As has been the norm for the past several weeks, we begin with Ebola and an update from Congo where confirmed cases as of last reporting have reached 2,905 with 1,269 deaths. “If we do not stop this outbreak today, it could become one of the worst Ebola outbreaks the world has ever documented,” said Africa CDC Director-General Dr. Jean Kaseya. The outbreak, however, shows no signs of even slowing down, much less being controlled. Violence and medicine shortages continue to hamper the response as well, even as Congo’s neighbours amp up border control measures. Amid all this comes this new article in The Lancet with the discovery of a novel clade of the Bundibugyo virus. A teeny-tiny ray of sunshine comes from another study that says the existing Zaire ebolavirus vaccine could offer some protection in the current outbreak too. Not that other diseases have taken a backseat, mind. Congo recorded nearly 32,000 suspected cholera cases as well in the latest update from the Africa CDC.

In more news from Africa, the war in Sudan continues, with North Kordofan, El Obeid in particular, as the new epicentre. A drone attack in a market killed and injured many, including children, while the Sudanese Armed Forces were accused of using banned chemical weapons in an airstrike on Umm Garfa. To no one’s surprise, El Obeid is now Sudan’s nucleus for hunger and displacement.

Kenya is looking to launch a new biotech park, worth $216 million, to not only reduce reliance on imported medicines but also to make the country a regional manufacturing hub. Bahati njema, Kenya.

Heads of state, and health ministers, and other stakeholders gathered in Accra, Ghana for a two-day health summit - the Extraordinary Session of the AU Assembly - to end AIDS and TB by 2030. Neither is likely to happen but it is encouraging to see Africa come together and have a plan for a future that is not dependent on international aid, or imported medicines.

It was a busy week for the Africa CDC too, who released a framework for controlling AMR on the continent over the next five years, and another for ensuring food safety. The agency also released a toolkit for healthcare workers responding to Hepatitis B, with a companion mobile app as well. The Africa CDC also launched a call for applications for anybody interested in a 3-day residential training program in mRNA technologies at its HQ. Apply now, if that is you.

Just a short while ago, we were bemoaning the very little time that hantavirus got to occupy the limelight. But this week, it raised its head again, with three confirmed deaths being reported from Venezuela. Health authorities said these cases are not likely linked to the devastating twin earthquakes the country recently experienced.

Ebola, hantavirus, Covid (which is still around), bird flu... so many potential pandemics in the wings. Great that our leaders have agreed on a pandemic pact. Not exactly but like we said when the latest round of talks began, they’ve agreed on deferring an agreement to the next round of talks. This time though, we’re so close, really close, like, unbelievably close, to an actual agreement because now we have two pathogen sharing models to choose from.

The UN Security Council also met this week to discuss whether critical minerals can fuel peace and prosperity instead of conflict. Heh!

In Gaza, food security and child nutrition both remain critical, while settler-terrorists continue attacks on people and property. And in south Lebanon, people can’t find a way home. And the ones who do find a way, find that they no longer have a home. Hey, homes are Hezbollah.

Elsewhere, a new report from two late-stage trials exploring a once-weekly HIV pill, combining Merck’s islatravir and Gilead’s lenacapavir, suggested that this regimen kept the virus suppressed. And in even better news, long-term data from two trials with lenacapavir with thousands of people, showed that only one person actually contracted the disease. Gilead still won’t sell the drug to MPP though.

India got its first dengue vaccine, with regulatory approval for Takeda’s Qdenga, making it the 43rd country to approve this jab. Talking about India, USFDA censure over quality control and manufacturing issues, we’ve seen a lot of those. This week, Alembic Pharma was at the receiving end of the regulator’s ire for not seeking explicit consent from patients involved in a study. Variety, as they say, is the spice of life.

Over in the US, the world’s foremost expert on pulling numbers out of one’s sun-starved rear end decided to impose 100%, going up to 200%, tariffs on generic drug imports beginning 2027. The US is also determined to ensure that we don’t see the back of AIDS, because ideology. Apropos of nothing, PAHO also released a report saying two out of five people in the Americas live with a neurological disorder.

The WHO has launched seven strategies to prevent drowning. We’re guessing swim, and stay afloat, are two of those. One other might be don’t enter water.

In the UK, in continuation of a centuries-long pattern, a woman was taken to the hospital where staff thought she was overreacting and they gave her an oxygen mask, attached to nothing. She died of a pulmonary embolism not long after.

And finally, it is time for good news. And is often the case in The Kable, the good news is caffeinated. A new review says three to five cups of regular black coffee is generally safe and may even be linked to lower risks of heart disease, stroke, heart failure, and Type 2 diabetes. Personally speaking, this editor can vouch for this. Because we have not suffered a single stroke or heart failure in over 30 years of drinking coffee. Go on then, brew yourselves a cup. It is science, after all.

Stories Of The Week

The law of averages. Global hunger is falling for the third year running. Great news, unless you happen to live where hunger is increasingly concentrated. The latest UN figures show 645 million people experienced hunger in 2025, down from 659 million the previous year. But while Asia and Latin America are pulling the global average in the right direction, Africa has quietly inherited an unenviable title: the world’s hunger capital. More than 300 million people on the continent are undernourished, and nearly two-thirds of Africans still cannot afford a healthy diet.

It’s a reminder, if one were needed, that global averages can be spectacularly misleading. Progress in India, Southeast Asia and parts of Latin America masks a widening geographic divide, where conflict, climate shocks, debt pressures and soaring food import bills continue to squeeze African food systems. The challenge is no longer producing enough calories. Globally, we already do. The challenge is making nutritious food affordable and resilient to increasingly frequent shocks. And that’s a much harder problem to solve with emergency food aid alone.

The uncomfortable truth is that hunger is becoming less of a global crisis and more of an African one. Unless investment shifts from short-term relief to local agriculture, infrastructure and regional food systems, the world may well hit its hunger targets on paper while leaving the continent carrying an ever-larger share of the burden. Statistics, after all, are remarkably good at hiding where the pain actually lives.
(UN)

Use it, don’t abuse it. A new global analysis, published in The Lancet, found that almost every country is overusing WHO’s “Watch” antibiotics, the powerful medicines meant to be reserved for specific infections. Instead, they’re increasingly becoming the default, accelerating the very problem they were designed to prevent. Meanwhile, many lower-income countries still struggle to access basic first-line antibiotics, creating a dangerous double standard: overuse where restraint is needed, and scarcity where access is essential. And it is not down to any one factor. Weak diagnostics, over-the-counter sales, fragmented surveillance and under-resourced health systems mean clinicians often prescribe broad-spectrum antibiotics because they have little else to go on. The result is a perfect breeding ground for antimicrobial resistance that doesn’t respect borders. Superbugs may be a global problem, but without stronger stewardship and better access to diagnostics, the next chapter of the AMR story will be written where health systems can least afford it.
(The Lancet Public Health)

A gift for our future. They say we don’t inherit the world but borrow it from future generations. It is apt then that antibiotic resistance in children is on the up. And getting worse. A global study analysing more than 106,000 samples from 82 countries found resistance rising across every region between 2004 and 2022, with dangerous pathogens such as Klebsiella and Acinetobacter baumannii becoming increasingly difficult to treat. Worse still, resistance to last-line antibiotics is projected to climb sharply by 2035, threatening to turn routine childhood infections into life-threatening illnesses.

Children have fewer antibiotic options than adults, yet they’ve largely been an afterthought in AMR surveillance and drug development. That’s a costly oversight. The bugs aren’t waiting for better paediatric formulations, more clinical trials or improved stewardship programmes. They’re evolving anyway. And unlike childhood, antimicrobial resistance is something we don’t simply grow out of.
(JAMA Pediatrics)

Disease in the water. Ah so you thought climate change is making the weather harder to predict and that’s it, eh? Well, it is also rewriting the rulebook for waterborne diseases because why the hell not! A new review warns that rising temperatures, floods and droughts could undo decades of progress against illnesses such as cholera and diarrhoea, particularly as shifting weather patterns make outbreaks more frequent, less predictable and harder to contain. The old assumptions about where and when these diseases emerge may no longer hold. Great news for quacks. Not so much for public health planners who already struggle to stay one step ahead. Investing in clean water and sanitation continues to remain essential (and we aren’t doing enough of that) but the study argues this needs to be paired with climate adaptation, better surveillance and more resilient health systems. Or, if you’re a believer, we could wait for the rapture or qayamat or pralaya and continue on our merry way till then.
(Nature Reviews Microbiology)

Boil and bubble. Who came up with the name El Niño? Sounds like such a cute, widdle thing. Not a name one would associate with large-scale destruction. But that is exactly what El Niño is promising this time around. Scientists are saying this could become the strongest El Niño in at least 150 years. Like we even know what happened 150 years ago. But we digress. Forecasts are that 2027 could be the hottest year ever recorded. And if the forecasts hold, it won’t be just broken temperature records. Crops will fail where they once thrived. Diseases will appear in places they didn’t before. Droughts, floods and wildfires will become less like disasters and more like seasons. Food prices, insurance costs and migration pressures will all follow. Climate change, even today, is often framed as tomorrow’s problem. Well, maybe El Niño circa 2026 is a time traveller from the future. All of the above was the good news though. The real danger is that this El Niño is unprecedented now but won’t in the future. Because every “once-in-a-century” event is already starting to sound like an annual record, simply waiting to be broken.
(Nature)

Breakthroughs

Old drugs, new tricks. The world’s antibiotic cupboard isn’t exactly overflowing, so perhaps it’s time we stopped throwing out the old ones. And, for a change, scientists have done useful research. They’ve shown that vancomycin – one of medicine’s last lines of defence – can be given a second life. Rather than inventing a brand-new antibiotic, they paired it with a small companion molecule that blocks a bacterial enzyme responsible for resistance, allowing the drug to do what it used to do best: kill bacteria. Considering that Big Pharma isn’t really breaking the bank chasing the next blockbuster antibiotic, one should be grateful maybe that researchers are building libraries of clever molecules that can restore the potency of existing drugs.
(Nature Communications)

Bottom line

A drain on the national wallet. Yes, we’re back to talking about climate change. Because India’s informal workforce is currently subsidising climate change by burning through roughly $78 billion in lost wages annually, roughly 2% of the national GDP. These workers, mostly migrants trapped in construction, brick-making, and agriculture, are losing up to 9% of their income because their bodies simply shut down in the sweltering conditions. The misery extends well beyond the workday, as many return to cramped, airless shelters that offer zero relief from the daytime furnace. With nearly a fifth of surveyed workers suffering from heat-induced kidney issues due to a lack of basic sanitation and hydration, the situation highlights a systemic failure to protect those doing the most physically demanding jobs. In a country like India, these numbers are still deceptive. Because these workers, this informal workforce, they’re the ones making all the buildings and the bridges and the tunnels and all the private and public infrastructure around the country. Right now, climate change is only accounting for 2% of national GDP bleed from them but if the country doesn’t make living conditions better for them, we might discover that all the castles we’ve built will come crumbling down around us.
(IIED)

The comeback kid. Just a few stories up, we spoke about how disease patterns are no longer what they once were. Here is proof by way of dengue which is enjoying a remarkable career resurgence thanks to climate change and chaotic urban planning, with warmer temperatures effectively turning previously safe zones into mosquito playgrounds. A systematic review of recent studies confirms that rising heat accelerates viral replication and extends the transmission season, allowing Aedes mosquitoes to thrive in highland and temperate regions that were once immune. This biological upgrade is compounded by unplanned urban sprawl, deforestation, and inadequate sanitation infrastructure, creating perfect breeding grounds in densely populated areas where residents have little control over their environment or health outcomes. The geographic expansion of the virus means that communities in low- and middle-income countries (LMICs) are facing a dual threat of hotter weather and more aggressive disease vectors, often without the resources to implement effective early warning systems or vector control.
(PLOS Neglected Tropical Diseases)

Woah, woah, woah! So many human illnesses in recent history can be attributed to animals. One would think this would’ve resulted in an increased budget for global animal health. But no, it is still being treated as an afterthought, receiving a mere fraction of a per cent of worldwide health spending. So what if it is the primary defence against pandemics and food insecurity. The latest report from the World Organisation for Animal Health (WOAH) highlights that diseases wipe out over 20% of global animal production yearly, devastating livelihoods in developing nations where livestock are essential for survival. Yet, veterinary services remain critically underfunded, with many countries seeing declines in capacity just as outbreaks of avian influenza, foot-and-mouth disease, and screwworm fly threaten to spiral out of control. The report also has a nod to irony, saying that bringing every country’s veterinary system up to international standards would cost less than a tenth of one per cent of the economic losses incurred as a result of the Covid pandemic, which likely originated from animals. Without integrating animal health into broader economic and security strategies, the world remains dangerously exposed to the next spillover event. But hope can move mountains, right? Who needs robust surveillance then?
(WOAH)

Long reads

A legacy unsought. We have a fair few items in this section as well today. Beginning with this piece in The Conversation talking about how political violence impacts the lives of young Africans for many, many years. The young people surveyed for this piece are from Côte d’Ivoire, Kenya, Malawi, Mozambique, Namibia, Nigeria, Uganda, Zambia and Zimbabwe. One dreads to think what a similar survey would present from respondents in Congo and Sudan.
(The Conversation)

Everything everywhere all at once. Another sobering read from The Conversation about the confluence of crises affecting the Greater Horn of Africa. Take your pick. Conflict. Climate change. Disease. Famine. Inflation. There is nothing that is off the table.
(The Conversation)

Gumming up the works. A brilliant exposé by The Reporters’ Collective on the loopholes that allow for a flourishing cannabis delivery business in India’s alternative medicine ecosystem.
(The Reporters’ Collective)

Tying ‘em up in knots. An investigation by Lighthouse Reports into Big Food and how much they care for public health around the world. Hint: Big Food cares about as much as Israel cares about people in Gaza.
(Lighthouse Reports)

And finally, speaking of Israel, a new report by Palestinian Feminist Collective traces Israel’s history of predatory, sexual violence. History that began in 1948.
(Palestinian Feminist Collective)

Maybe it is the speed of the outbreak, maybe it is the intensity. Or maybe it is the struggle to keep pace with it. Whatever the cause, though, health authorities in Congo aren’t as diligent with posting updated info as they were in the first month of the outbreak.

The latest info, via the country’s public health institute, says cases are now being reported from two new provinces, Haut-Uele and Tshopo, with total confirmed cases now standing at 2124, including 828 deaths. Contact tracing is still not at 100% and patient zero is still unidentified. Ebola hospitals are still being attacked, causing patients to run away and health workers to stay away. The WHO says the outbreak might actually be up to four times larger than reported numbers, thanks to gaps in contact tracing and reporting. The agency also reiterated Africa CDC’s message last week about the outbreak outpacing response, and about a shortfall in response funding. Complicating matters further is the fact that new infections are being reported from outside known and verifiable transmission chains and the fact that the virus has spread way beyond the original outbreak area. There are credible reasons to believe that the outbreak might be making its way to South Sudan. But not to the US because the US says Americans returning to their homes from DRC will have to quarantine elsewhere, whether they appear ill or not.

It’s not all bad news, however. 60+ days into the outbreak, CEPI has launched a Phase 1 vaccine trial with Oxford, based on the same platform Oxford used for its Covid vaccine. CEPI might yet achieve its 100 Days mission in the first real test of it. The WHO-backed EBO-PEP clinical trial to check post-exposure prophylaxis (PEP) with obeldesivir was launched in Congo by the National Institute for Biomedical Research (INRB). The Africa CDC launched an initiative to manage biosecurity in the outbreak response, something that doesn’t often get the importance it deserves.

And the best news from this outbreak, Uganda discharged its last patient and began the 42-day countdown to declare the outbreak over within its boundaries.

Elsewhere at the UN, officials said six schools in Palestine “remain inaccessible” while six more have been closed and ten have been abandoned due to “settler” attacks. In fact, Hamasthe UN went so far as to say “settler attacks have become a leading cause of Palestinian injuries in the West Bank, accounting for 55 per cent of all injuries in 2026. “

The mRNA patent lawsuits, they just keep on coming. Sanofi has joined the fray, filing separate lawsuits against Pfizer and Moderna because why not?

After taking aim at dengue last week, India’s Serum Institute has tied up with Gates MRI to potentially launch a once-in-a-hundred-years vaccine for TB.

In a bit of a surprise, Bavarian Nordic has actually entered into a partnership with a country from the global South, tying up with Brazil’s Eurofarma for a chikungunya vaccine.

New Zealand is coming to the bird flu party with reports of the first case in a native bird.

And finally, worried about ageing? Go to a concert, or a museum. Or better yet, watch a movie at the cinema. If you need a recommendation, here is the perfect one.

Stories Of The Week

A shot in the arm, but not for everyone. Global childhood immunisation coverage edged higher in 2025, marking a slow recovery from pandemic-era setbacks, but millions of children remain without protection against preventable diseases. According to the latest estimatesfrom the WHO and UNICEF, 90% of infants received at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine, while 85% completed the recommended three-dose series, both up by one percentage point from 2024. However, 13.5 million children still received no routine vaccines during their first year of life, highlighting persistent gaps in access to essential healthcare.

While the number of “zero-dose” children fell by nearly 750,000 compared with the previous year, progress remains uneven. More than half of unvaccinated children live in countries affected by conflict, instability or humanitarian crises, where disrupted health systems continue to hamper immunisation efforts. At the same time, vaccine hesitancy and inequitable access remain significant barriers in many regions, contributing to outbreaks of vaccine-preventable diseases such as measles (hello, freedumb) and diphtheria.

The gains, modest as they may be, are likely to be only temporary though. Because the real impact of all the recent funding cuts is only beginning to affect immunisation programmes worldwide. The data next year will probably be much grimmer. Looks like yet another SDG - SDG3 this time - that we’re unlikely to achieve. Oh well, misery sure loves company.
(UNICEF)

Gumroad. In Sudan, the conflict is increasingly being financed through an illicit trade in looted gold, gum arabic and other natural resources, according to a new UN report, which warns that armed groups are exploiting the country’s economic assets to sustain the conflict. The report describes a war economy built on smuggling, resource theft and the collapse of state institutions, allowing rival factions to generate revenue while deepening one of the world’s worst humanitarian crises.

The consequences are being felt far beyond the battlefield. There has been a fresh cholera outbreak, with thousands of suspected cases reported in recent weeks as conflict continues to disrupt healthcare, water supplies and sanitation services. Communities displaced by the fighting remain particularly vulnerable, with limited access to clean water and essential medical care.

Elsewhere, the UK announced that it is imposing sanctions on the “illicit gold networks fuelling Sudan’s war.” For a minute we thought that meant the UK would be imposing sanctions on the backers of the RSF. You. Aye. Eee. That would be expecting too much.
(UN, UN)

Bottom line

A lesson for the futurepresent. Climate shocks are placing growing pressure on South Africa’s food businesses, with extreme weather disrupting crop yields, supply chains and operating costs, according to new research, and the evidence of our own eyes. Small and medium-sized enterprises are among the hardest hit, facing challenges ranging from drought and flooding to power disruptions and volatile input prices. Yet many businesses continue to rely on short-term responses rather than long-term adaptation strategies.

The study argues that building resilience will require more than reacting to the next climate event. Businesses need better access to climate information, affordable finance, stronger infrastructure and closer collaboration across the food system to improve preparedness. Without greater investment in adaptation, climate-related disruptions are expected to become a recurring business risk rather than an occasional setback. And this is a learning that will increasingly be true for countries all over the globe.
(The Conversation)

Long reads

Lessons from Africa. A brilliant piece on Africa’s response to the ongoing Ebola outbreak and the lessons the world can learn on how to manage global health in the future.
(Nature)

From the river to the sea. Palestine has become the litmus test for most of the world today. And this searing essay in Equator Mag illustrates exactly why the western mind can’t cope, and why it needs to keep slandering Palestine to preserve its own delusion of moral rectitude.
(Equator)

War, water, women. We almost didn’t include this piece because Oxfam says it was published by their country office for the occupied Palestine territories. What crap! There is only Palestine. However, the report is essential reading, and it talks about how the ongoing Israeli genocide and the water blockading has made life especially daunting for women. Because even crises are gendered.
(Oxfam)

Ebola continues to remain the big story. But first, the possible Marburg outbreak in Uganda we mentioned last week... yup, there has been no further reporting on it. Even though the WHO chief mentioned in a statement last week that authorities in Uganda had notified the agency of a case, there is no such statement from Uganda itself. And considering that there is no follow-on statement from either the WHO or the Africa CDC, we guess it is kinda safe to say that Marburg is not looming right now.

Back to Ebola then. Uganda hasn’t reported any new cases but in DRC, the outbreak continues to gather steam. Cases rose significantly through the week, from 1,561 to 1,708, to 1,759, with over 600 deaths so far. Suspected cases have also been reported from a new province. The WHO said the outbreak is still spreading and the Africa CDC said the outbreak is moving way faster than the response. Amid all this, frontline health workers in DRC have been protesting against payment issues outside Ebola treatment centres.

Elsewhere, news that we missed earlier, South Sudan became one of the latest countries to sign up to the US’ America-first bilateral health deals. Now, we have been largely critical of these bilateral deals but in South Sudan’s case, we’ll make an exception, even if the deal won’t begin to make up for all the aid the country has lost.

From Sudan, Radio Dabanga brings an interview with the director of Lighthouse Reports, highlighting their new report that details the RSF training camps and supply routes in Libya that keep on stoking conflict in Sudan.

Over at the WHO, it was time to discuss the pandemic pact again. This meeting is the 7th time the Intergovernmental Working Group is meeting to discuss the same thing again and again over what we assume will be flakey-flaky croissants and delectable scones and hopefully bitter coffee. And we don’t need a crystal ball to predict that when the meeting concludes on July 17, they will release a statement that they’ve agreed to continue talking at the 8th such meeting in September.

DNDi has signed a licensing agreement with India’s Serum Institute for an in-development mAb for dengue. The deal will also see them take the candidate through Phase 3 trials in Malaysia, Thailand and Brazil.

The heatwave that roiled through western Europe recently saw nearly 4,000 excess deaths in France, Belgium and Netherlands while a preprint study claimed it might even be as high as 20,000. The WHO also told Europe to not sit back and take it easy just yet because more heat is en route. So what if June 2026 was the hottest June western Europe has ever seen?

Right. Back to disease updates then. Germany has reported a case of swine fever, Australia has reported bird flu in yet another state, and more worryingly, in a local seabird. At The Kable, we still believe if another pandemic were to hit the world, it will come on the wings of bird flu. This newly published paper where researchers discovered H5N1 in porcine tissue is just more grist for the mill. Oh, that’s just tissue, not something alive. Yeah, but it is happening with current strains. And pigs are where flu viruses of all kinds go to mix and mingle and mutate. And it is probably already happening in the real world. We’ve already seen seals and whales and bears and cats and dogs and various other animals contract bird flu. Hey, yolo!

And finally, since it is the brave new world of 2026 we’re living in, it is an AI announcement we’re ending with. A Sino-American biotech (techbio?) company Aureka has launched what it calls Open Drug Discovery Engine, or OpenDDE (so innovative) for short. The tool, according to them, will be the basis for the next generation of drug discovery. And they want researchers, startups, labs, and even MNCs to use it.

Before we dive into the stories of the week...

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Stories Of The Week

Tropic of Cancer. By 2050, if A global climate meltdown doesn’t kill us all or Bird flu doesn’t take us all, then Cancer will claim its rightful place in the limelight. Why? Because the WHO says by 2050, cancer could be diagnosed almost 35 million times a year. That’s up from 20.6 million in 2024. It is already killing close to 10 million people annually today. More than 26,000 a day, second only to heart disease on the world’s list of ways to die.

The real story, however, is in the survival numbers. A woman diagnosed with breast cancer in a wealthy country has an 87% chance of being alive five years later. A woman diagnosed in a low-income country has something closer to 42%. Fewer than one in three countries have bothered to fold cancer treatment into universal health coverage, which tells you roughly how seriously “universal” is being taken. Access to the WHO’s own list of 20 essential cancer medicines runs as low as 9% in poorer countries, against numbers in the 90s for rich ones.

Geographically, the load falls unevenly and not always where you’d expect. Asia carries over half the world’s cases and deaths, roughly proportionate to its population. Europe, however, has 9% of the world’s people, but 21% of cases and a fifth of deaths. Africa and much of Asia see fewer diagnoses but disproportionately more deaths, obviously because systems aren’t built to catch cancer early.

Then there is the part WHO’s own patient survey turned up, which is less about biology and more about what illness does to a household. Nearly half of patients surveyed reported financial hardship because of their diagnosis. Over half reported mental health strain. Caregivers, largely invisible in these figures, absorbed the unpaid labour and the isolation that comes with it, more or less everywhere.

But hey, it is not all doom and gloom. Tobacco use is falling. Eighty-two per cent of countries now have a national cancer control plan on paper, up from half in 2010. HPV vaccination is spreading. Not that it changes any of arithmetic above, but we gotta take a silver lining where we find it.
(WHO)

Bottom line

It’s official. El Niño is here, and it is developing fast. The WMO expects a strong event to take hold between July and September 2026, with ocean temperatures across the central and eastern equatorial Pacific running more than 2°C above normal in some monitored regions. The forecast models agree with unusual consistency, which is the sort of thing meteorologists say when they want you to actually pay attention.

The mechanics are familiar by now. Warmer Pacific waters reshuffle rainfall and pressure patterns worldwide, nudging the odds toward heatwaves, drought, and heavy rainfall depending on where you happen to live. Indonesia and Southeast Asia are looking at a drier monsoon season. East Africa may see a wetter rainy season from September through December, and possibly flooding, if the Indian Ocean Dipole develops alongside it as expected. The Indian subcontinent and much of Australia are pencilled in for below-normal rainfall.

But what gets lost in the meteorology prediction is that El Niño is, functionally, a public health event. Past ENSO cycles have tracked with spikes in heat stress, wildfire smoke exposure, vector-borne disease, and malnutrition tied to failed harvests, with the severity depending on how vulnerable the local population already is. None of that is coincidence, and none of it is confined to any one region’s problem to solve.

For the WMO, this isn’t a seasonal footnote. At least, we hope it isn’t. Because it’s prepping for an unprecedented mobilisation across the UN system, briefing humanitarian agencies and regional climate centres directly, saying early warning only helps if it arrives before the drought does. Regardless, the window for preparedness is narrowing in some regions already, which is a diplomat-speak for some governments are going to be planning water and energy rationing later than they should have.

And this fragility is not one El Niño is making. El Niño is simply exposing what we’ve caused, arriving as it does on top of a climate baseline that is already roughly 1.3 to 1.5°C warmer than pre-industrial levels. This, combined with the natural cycle’s own temperature bump, typically around 0.2°C, is smaller than the warming already loaded into the system. Which means the countries with the thinnest health infrastructure and the least fiscal room to absorb a bad harvest are, once again, the ones being asked to prepare fastest for a problem they had the smallest hand in creating. Cue the violins.
(WMO)

Long reads

You scratch my back... There are many things the US has given the world. Collapsed democracies. Bombed out countries. Exploitation. A profits over people mentality. Arguably though, none of these are as insidious as that grand old American tradition of lobbying. The Examination takes a look at how lobbyists are opening doors for Big American Tobacco all over the world.
(The Examination)

Match made in heaven. There have been papers on the rise of antimicrobial resistance, and on the rise of microplastic pollution. And we’ve covered them in The Kable. We’ve even covered papers on how the two are increasingly intermingling. But here Mongabay lays bare in graphic detail how a marriage between microplastics and microbes is the perfect afterlife for AMR.
(Mongabay)

In Ebola news, the outbreak in Democratic Republic of Congo (DRC) shows no signs of abating. The latest update from the health ministry shows confirmed cases at 1,406 with 438 deaths. Worryingly, there is still a large number – over 17% – of untraced contacts. Cases have spread to two new provinces over the past week, with authorities banning gatherings as a means to curtail further spread. Experts, meanwhile, worry that we’ve not even begun to see the peak of the outbreak yet. In potential good news, WHO’s PARTNERS (Platform Adaptive Randomised Trial for New and Repurposed Filovirus TreatmentS) clinical trial – to test an antiviral drug and an antibody cocktail – has begun but in a secret location. The Africa CDC has asked for an urgent infusion of $18 million to help with research, trials and outbreak response. The WHO also added the first diagnostic test for the Bundibugyo virus to its Emergency Use Listing, a molecular RT-PCR assay that detects BDBV by identifying viral genetic material in blood samples.

In Uganda, no new Ebola cases have been recorded in over 10 days, but it looks like there may be an outbreak of Marburg brewing over there. There is a bit of conflicting information here and no official info available yet on either Africa CDC or WHO channels but reports say two cases have been notified to the WHO, with one death. Uganda has had five Marburg outbreaks before, most recently in 2017, when it contained the outbreak within one month. In this particular instance though, there is no confirmation even from Ugandan health authorities about any outbreak. Also, the one confirmed death is an 18-month-old child, who is very unlikely to be the index patient, if there were an outbreak.

Marburg or not, experts are worried about malaria in Congo because, with history as proof, more people die of malaria during an Ebola outbreak than of Ebola itself.

Speaking of dying, spare a thought for the poor Andes hantavirus which couldn’t even have a proper day out in the sun, failing to dominate headlines for even a fortnight. The WHO has now declared the outbreak so over.

Tanzania has become the newest African nation to sign up to the US’ America-first bilateral health deal. In the announcement, Tanzanian authorities proactively said the deal does not include specimen sharing, and that Tanzania and the US share priorities in, among other things, health and human development. Pity there is no readily available emoji for irony.

It wasn’t too long ago that Big Pharma and Big Tech were two distinct entities, each trying to extract everything they could while putting on a benevolent face. Lately, that distinction is increasingly blurry. Blurring it even further is Anthropic, who this week launched Claude Science, an AI tool to help drugmakers discover drugs.

And finally, the UN has its first global AI assessment out. The report, with the usual mealy-mouthed title, covers advances in AI, applications in science, health, education and agriculture, implications for economies, and the environment, among others, and the impact of AI on human rights, information, democracy, child safety, and a whole bunch of other factors. However, considering that this panel also includes someone who was part of the Israeli military’s Unit 8200, yeah, we aren’t taking anything this panel has to say about AI’s impact on anything human seriously.

Stories Of The Week

Not done with Ebola yet. Why? Because a new UNDP assessment says the ongoing outbreak is likely to push nearly one million additional people into poverty. Because it is not just the the immediate health toll that needs counting. The disease disrupts trade, closes borders, and destroys informal livelihoods, hitting women hardest as they dominate cross-border commerce and caregiving roles. Even if contained soon, which is not looking likely, the economic damage could exceed $1 billion in GDP losses for the DRC alone, wiping out tens of thousands of jobs and halting education and healthcare services. The ripple effects threaten to undo years of fragile development gains across neighbouring countries too.
(UNDP)

Hungry AF. Northern Nigeria is facing its worst hunger crisis in nearly a decade, driven by escalating conflict and severe cuts to humanitarian aid. Over 17 million people across nine states are now experiencing crisis-level food insecurity, with hundreds of thousands in Borno state alone facing catastrophic starvation. Insurgent attacks have spread beyond their traditional strongholds, displacing families, destroying farmland, and blocking aid routes. With funding shortfalls forcing agencies to slash assistance, millions of vulnerable people, particularly children, are left without life-saving nutrition support. The collapse of aid networks has triggered desperate coping mechanisms, including recruitment into armed groups and increased gender-based violence. Women and girls, as always, bear the brunt of the crisis, facing heightened risks of exploitation as resources vanish.
(WFP)

The SDGs? Who even believes in them anymore? If last week, it was SDG.7 on the brink, this week, we’re talking air pollution so SDG.3 and SDG.11 join in the fun too. Global progress on reducing air pollution hit a wall after 2020 and hasn’t moved since. While high-income nations have managed to lower fine particulate matter levels, low- and middle-income countries (LMICs) continue to breathe dangerously polluted air. Roughly 6.5 billion people live in areas exceeding even the least strict safety guidelines, with the burden falling disproportionately on poorer regions. Asia shows some improvement, but Africa and parts of Western Asia remain stagnant, meaning billions are still exposed to toxins linked to heart disease, stroke, lung cancer, and respiratory illnesses.

Indoor pollution remains a silent killer, with 2 billion people still relying on inefficient stoves and dirty fuels for cooking. Rural areas in low-income nations are seeing rising pollution levels, while urban centres slowly improve. The gap between those who can afford clean energy and those trapped by poverty keeps on widening. So those sci-fi movies where air quality was a marker of economic privilege aren’t too far from becoming reality, if they aren’t already. Without urgent policy shifts and investment in clean technologies for developing regions, these health disparities will only deepen. Oh. These health disparities will deepen.
(WHO)

Who’s a fun guy? Not me! Fungal infections, often dismissed as minor annoyances like athlete’s foot, are quietly killing millions and resisting treatment, yet they’ve been largely ignored by global health agendas. Heck, mortality stats for fungal diseases are comparable to major infectious diseases but they still have a disproportionately weak therapeutic pipeline. The neglect stems from a combination of underfunding and the misconception that fungi are less dangerous than bacteria or viruses. However, with agricultural chemicals and medical overuse driving resistance, deadly invasive fungal infections are becoming harder to treat. A new WHO blueprint aims to fix this oversight by addressing the rising threat of antifungal resistance and improving diagnosis, treatment, and surveillance. These diseases affect over 300 million people annually, hitting immunocompromised individuals hardest, but they rarely make it into national health plans or antimicrobial resistance strategies. The new plan calls for better stewardship of antifungals, expanded access to diagnostics, and integrated One Health approaches to curb environmental drivers of resistance. The new framework seeks to integrate fungal threats into broader public health monitoring, train healthcare workers, and support research into neglected pathogens. The question remains though: development costs are high. Commercial incentives are thin. Will Big Pharma step in? Wait, don’t answer that. Let us live in hope.
(WHO)

Breakthroughs

Did we just say fungus and hope? Well, well, well... A South African research team has turned a fungus harvested from compost into a potential game-changer for vaccine independence on the continent. By using this modified fungal platform, they can produce virus-like particles cheaply and quickly without the need for ultra-cold storage or expensive mammalian cell cultures. Early tests show promise for both livestock diseases like Rift Valley Fever and human vaccines, including one tailored to HPV strains prevalent in sub-Saharan Africa. The goal is to shift Africa from being a mere packaging hub for imported medicines to a centre of genuine design and manufacturing, potentially dropping costs to around a dollar per dose.

This approach tackles two major hurdles: cost and infrastructure. Traditional vaccine development requires millions of dollars and specialised facilities that LMICs lack. This fungal method uses basic fermentation techniques available locally and produces doses stable at standard refrigerator temperatures, easing distribution in remote areas. Sure, regulatory and funding challenges lie ahead but this is pure innovation, and one that could lead the path that Africa has been seeking toward sovereign health security.
(Gavi)

Bottom line

That ocean, it’s so hot right now. Global sea surface temperatures have officially smashed the record set in 2024, pushing Earth into what scientists are generously calling “uncharted territory.” We’ve mentioned previously that we aren’t betting people. But to borrow a metaphor, this ocean warming is a perfect storm of human-driven climate change loading the dice and a strong El Niño rolling them. The oceans, having absorbed 90% of excess heat from global warming over the last century, are now so primed that a natural weather cycle easily tips them into new highs. Experts warn this isn’t a blip but likely the start of a sustained era of extreme warmth, setting the stage for 2026 and 2027 to dethrone previous hot years while fueling stronger storms, faster ice melt, and more chaotic weather patterns worldwide.

And yes, you know how the story goes. Warmer waters mean more energy for hurricanes, increased evaporation leading to heavier rainfall and flooding, and accelerated marine heatwaves that devastate ecosystems. What used to be a once-in-lifetime kinda record is rapidly becoming/has become the new baseline. The window for preventing further escalation theoretically exists but it is a really narrow window. If you live on the coast anywhere, brace for impact.
(Copernicus)

Long reads

The long road ahead. Making its entry for the first time in The Kable, Semafor Africa talks about the challenge ahead for Africa’s vaccine sovereignty goal. And it may not be the most obvious one(s).
(Semafor)

And the truth there is that Ebola is on a non-stop rampage. Confirmed cases in DRC have crossed 1000, with the latest report from Congolese health authorities pegging it at 1,155 cases, including 304 deaths. 37 new cases and ‌five ⁠new deaths just 24 hours after the previous update. No new cases have been reported from Uganda or anywhere else in Africa but France did report its first case in a doctor who returned from DRC, after having arrived as part of a humanitarian mission and spending one month in Ituri. Now ordinarily, we salute people who perform humanitarian service, especially when done truly altruistically. However, this doctor boarded a commercial flight to France when symptomatic - almost asymptomatic, according to authorities, which we believe is French for bullshit. So now, not only is this one doctor diagnosed, everybody else on that flight needs to be traced and monitored and potentially their contacts too. Très bien. Anyhoo, after this case was reported in France, authorities in DRC have tightened domestic and international travel rules.

In other Ebola news, the Africa CDC said the earlier $518 million estimate it had worked out with the WHO may not be enough to combat this outbreak. The agency’s new estimate is $1.4 billion. However, at the rate this outbreak is spreading, combined with the slow rate at which pledged funding is actually coming in, we’re pretty confident that number may not be enough either. In Kenya, the government said it is pausing a planned facility to quarantine Americans exposed to Ebola. The WHO said it is deploying antivirals from Mapp and Gilead in a trial to see if either drug can reduce mortality in patients, either used individually or in combination. The drugs are coming, thanks to donations from the US and Gilead, surprising on both counts. Elsewhere, UNICEF and Gavi too have launched a joint call, asking manufacturers to pitch in for accelerated access vaccines for Bundibugyo.

With all of this happening in the Ebola front, one would think the world wouldn’t have space for much more disastrous at the same time, right? Well, on Wednesday, two earthquakes - first, a magnitude 7.1 one, followed barely 40 seconds later by a magnitude 7.5 one, devastated Venezuela. On the same day, there were two other “lesser” quakes - a magnitude 5.6 one in California, and a magnitude 6.9 one in Japan. But let’s stick with Venezuela because this was the strongest earthquake in over 125 years. Early estimates are at 235 lives lost, with more than 40,000 people still missing.

In Sudan, roughly around 8 months ago, the RSF took control of El Fasher, and the world was silent witness to everything that unfolded after. Ethnic cleansing, mass executions, forced displacement. Now, all of that history is looking very likely to be repeated in El Obeid, and once again, we will all bear silent witness.

A teeny-tiny bit of sunshine: at a UN meeting on HIV/AIDS earlier this week, countries were able to adopt a declaration to end AIDS as a menace to public health by 2030. Sure, it is just symbolic, and we are not gonna make AIDS less of a threat in four years. But it is good nevertheless to know that multilateral agencies can still get countries to pull together for a common cause, even in the face of the usual dissenters like the US, Israel, Russia, and five others and 14 abstentions.

In Australia, a second state has reported a case of bird flu, resulting in increased testing.

In France though, it is not bird flu but heat that is killing poultry by the hundreds of thousands. And people by the dozens. All as part of the heat wave roiling Europe. No ordinary heatwave this. France has already twice broken its record for hottest June day ever. In Switzerland, older people are flocking to movie halls to beat the heat. In the UK, they had to cancel a conference on climate change, because of climate change. Maybe Europe will now push to join the climate vulnerable countries list and maybe even support their push for a global funding framework.

One of the lesser-talked about facets of colonisation is how the English especially criminalised and taboofied any form of alternate sexuality in all the places they invaded in their quest for salt, spice, flavour and riches. And now, after a few decades of pretend-progressiveness, the UK government is back to its frigging friggishness, this week in the form of an act criminalising gender and sexuality conversion therapies.

In the US, not too long ago, all the establishment figures were talking about how they will no longer be subject to the tyranny of vaccines. Their “Secretary Of War” went on to make vaccines optional for military cadets because ‘Murrica wipes the floor with flu. Earlier this week, the flu shot was made mandatory for all recruits, thanks to a flu outbreak at a camp that, at last count, left at least 300 cadets wiping the floor, after possibly leaving all kinds of snot and snivel on it.

Was a time when techbros was a term exclusively reserved for one gender. Can’t say that anymore. Regardless of gender, what hasn’t changed is the obsession anybody that identifies as a techbro has with saving the world. OpenAI, Anthropic, Stripe and Bill Gates are joining hands to pool $500 million into a new venture which wants to prevent the flu, and one day eliminate all respiratory viruses. They’ve even already got all their acronyms in a row. Because all we needed was new air cleaning technologies to end respiratory viruses. Especially with money from industries already known to pollute air and water.

There was another announcement about fighting respiratory viruses on the same day, this time from the UK-based, fake-sounding but very real, Advanced Research + Invention Agency. This announcement actually has the legs to maybe effect some real change.

And finally, the US has been leaving no stone unturned in rolling back protections for endangered species on air, land, and water. But, at least, it is working with a “deextinction” company to create a vault of genetic material from endangered and threatened species so that in 10,000 years, we can revive the dugong.

Stories Of The Week

War, and it’s always women’s bodies on the line. A new UN human rights report sets out the scale and brutality of conflict-related sexual violence in Sudan since the war began in April 2023. Investigators verified 546 incidents across sixteen of the country’s eighteen states, affecting at least 838 victims, all but fifteen of whom were women and girls. The report is explicit that these figures represent only a fraction of the true total, with stigma, displacement and the collapse of services leaving most cases undocumented. The violence has spread along the same routes as the conflict and the mass displacement it has caused, and has been used consistently to terrorise civilian populations.

The catalogue of abuses is extensive: rape and gang rape, sexual slavery, forced marriage, forced prostitution, sexual torture and trafficking. Almost a quarter of verified incidents involved gang rape, and in one case at least ten men raped a single girl. At least eighty-five women and girls were held in sexual slavery and forced into domestic labour or income generation. Most incidents were attributed to fighters in RSF uniforms, affiliated fighters and allied militias, though the national armed forces and other armed movements were also implicated. At least thirteen victims died, mostly following gang rape, and the youngest among them was nine years old.

The report identifies a clear ethnic dimension, with many Masalit victims from West Darfur reporting that attackers asked about their tribe before assaulting them. The UN finds reasonable grounds to believe that some of these acts, committed as part of a widespread and systematic attack on civilians, “may” (quotes ours) amount to crimes against humanity. It warns that without justice, victim-centred responses and serious efforts to address stigma, the prospects for peace and social cohesion in Sudan will be undermined for years to come, and it calls for independent investigations and accountability extending to those who held command responsibility.
(UN)

Target the kids. An independent UN commission of inquiry has concluded that Israeli authorities and security forces deliberately targeted Palestinian children, amounting to genocide and atrocity crimes in Gaza and war crimes in the occupied West Bank. The finding builds on the commission’s earlier determination that genocide had been committed against the Palestinian population in Gaza, and states that the scale and systematic character of military operations have continued to produce death, injury and trauma among children. The report covers the period since late 2023, when an attack on Israel killed around 1,200 people and saw 250 taken hostage, followed by a war that has killed more than 70,000 Palestinians in the territory.

The commission reports that 20,000 children have been killed and a further 44,000 injured since October 2023. It documents children arrested and subjected to torture and other mistreatment in Israeli detention, with families left without information about their whereabouts, alongside the use of sexual violence against children. It points to the targeting of neonatal and maternity care, the destruction of schools and orphanages, and a blockade-driven starvation that has directly caused deaths. The commission stresses that the harm is not confined to those physically wounded, describing lasting and intergenerational psychological damage and a childhood that has, in its assessment, been erased.

The killing has not stopped under the “ceasefire” announced in October 2025. UNICEF reports that 265 Palestinian children have been killed in the eight months since, an average of one child a day during a period supposedly defined by restraint, with the children dying in their homes, in schools, and while playing football or fishing rather than in any battlefield. They were shot, bombed and struck by quadcopters, and the agency attributes more than 90% of these deaths to Israeli forces, citing shifting boundaries of occupation and a near-total absence of accountability. The child deaths form part of nearly 1,000 Palestinians killed and more than 3,100 injured since the ceasefire began. Conditions for survivors remain dire: no hospital in Gaza is fully operational, clean water is a daily uncertainty for 1.1 million children, nearly 1.9 million people have been displaced, and more than 770,000 children are experiencing heightened distress. Israeli authorities continue to block the spare parts and fuel needed to keep generators and water systems running.

The commission frames the targeting of children as an assault on the Palestinian people’s capacity to exist and to determine their own future, tying the survival and protection of children to the right of self-determination. It calls for an end to the violations, for Israel to end its presence in the occupied West Bank including East Jerusalem in line with the International Court of Justice advisory opinion, and for member states to uphold their legal obligations and prioritise accountability and access to justice. Heh.
(UN, UN)

Energy, energy, energy. Yet another SDG tracking report. Yet another shortfall. This time, it is with SDG 7: Ensure access to affordable, reliable, sustainable and modern energy for all. The latest Tracking SDG 7 report finds that 655 million people worldwide still lack access to electricity, while around two billion continue to rely on polluting fuels for cooking. Sub-Saharan Africa carries a wildly disproportionate share of both deficits, with over 560 million people there living without electricity and roughly 970 million without clean cooking. Most regions are now close to universal access, but progress in Sub-Saharan Africa has slowed to the point where the pace of electrification would need to triple to hit the 2030 target. The rural electricity deficit in the region has actually grown since 2010, which is a striking direction of travel for a goal the world has formally committed to meeting.

However, unlike most recent reports, this report is not unrelievedly grim. Renewables now supply more than 30% of global electricity consumption, generating capacity has reached record levels, and off-grid solar and mini-grids are already serving hundreds of millions of people as a cost-effective route to access. The trouble is distribution. Generating capacity in low-income countries sits at 33.6 watts per person against 1,224 watts per person in high-income countries, a roughly thirty-sevenfold gap that rather punctures any narrative of shared progress. Affordability is the recurring obstacle, with many households unable to meet connection fees or wiring costs even where infrastructure exists.

Financing tells its own story. International public flows for clean energy to the poorest countries fell by 11% in a single year, and around 80% of what does arrive comes as debt, loaded onto economies already straining under the cost of borrowing. Clean cooking remains the largest gap of all, affecting a quarter of humanity and linked to roughly three million deaths a year from household air pollution, a burden that falls hardest on displaced populations and on the women and girls who spend their hours gathering fuel. The custodian agencies warn that on current trajectories the world will (surprise, surprise) miss this SDG entirely, and that closing the gap will require political will and grant-based support aimed squarely at the communities most at risk of being left behind.
(WHO)

Bottlenecks? What are bottlenecks? Many places around the world, historically and even today, are dealing with drug shortages leaving people resorting to shady marketplaces and alternative treatments for their various ailments. And then, there is this growth industry. The UN’s World Drug Report 2026 finds that traffickers are exploiting new technology and a generally unstable world to roll out novel products, test fresh routes and muscle into markets that were previously left alone. An estimated 331 million people used a drug in 2024, around 6.2% of the working-age population, up from 5.2% a decade earlier. Cannabis remains the runaway leader with 256 million users, trailed by opioids, amphetamines, cocaine and ecstasy. Innovation, that prized quality of legitimate enterprise, is flourishing here too: five times as many drug types turned up in seizures in 2024 as before 2000, and 755 new psychoactive substances were circulating, 118 of them appearing for the first time.

The product lines are shifting in revealing ways. Afghanistan’s 2022 opium ban has throttled plant-based supply, and the increases in Myanmar, Laos and Mexico have not made up the difference, so traffickers are pivoting towards synthetic opioids such as fentanyls and nitazenes, a turn that could permanently reshape the market and the harms that come with it. Methamphetamine has gone fully global, with seizures rising 13% a year on average and new footholds in the Middle East, Africa, parts of Europe and the Pacific Islands; the collapse of the captagon trade after the fall of the Assad regime appears to be nudging West Asian users towards meth instead. Cocaine production has more than quadrupled over ten years to beyond 4,000 tonnes in pure form, and supply may soon outpace even the expanding demand, which is precisely why the cartels are working so hard to open new customer bases in Africa and Asia. Cannabis use has climbed 40% in a decade, helped along by softening perceptions as legalisation spreads, with North America increasingly exporting to the rest of the world.
(UNODC)

Breakthroughs

Dirt strikes back. Good news, and for once it is not buried in a continent-sized caveat. A common soil bacterium has been hiding a whole pharmacy in plain sight. Researchers have found a so-called megacluster of genes in Streptomyces, one of the most studied bugs on the planet, that churns out five compounds at once, four antibiotics and a helper protein, all ganging up on different stages of the same essential metabolic pathway that bacteria need to grow. The pathway in question is the production of biotin, otherwise known as vitamin B7, which it turns out superbugs cannot live without. And because evolution spent who knows how many millennia perfecting this multi-pronged assault, the chemistry is already optimised, free of charge. The cherry on top is that hitting four targets in one pathway makes it fiendishly difficult for bacteria to wriggle out via resistance, which is rather the whole point given that drug-resistant infections are forecast to kill some 39 million people between 2025 and 2050.

The team confirmed the find by cloning a 65,808-base-pair stretch of DNA containing the whole cluster and dropping it into a lab strain to watch it work, then spotting the same arrangement conserved across several Streptomyces species, which suggests nature has been quietly running this combination therapy for ages while the pharmaceutical industry wrings its hands over why new antibiotics are so unprofitable. It is, frankly, a little humbling that the answer to one of medicine’s most expensive and intractable problems may have been sitting under everyone’s feet, in the same genus that gave us streptomycin and the first real weapon against tuberculosis. There is the usual long road from petri dish to pharmacy, naturally, and nobody should start celebrating the death of the superbug just yet. But after a run of stories where the microbes are winning, it is genuinely cheering to report that the dirt has been keeping an ace up (down?) its sleeve (hole?), and that someone finally thought to look.
(Nature)

Bottom line

Setting the sky on fire. There is a special kind of genius in importing expensive gas to keep the lights on while simultaneously burning off vast quantities of the stuff at your own oilfields, and in 2025 the world managed it with real conviction. Global gas flaring rose for the third year in a row to 167 billion cubic metres, torching an estimated $54 billion worth of energy into the sky for no purpose whatsoever. To put the scale in perspective, that is nearly the entirety of Africa’s annual gas consumption and more than the LNG passing through the Persian Gulf in a year, set alight and waved goodbye to. Nine countries, including Russia, Iran, Iraq, Venezuela, Nigeria and the United States, are responsible for over four-fifths of the bonfire while pumping nearly half the world’s oil, which is at least a tidy correlation between producing the most and wasting the most.

The report shared by the World Bank is at pains to point out that the technology, policies, regulations and financing to capture this gas all exist and have done for years; what is missing is the will to bother. Ending routine flaring everywhere would cost somewhere between $70 and $100 billion, which is less than twice the value of the gas being wasted annually, making it one of the rare problems that pays for itself if anyone deigns to act. And action works when it happens: Kazakhstan has cut its flaring by 87% since 2012, including a further 16% in a single year, which rather demolishes the excuse that this is all too difficult. The rest is structural inertia, poor regulation and operators who simply do not treat the waste as their problem, with the bill, as ever, landing on the millions left short of reliable power while the flames keep climbing. Well.
(World Bank)

Long reads

The violence of climate change. How does climate change lead to an increase in FGM, you ask? The Conversation is here to answer that very question. One of those stories, which, once you’ve read them, you wonder how it could ever have been any other way.
(The Conversation)

The mosquito migration. Gavi has a piece on the recent malaria outbreaks across Africa. Turns out the mosquito involved made its way from South Asia.
(Gavi)

Let’s hop right in then. Beginning of course with Ebola which shows no signs of slowing down. The most recent update from authorities in DRC had confirmed cases pegged at 837, with 196 deaths. The silver lining here is that the same bulletin says 49 people have also recovered in the current outbreak. However, as the Africa CDC pointed out in an interaction with Al Jazeera, contact tracing is a huge issue, with more than 85% of active contacts not being followed up on. In Uganda, the outbreak hasn’t assumed worrying proportions (yet) with no new cases in 10 days, and total cases holding steady at 19, including 10 recoveries. The Africa CDC also said this Ebola outbreak might be the worst ever, and at the four-week mark, this outbreak is actually three times bigger than the previous largest outbreak. Financial support, at least in the form of pledges, is still rolling in, $910 million from a slew of donors at an AU meeting being the latest. The EU has committed to over $500 million in aid, including treatments. The US is allotting $107 million in emergency funding, but this covers both its domestic response and whatever they do in DRC. In a bit of a surprise, the US also committed $50 million to CEPI to fasttrack a vaccine, whenever available, into clinical trials.

In other news, the Africa CDC was accredited as an implementing agency by the Pandemic Fund, wonderful news for the continent’s health sovereignty agenda. In more good news, Egypt became the first African Union state to sign up to the African Pooled Procurement Mechanism (APPM).

ECOWAS’ recently launched West African Health Organisation (WAHO) received $14.26 million from the African Development Fund to improve health systems across Benin, The Gambia, Guinea, Guinea-Bissau, Liberia, Sierra Leone and Togo.

In India, for no reason whatsoever, authorities have now decided that cough syrups can only be sold by pharmacies.

There was also a UN Security Council meeting to discuss Gaza this week but we’re not really bothering with summarising anything that comes out of that toothless body. Not when Israel is doing what it’s doing on the beach at Khan Younis, in Gaza city, or across Lebanon. A council that includes Israel should not have security in its name.

And finally, a two-year-long investigation by the MSF into the actions of its own staff in Chad who sexually exploited and abused Sudanese refugees, women and children, resulted in 16 MSF staff members being dismissed. Which is good but not enough. They need to be named in public so they never again get access to positions where they can take advantage of people who’re already in desperate straits. How low do you have to be to abuse people who’re escaping strife with whatever they can, reposing their trust in people who’re supposed to help them? How is the MSF okay with being so quiet about it themselves? Just one short note on their website? They are the ones who should be making a bigger noise about it, especially considering this is not the first time this is happening with them. Each time something similar has been reported with MSF, their own statements say the number of cases of abuse is likely an understatement. Yet, they can’t seem to change the system that enables this abuse.

Stories Of The Week

Too good to be true. UNICEF has released a new report - The Children’s Climate Risk Report 2026 - and honestly, without even reading the report, we could have predicted most of what it said. But read it, we did. And almost every one of the 2.3 billion children alive is now exposed to at least one climate hazard, around 1.1 billion are juggling three or more at once, and a few million have managed to collect as many as six, and UNICEF can now tell you almost exactly where each of them lives. How? Because the mapping tech has improved oh so much. And that has shown us that the picture is way, way worse than we thought. Heatwave exposure has jumped from the 820 million children estimated in 2021 to 1.5 billion, and the number breathing air that breaches safe limits has climbed from one billion to 2.3 billion. Some of that jump is obviously a warming planet. Some is possibly also down how little anyone bothered to measure before.

Like a movie we saw recently where multiple disasters strike almost simultaneously, the hazards in this case too do not arrive politely, one at a time. Drought pairs with extreme heat and heatwaves to afflict an estimated 296 million children, a loop that manufactures malnutrition, thirst and heat illness with every turn, and the rate at which these extremes overlap rose by 69% in the decade to 2021. The burden is distributed with the usual care. Children across the Sahel breathe wind-blown dust that carries meningitis through a belt already recording the world’s highest rates of it; every child in the two dozen small island states sits one storm away from losing their health system overnight; and roughly nine in ten air-pollution deaths occur in the low- and middle-income countries (LMICs) that did least to warm the atmosphere. Climate shocks uprooted the equivalent of 21,000 children a day between 2016 and 2023. Italy, where six million children also swelter, is offered up as cheerful proof that adaptation spending works, which rather gives the game away about what actually decides whether a hot day becomes a catastrophe.

Oh but it is so expensive! Who can even fight nature? Well, the UNICEF report actually says the economics are not in dispute. Every dollar spent adapting essential services for children is reckoned to return more than ten times over a decade, while the schooling that climate disruption wiped out for 242 million students in a single year could cost them up to $11 trillion in lifetime earnings. Against this, developing countries need somewhere between $310 billion and $365 billion a year for adaptation by 2035; in 2023 they received $26 billion in international public finance, a shortfall of twelve to fourteen times. The response from COP30 was to agree to triple the adaptation target to $120 billion a year by 2035, an act of ambition slightly undercut by the fact that the previous, smaller target of $40 billion had yet to be met.

But that has always been the way. Miss a goal. Then announce a larger one. Then move it further away. And so on till the kids are all grown up or dead.
(UNICEF)

We won’t let climate kill our kids. Because we’ll do it first, in large part aided and abetted by our governments. For the past three decades, the UN has been counting the grave violations committed against children in war, and 2025 was the year it had to report the worst figures of the lot: 38,558 violations verified against 24,174 children, the highest tally since the monitoring began, with girls making up a third of the victims. For the first time, it was not the rebels and militias but national armies and government forces who led the field, particularly in killing and maiming children, bombing their schools and hospitals, and blocking the aid meant to keep them alive. These are, of course, the same states formally entrusted with protecting children in the first place, which the UN noted points to a deeper erosion of respect for international law. International law. Two words that have increasingly meant less and less over the past decades and centuries even!

But let’s stick to the UN report because the breakdown there is more like a catalogue of everything the laws of war were written to prevent. Killing and maiming stayed the most-verified category, with 6,266 children dead and 7,958 maimed, the former up 34% in a single year; denial of humanitarian access ran to 8,322 incidents; 6,607 children were recruited into hostilities and 5,129 abducted, frequently for that purpose or for sexual violence, with gang rape increasingly deployed as a deliberate tactic. The worst settings were Palestine, obviously, the DRC, again obviously, Nigeria, Myanmar and Somalia, and the report flags the growing use of artificial intelligence in deciding whom to target, so the future at least promises to be efficient about it.

There were, however, some bright spots. Over 13,112 children were pulled out of armed groups and given reintegration support, and around 40 fresh commitments to do better were extracted from warring parties, commitments whose track record is rather summed up by the document they appear in.
(UN)

Let them have bread at least! Hah, not a chance. The FAO and the World Food Programme have produced their twice-yearly forecast of where mass starvation will arrive next. Not much has changed since the last such forecast. Thirteen countries are flagged as hunger hotspots for June to November, with Sudan, South Sudan, Yemen and Palestine at the top, and northeast Nigeria and Somalia newly promoted to the highest tier on the strength of populations now staring at the technical category called Catastrophe, defined with bureaucratic precision as starvation, death and destitution. Sudan alone has 19.5 million people, two in five of its population, at crisis levels or worse, with a famine risk identified across fourteen areas and the number facing outright Catastrophe projected to climb to 200,000. The number of people facing severe acute food insecurity across these countries has risen to around 266 million, while funding for food, agricultural and nutrition assistance has fallen by an estimated 59% between 2022 and 2025, dropping back to levels last seen nearly a decade ago. Conflict drives twelve of the thirteen emergencies, which is to say almost all of this hunger is being manufactured deliberately, and the agencies helpfully add a forecast El Niño on top, in case the wars were not delivering on their own. Boy, where’s a cheeseburger when you really, really need one?
(WFP)

Breakthroughs

Hope on the horizon? Did you notice hantavirus has completely receded into nothingness almost as if it never existed? Except maybe for that one quarantining American who is being kept in confinement by their “health” secretary against medical opinion. Not everybody else has forgotten hantavirus though, thankfully. Researchers at the University of Texas Medical Branch have published findings in The Lancet showing that a single dose of an experimental mRNA vaccine gave animals complete protection against Andes hantavirus. Yup, the same one from the cruise ship. The new candidate triggered detectable antibodies within 14 days and held its protection even at a fraction of the standard dose. Researchers also suggest the speed of the immune response could open a post-exposure window, theoretically allowing the vaccine to intercept the virus in people already exposed but not yet symptomatic. It remains preclinical and human trials are the next step but progress is progress, yaar.
(The Lancet)

Bottom line

Teach a man to fish... and he will deplete the sea. But the world did eat more fish in 2024 than ever before, with FAO logging a record 188.2 million tonnes of fisheries and aquaculture production, and per capita consumption at an all-time high of 20.7 kilograms a year. And for the first time, farmed fish has overtaken the wild-caught kind for human consumption, with aquaculture alone hitting 103.3 million tonnes. The report - The State of World Fisheries and Aquaculture 2026 - says this is a turning point for global food systems, and in fairness it is a genuinely useful source of protein and omega-3s for poorer coastal populations, supporting the livelihoods of roughly 600 million people. It is also the fact that we have caught so many wild fish that we now have to grow our own, which the report files under achievement rather than warning. The report does have warnings though. Hehe. How could it not? Intensive fish farming strains ecosystems, spreads disease and pollutes when run badly, while warming, acidifying and species-scrambling oceans are already disrupting capture fisheries and the communities that live off them. So yes, we did break a record, yay! But it might be one of the very last we do. But no matter how many fish in the sea...
(FAO)

2 is the new 1.5. Or maybe it is 2.5? Whatever, it’s hot. And it’s gonna get hotter still. Health Policy Watch has all the tea from the fourth annual Indicators of Global Climate Change report. And the report says we are about ready to stop flirting with the Paris Agreement’s 1.5°C limit, and marry it permanently. The wedding will happen anytime from now to about 2034, assuming emissions hold their current course. Thankfully, emissions are showing every sign of doing just that. Human-caused warming reached 1.37°C in 2025 and is climbing at 0.27°C a decade, the fastest rate ever recorded, and the carbon budget stood at 130 billion tonnes in January and will be spent in a little over three years. Nearly every indicator the report tracks moved the wrong way: greenhouse gas emissions hit a record 56.8 billion tonnes of CO2-equivalent, atmospheric CO2 passed 425 parts per million, seas reached a record high, and the Earth’s energy imbalance, the heat coming in versus the heat getting out, has more than doubled and now runs 40% above what the IPCC reckoned five years ago. In what they probably meant as comfort, the scientists who delivered the report pointed out that none of this is a surprise.
(Health Policy Watch)

Long reads

Take a dip in the sea. Getting into the water may soon cease to be an option to cool down, as Nature describes here. Oceans across Asia broke heat records last year, and it is very likely ocean warming cannot be reversed. What a hopeful note to end this week’s issue on.
(Nature)

Without much ado, let’s quickly get into the Ebola story then, shall we? At last count, 676 confirmed cases in Democratic Republic of Congo (DRC) as per the health minister, combined with the 19 confirmed cases in Uganda from the Africa CDC’s latest update, taking the number of confirmed cases to just under 700. Worryingly, the update from the DRC health minister above also says the outbreak has spread to three new health ‌zones. Equally worrying, an update from the UNHCR says two Ebola-related deaths have been confirmed in a displacement camp in eastern DRC. The Africa CDC and the WHO have partnered in a $518 million plan to fight the outbreak. The Africa CDC has also got financial support from other places - $12.54 million from the European Commission and $220.6 million from the Pandemic Fund. CEPI has invested $60 million to fast-track three vaccine candidates from IAVI, Moderna and University of Oxford into trials and Gavi too has committed an additional $50 million. Hopefully all of these commitments will come in handy soon, especially in DRC where shortages have caused testing to lag, or even stall in some cases. And where orphaned babies are dying to Ebola. In a slight bit of good news, the number of caseworkers who’ve recovered from Ebola has gone up fourfold since we last reported on it. No confirmed cases of Ebola have been reported from anywhere outside of DRC and Uganda yet which is a positive but we fear unless there is at least a cluster somewhere in Europe or North America, the urgency to find a vaccine that we’re seeing now may not persist.

In other Africa news, there has been a surge in cholera cases in Borno State, Nigeria with 7850 suspected cases and 74 deaths in five weeks.

In Ghana, the parliament passed its regressive, transphobic, homophobic bill into law.

In disease news elsewhere, 26,000 Saiga antelopes have died of unknown causes in Kazakhstan, bang in the middle of calving season. Must be pre-partum angst.

In Kerala, India, an outbreak of Shigellosis that was first reported in the north of the state has resulted in one confirmed death and over 400 people seeking treatment with reports now coming in from three districts. Thankfully, this is India’s most advanced state when it comes to public health infrastructure. Testing, containment, community contact tracing and disease surveillance that most other Indian states, and even many other countries, simply do not match. Which is why this state reports more illnesses than any other. Like this Nipah virus infection it has confirmed in one person, immediately identifying 77 contacts, including 58 health workers, with all high-risk contacts already in quarantine.

In the US, after nearly 60 years without a confirmed domestic case, USDA confirmed the first local detection of New World Screwworm in a 3-week-old calf in Texas, with larvae identified in its umbilical area. Since then, additional detections have been confirmed in other counties in Texas, as well as New Mexico, and earlier this week, even in a dog in Texas. As with many other things with the current US dispensation, you could call this manifest destiny because they did have a screwworm monitoring programme which was abruptly terminated last year when they made their government efficient.

Separately, for whatever reasons of their own, two US researchers were arrested for bringing mpox samples - deactivated of course (hopefully) - back to the US, and then lying to authorities about it.

And since we are talking about disease, with recent reports from India and Bangladesh, we have now crossed more than 1,000 cases of bird flu in humans, with a nearly 50% fatality rate. We’re not betting people, but if you offered us long odds on bird flu being the next pandemic, we’d take it.

In good news, last month was only the second-hottest May ever recorded. Yay. And also the coolest May of the rest of your lives.

And finally, in the most Australian of Australian news, Australia’s Department of Climate Change, Energy, Environment and Water (DCCEEW) has seized more than 100,000 live exotic cockroaches, the largest seizure of illegal exotic invertebrates in Australia. This is honestly the first time ever we’re keying in exotic and cockroaches in the same sentence. And since this is Australia, yes, the cockroaches are gonna die. They’re getting euthanised.

Stories Of The Week

Sounds like a baby, heats like a stir fry. The WMO confirmed it last week: El Niño is back. The Pacific-warming phenomenon is now reckoned to have an 80% chance of taking hold between June and August, rising to 90% after that, and it arrives promising above-average temperatures nearly everywhere along with the extreme weather that tends to follow. Tropical Pacific readings are already running roughly 6°C above average, which gives the system plenty of extra heat to feed on.

The WMO is at pains to point out that climate change does not make El Niño itself more frequent or more intense. What a warmer ocean and atmosphere do is load the dice, handing each event more energy and moisture for heatwaves and downpours. The last El Niño, in 2023-24, was among the five strongest on record and helped push 2024 to its unwanted title of hottest year yet. Which means either 2026 or 2027 will take that throne over from 2024. UN authorities call this “the urgent climate warning it is.” Well, sure. Doesn’t mean we have to treat it as urgent. Why buck history and tradition? Bolster early warning systems? Ignore! Fund seasonal forecasting? Boooooring!!! Sweat buckets? Woo-hoo!
(WMO)

Leggo my eggo! So you ate some undercooked chicken and got a grumpy tummy, eh? Or maybe it was the three-day old pizza that did it? Yeah, but that isn’t what the WHO calls unsafe food. New WHO research published in The Lancet this week suggests the deadlier threat is quieter and slower. Unsafe food kills 1.5 million people and sickens 866 million every year, a burden the WHO puts on a par with TB, and the leading cause of those deaths is not even a bug.

The headline finding, quantified for the first time, is that more than a million people died in 2021 from cardiovascular disease and cancer linked to inorganic arsenic and lead in their food. Diarrhoeal diseases still cause the most illnesses, but chemical hazards top the death toll. Arsenic, lead and methylmercury enter soil and water from both natural sources and human handiwork, decades of leaded paint and petrol among them, are taken up by plants and fish, and end up on the plate.

The burden, predictably, is not shared evenly. Southeast Asia and the Western Pacific fare worst for chemical contamination, while Africa and Southeast Asia carry the heaviest overall load. Children under five, who make up 9% of the world’s population but account for roughly a third of all foodborne illness, are the most exposed, and for them lead and mercury are not a passing sickness but a lifelong sentence of neurological and developmental harm. The report’s authors add that climate change and antimicrobial resistance are both making matters worse, the first by raising contamination risks, the second by rendering infections harder to treat.

The prescription is the same old One Health line: clean up contamination at source through better farming, tighter industrial controls and stronger environmental rules, and stop treating health, agriculture and environment as separate filing cabinets. Yeah. Tighter industrial controls. Stronger environmental rules. Maybe in a faraway distant utopian future, both of those will happen. But for now, the poison is already in the soil, and chemicals, once in the food system, are stubbornly difficult to get back out.
(WHO)

Peace? Not when we can have war! The Institute for Economics & Peace (IEP) has been publishing the annual Global Peace Index for 20 years now. The 20th edition just landed. Considering that for 12 years running, peacefulness in the world is going down, maybe the index needs to be renamed? Anyhoo, the data. There are 119 countries less peaceful than they were in 2008, with conflict the chief culprit, and the number of conflicts is the highest since the end of the Second World War. Sixty-one active state-based conflicts were under way in 2024, double the figure of fifteen years ago, and almost all of that growth comes from internationalised intrastate wars, the kind where outside powers wade into someone else’s civil conflict. Those are up more than 175% since 2010. We won’t even begin to guess how many of these conflicts are in Africa with countries from West Asia taking part in fomenting them. Or in West Asia with terrorist-settlers causing them.

One new note in the report is the machinery. The report warns that warfare is undergoing a technological revolution that international law and diplomacy have not begun to catch up with, and that for the first time machines are making life-and-death combat decisions faster than any human can review them, with no global agreement on the rules meant to govern them. Drones have become the defining weapon of the age, spreading faster than any government can track: attacks rose by roughly 11,500% between 2018 and 2025, with 565 separate armed groups managing at least one. The footprint reaches well beyond the battlefield, too. AI data-centre electricity demand is projected to double to 945 terawatt-hours by 2030, and Ireland’s data centres alone already draw 22% of the country’s metered power.

Against all of this, the world spent $49.2 billion on peacebuilding and peacekeeping in 2025, up from $37.3 billion in 2008 but still just 1/2 a percent of total military spending. If we spend 200 times as much on war as we do on peace, do we even deserve peace?
(IEP)

Good news comes drip-drip-dripping. There are 41.6 million documented refugees in the world today. If you’re wondering what’s good about that, it’s down 3% from the previous year. The UNHCR released its flagship Global Trends Report this week and this drop in refugee numbers is the first in a decade.

The reason the totals dropped is that returns picked up sharply. Some 14.7 million displaced people went back to their areas or countries of origin in 2025, 4.4 million refugees and 10.3 million internally displaced, with the steepest rises in Afghanistan, Sudan and Syria. Refugee returns were the second highest in the 60 years the agency has kept records. It is careful to note, though, that many of those journeys happened under pressure and led back to precarious conditions, which is a long way from the safe and dignified return the Convention envisages. Meanwhile 5.4 million people fled across borders during the year, so the flow has not stopped, only shifted.

The backdrop keeps generating new caseloads faster than old ones close. Sudan remains the largest crisis on earth, with 9.1 million people displaced inside its borders, and in West Asia, one “country” is insistent on creating as many refugees as it can every hour. At least the ones it can’t kill.
(UNHCR)

No worker, no cry! We’ve all read the news and reports about how cancer is on the rise around the world and how we’ll have yea so many cases of cancer by 2050 or whatever. But one so far unreported corollary of that is that we’re also on track for a devastating shortfall of cancer care workers. How devastating? Is 100 million devastating enough? Who says? The Lancet Oncology does! No prizes for guessing that the burden will overwhelmingly fall on LMICs, where nearly 70% of new cancer cases are expected to occur.
(The Lancet Oncology)

Breakthroughs

AI in your body. The day has come. Way sooner than anybody could’ve predicted. The first AI-designed vaccine has entered human arms in a clinical trial. Researchers at the University of Cambridge and its spinout DIOSynVax have put a universal coronavirus vaccine through its first human trial, and it cleared the bar that first trials are meant to clear: in 39 healthy volunteers it proved safe and produced no significant side effects. More interesting than the safety result is the design. Rather than chasing a single strain, the team used AI to comb genetic data from across the Sarbeco coronavirus family, the group that includes SARS-CoV-2, the original SARS and various bat viruses with spillover potential, and distilled the features they share into one synthetic “super-antigen”. The aim is a jab that holds up against viruses not yet circulating in humans, escaping the reactive cycle of reformulating shots to catch each new variant. In the trial it stirred immune responses against SARS-CoV-2, SARS and related bat viruses alike, and was delivered needle-free through a micro-fluid jet. But hold on to your horses. This is just a Phase 1 trial. The vaccine has not been shown to prevent infection or disease in the real world, the cohort was 39 people aged 18 to 50, and a larger Phase 2 study is still to come to test whether the broad protection holds across a more diverse group. Let’s hope it does, even it was designed by AI. Maybe it will only cause aitism.
(Journal of Infection)

Bottom line

Spend now, save later? Pshaw! The FAO has released a new report, which like a lot of recent reports, has put a price on inaction. This time, it is making the economic case for weaning the global livestock sector off its antibiotic habit. On current trends, driven by rising appetite for animal-source foods and ever-more-intensive production, antimicrobial use in livestock is set to climb by nearly 30% by 2040 against 2019 levels. Cumulative production losses under a high-resistance scenario could reach around $318 billion by 2040, against roughly $53 billion under the most aggressive phase-out of antimicrobial growth promoters.

But who even has time for the long game? Antimicrobial growth promoters deliver clear, immediate productivity gains, particularly for producers in resource-poor settings with high disease risk and little access to vets, biosecurity or affordable alternatives. The costs of giving them up are up-front, concentrated and obvious. The costs of resistance, by contrast, arrive slowly and are spread thinly across everyone, which is precisely why the reckoning keeps getting deferred.

The FAO nevertheless is framing it as antimicrobial effectiveness being a global public good, and the gains from preserving it being long-term and widely shared while the pain of restraint is felt now and locally. True that but the “solution” offered is regulation paired with economic incentives, investment in veterinary services, surveillance and diagnostics, and a push towards vaccination, biosecurity and better husbandry, with the report pricing the transitional bill at a minimum of $28.4 billion.

The geography is worth noting too: by 2040 Asia and the Pacific are forecast to account for nearly 65% of livestock antimicrobial use and South America around 19%, while Africa’s share stays smaller but grows among the fastest. Global livestock production is projected to rise about 23% by 2040, led by poultry and milk, so the demand driving the antibiotics is not going anywhere, and the question is whether the sector pays a manageable bill now or a far larger one later. We know we said we don’t bet but we’re betting on the latter.
(FAO)

The good we do. New research led by Lancaster University finds that the chemicals brought in to replace the ozone-destroying CFCs, the refrigerants and air-conditioning gases we congratulated ourselves on adopting, have been quietly seeding the globe with a “forever chemical”. Between 2000 and 2022, the team estimates, the breakdown of these CFC replacements and certain inhalation anaesthetics deposited around 335,500 tonnes of trifluoroacetic acid, or TFA, onto the Earth’s surface. It is a member of the PFAS family, it resists breaking down, and it is now turning up in rainwater, in human blood and urine, and in Arctic ice-cores thousands of miles from any factory. The fix came with its own slow leak.
(Geophysical Research Letters)

Not your (amoe)bae. Most disease and pandemic scenarios talk about viruses, bacteria, and maybe, in passing, fungi. Nobody even talks about amoebae. Maybe it’s time to take them a little more seriously. That, in essence, is the argument of a new perspective published in the journal Biocontaminant, in which researchers make the case that free-living amoebae, the single-celled organisms that live quietly in lakes, rivers, soil and our water systems, are an overlooked public-health risk that warrants far more attention. Most are harmless. A small number are not, the best-known being Naegleria fowleri, the so-called brain-eating amoeba, which can cause a rare and almost invariably fatal brain infection when contaminated water gets up the nose. What makes the group worth worrying about is its sheer hardiness: these organisms shrug off high temperatures, tolerate chlorine and other disinfectants, and can take up residence inside the very distribution networks we assume are clean. The sharper concern is what the amoebae carry. They can act as living shelters for other pathogens, with bacteria and viruses hiding inside them and riding out the disinfection that would otherwise kill them, a Trojan-horse trick the authors say may also help spread antibiotic resistance.
(Biocontaminant)

Long reads

Wanna hear a joke? Pandemic-ready! The Conversation Africa talks about how Africa and the world isn’t ready for the next pandemic. Of course we aren’t. We haven’t learnt any lessons yet.
(The Conversation)

No country for girls. In India, foetal sex determination and then abortion if it turned out to be a girl was so rampant the government banned it decades ago. Now, SciDevNet says these tests have gone online. And shady. And the practice itself has gone with Indians to wherever they go.
(SciDevNet)

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

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.