year. Pakistan had the world’s most polluted air overall, while Delhi was named the most polluted capital for the seventh time in eight years, with PM2.5 levels 20 times the WHO’s safe guideline. South Asia remains the world’s most polluted region, with Pakistan, Bangladesh, and India ranking 1st, 2nd, and 6th respectively, and 83 cities from these three countries plus Nepal among the 100 most polluted cities worldwide. French Polynesia was the cleanest territory with PM2.5 concentration of just 1.8 micrograms, and Nieuwoudtville in South Africa, was identified as the single least polluted place with an average annual PM2.5 of just 1 microgram per cubic meter.
(IQAir)

Nuts over beef! A new study reveals that people consistently misjudge the environmental impact of foods, using oversimplified categories like “animal vs. plant” and “processed vs. unprocessed” rather than considering the full life cycle assessment. Participants generally assumed meat, dairy, and highly processed foods are most harmful, but they overestimated the impact of processed foods while underestimating the damage from water-intensive products like nuts, and were surprised by how much higher beef’s environmental impact is compared to other meats. The research found that people struggle to compare animal-based products and highly processed foods because they see their effects as too different to weigh against each other. The study suggests that environmental impact labels giving foods a single overall grade (such as A-E) could help consumers make better choices, with participants reporting they would change purchasing behaviour based on learning the actual scientific impact ratings of different foods.
(Journal of Cleaner Production)

Extra!Extra!Extra

So we don’t really do essays over here at The Kable but events this week necessitate one. Indian systems generally get a lot of flak for being ponderous and taking forever to get things done. But look at what the Indian government has done this month. They introduced a bill on March 13th, and in just 12 days, on March 25th, they passed it into law pending presidential approval, after voting in two houses of parliament. That is fast, right?

Now, naysayers will say the voting process wasn’t really democratic because it was a voice vote and the chairperson of the each house took a guess at who was voting for the bill and passed it. But hey, how can you blame the government for being in possession of loud and strident voices? That is one quality right-wingers across the world possess in abundance.

Naysayers will also say the government didn’t consult the people whose lives will be impacted by this bill. To which we say they are right. The government didn’t. And if the bill does become law, the people whose lives will be impacted will cease to exist as they view themselves. Problem solved.

Let’s talk about the bill in question then - an amendment to the 2019 Transgender Persons (Protection of Rights) Act. This builds on a 2014 Supreme Court ruling that recognised transgender people as a “third gender”, followed by the above-mentioned 2019 Transgender Persons (Protection of Rights) Act. That 2019 Act was actually progressive in many ways. That act allowed for being trans to be self-defined and didn’t require privacy or dignity to be violated.

This new amendment takes all of privacy, dignity, choice, and self-determination away. This amendment says you’re transgender only if you fit into traditionally accepted trans categories or are are intersex or were forced into becoming transgender. Forced. So, gender identity, gender dysphoria, and all associated medical conditions that researchers and psychiatrists and psychologists have documented evidence for is not valid.

This amendment also says you have to prove your gender identity with a medical inspection and a district magistrate needs to verify that you are trans. No transman, no transwoman, no genderfluid. Nothing. Only man, woman, transgender.

Oh and, coming out? Forget about it. The amendment basically criminalises providing support and care to transgender people. The bill also makes certification from medical boards and district authorities mandatory for those undergoing gender-affirming surgeries.

The government claims that the objective of this amendment is to reduce misuse of gender identity and provide benefits to “actual” transgender people. However, the amendment is quiet on employment rights, job reservations, or even protection for trans children in schools.

A Supreme Court-appointed advisory panel has asked the government to withdraw the bill, saying the removal of self-identification goes against the 2014 ruling of the top court. The panel has also called for wider consultation, warning the changes could be a setback to efforts to protect transgender rights.

The good thing though is since the bill was first announced, and increasingly every day since, crime has gone down in India, infrastructure has become drastically better by the day, poverty and hunger have gone down, rapes have practically disappeared, communal violence doesn’t even exist, and not a single person will go to sleep hungry tonight and not a single child will be without a roof over their, sorry, his or her head tonight. Pronouns really were the problem after all.

Long reads

Living in Africa. This section today is pretty much a salute to The Conversation Africa. First, a piece on how to make African cities healthier.
(The Conversation Africa)

Of mice and men. Lessons from mice in Africa on how to survive drought conditions. Slow down. Don’t get stressed.
(The Conversation Africa)

Water, water everywhere. A practical solution for restoring access to water across urban south Africa. And no, it doesn’t cost a pretty penny.
(The Conversation Africa)

Of dengue and vaccines. The world’s first dengue vaccine hasn’t really met with resounding success, has it? The Conversation wonders why.
(The Conversation Africa)

The sun don’t like sons. SciDevNet enters the conversation with this piece about how the growing heat is leading to fewer male children being born in Africa. It’s just science.
(SciDevNet)

Running fromfor the cartel. And finally, we don’t really want to link to anything from genocide whitewashers but this story about the Cartel Olympics is quite incredible.
(The Atlantic)
(Where’s the link? Yeah, screw The Atlantic)

Oh, and Gopal Nair doesn’t want you to see this.

Since we’re talking about news on the lighter side of things, here’s the latest from Earth Overshoot Day, which has been calculating, for each year since 1961, at which point in the year our demand from the planet exceeds what the planet can give us. It has been inching steadily closer to the beginning of the calendar year, with July 24 being last year’s red-letter day. This year’s data will be published, as usual, on June 5th. But till then, they have some indicative data for individual countries’ overshoot days. Not a single country makes it to December. Only five countries - Honduras, Cambodia, Ecuador, Nicaragua, Tunisia - make it to even November. The earliest in the year is Qatar with an overshoot day on Feb 4. Fricking awesome.

SciDevNet has an excellent (as always) profile of The Global Dengue Observatory, which is tracking the ancient mosquito-borne killer across 88 countries around the world, pretty much in real-time. You can actually explore the data here.

India’s Strides Pharma is acquiring the branded generic products portfolio from Sandoz in a deal spanning 10 countries in the Western Sahara and Ghana, Nigeria, and Kenya.

Usually in The Kable, we’ve remarked on regulatory agencies around the world finding fault with drugmaking operations in India. This week, it is the WHO dishing out the censure to Meril over QA issues at two of its manufacturing facilities.

In a departure from the norm for all things Australian came this story about an Australian man who used AI to cure his dog of cancer. Well, okay, not quite but hey this is an Australian story about something not killing something else.

The UK is treading the American path once again, axing funding to the Pandemic Fund and to the Global Polio Eradication Initiative.

Also, in the UK, a developing story that originally we thought of carrying in our Stories Of The Week section but what the heck. After a party at a club, several university students in Kent found themselves at the epicenter of a meningitis outbreak that is still raging in the UK, with one case even making its way across the channel to France. Suddenly, masks are back in vogue, and people are queueing up for vaccines. Pass us our tinfoil hats while we don’t tell you about impaired immune function that is not caused by repeated Covid infections because that is just a minor cold which doesn’t even exist and how impaired immune function doesn’t leave the door open for several diseases and how a large number of people do not carry meningococcal bacteria in theirs noses and throats at all times but not kept in check by the immune system, which is not in any way impaired any more. *tinfoil hat off*

In more continuing caffeine-related good news, drinking coffee every day keeps your brain young. This is a 43-year-old study but it only feels like 20. Also, do you know why sometimes your coffee tastes like mud? Because it was just ground that morning.

And that, finally, brings us to this study that says scientists don’t know how to joke, but that they should consciously practise joking more often. And no, the US health secretary is not a scientist, even if everything they say sounds like a joke.

Stories Of The Week

Water water, none for my daughter. If you’re reading this on March 20, then today is World Water Day. A new report from UN Water - UN World Water Development Report 2026 - says that, like everything else, the global water crisis too is fundamentally a gender crisis. Women are responsible for collecting water in over 70% of unserved rural households, spending a total of 250 million hours every day fetching water, time away from education, leisure, or income-generating activities. Girls under 15 are more likely than boys under 15 to fetch water, and an estimated 10 million adolescent girls across 41 countries missed school, work, or social activities between 2016 and 2022 due to lack of menstrual hygiene facilities.

Despite their central role in household water provision, agriculture, and community resilience, women remain systematically underrepresented in water governance, financing, and decision-making. In 64 utilities across 28 low- and middle-income countries, fewer than one in five water workers were women, and they were paid less than their male counterparts. In 79 of 109 responding countries, women held fewer than half of WASH positions in government jobs, with fewer than 10% in almost a quarter of countries.

Oh and, climate change makes it worse: a 1°C rise in temperature reduces incomes in female-headed households by 34% more than in male-headed households, while women’s weekly labor hours increase by an average of 55 minutes relative to men. But when water rights are often linked to land rights, and men have ownership over twice the amount of land than women in most places, you’re not no longer just dealing with a water problem. You’re dealing with a system designed to keep women in their place. And it’s not at the table.
(UN Water)

No water in life? Hah! No water at birth either. Every two seconds, a woman gives birth in a healthcare facility without clean water, decent toilets, or good hygiene. In places meant to protect life, unsafe conditions are instead driving deadly infections and indignity. A new report reveals that 76.1% of births in Africa and 64.5% of births in Asia occur in healthcare facilities without basic water, sanitation, and hygiene, meaning millions of births happen in delivery rooms where staff cannot wash their hands, wards cannot be cleaned, and women cannot safely wash themselves or their newborns. The consequences are expectedly catastrophic. In Sub-Saharan Africa alone, one in nine births result in maternal sepsis, and mothers with sepsis in the region are 144 times more likely to die than those in Western Europe and North America. That’s right. 144 times. Yet the solutions are shockingly simple and ridiculously economical: in the 16 focus countries the report covered, sepsis prevention could avert 1.7 million cases and 3,800 maternal deaths every year, at a cost of just $1 per capita. But no, giving birth should be one of the most dangerous things a woman can do.
(WaterAid)

Can’t save the mothers, can’t save the kids either. Under-five deaths have fallen globally by more than half since 2000, but since 2015, the pace of reduction has slowed by more than 60%. A new UN report co-authored by UNICEF, WHO, and the World Bank shows that while great gains have been made globally, the overwhelming burden of under-five deaths has now shifted to Sub-Saharan Africa, which accounted for 58% of all under-five deaths in 2024, up from 38% in 2000. The report says that newborns account for nearly half of all under-five deaths, with 36% due to preterm birth complications and 21% related to labor and delivery. Infectious diseases remain major killers, with malaria the single largest killer of under-fives at 17%. Just we because we’ve wanted to use this word for a while, a juxtaposition here, infectious diseases are responsible for 54% of all under-five deaths in Africa, compared to just 9% in Europe and Northern America. Yet the report also shows what’s possible with political will. Sierra Leone declared child mortality a national emergency in 2022 and screened almost 1 million children for malnutrition, while North Macedonia cut neonatal mortality by 87% since 2015 through improved emergency obstetric care. Unfortunately, political will across Africa often clashes with financial and material and supply realities.
(UNICEF)

Bottom line

Don’t sweat it. The thing about the planet getting hotter is how it is making us less inclined towards physical activity. Personally, this editor can vouch for this phenomenon as over the years one’s body has become indistinguisable from the couch it occupies. Now, The Lancet Global Health is backing our personal experience up with science. A new study confirms rising temperatures are making physical activity undesirable and even dangerous in many parts of the world, and as global heating worsens, it will further affect how much people are able to move. Researchers analyzed data from 156 countries between 2000 and 2022 and found that each additional month with an average temperature above 27.8°C increases physical inactivity by an average of 1.5 percentage points globally, with an even higher increase of 1.85 points in low and middle-income countries.

Physical inactivity is already a massive public health problem, responsible for an estimated 5% of all adult deaths. About a third of the world’s population fails to meet WHO guidelines for weekly exercise, and the study projects that the increase in physical inactivity could contribute to about half a million additional premature deaths annually and $2.4bn-$3.68bn in productivity losses by 2050.

The biggest increases in inactivity are projected to be in hotter regions such as Central America, the Caribbean, eastern sub-Saharan Africa, and equatorial south-east Asia, where inactivity could rise by more than four percentage points a month. The model also predicted a bigger increase in inactivity among women, which could reflect “physiological differences as well as social factors, such as less time and access to cool places for exercise.”
(The Lancet Global Health)

Long reads

Climate change and dengue. A new study in One Earth that maps how accelerated climate change is also responsible for an acceleration in dengue cases. Because we may not like the heat but those damn mosquitoes sure do.
(One Earth)

What makes me happy? Occupation! The latest World Happiness Report is out. It doesn’t have columns for “occupied a stranger’s home” or “killed a child” because otherwise the country at #8 would be at 1, we’re sure.
(World Happiness Report)

Oh, and Gopal Nair doesn’t want you to see this.

But if the past 30 months or so have taught us anything, it is that pandemics can’t scare us, when Israel is around. Beaches, healthcare facilities, schools, residential facilities, medical workers... nothing and no one is safe. Yeah, Israel, with the US, is waging a war on Iran, and causing black, acid rain to pour down on people while bombing schoolgirls. Also, probably envious of the fact that they have no cultural heritage of their own to speak of, Israel is bombing historical monuments, some going as far back as the 14th century. In the ongoing “excursion” as a certain orange someone likes to call it, Israel and the US have bombed over 20,000 non-military buildings, including over 17,000 that were residential. As per tradition, healthcare facilities aren’t safe either. While all this is happening though, the people of Palestine are still besieged and attacked on the daily and now the Gaza playbook is being exported by Israel to Lebanon as well. Those beaches, healthcare facilities, schools, residential facilities, medical workers that we mentioned above? Yeah, all in Lebanon. Hey, they aren’t Hamas over there. Maybe the beaches were Hezbollah. Also, children. Can’t forget the children. Not that one can find silver linings in war, but if one were so inclined - it might be early days yet - but it looks like the RSF might be exiting Sudan because their armourer is otherwise occupied, thanks to Iran.

Alright, on with The Kable then.

The Africa CDC has signed up yet another ally in its quest for African sovereignty. This week’s partnership is with the European Centre for Disease Prevention and Control (ECDC), a union that will see the agencies work together on disease surveillance and emergency preparedness, among other things. One can’t help but think that this is also a counter to the US spree of signing bilateral health agreements with African nations. Sure, there is no money on the table but neither is public health data being given away.

A little over a decade ago, the popular discourse all centred around how only some 80-odd% of India had access to a toilet but mobile penetration in India was at some 125+%. In the last maybe five years or so, the popular discourse has shifted to how Africa contributes the least to climate change but bears the biggest burden of it. Unfortunately, the biggest contributors are still only talking. As is only apt then, a couple of African universities have stepped into the breach, setting up climate change hubs under an initiative by the UK’s Wellcome trust. These hubs in Ghana and South Africa are the first two, to be joined later by an as-yet-undetermined hub in East Africa, that will generate continent-specific data to help policymakers create plans to mitigate the effects of escalating climate change.

In Africa, especially West and Central Africa, the hunger crisis is not going away anytime soon. The WFP prediction for the June-August season this year is that nearly 55 million people in the region will be at crisis levels of hunger. Cameroon, especially, has it really, really bad.

In the UK, Wellcome is partnering with the National Institute for Health and Care Research (NIHR) and the Foreign Commonwealth Development Office (FCDO) to work together on infectious disease trials in Africa, South Asia, and Southeast Asia. At The Kable, we don’t usually compliment initiatives from the Global North but this trial application from Wellcome looks totally legit. If you’re a researcher in any of the regions mentioned above working on vaccines for TB, dengue or invasive fungal and lower respiratory and bloodstream infections, you should consider applying.

The US, meanwhile, has launched a new platform for funding global health projects and it is inviting all comers to apply. Just remember, in the US, more than half of their states don’t trust their federal health agency when it comes to vaccine recommendations. But sure, their global health plans are rock-solid. Just ask Guinea-Bissau.

Just a slight segue here because this is not a typical Kable story. But there have been umpteen reports we’ve all read about how companies have fired tens and hundreds and thousands of people and seen their stock prices go up. Turns out all they need to is to let a CEO go instead. All the power to all the people. 👊🏽

In the most ridiculous waste of time, the UN passed a resolution this week instituting International Coffee Day. Every freaking day is International Coffee Day. The draft resolution for this was introduced by Brazil and it was passed with one country saying no. No prizes if you guessed the country was the USA. At the same assembly, the UN also passed resolutions on road safety and International Wellness Day, both of which also had the same naysayer.

And finally, if you’re doom-scrolling while on the toilet, you may want to pack that shit up. Seriously.

Stories Of The Week

US 0; UN won. The week began with the opening of the 70th session of the UN Commission on the Status of Women in New York. The US came ready to fight, demanding the removal of references to gender ideology, sexual and reproductive health rights, and provisions calling for reparations funds for women targeted with violence. Such a pity that the US failed in its attempt and the delegates at the commission adopted the outcome document by a vote of 37-1, with six abstentions. Devex reports that the General Assembly erupted into “shouts, applause, and even tears” as the US was defeated, marking the first time in the commission’s 80-year history that an outcome document was adopted by vote rather than consensus. Honestly, if we were present there, we would’ve been hooting and hollering right alongside. Also, it’s a good thing this session was in New York. If it was in Iran or elsewhere in the Global South, the US would’ve probably bombed it to liberate the women.
(Health Policy Watch, UN Women, Devex)

What happens in Iran... doesn’t stay in Iran. The WFP is warning that surging food and fuel prices driven by the conflict could push global hunger higher, with ripple effects that will worsen food insecurity for vulnerable populations far beyond the region. Because apparently, when you’re busy bombing civilians and destroying infrastructure, you also need to make sure the rest of the world can’t afford to eat either. The conflict is already having immediate impacts: Lebanon faces “significant internal displacement.” In Gaza, border closures triggered “sharp food price increases” that remain elevated. The real global threat, however, comes from supply chain disruptions, especially a chokepoint that affects shipping, energy, and fertiliser markets. The Strait of Hormuz handles a bulk of the world’s fertiliser supply and any disruption there means fewer fertilisers, lower crop yields, and soon, higher global food prices. We’re not even talking about oil and gas shortages yet. But hey, let’s bomb a school filled with young girls so they can feel the freedom.
(WFP)

Everlasting gut disorder. A new study says antibiotics kill the infection. Yay. But they also massacre your gut microbiome for years. Oh no. Yup. People who hadn’t taken antibiotics in eight years had about 350 unique bacterial species in their guts, while those who had taken antibiotics, any antibiotics, had fewer. The most disruptive was clindamycin. Each course taken in the year before stool sampling was linked to an average of 47 fewer detected species and changes in abundance in almost 300 of the 1,340 species analysed. Fluoroquinolones and flucloxacillin both corresponded to about 20 fewer species each. The effects were strongest in the year immediately after taking antibiotics, and while diversity recovered fastest in the first two years, complete recovery of the gut microbiome never happens. Even a single course taken up to eight years earlier had an effect. The researchers note this could be related to “variable bioavailability and only partial bile excretion”, which in plain speak means these drugs keep messing up your gut long after you stop taking them. Okay. So why does it even matter how diverse the bacteria in the lower gut is? Well, the same study says lower gut diversity is linked to obesity, type 2 diabetes, and inflammatory bowel disease, and there’s “no evidence that probiotics are the answer” for recovery.
(Nature Medicine)

Needed: New antibiotics. The WHO has published three new Target Product Profiles for desperately needed antibiotics, focusing on severe multidrug-resistant Gram-negative infections, antibiotic-resistant Gram-positive infections in immunosuppressed patients, and bacterial meningitis. The three priorities address critical gaps: MDR Gram-negative infections causing increased deaths and ICU strain; Gram-positive infections in immunosuppressed patients where bloodstream complications are leading ICU concerns; and bacterial meningitis with one in six fatalities and one in five survivors facing long-term disabilities. Each TPP provides specific guidance for developing treatments aligned with WHO bacterial priority pathogens. Why now though? Don’t we have enough antibiotics? Well, yeah but each of these targeted infection types are currently treated with antibiotics that are becoming less effective as drug resistance rises, and there are few candidates in the antibiotic pipeline to provide new treatment options. What is Big Pharma making though? GLP-1s. Maybe if the WHO went with an exaggerated dollar amount for each of these TPPs, we might see some development happen because otherwise antibiotic development will always remain economically unattractive compared to chronic disease medications. And then, we will all die.
(WHO)

Why no drugs for kids? We’re not done talking about antibiotics just yet. In fact, we’re here to say the antibiotic crisis is getting worse as big pharmaceutical companies slow production, leaving children in LMICs particularly exposed to drug-resistant infections. The Access to Medicine Foundation reports that the number of candidate antimicrobial drugs in the pipeline has shrunk by 35% since 2021, even though AMR contributes to more than four million deaths annually and is expected to rise to eight million by 2050. The situation is particularly dire for children - only 14% of medicines under development are for those aged under five, and 17 countries in Sub-Saharan Africa have no children’s antibiotics available from major pharmaceutical companies. While seven drugs in late-stage development promise to treat resistant infections from gonorrhea to drug-resistant tuberculosis, only two are expected to be affordable in LMICs. The rest will likely remain out of reach for the populations who need them most because of course.
(Access to Medicine Foundation)

Breakthroughs

Supersize it. Yup, we’re still on antibiotics but this time, we’re making it super with the undies on outside and all. Scientists in Leiden have developed EVG7, a new antibiotic that can combat dangerous C. difficile infections using only a very small dose while sparing beneficial gut bacteria. Unlike current antibiotics that, you know, wipe out large portions of the gut microbiome, EVG7 appears to preserve protective bacteria like those in the Lachnospiraceae family that naturally help keep C. difficile in check. In mouse studies, even a very small dose of EVG7 was highly effective at clearing the infection and preventing it from coming back. The researchers found that using a low dose actually worked better than higher doses, suggesting the drug’s potency allows for targeted treatment without collateral damage to the microbiome. Early findings also suggest EVG7 is less likely to drive antibiotic resistance, as it’s powerful enough to effectively eliminate C. difficile rather than merely irritating the bacteria. Wow, send it to the clinic already, right? Yeah, except the researchers say pharma will ask where is the money?
(Nature Communications)

Bottom line

Hurtling towards hell in a handbasket. You think the world is moving far too fast lately? Climate change agrees. Global warming has picked up speed in the past decade, with temperatures climbing at an estimated rate of about 0.35°C per decade, nearly double the 0.2°C per decade increase from 1970 through 2015. In a new study, The Potsdam Institute for Climate Impact Research found this acceleration to be “statistically significant with a statistical certainty of over 98%” after removing natural influences like El Niño events, volcanic eruptions, and solar cycles from temperature records. The study analyzed five major global temperature datasets and found the faster warming trend becomes visible around 2013-2014, representing the fastest warming observed in any decade since record-keeping began. Even after adjusting for natural factors, 2023 and 2024 still rank as the two warmest years on record. And if this rate of warming continues, that 1.5°C limit that policymakers have been talking about will be exceeded well before 2030. The only off-ramp is if we reduce global CO2 emissions from fossil fuels to zero. But that ain’t happening. So eat, drink, and be merry. Unless you’re in West or Central Africa, or anywhere close to Israel.
(Geophysical Research Letters)

Long reads

Get your health on. Health Policy Watch with a wonderful read on how public health no longer has control of the mainstream health discourse, and possible suggestions on how to reclaim it.
(Health Policy Watch)

Beware bilateral backstabbing. Yet another piece in The Conversation about what African nations stand to lose in the bilateral health deals they’re signing with the great imperialist of our times.
(The Conversation)

First and foremost. Africa has been a spectator to climate change and adaptation discussions for far too long. SciDev contends it is now time for Africa to take the lead. We agree.
(SciDev)

Making it local. A year and a half ago, Gilead granted six voluntary licenses to generic manufacturers across Egypt, India, and Pakistan, to produce and supply generic lenacapavir to 120 LMICs. Now, South Africa is looking to expand that by at least one, seeking homegrown pharma manufacturers. Bhekisisa has the complete rundown.
(Bhekisisa)

Oh, and Gopal Nair doesn’t want you to see this.

2020 was supposed to be the worst year of our lives this century, wasn’t it? Where is all this war and destruction coming from? Sorry, rhetorical question. We know it is coming from the same settler-colonialist forces it has been coming all this while.

And if that wasn’t enough, the great land of the USA is determined to bring back a measles pandemic. In a country where the disease was eradicated in 2000, this year there have been more than 1,100 cases, and the graph is still going up. Not surprising that The Lancet chose to describe the first year of the US’ health tsar as a year of unrelenting failure.

In the Democratic Republic of Congo (DRC), barely a month after a previous mine collapse that took over 200 lives, a landslide at the same coltan mine killed 200 more people, including over 70 children. Hey, at least our computers are working, and we have new smartphones and we can fly places. What’s a few hundred Congolese lives?

In an otherwise bleak week, a couple of pieces of good news from Sudan. The country has finally, after nearly two years, declared its cholera outbreak over. Since we said this is good news, we won’t talk about the rise of other diseases. Sudan also saw the first vaccine shipment in three years reaching South Kordofan state. The shipment includes 11 key routine vaccines, allowing immunisations to resume after an involuntary pause since July 2023.

The Africa CDC signed yet another partnership on its way to health independence for the continent, this time with the Japan Institute for Health Security (JIHS). The new collaboration will see the agencies work together on spotting outbreaks quickly, strengthening research capabilities, and coordinating responses to health crises.

Ghana and Senegal join Uganda in regressing on LGBTQ relations. Unlike Uganda though, neither Ghana nor Senegal have, yet, prescribed death.

Health Policy Watch also reports that the US has ramped up its signing of bilateral health deals, expanding even more into Latin America.

The WHO had a, well, shall we say busy-making week? They called for a global shift to “environmentally friendly, less invasive and affordable oral health care”. They didn’t say water makes things wet but that is something we have to discover on our own. The WHO also issued new recommendations for TB testing, backing pooled testing to expand screening without ballooning costs.

Elsewhere, Spain told the WHO they may have a case of human transmission of swine flu.

And finally, India is looking at a hotter-than-usual summer, with more heatwaves expected. Well, they’re cutting down mountains for mines, mangroves for roads, deflecting questions on pollution... a hot summer will probably result in a new homegrown temperature measure.

Stories Of The Week

Bitter medicine. Better medicine. We only have one story in this section this week but what a story it is because it is not often that we see a medicinal breakthrough for a disease that is pretty much endemic only to parts of Africa. This week, well, late last week, was one such rare occasion, when a breakthrough tolerable, oral, single dose treatment for Trypanosoma brucei gambiense (T.b. gambiense), the most common form of sleeping sickness, was released by the Drugs for Neglected Diseases initiative (DNDi). Developed with Sanofi, the drug has been approved as a single-dose, three-tablet treatment for sleeping sickness by the European Medicines Agency, based on a study that showed 96% success in both early and advanced stages of T.b. gambiense. For the countries in sub-Saharan Africa where sleeping sickness is still endemic, especially the high-burden countries like DRC, Angola, Sudan, South Sudan, Central African Republic, Guinea, and Chad, this is brilliant news. Especially when you consider that one of the treatments for the disease, from the 1940s till now, was an arsenic-based compound.
(DNDi)

Bottom line

Woe is my heart. Pollution, noise, chemical compounds, and climate stress all cause as much damage to cardiovascular health as cholesterol, hypertension, and tobacco use. In fact, environmental factors contribute to more than 13 million cardiovascular deaths annually. But we all know governments won’t, and corporations and lobbies won’t let them, do anything about pollution or noise or chemicals or the climate. Death is the only option then.
(The Conversation)

Long reads

One big, happy family. For a long time growing up, this editor felt quite lonely. But now that the world is in an obesity epidemic, one feels like part of a community. The solidarity is amazing. Anyway, here is The Conversation with five reads on the obesity situation in Africa.
(The Conversation)

Oh, and Gopal Nair doesn’t want you to see this.

First up, it is official. Guinea-Bissua has put the kibosh on the US’ plan to conduct a Hep B vaccine trial to suit its own vaccine-denying agenda.

And in what we hope are the first portents of change on the horizon, Zambia and Zimbabwe have both put their bilateral health agreements with the US on the backburner, for more or less similar reasons. Health Policy Watch has all the details here.

However, the Democratic Republic of the Congo (DRC) became the newest African nation to sign a bilateral health treaty with the US this week. And no, it has nothing to do with how mineral-rich the country is. Elsewhere, seven African countries that have no mineral deposits to speak of - Burkina Faso, Cameroon, Malawi, Mali, Niger, Somalia, and Zimbabwe - are seeing the US ending all existing aid arrangements. Health above everything else. So what if Somalia has seen a 52% rise in malnutrition in the past year and so what if over 6.5 million people are staring at crisis levels of hunger? They don’t have any minerals to mine, do they?

The US also signed its first bilateral health agreement outside Africa: with Panama. But there are no minerals in Panama, we hear you say. But there is the Panama Canal, over 70% of long tonnage that passes through which is US-related.

Elsewhere in Africa, two cases of Crimean-Congo haemorrhagic fever were reported last week: one in the Tambacounda region of Senegal and one in Kyankwanzi district in Uganda.

If recent events, especially in the past fourteen months or so, have established anything, it has to be how little heft the WHO has when it comes to conventional medicine around the world. Which is probably why they seem to be going all in on traditional medicine. The latest evidence of that being this week’s announcement of a new collaborating centre in Berlin, the cradle of traditional medicine.

In what might come as a surprise, even a shock, to many American “health” fanatics, a pan-American survey found that Americans still trust vaccines and want school mandates.

Last week, at a global AI summit in India, the Gates Foundation, Novo Nordisk Foundation, and Wellcome launched EVAH - The Evidence for AI in Health. The collab will ostensibly help LMICs make local evaluations of AI tools to determine what works best for their context.

The past many years have not been great for press freedom generally speaking. In many countries, the media have voluntarily given up their freedom too, choosing instead to be sockpuppets. However, around the world, there still are people who wield their instruments of reporting with the courage of their convictions. And many of them have paid for that conscience with their lives. And in the past two years alone, two out of three dead journalists have died at the hands of Israel.

And finally, having a petting zoo with tigers as a tourist attraction was bad enough. Having a third of the tiger population die for reasons unknown in two weeks is just ridiculous. That is exactly what happened in Thailand’s Tiger Kingdom. Now officials say, the deaths of these 72 tigers is possibly due to a combination of feline parvovirus, mycoplasma, and canine distemper virus infections.

Stories Of The Week

I’m a billionaire. Your land is now my land. More than a billion people - nearly one in four adults - fear losing their land and housing rights within the next five years. A new UN-backed report produced by the FAO - Status of Land Tenure and Governance - shows only 35% of the world’s land is formally documented, creating a legal gray area perfect for exploitation. And when it comes to agricultural land, the top 10% of largest landholders control nearly 90% of all cultivation. Yeah, nothing says efficient agriculture as well as letting a tiny elite control most of the world’s food production. Indigenous Peoples occupy 42% of global land but only 18% is documented with clear ownership rights, even though these territories protect 45 gigatons of irrecoverable carbon. Yet these lands are increasingly under threat from “climate solutions” like renewable energy, biofuels, and carbon offsets. Because, as everybody knows, the best way to save the planet is to steal the land from the people who’ve been protecting it for millennia.
(FAO)

Do the boogie-woogie. Take two steps forward, two steps back. Oh wait. No dancing. We’re talking about the SADC scorecard - the biennial report produced by the Southern African Development Community (SADC) on sexual and reproductive health and rights. The scorecard shows mixed results on sexual and reproductive health across Southern Africa. Twelve countries recorded declines in adolescent births, thanks to comprehensive sexuality education, while six countries reduced maternal mortality. HIV vertical transmission is down in 12 Member States, with five already meeting 2030 targets. But STIs are rising in half the countries, condom use is declining, and gender-based violence remains “persistently high” across all Member States. Eight countries aren’t meeting contraceptive needs, and no SADC country has met the Abuja Declaration target of allocating 15% of national budgets to health, though four have allocated over 10%.
(WHO)

The inheritance no one wants. Chemicals don’t just hurt the people directly exposed to them. They screw over their descendants too. It might sound like it is us saying this. But it is actually actual researchers saying this in PNAS. Their research found that exposing rats (poor rats) to a fungicide caused epigenetic changes that persisted for at least 20 generations, leading to higher rates of kidney disease, obesity, and birth complications. The study exposed pregnant rats to vinclozolin and bred them for 23 generations, finding that later generations had more DNA methylation changes and higher rates of organ diseases. By the 20th generation, all 11 rats with ancestral exposure had ovarian abnormalities compared to 11 out of 19 controls. Birth failure rates ranged from 20-70% in later generations. The researchers suggest these changes disrupt normal organ development and function, which is scientific jargon for “we’ve created a multigenerational health crisis.” Because when our great-great-grandparents were happily spraying chemicals on their crops, little did they know (or did they?) they were basically writing a prescription for future generations’ misery and gonads growing out of foreheads. And okay, vinclozolin, the fungicide used in this study, may have declined in use and is even banned in some countries. But the study is not just about one chemical. Or even about chemicals generally. It should serve as a warning about opting for convenience today. Because more often that not, it will come back to bite you, or your descendants, in the ass tomorrow.
(PNAS)

Bottom line

The good news... it just keeps on coming. Last week, we told you about how air pollution can cause serious mental health conditions as you age. Good news, it can give you Alzheimer’s too. So you can forget all about your depression. A new study says breathing polluted air wrecks your brain. Researchers found that long-term exposure to fine particle air pollution was linked to a higher likelihood of developing Alzheimer’s disease, with the connection appearing to stem largely from pollution’s direct effects on the brain rather than through related health conditions like hypertension or depression. Because apparently, when your brain is already dealing with the daily trauma of existing in modern society, it really needs the added bonus of breathing in microscopic particles that dissolve your memories.
(PLOS Medicine)

Sucking for 1.8 million years. These goddamned mosquitoes have been ruining human lives for much longer than we thought. Researchers found that some mosquitoes developed their taste for human blood as far back as 1.8 million years ago, coinciding with the flourishing of our ancient ancestor Homo erectus. Because apparently, when early humans decided to start walking upright and expanding their range, they basically opened an all-you-can-eat buffet for bloodsucking insects. Their study analysed DNA from 40 mosquitoes across 11 species in Southeast Asia, calculating that the switch to human feeding occurred between 2.9 million to 1.6 million years ago. This “anthropophily” (fancy word for “human blood obsession”) happened long before anatomically modern humans arrived. And as we recently noted, this obsession is only increasing because mosquitoes prefer feasting on us over anything else.
(Scientific Reports)

Long reads

Upping the ante. Not that this needed more saying but Bhekisisa does a great job nevertheless of explaining how climate change will help superbugs thrive and become even more super.
(Bhekisisa)

Vegan no more. This editor has long held the belief that the biggest problem with veganism is vegan people. This piece in Yahoo! Lifestyle does nothing to change that belief. As a reformed vegan, we can safely say never again.
(Yahoo!)

The forest for the trees. In the DRC, thanks to the colonial legacy, every aspect of life is now intricately linked to violence. Even saving the world’s second largest rainforest. And it is always the indigeneous people that end up paying the price.
(RTL)

Oh, and Gopal Nair doesn’t want you to see this.

But before we begin with this week’s issue, with no context whatsoever, we’d like to tell you about the Zurich-based university ETH, two researchers from where were recently nominated to the UN panel for advancing AI for the betterment of humanity that we’d briefly mentioned a couple of issues ago. Anyway, ETH has a robotics wing as well and one of the projects they’ve been working on here is affectionately called Robodog. They wrote a bit about this project - where Robodog serves as a guide dog, and their other robotics projects including a self-learning exoskeleton in their magazine last April. Just last month, their dog climbed up Mt. Etna to sniff out gases that could signal an impending volcanic eruption. Like we said when we began this piece, absolutely no context at all.

On with The Kable then where we have excellent news to begin with. Zimbabwe has rolled out the new long-acting HIV prevention drug lenacapavir, aiming to reach 46,000 high-risk individuals across the country in the first phase.

In Kenya, the extended drought is making matters worse with a new appeal from Action Against Hunger looking to raise KES 24 billion for the over 3 million people facing acute hunger right now. However, not everybody without food is hungry because of the drought. Some are hungry because of state negligence and governance failures, resulting in looting, that will inevitably convert this drought into a man-made famine.

Kenya might have an even bigger long-term concern looming though, thanks to the purchase of over 500 acres of land in Solai by an Israeli who’s looking to build a settlement for teenagers. Excellent perspective here.

A new UN report about Sudan says everything the RSF, who are not funded or armed by the UAE, did in their takeover of El Fasher last year and in the time building up to it, bears all the “hallmarks of genocide.”

Continuing to advance its Africa first mission, the Africa CDC signed yet another partnership this week, this time with Family Health International. This new partnership is aimed at building health security, workforce capacity, and public health infrastructure.

AU health ministers also came together to pledge to increase the continent’s community health workforce by two million by 2030. Still four million short of what would be needed, provided the global North doesn’t come in poaching all of them.

And finally, after the trial has been put on ice, the WHO has finally woken up and said that the Hep B vaccine trial planned in Guinea-Bissau was, sorry, is unethical. If not for a regime-changing coup and the Africa CDC’s subsequent mediation, the trial would’ve gone ahead with nary a word from the WHO.

The WHO also did something useful this week though by pre-qualifying the new oral polio vaccine. All that remains is to convince the Taliban and US health authorities that vaccines work.

The WHO also issued another report this week that conflict and instability make pregnancy more dangerous. No sh!t, Sherlock! You try giving birth while standing on a rickety balance beam as bombs are exploding all around you.

CEPI says they have a new plan to save the world from future pandemics and epidemics. They just need to raise $2.5 billion first.

Saudi Arabia has been trying to position itself as a regional hub for biopharma manufacturing and Germany’s Stada has taken the bait, planning an €85 million investment for a new production set-up in the planned Sudair Industrial City. The planned Sudair Industrial City will be nothing like the planned The Line smart city, we’re telling you.

Elsewhere, that beacon of science, the US, has decided that climate pollution no longer needs to be regulated because it is not a health concern. Heck, it never was. Oh and, the orange one also said glyphosate is a federally-protected critical resource.

In the UK, this week saw the first arrest in the royal family for over 400 years and the first death due to cholera in over a 100 years.

Mpox keeps rearing its pustule every so often in “unexpected” places. This week, it was the turn of England and India, both reporting a clade Ib/IIb recombinant.

And finally, researchers either bored out of their skulls or with an ardent deathwish or just inherently nihilistic, decided to unearth bacteria frozen for 5,000 years in an underground ice cave. And yeah, it is resistant to 10 modern antibiotics.

Stories Of The Week

The bet that paid off! Global health money is having a scarcity moment. So it’s useful, no borderline therapeutic, to see an analysis claiming outsized returns from a model that rarely gets the spotlight. A Lancet Global Health study is here with that clear win, estimating that every $1 invested in the Medicines for Malaria Venture (MMV) from 2000–2023 returned $13 in monetised health benefits, with MMV-backed drugs credited with averting 1.6m deaths and 87m disability-adjusted life-years (DALYs). MMV, the not-for-profit product development partnership launched in 1999, has helped bring 19 malaria medicines to market reaching 1.3bn people, including a Novartis antimalarial for newborns and babies under 5kg launched late last year in Ghana, while pregnancy-focused treatments move into Phase 3, because malaria still kills nearly 600,000 people a year (95% in Africa) and the parasite, inconveniently, doesn’t care about flat budgets or strategic plans. With artemisinin resistance rising and climate shocks and conflict widening the risk map, WHO warns that without new treatments we’re looking at 78 million extra cases over five years and another 80,000 deaths annually. Now here is proof that the PDP model works. How does one get partners on board though?
(MMV)

The AMR accelerator under your sink. The FAO has a new study out and researchers contend that food loss and waste (FLW) is not just a climate and efficiency problem. They believe it can also act as a reservoir, and in some cases even an accelerator, for antimicrobial resistance (AMR), meaning it deserves a seat at the AMR surveillance table. In a new scoping review in Infectious Diseases of Poverty, they warn that dumping FLW into landfills and open sites can intensify AMR risks, while treatment pathways like composting and anaerobic digestion can reduce resistance genes if optimised and properly managed (and yes, that “if” is doing a lot of heavy lifting here). The review points to evidence of high levels of resistance genes in kitchen and institutional food waste, sometimes reportedly higher than in sewage sludge or swine manure, with animal-derived waste (notably fish) showing greater magnitude and diversity. Landfills get special scrutiny: mixed biological and chemical waste streams, exposure to scavenging animals and migratory birds, and leaching into water sources all widen the pathways for dissemination. Great. Can’t even throw food you don’t like anymore. Eat it. Eat it all up.
(Infectious Diseases of Poverty)

And then there were six. Normally, we don’t carry stories from Gavi’s VaccinesWork feature here. But this one - the 6 threats that Gavi thinks could shape global health this year - is worth carrying. So, what are the 6 threats?
1. Disease outbreaks caused by conflict. Okay, we’ve got several of those around the world. Check.
2. Climate change and arboviruses. Okay. Eff you, mosquitoes.
3. Global health funding cuts. Hey, money before morals, okay?
4. Health misinformation. Hehehe. RFKehehe.
5. Marburg virus. Hey, who cares what happens in Africa?
6. Disease X. Shut up, you fearmongerers. There was never a pandemic. And vaccines are mind control drugs.
(Gavi)

Breakthroughs

One shot to cure them all? Stanford researchers say a single nasal-spray “universal vaccine” could offer broad protection against coughs, colds and flu viruses, plus bacterial lung infections, and might even dampen certain allergy responses. Published in Science and tested so far only in animals, the approach is a deliberate break from classic vaccine design: instead of training the immune system to recognise one pathogen, it mimics immune signalling to keep lung macrophages on “amber alert”, ready to respond to whatever turns up. In the animal work, this heightened readiness reportedly lasted about three months, cut viral invasion by 100–1,000-fold, and showed protection against Staphylococcus aureus and Acinetobacter baumannii, alongside reduced responses to house dust mite allergens (a trigger for allergic asthma). Would be great if it worked in the real world in humans without immune disorders. One can hope, no?
(Science)

Bottom line

How hot is my glass? In bad news for every single urban architect in Dubai and all major cities around the world, a new Oxford-led dataset in Nature Sustainability warns that extreme heat exposure ramps up fast as we cross 1.5°C, with the uncomfortable truth that the real adaptation crunch happens before 2030, not comfortably “by 2050”. At 2°C warming, almost four billion people could be living with extreme heat by mid-century, with the biggest exposure by population in India, Nigeria, Indonesia, Bangladesh, Pakistan, and the Philippines. What does this have to do with urban architects, you ask? Well, the study explicitly out the aesthetic-industrial complex: shiny glass-facade high-rises that signal modernity while trapping solar heat, locking in punishing cooling demand and overheating risk across their lifetimes. Also, budding architects, if the shiny glass facades of buildings around the world impress you, remember this, a 1.5°C world is not a future scenario, it’s your new design brief. Stop designing future retrofits into skylines.
(Nature Sustainability)

How dark is my air? So you thought air pollution affects your lungs alone? Maybe your hearts also? Wrong. It also worsens serious mental health conditions, including anxiety, depression and schizophrenia spectrum disorders. A 2026 review of 25 studies in Environmental Researchfound long-term exposure is most concerning, but even short-term spikes can aggravate anxiety disorders. With nearly 99% of the world already breathing air above WHO guidelines, one can see why this matters everywhere but the US.
(Environmental Research)

How red is my flame? A new Science Advances study finds the number of days with the hot-dry-windy conditions that prime extreme wildfires has nearly tripled globally over the past 45 years, and the problem is getting nastier because fire weather is becoming increasingly synchronous across regions, meaning multiple places are primed to burn at the same time. In the 1980s and early 1990s, the world averaged about 22 synchronous fire-weather days a year; by 2023–2024, it was 60+ days, with researchers estimating more than half of the increase is driven by human-caused climate change because of course. All regions around the world have seen a spike in this behaviour except Southeast Asia where the days are getting muggier. Also, what is it with researchers and naming their study papers with such excrutiatingly boring titles that nobody would want to read? This study, for example, was titled Increasing synchronicity of global extreme fire weather when they could have easily titled it Burn, burn, burn.
(Science Advances)

Long reads

Hunger makes the world go round. This piece in The Conversation says climate change will see 1.1 billion people go hungry by 2100. The good news the title refers to must be the fact that there may not be that many people by 2100, eh?
(The Conversation)

Can’t forget what we never learned. Gavi speaks to an expert to figure out whether we’ve forgotten the lessons we learned from Covid. What lessons?
(Gavi)

Climate change comes for coffee. The saddest news we’ve read so far this year is about how coffee-growing countries are becoming too hot to grow coffee.
(Climate Central)

Oh, and Gopal Nair doesn’t want you to see this.

Beginning with a little update from Gaza, where for so long the light at the end of the tunnel has been so dark, people have been finding ways to make their own light. And as the world “celebrates” World Radio Day today, a few brave people in Gaza have managed to re-open a radio station - Zaman FM, just one of 23 that were operational 850 days ago. That is the only light to be found in Gaza this week. Unless you count the light from aerosol bombs - US-supplied thermobaric weapons - that Israel used to evaporate more than 2,800 Palestinians. Gaza is also overrun with a mystery respiratory illness right now. And with lab supplies still mostly missing, doctors aren’t able to even identify the nature of the illness, leaving them only treating symptoms. At least 10 people have died with 100s more sick. It is actually surprising that Israel, a world leader in organ donations, would leave healthy people to die with their organs intact.

Moving on to Africa, where hunger is rampant. In Kenya, with four consecutive wet seasons, including the last one which was the driest ever recorded, drought is threatening to leave over two million people without food. And water.

And that is not even the worst hunger crisis in Africa. Or even in the Horn of Africa. Nope. That place belongs to Sudan, home of the world’s largest displacement crisis. For a country that was historically the breadbasket of the region, Sudan is now facing what a humanitarian group calls “famine of Biblical proportions.” Unlike the drought in Kenya, which can be attributed to nature, the famine in Sudan, like most famines in Africa through history, is human in origin. Thanks to the arming of militia by vested interests seeking to dominate the gold trade. Who? Not entirely sure but it sounds a lot like you ay ee.

Alright, just because it is Friday the 13th doesn’t mean you can’t have some good news. And that good news comes courtesy of South Africa where Africa’s first Africa-led HIV vaccine trial is breaking new ground.

That is not the only vaccine news from South Africa. With foot-and-mouth disease running riot in cattle, the country is launching local vaccinations for that too.

In Nigeria, a doctor succumbed to Lassa fever last week, making it the first official death this year, to add to the 215 reported deaths from last year. The CEPI vaccine can’t come here fast enough.

Elsewhere, with no acronyms for this partnership, the Africa CDC has linked up with the United Nations Population Fund (UNFPA) to work together on health initiatives for adolescents and women.

In more bad news for Africa, Burundi has become the 16th country to sign a bilateral health agreement with the US.

And without any further ado, the US has quickly moved to securing mineral supplies for itself, signing a flurry of trade deals for access to critical and rare earth minerals.

The US also announced a partnership with Hungary, that bastion of religious freedom, to promote religious freedom in sub-Saharan Africa and the Middle East.

The US doesn’t believe in flu vaccines anymore. The US doesn’t believe in the WHO anymore. But WHO officials believe the US will participate in the WHO meeting to decide the composition for the upcoming season’s flu shot. Faith can move mountains, they say.

India may have controlled its Nipah virus outbreak but a neighbouring country, Bangladesh, has seen one person die of it.

Taking a leaf out of the US’ aid playbook, the EU is likely cutting its contribution to the Global Fund.

In China, three new human cases of bird flu have been reported. But no, don’t worry. We’re all gonna die someday anyway.

Moderna and mRNA vaccines may have fallen out of favour in the US but in bad news for djchicus and other vaccine deniers on social media, Mexico is signing a long-term deal with Moderna for local production of mRNA goodies.

And finally, we’ve been saying this many times, including here in The Kable. Coffee is good, no great, for you. Science backs it up. This new study says drinking coffee slows down brain ageing too. But yes, there is a real condition that affects some people who can’t drink coffee. It’s called low IQ. It’s curable though. Grab a cup of joe.

Stories Of The Week

Obesity 1, Immunity 0. A new study in The Lancet has more bad news on the obesity front. People with obesity are 70% more likely to be hospitalised or die from infectious diseases, with one in 10 infection-related deaths globally linked to the condition. The study of over 540,000 people found that obesity significantly increases risk across a wide range of infections including flu, Covid, pneumonia, and gastroenteritis. Those with the most severe obesity (BMI ≥40) face three times the risk. The researchers estimate that obesity may have contributed to around 600,000 of the 5.4 million infectious disease deaths worldwide in 2023. The solution? “Policies that help people stay healthy and support weight-loss, such as access to affordable healthy food and opportunities for physical activity.” Not our words. Literally quoting the study. Because what could be more revolutionary than telling people to eat better and move more?
(The Lancet)

Lob, lob, lobbies. One of the reasons for increasing obesity around the world is the proliferation of ultraprocessed foods (UPFs) and the preponderance of the lobbies behind it. And a new report from Harvard, University of Michigan, and Duke University reveals why these lobbies exist. For the same reason tobacco lobbies exist. Because UPFs have more in common with cigarettes than with actual food. These industrially manufactured products are engineered to encourage addiction and consumption, with marketing claims like low fat and sugar-free serving as health washing that stalls regulation, much like cigarette filter ads back in the day.

The study authors say that UPFs share characteristics with cigarettes in production processes and manufacturers’ efforts to optimise “doses” that act on reward pathways in the body. The researchers suggest lessons from tobacco regulation - litigation, marketing restrictions, structural interventions - could should (emphasis ours) guide UPF regulation. Because, unlike tobacco, just saying no is not an option here for consumers. The food you eat shouldn’t be what you dig your grave with.
(The Milbank Quarterly)

Bottom line

Get rich or die trying. Yet another report about the harm that capitalism is causing to nature that businesses will ignore. Even if this report says that doing so will result in those businesses themselves going extinct. Because look at the words in the assessment approved by 150 governments. It says companies can either “lead the way or ultimately risk extinction... both of species in nature, but potentially also their own.” Companies will say ‘potentially’ is doing a lot of heavy lifting here. Clean water, fertile soil, and a habitable planet for your business to exist is just too complicated for modern capitalism. The report might say that all businesses, even those “seemingly far-removed from nature,” rely on ecosystem services for free. But denial is free too. And for everything else, there is Mastercard.
(IPBES)

Malaria takes flight. It seems like we can hardly spend a week in peace without some mention of mosquitoes and malaria. And in Hawai’i, it’s worse. It is birds who are acting as malaria vectors. A new study reveals that Hawai’i’s birds aren’t just victims of malaria, they’re also helping it spread. Almost every forest bird species in Hawai’i can transmit the disease, explaining why it shows up nearly everywhere mosquitoes live across the islands. The parasite was detected at 63 of 64 locations tested statewide, and infected birds can remain contagious for months or even years while appearing only mildly infected. The study examined blood samples from over 4,000 birds and found that both native and introduced species contribute to spreading the parasite. Even birds carrying very small amounts of the parasite were able to infect mosquitoes, meaning a wide range of bird communities maintain ongoing transmission. As if birds carrying bird flu wasn’t bad enough. These are the times when we wish that birds aren’t real guy was right.
(Nature Communications)

Not good enough for me but bom demais for thee. A new study doesn’t bode well for agricultural produce in Latin America and consumers of said produce. Almost half (48.9%) of the pesticides authorised for use on major agricultural crops in eight Latin American countries are banned or not approved in the European Union due to health and environmental risks. Researchers identified 523 active ingredients approved for use in the region’s ten main crops, with 256 of them banned in the EU. Costa Rica had the highest number of banned pesticides (140), followed by Mexico (135), Brazil (115), Argentina (106), and Chile (99). The study found that crops with the highest production and export value - soybeans, maize, wheat, and rice - contained a higher concentration of substances not permitted in the EU. Latin America has seen pesticide consumption increase about 500% between 1990 and 2019, making it the region with the highest growth in pesticide use. As expected, the human costs are devastating: research links chronic pesticide exposure to more aggressive breast cancer tumors, and pesticides have been detected in breast milk in at least ten Latin American countries. The authors recommend an “immediate ban on the production, sale and use of all active ingredients classified as highly hazardous.” But that would mean putting people over profits, which is not how the world works.
(Proceedings of the Royal Society B)

Long reads

Dark clouds, silver lining. The Conversation has a piece on the future that climate change has for Africa when it comes to heat. Good news, no more heat waves. Bad news: it will be hot all the damn time.
(The Conversation)

Peace? Not on our watch. The Conversation again with a think-piece on the new peace plan for Sudan and whether it will work. Well, let’s see. Who’s involved? The US. Saudi Arabia. UAE. Hell, yeah, this peace plan will work.
(The Conversation)

Even death won’t do us part. For Palestinians, death is not where Israeli torture ends. Their bodies are also not left in peace.
(The Baffler)

Pizza anyone? Not a long read, but a long watch. A really, long one. Like, two hours long. Of maggots eating pizza. 10,000 maggots. Enjoy.
(Science)

Oh, and Gopal Nair doesn’t want you to see this.

Anyhoo, on with The Kable.

In Malawi, government authorities have declared a polio outbreak after the virus was detected in wastewater samples from a public toilet in Blantyre City. This is the second time in the last four years that Malawi, which was declared polio free in 2005 - 15 years before the African continent, has declared a polio outbreak. The previous outbreak in 2022 saw 9 wild poliovirus cases - one in Malawi and eight in neighbouring Mozambique - with over 33 million children vaccinated.

Polio is not the biggest concern for Mozambique this week though. It is flooding. Heavy rain, and subsequent flooding, since mid-December is now wreaking havoc across southern Africa, with Mozambique bearing the brunt of it all. According to the WHO, 1.3 million people have been affected, and in Mozambique, nearly 10000 km² of land is flooded, with homes, farms, hospitals all under water.

How about some good news for a change? Maybe even a series of good news? Okay then!

The Africa CDC has opened its first warehouse for medical supplies in Addis Ababa. All that remains now is to stock it.

In even more awesome news, preventative cholera vaccines are back in vogue baby. When cases had reached an all-time high way back in the hazy past of 2022, increased supply, combined with one of the only two cholera vaccine manufacturers deciding to not make the vaccine anymore, meant that authorities could only react to cholera outbreaks, not prevent them. And in the three years since, cholera has been running riot all around the world. Hopefully, this restart means cholera begins to make its way out this world for good.

And in even better news, a new paper in Vaccines completely vindicates, not that vindication was needed, the scrapping of the US-sponsored Hep B single-blind vaccine trial in Guinea-Bissau. The Danish vaccine “research group” tasked with the trial - Bandim Health Project (BHP), this paper says they can’t find comprehensive data on primary outcomes for 10 of the group’s studies carried out over two decades in Africa.

There is more good news. The first ever vaccine that targets the entire SARS virus family is going into the clinic. Developed by UW Medicine with SK Bioscience, this vaccine, if successful, will protect us all against Covid and all past and future coronaviruses.

Samsung Biologics has become the newest manufacturer to join CEPI’s global vaccine manufacturing network, as part of CEPI’s 100 Days mission.

In other news, the US pledged $2 billion for the UN but the WHO chief, at the WHO Executive Board meeting, said health systems are nevertheless at risk, thanks to funding cuts. Another UN agency - UNICEF - called for criminalisation of AI content depicting child sex abuse, which the world’s richest “man” claims falls under the purview of free speech. Interestingly, UN Secretary-General António Guterres also announced a list of 40 people to a UN AI panel to aimed at ensuring AI was used to benefit humanity. The panel also includes someone who was part of the Israeli military’s Unit 8200. You know, the people behind the pager explosions in Lebanon. Yup, such a carefully vetted panel this is that cares about humanity.

It’s been quite the busy week for the WHO as well. The agency partnered with Denmark’s DTU National Food Institute to set up a centre that will work on food safety and diet management. Good idea in theory but so far we’ve seen nothing on the DTU website that indicates this will do anything for anybody outside Denmark, much less the global South. Also, at the WHO Executive Board meeting, the WHO seems to have come to terms with the fact that chasing the SDGs is no longer an option. Instead, it has a new plan - a 10-year emergency care strategy that will take us through to 2035, meaning there are five more years before we start questioning anything. The WHO also called for including the toll neglected tropical diseases (NTDs) take on mental health in all assessments of disease care, which is a welcome first. And finally, the WHO launched its 2026 emergency appeal, looking to raise $1 billion to respond to 36 emergencies globally. Although if the WHO were to wait for a bit, Israel and Dubai will bring that count down by two, because Palestine and Sudan are both in the list.

The US may be done with the WHO and the UN but that memo hasn’t necessarily trickled down to all US cities and states. New York City, Illinois and California have all joined the UN’s health network in the past 10 days.

If the WHO gave us a lot of content this week, India isn’t far behind either. But first, a bit of the same-old, same-old, this time featuring Strides Pharma whose formulations unit in New York received a voluntary action indicated report from the US FDA. US drug authorities also shut down 200 illegal online pharmacies linked to an India-based criminal organisation. Medical device firms in India have been asked to “promptly” notify government authorities of all adverse events due to medical devices, whether serious or not. The spurious cough syrups that claimed the lives of a few children in India late last year are not done claiming lives. One child, who was in a coma since December, has now finally given up the ghost. An investigation by The News Minute reveals that some Indians get off to some really nasty kinks. Like watching hospital videos of childbirth and vaginal exams. And finally, India is seeking to go big on biologics and biosimilars. In its recently declared budget, the government has set aside ₹100 billion to increase research and production. The funds will go towards creating three new national research institutes and funding 7 existing ones, while also building more than 1,000 clinical trial sites.

One of the world’s largest destination for other countries’ waste, Malaysia has decided to ban all e-waste imports. They’re also looking to impose a stay on import of plastic waste.

And finally, the farm in the Netherlands where they found bird flu antibodies in a cow? Well, the country’s Public Broadcasting Network reports that the agriculture minister says five cows now have bird flu antibodies. Moo! We mean, boo!

Stories Of The Week

Buzz off, ye mosquito. Nobody loves you. We’ve said this before but it bears repeating. Not all nature’s creations need to survive. It is fine for some to go extinct. Like effing mosquitoes. Here, we were just beginning to celebrate a few wins in the war against malaria. Along comes this new study that says climate change is bad for Africa. Okay, what does that have to with mosquitoes, you ask? Nothing, except the study says by 2050, climate change could lead to 123 million additional malaria cases and 532,000 additional deaths across the continent. And extreme weather events account for 79% of additional cases and 93% of additional deaths. Because floods and cyclones are destroying not just homes and healthcare access, but also malaria control programs. But hey, at least we can all feel good about those “climate resilience strategies” that will totally work, unlike all the other global health promises that have gone nowhere over the past 50 years. The study also notes that most of the increases will occur in areas already dealing with malaria, because apparently Africa doesn’t have enough problems already.
(Nature)

Money can’t buy you happiness. Maybe. But aid can and has saved millions of lives from the preventable diseases that flourish in countries systematically exploited by centuries of colonialism. Over the past two decades, development assistance was associated with a 23% reduction in all-cause mortality and 39% fewer child deaths across low- and middle-income countries (LMICs). HIV/AIDS deaths dropped 70%, malaria deaths fell 56%, and NTDs saw 54% fewer deaths. But apparently, atoning for centuries of plunder, exploitation, and resource extraction is just too damn expensive. The study projects that ongoing funding cuts could result in 9.4 million to 23 million additional deaths by 2030, including 2.5 million to 5.4 million children under 5.
(The Lancet Global Health)

7 million. That is how many lives can be saved from cancer just by getting people off of alcohol and smoking. A new study commissioned by the WHO and published in Nature Medicine says almost 40% of global cancer cases are preventable. Tobacco causes 15% of all new cases, infections account for 10%, and alcohol consumption for another 3%. The study shows gender disparities too - 45% of male cancers are preventable versus 30% in women, with smoking accounting for 23% of male cases versus 6% in women. Meanwhile, geographical ranges vary from 24% preventable in North Africa to 57% in East Asia. The WHO urges countries to develop “context-specific prevention strategies” including “strong tobacco control measures, alcohol regulation, and vaccination against cancer-causing infections.” Because what could be more revolutionary than telling people to not poison themselves?
(WHO)

Breakthroughs

AI on steroids. The problem with equating LLMs with AI is that people forget AI can actually do good, even great stuff. Like these researchers who created MOSAIC, an AI system that can help chemists synthesise new compounds. The system recommended lab conditions that successfully generated 35 new potential pharmaceuticals, agrochemicals, and cosmetics without requiring hours of tedious searching through chemical reactions. When tested, MOSAIC successfully produced 35 out of 52 target compounds and even accurately predicted their color and form. The system is already being used by Boehringer Ingelheim to design new synthetic pathways. Oh and, save money. Which is apparently what AI is really good for: replacing human labour to increase corporate profits.
(Nature)

Bird flu? Not up my nose. We’re sure sometimes researchers do research just for the sake of using up available funds. Why else would you do research about whether sea turtles can hear ship noises or which dinosaur made which footprint? But sometimes, researchers do useful research too. Like these, uhm, researchers at Washington University School of Medicine in St. Louis who’ve developed a nasal spray vaccine that shows strong protection against H5N1 bird flu in animal tests. The vaccine outperformed traditional flu shots by targeting the virus where it starts - in the nose and lungs - potentially preventing both severe disease and transmission. The nasal vaccine triggered strong immune responses in hamsters and mice, providing near-complete protection against H5N1 infection. It remained effective even in animals with existing flu immunity. The researchers note that this approach “could disrupt the cycle of infection and transmission”. With H5N1 having jumped to dairy cows in the US, this vaccine, if successful, might actually be useful, unlike many pharmaceutical “innovations” that prioritise profits over public health.
(Cell Reports Medicine)

Bottom line

Pave paradise for a parking lot? Fine, here’s a virus! A new study from the University of Stirling confirms what indigenous peoples have known for millennia: when humans destroy natural habitats, diseases spread from animals to humans. Deforestation, farming, fast-growing cities, and fragmented habitats all heighten the risk of zoonotic diseases like Covid and malaria, particularly those spread by mosquitoes, rodents, and bats. Because disrupting natural ecosystems that have evolved over millions of years is a great idea for short-term economic gain. The study does show that some ecosystem restoration can help. Protecting wetlands and conserving natural habitats reduces disease risk. But certain forms of tree planting can actually increase risk during early recovery stages. However, most research has been done in wealthy countries even though the major disease issues are in lower-income regions. The study has identified 50 priority locations and developed an “open online atlas” for policymakers because what could be more helpful than another online tool that nobody will use while the planet continues to burn.
(Nature Sustainability)

Those damn mosquitoes again. Need more confirmation of what we just said above? Well, here’s a new study from Brazil. And it has mosquitoes. Mosquitoes that bite. Mosquitoes that bite humans. Mosquitoes that bite humans instead of wildlife. In the rapidly shrinking Atlantic Forest, researchers found that many mosquito species now prefer feeding on people rather than the diverse wildlife that used to be available. This dramatically raises the risk of spreading dangerous viruses like dengue, Zika, and Yellow Fever. The study tracked 1,714 mosquitoes from 52 species, finding that 18 out of 24 blood-fed mosquitoes had fed on humans, compared to just one amphibian, six birds, one canid, and one mouse. Some mosquitoes even showed mixed meals, like one that bit both an amphibian and a human. With fewer natural hosts available, mosquitoes are forced to seek new, alternative blood sources and humans are the most convenient ones. The researchers also say this preference “significantly enhances the risk of pathogen transmission”, which in plainspeak means “we told you so” when it comes to deforestation. The study identified gaps in current data (only 38% of blood meals could be identified), but the message is clear: destroy forests, get more diseases.
(Frontiers in Ecology and Evolution)

Long reads

Pandemic planning. It has been six years since the WHO’s declaration of Covid as a pandemic. And the WHO wonders whether we’re ready for the next one? Heh, NO!
(WHO)

Africa to the fore. In this piece in Devex, Angola’s president and the current chair of the African Union, João Manuel Gonçalves Lourenço argues, rightfully, that health security in Africa is inextricably linked with global health security. And the only way to ensure is to let Africa lead the way.
(Devex)

Cough, cough. Gavi has a set of winter-illness myths for you to read and wonder about. So, go out with that wet hair. Don’t sweat it.
(Gavi)

Eat the planet. An infographic for physicians to discuss with their patients on how to integrate One Health into their daily life. You can use it too. One habit per month.
(Planetary Health Alliance)

Burning rubber. A brilliant investigative piece from The Reporters’ Collective on how India banned waste tyre burning domestically, and then became the world leader in burning waste tyre.
(The Reporters’ Collective)

Oh, and Gopal Nair doesn’t want you to see this.

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Some good news first. Ethiopia has officially declared its first-ever Marburg outbreak over, after 42 days with no new cases.

Yet another acronym for the Africa CDC which has gone ahead and set up a new Central Data Repository (CDR) to manage public health data across the continent. One can’t help but think the recent collaboration between the Gates Foundation and Open AI has something to do with this. Why do we think that? Because the agency has also laid down guidance for all clinical trials in Africa, which is an obvious attempt at forestalling any future imperialist “ideological” interventions like was just attempted in Guinea-Bissau.

Elsewhere, the UN says the situation in Gaza continues to be dire (their words), with children being the most affected. Israel responded by promptly bombing and setting fire to UNRWA headquarters in East Jerusalem.

In other news, the US continued its relentless focus on science by insisting that it will fund Gavi only if drops thimerosal from all vaccines it administers because “hurr-durr it causes autism.” The WHO says it doesn’t do so. Heck, the US CDC itself says thimerosal is safe. But what can we expect from a country where the vaccine panel chief now says vaccines for measles and polio, and maybe all diseases, should be optional? Yup. Polio. Only the second-greatest vaccination story of all-time ever. Finally something US and Taliban health officials can agree on.

In a bit of a surprise, an Indian drugmaker has seen drug sales suspended in a country after inspection by a regulator. The surprise is not in the suspension but in the fact that the regulator was from China and the inspection was virtual and that was enough for Sun Pharma to lose the ability to sell their Alzheimer’s drug in China. And boy, the inspection report is seriously damning. This is the same Sun Pharma facility that has several times been at the receiving end of the US FDA’s ire as well. It is refreshing to know that the more things change sometimes, the more they stay the same.

India’s Nipah virus outbreak has now been contained, according to Indian health officials. However, they’ve still not identified how the two nurses who fell ill contracted the illness. We’re pretty sure it’s not because they were in contact with an ill person themselves. Maybe a bat flew into their mouths.

And finally, in bad news for cows everywhere, bird flu antibodies have been detected in cows outside of the US for the first time, in a farm in the Netherlands. Authorities only discovered this because a cat fell ill and died, leading them to the infected feline-killing cow. They don’t know how bird flu reached the farm but it probably has nothing to do with the name.

Stories Of The Week

Aid for me, but not for thee. So you’re a country in the Global South and you thought the “developed world” has been ramping up aid all this while to help LMICs? Yeah well, you thought wrong. Says who? Says Eurodad. The European Network on Debt and Development released a new report that says foreign aid isn’t actually for helping poor people. After a decade of “technical reforms” to modernise foreign aid, official development assistance has drifted far from its ostensible original purpose of poverty reduction. Instead, rich countries have reshaped what counts as aid to advance their own domestic priorities. Surprise, surprise. Aid increasingly comes as loans rather than grants, gets spent within donor countries themselves, or is used to de-risk private investment. In 2024 alone, least developed countries spent more on debt repayments than they received in aid - a perfect system for keeping poor countries poor. Meanwhile, aid has shifted away from the poorest nations toward middle-income countries where donors have strategic interests. Because nothing says “development” like wealthy nations deciding who deserves help behind closed doors. The only thing we’d like to add to all of this is, if our organisation acronymised to Eurodad, we’d change our name. Wtf!
(Eurodad)

You will want some popcorn for this. Scientists have made a “groundbreaking” discovery: obesity and high blood pressure can cause dementia. Who knew? A Danish study finally confirmed what every health teacher from 1995 could have told you, using fancy genetic analysis that cost millions to prove that clogging your arteries might be bad for your brain. The researchers call this an “unexploited opportunity for dementia prevention” because apparently telling people to not eat junk food and exercise is just too damn obvious for modern medicine. And here’s the kicker. Weight-loss meds have already been tested on early Alzheimer’s patients with zero effect, because treating symptoms after your brain is already turning to mush doesn’t work. But hey, let’s keep funding those “breakthrough” studies while we ignore the basic health advice that could prevent the whole damn thing. Because this is modern medicine where the cure or the prognosis is always more profitable than the prevention.
(The Journal of Clinical Endocrinology)

Catch them early. To emphasise the point we were making in the previous story, the WHO also says prevention is the way to go. In a stunning revelation that has shocked absolutely no one, the agency has finally figured out that feeding children healthy food in schools might actually be good for them. Because apparently decades of childhood obesity, diabetes epidemics, and lifelong health problems weren’t enough of a clue that maybe school lunches shouldn’t consist of pizza fries and mystery meat.

The WHO’s “groundbreaking” guidance comes just as childhood obesity officially surpassed underweight cases globally for the first time in 2025 - with 1 in 10 kids now obese and 1 in 5 overweight. But hey, at least we’ve got guidelines! The recommendations include such revolutionary concepts as “less sugar” and “more whole grains,” while noting that only 48 countries even bother to restrict marketing of unhealthy foods to children. We can’t wait for the processed food lobbies to shred this report to use in their packaging. Or maybe even in their foods.
(WHO)

Duh! Double-duh! The world’s water, sanitation, and hygiene systems are broken, says a new UN-Water GLAAS report. Despite having policies and targets in place, only 13% of countries actually have the resources to make them work, leaving 2.1 billion people without safe drinking water, 3.4 billion without sanitation, and 1.7 billion without basic hygiene. We’re definitely on target for SDG Goal 6. Hey, we have plans, okay? So what if they aren’t implemented? Implementation is lax because, as the report notes, 64% of countries deal with overlapping responsibilities leading to “inefficiencies”, meaning we’re too busy pointing fingers to actually fix anything. Meanwhile, there’s a 46% funding gap between what’s needed and what’s available, while 1.4 million people died in 2019 alone from preventable water-related causes and 560,000 got cholera in 2024. But hey, at least 80% of countries are “addressing climate risks in WASH policies”, which probably means they mentioned climate change in a PowerPoint presentation once. But honestly, all this doom and gloom is only for people with no imagination. If you can stick your fingers in your ears and run around shouting nyah-nyah-nyah-nyah-nyah all day, everything will be fine and all manners of things will be fine.
(WHO)

Bottom line

Stop plastic production? Why? We’re all gonna die anyway! A new study in The Lancet Planetary Health says plastic pollution is about to get a lot worse. Health impacts from plastics could more than double by 2040, with global plastic production potentially not peaking until beyond 2100. Because apparently, the idea that we might want to stop poisoning ourselves and the planet with plastic is just too damn radical for modern civilization. The researchers found that emissions throughout plastic lifecycles contribute to “global warming, air pollution, toxicity-related cancers, and non-communicable diseases”, which is a fancy way of saying plastic is killing us slowly. The study also notes that “non-disclosure of the chemical composition of plastics is severely limiting lifecycle assessments in informing effective policy.” In other words, plastic companies won’t tell us what’s in their products, making it kinda hard to regulate them. Who could have seen that coming?
(The Lancet Planetary Health)

My bacci strongest! Researchers in India have found that sewage in Indian cities has become a breeding ground for dangerous bacteria that are “training” themselves to resist antibiotics. The study traces antibiotic residues from hospitals, households, and agricultural sources that are helping bacteria share drug-resistant traits, making them stronger and more dangerous. The findings are predictably grim: resistance genes were found to be 50% more prevalent in sewage than in hospital samples, with bacteria in wastewater sharing genetic sequences with pathogens causing global hospital infections. Scientists detected traces of 11 different antibiotics in sewage, including kanamycin in 67% of samples and azimycin in 56%. Clearly the best place to dispose of unused antibiotics is down the drain where they can create superbugs. With 94% of bacterial isolates resistant to more than 10 antibiotics, sewage has become the perfect incubator for the next pandemic. Can’t wait for statements from quasi-government officials about how drug resistance might actually be good for you.
(Nature Communications)

Long reads

Future-forward. Not a read at all but a peek into what the future portends, climate-wise. An interactive map, developed by a team from the University of Maryland that shows you how the climate will be over the next fifty years at home and around the world. Hint: there won’t be a lot of ice-cream.
(CityApp)

Wither pandemic agreement? An excellent read from Health Policy Watch. A brilliant dissection of the incongruence between what the rich countries want and what LMICs need.
(Health Policy Watch)

Can’t teach an old dog new tricks. If you needed more convincing that signing any bilateral deal with the US is bad, here is Health Policy Watch again with the tea, revealing how the US is making aid conditional on countries accepting its bullying.
(Health Policy Watch)

Oh, and Gopal Nair doesn’t want you to see this.

The week had some excellent news on the Africa CDC front. After making its first declaration of a pan-continent emergency nearly 18 months ago, the agency has now downgraded the emergency label from mpox. Not that mpox has disappeared from the continent but the severity of the outbreak has definitely lessened, enough for it to no longer be classified as an emergency. Even more significantly, for the first time, an African nation has stood up to the anti-science vaccine skeptics who think they rule the world, thanks to the Africa CDC. For the uninitiated, Guinea-Bissau was scheduled to implement a single-blind trial for a hepatitis B vaccine, which would have seen half the kids in the trial not receiving the vaccine. This, in a country where a little more than one in 10 children are already infected with hepatitis B by the time they turn 18 months. This trial has been pushed by the US to gauge the effect of the vaccine on neurodevelopment by five years of age, with the relentless assertion that it is going ahead, science be damned. Anyway, good on the Africa CDC and good on the new health dispensation in Guinea-Bissau.

In potentially alarming news for Africa, and other LMICs, the European parliament this week mooted a new act to “ensure supply of critical medicines in Europe.” The act - Critical Medicines Act (CMA) - is ostensibly aimed at reshoring production of critical medicines, essential drugs, antibiotics and APIs within the EU. So what if it means global supply gets affected? And so what, if in the words of the EU lawmaker who drafted the bill, it is in response to trade pressure from the US? They can’t take on the US so they instead decide to punch down.

Elsewhere, the Gates Foundation is teaming up with OpenAI in a $50 million partnership to help African countries, beginning with Rwanda, use AI to improve their health systems. Of course, no countries in the global North will share their public health data with OpenAI and that has nothing to do with this.

The Gates Foundation also linked up with the Novo Nordisk Foundation and Wellcome this week to set up a $60 million grant to fund research into AMR.

CEPI is pumping in $30 million into a collaboration looking to upgrade the only working Zaire ebolavirus vaccine we have now. MSD will work with Singapore-based Hilleman Laboratories for clinical development of the updated vaccine while SK bioscience and IDT Biologika will develop the updated drug substance process and associated drug product. MSD will also look at working with public sector buyers in LMICs to make the vaccine more affordable.

India’s Nipah virus outbreak in West Bengal seems to be gathering steam with confirmed cases going up 250% to five, with hundreds still iffy.

And finally, the answer to all of life’s questions might be 42. But the number that responsible forat least half of life’s problems, at least Earth’s problems, is 32. Because that is the number of fossil fuel companies around the world responsible for half of the world’s CO2 emissions, with state-owned fossil fuel producers making up 85% of the top 20, all from countries that opposed a fossil fuel phaseout at last month’s COP30 summit in Brazil. Go figure. 🙄

Stories Of The Week

Hungry, hungry hippos. Yet another report has confirmed what we all knew: the world is a dumpster fire and people are going hungry. In a stunning revelation, not, from Action Against Hunger, their 2026 Global Hunger Hotspots report discovered that war, climate disasters, and economic collapse are making people starve. Shocking stuff. 196 million people are starving worldwide, with Nigeria (31.8 million), Sudan (25.6 million), and DRC (25.6 million) leading the crisis. But the real kicker is Gaza, where a mere 94% of the population is facing catastrophic hunger. Because nothing says “humanitarian progress” like systematically starving an entire population into submission. Oh wait, 6% isn’t starving yet? Must be Hamas. South Sudan and Haiti aren’t too far behind with 56% of the population critically hungry.

More numbers? Sure. 30 million kids have acute malnutrition, thanks to a global funding shortfall of 65%. But hey, at least the US managed to cut humanitarian aid by 83% - finally, some fiscal responsibility! Never mind that USAID programs have saved 90 million lives over the past two decades, or that these cuts could kill 14 million people, including 4.5 million children. Priorities, people. The report’s “urgent recommendations” include such groundbreaking ideas as “ensure humanitarian access” and “provide adequate funding.” Because what could be more revolutionary than letting people eat, eh?

We know the problem. We have the solutions. What we lack is the political will to care about people who aren’t rich. Because, hey, trickle-down economics will work. All you need is just a little patience.
(Action Against Hunger)

Bottom line

Water water everywhere? Huh! In your dreams. For long, we’ve held this belief that wars of the future will be fought over water. That future is here now. UN scientists have finally caught up to what we already knew: the planet is broke, hydrologically speaking. In a stunning revelation, they’ve declared the dawn of “global water bankruptcy” - a fancy term for 4 billion people facing water scarcity, 50% of large lakes vanished, and 70% of aquifers draining like leaky faucets. But hey, at least we’ve got time for more “urgent UN conferences” in 2026! Because nothing says “action” like another round of diplomatic hand-wringing while your taps run dry.

The report distinguishes between “water stress” (reversible) and “water bankruptcy” (oops, too late). With 2.2 billion people lacking safe water and $307 billion in annual drought costs, this is what happens when you treat water as a disposable resource rather than the foundation of life. In a world that can’t even manage basic climate commitments, water bankruptcy management sounds about as realistic as expecting politicians to put people before profits. But hey, maybe a decade’s worth of conferences will finally fix it.
(UNU-INWEH)

Spending isn’t saving. The financial wizards at the UN did some number-crunching and well, it seems for every $1 spent protecting nature, $30 go to destroying it. In 2023 alone, $7.3 trillion flowed into “nature-negative activities” while a paltry $220 billion supported actual solutions. Because apparently, the planet’s health is a luxury item only available to those who can afford boutique environmentalism. The UNEP’s State of Finance for Nature 2026 report calls for a “big nature turnaround”, including innovations like ooh, greening urban areas and wow, phasing out harmful subsidies, oh and scaling up “nature-positive” investments. Let’s tell that to the 32 fossil fuel companies we mentioned above, eh?
(UNEP)

Long reads

Eat the rich. Carry your reusable straws and your reusable travelling coffee cups everywhere you go. Save the planet. Meanwhile, it didn’t take the 1% even 10 days to blow past their carbon budget for 2026. Some did it in three days. They sure aren’t gonna save the world. Guess it’s down to us and our recycling.
(Oxfam)

Bilaterism sucks. We haven’t been fans of African nations signing bilateral health deals with the US. Now someone has put down in ink all the reasons why this is shitty for Africa. “Health data is a public asset.” “Diseases do not respect borders.” And a whole lot more.
(SciDevNet)

City lights. They say most of the world will be living in urban areas soon. Well, most of the world better get used to living without water. And if you want an interactive map to find out if you are in one of the cities where water will be a luxury, here you go. Spoiler: you probably are.
(Watershed Investigations)

Oh, and Gopal Nair doesn’t want you to see this.

Things are going hunky-dory in the US meanwhile. Faced with an increasing number of measles and flu cases - over 11 million at last count, “health” officials have responded by cancelling 6 childhood vaccines because freedumb. Not content with wreaking havoc on health domestically, the US also withdrew from 66 multilateral bodies, which honestly? Good riddance. Thank you for your attention to this matter.

As the old year progressed into the new, what remained unchanged was Israel’s devotion to calling things Hamas. They came up a plan to bar many NGOs from Gaza, including Doctors Without Borders because Doctors and Borders are both Hamas obviously. And Oxfam released a report about how, during this “ceasefire” Israel hasn’t let in water into Gaza. Well, everybody knows water is Hamas. And Oxfam released the report so they’re obviously Hamas. Duh!

Meanwhile, back to the world that isreal, bird flu is still around. South Korea reported yet another case - the 33rd this season - at a farm with half a million birds. And for the first time, India has officially reported bird flu, from the only Indian state we know that officially reports cases of disease without being coerced into doing so.

Elsewhere in India, there has been an outbreak of Nipah in West Bengal with two confirmed cases but over a 100 contacts under watch. And in India’s cleanest city for 8 years running, the water didn’t get the memo, flowing as it was with sewage, resulting in microbial contamination that landed thousands in the hospital and 15 deaths, as per official numbers.

And finally, in India, authorities have launched a desperate hunt for an elephant that has killed 22 people in a recent rampage, adding to over 2800 human deaths in five years from elephant encounters. But we still won’t let the wild things be.

Stories Of The Week

Mercury retrograde: Cancer rising fast. Cancer cases have quietly doubled since 1990 and hit 18.5 million in 2023, with deaths climbing 74% to 10.4 million a year. Projections for the future aren’t very subtle either: 30.5 million new diagnoses and 18.6 million deaths annually by 2050 if we stay on this trajectory. Yes, population growth and ageing are doing their part, but the more damning detail is how much of this is optional. Around 42% of cancer deaths in 2023 were linked to modifiable risks across 44 factors - tobacco leading the pack, alongside unhealthy diets, obesity and high blood sugar - meaning a huge slice of mortality is tied to policies that exist, interventions that work, and systems that routinely fail to deliver them at scale. And the burden is shifting hard towards low- and middle-income countries: progress in age-adjusted death rates has largely accrued to richer settings, while incidence and mortality rates in several resource-limited countries continue to climb. This is what global health equity looks like in practice: the highest-growth cancer markets are the places least equipped to diagnose early, treat well, or keep patients alive long enough to count as a success story. No, the fix is not Movember. It’s boring, expensive, politically inconvenient work like taxes and regulation on tobacco and ultra-processed foods, serious screening and diagnostic capacity, reliable treatment access, and better registries so countries can see what’s actually happening rather than guessing. Because without all of that, the next 25 years won’t just bring more cancer. They’ll bring more preventable cancer. No, this is not about Israel.
(The Lancet)

Evidence trumps hearsay. During the early days of Covid vaccine rollouts, there were a lot of very loud vaccine deniers around the world, some of them in prominent health positions now. Much to their consternation comes this new study that says for all the noise, most such vaccine hesitancy turned out to be less ideology and more nerves. This massive study tracking attitudes and actual jab uptake in 1.1 million adults shows that fears about side effects and effectiveness dominated early scepticism, and largely melted away once real-world evidence and rollout caught up. Hesitancy peaked at 8% in early 2021, fell to just over 1% a year later, and never really recovered, with around two-thirds of initially hesitant people eventually getting vaccinated. The holdouts were a smaller, stickier group shaped by deprivation, institutional mistrust, and past healthcare experiences, factors that predict scepticism far better than conspiracy memes ever did. Demographic differences mattered (fertility concerns among women, low personal risk perception among men, needle fear among the young), but the bigger lesson is structural: clear information, time, and visible safety data worked for most people. What didn’t work was pretending all hesitancy is the same. “Trust the science” only works if the system first gives people a reason to trust it. Disclaimer: this study didn’t include any people in the land of the freedumb so, well. And evidence trumping hearsay is obviously not about Israel.
(The Lancet)

Raise the sin tax. In two blunt new reports, the WHO says governments should significantly raise taxes on alcohol and sugary drinks, because right now these products are getting cheaper while obesity, diabetes, cancers and injuries get more expensive. The numbers certainly support the WHO’s contention. Only 14% of countries adjust health taxes for inflation, sugary drink taxes average a limp 9%, and a 330ml soda is taxed at just 2.4% - compared with 50–60% for tobacco. Wine escapes tax entirely in at least 25 countries, mostly in Europe, and alcohol overall has become more affordable in most places since 2022. The evidence is already in: the UK’s sugar levy cut sugar consumption, raised £338 million in a single year, and was linked to lower obesity rates in girls, while Lithuania’s alcohol tax hike was followed by a near-5% drop in all-cause mortality. But hey, lobbies for the win. And no, again, this is not about Israel.
(WHO)

Breakthroughs

A fungus goes industrial. Don’t let anybody ever tell you that The Kable is all doom and gloom. Who else would tell you that after 50 years of lying in cancer research’s “promising but impractical” drawer, Verticillin A, has now been synthesised for the first-time ever in a lab? Always seen as potent on paper but nearly impossible to make in real life, researchers have pulled off what can only be called a miracle, cracking a molecule so structurally fussy and unstable that nature itself only produces it in trace amounts. The payoff is significant. With on-demand production finally possible, scientists can study verticillin A properly, tweak it, and test variants—something extraction from a microscopic fungus never allowed. Early lab results are encouraging: the synthetic compound and its cousins showed activity against diffuse midline glioma cells, a rare and aggressive childhood brain cancer, and hit the protein targets they were meant to. This isn’t a new cancer drug yet but it is the unglamorous step that usually comes first. You can’t develop what you can’t reliably make.
(Journal of the American Chemical Society)

Bottom line

Heat? What even is heat? First the excellent news. 2025 wasn’t the hottest year recorded, yay. 2025 was only one of three hottest years on record, scientists say. It also marked the first three-year stretch where global temperatures averaged 1.5°C above pre-industrial levels. The world is now on track to breach the 1.5°C, instead of avoiding it till the end of the century. Double yay. Oceans are now storing record levels of heat, polar sea ice has hit new lows, and extreme weather is behaving exactly as climate models said it would: hotter heatwaves, heavier floods, stronger storms. Prevention is no longer an option. Damage control might still be. The only thing still optional is how badly we let it hurt. Not on a scale from 1 to 10 but on a scale from 7 to 10.
(WMO)

Microplastics. Now inhalable too. So you thought plastic pollution was mainly a sea turtle problem, eh? Well, here’s the upgrade nobody ordered: urban air. Researchers in China used a semi-automated, computer-controlled electron microscopy method to measure airborne micro- and nanoplastics in two cities, and the results are wildly higher than what older, more manual techniques suggested. By two to six orders of magnitude. Meaning we may have been undercounting plastic in the air by anywhere from 100x to a million-fold, largely because our detection methods were built for what humans can reliably spot, not what actually exists. The study also maps how these particles move through the atmosphere, showing that road dust resuspension and rainfall are basically the conveyor belts: cars grind and kick particles up, and then wet deposition drags them back down, sometimes clumped and mixed as they travel. So yeah, air may be one of the most important pathways in the global plastic cycle, not a minor side route. We’ve been tracking plastics in oceans, soil, and food; meanwhile the atmosphere has been quietly doing the logistics.
(Science Advances)

At least nature will protect us, right? Think again because even nature has her limit. One of the more comforting stories in climate modelling has been that rising CO₂ gives plants a growth boost, and that extra biomass quietly soaks up some of our mess. The catch, as usual, is nutrients. A new analysis argues that major Earth System models have been giving plants too much credit because they’ve been overestimating natural nitrogen fixation - the microbial process that turns nitrogen into forms plants can actually use - by about 50% on natural surfaces. If the nitrogen isn’t there, the CO₂ fertilisation effect stalls, and the “free” carbon drawdown shrinks. The study suggests this error trims the projected CO₂ fertilisation effect by roughly 11%, which may not sound catastrophic until you remember that climate projections are built from lots of “only 11%” assumptions stacked on top of each other. There’s also a second-order problem: nitrogen cycling isn’t just a plant-growth story, it’s an emissions story, producing nitrogen oxides and nitrous oxide that can push the climate system in unhelpful directions if you mis-specify the flows. So yes, the biosphere buffer looks thinner than advertised, and the uncertainty in future warming looks less like a rounding error and more like a budgeting problem. If your mitigation plan relies on forests bailing you out, this is your reminder that plants run on nitrogen, not optimism or advertising.
(PNAS)

Long reads

Get inked? Maybe not. Yeah, this editor does have a few tattoos. But maybe if we knew then what we know now, those tattoos may not have happened? What do we know now? For example, how tattoos can cause immune dysregulation. Fun reading.
(The Conversation)

Everything is f***ed. Especially on a climate front. One of the many reports that the WMO used in its 2025 report above is Copernicus’ Global Climate Highlights 2025. You may want to explore the complete interactive report too. Give doomscrolling a new name.
(Copernicus)

Equity? Heh! The World Inequality Lab released the (what else?) World Inequality Report 2026. It doesn’t make for very pretty reading. For example, just about 56000 people have 3 times more wealth than half the world combined. One might say eat the rich. But how are 56000 people supposed to be enough food for 8 billion others?
(World Inequality Lab)

Oh, and Gopal Nair doesn’t want you to see this.