Hello, and welcome back to The Kable for an ultra-long issue that we’re sure will piss a lot of people off. Why, you ask? Because all over the world one common unifying factor in popular discourse, especially in the last decade or so, has been the visceral hatred for trans rights. And honestly, we don’t get it. Here are a bunch of people who want just exist but something about that need to exist triggers people so badly they always come up with absolute strawman arguments to deny the very existence of one of the most marginalised groups of people. But more on that later.
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.
Thanks for
Very exhaustive review of health services worldwide