Each year, more than 21 million adolescent girls in low and middle-income countries become pregnant. About half of these pregnancies are unintended. Nine in 10 adolescent births occur among girls who were married before turning 18.

“Early pregnancies can have serious physical and psychological consequences for girls and young women,” said Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO. “(They) often reflect fundamental inequalities that affect their ability to shape their relationships and their lives.” 

Too young to give birth

Teen pregnancy carries serious health risks. These include higher rates of infection, complications, and premature birth. It also disrupts education and limits job opportunities later in life. Many young mothers end up trapped in poverty.

To help prevent teenage pregnancy, WHO is calling on governments to offer better alternatives to child marriage. These include improving access to education, financial services and jobs.

If all girls finished secondary school, child marriage could be slashed by up to two-thirds, according to the UN Children’s Fund (UNICEF).

Stolen childhood

There has been global progress. In 2021, one in 25 girls gave birth before age 20. Twenty years earlier, the rate was one in 15. However, big gaps remain. In some countries, nearly one in 10 girls aged 15 to 19 still give birth each year.

“Early marriage denies girls their childhood and has severe consequences for their health,” said Dr Sheri Bastien, Scientist for Adolescent Sexual and Reproductive Health at WHO.

She emphasized the power of education in transforming girls’ futures. At the same time, both boys and girls need to understand the concept of consent “and challenge the major gender inequalities that continue to drive high rates of child marriage and early pregnancy in many parts of the world.”

The WHO guidelines update advice issued in 2011. They promote comprehensive sexuality education which the UN agency says is essential so that boys and girls know how to use different types of contraception and where to seek advice. 

“It has been shown to reduce early pregnancies, delay the onset of sexual activity and improve adolescents’ knowledge about their bodies and reproductive health,” WHO said.

It follows a campaign last year that reached hundreds of thousands of young children under the age of 10.  Polio virus was recently detected in wastewater samples in Gaza, indicating that circulation is ongoing, thus putting young lives at risk.

The campaign is being led by the Palestinian Ministry of Health and implemented with support from the World Health Organization (WHO), the UN Children’s Fund (UNICEF), UN Palestine refugee agency UNRWA and other partners.

UNRWA Commissioner-General Philippe Lazzarini wrote in post on the social media platform X that 1,700 team members are taking part across the agency’s health centres and mobile points.

Separately, WHO Director-General Tedros Adhanom Ghebreyesus said “teams are on the ground providing support to ensure a quality campaign.”

UNRWA health teams constitute a third of the response, comprising 555 out of the total 1,660 teams involved.

They will be issuing vaccinations in 10 of its health centres: one in Rafah, three each in Khan Younis and the Middle Area, and one in Gaza City in the north.  Around 60 UNRWA mobile medical points will also carry out vaccinations.

The campaign is set to run through 26 February.

The findings, published in Nature Medicine on Monday, warn that if current trends continue, the world will see 3.2 million new breast cancer cases and 1.1 million related deaths each year by mid-century.

The burden will be disproportionately felt in low- and middle-income countries, where access to early detection, treatment and care remains limited.

“Every minute, four women are diagnosed with breast cancer worldwide and one woman dies from the disease, and these statistics are worsening,” said Dr. Joanne Kim, an IARC scientist and co-author of the report. 

“Countries can mitigate or reverse these trends by adopting primary prevention policies, such as WHO’s recommended ‘best buys’ for noncommunicable disease prevention, and by investing in early detection and treatment,” she explained.

A growing global burden 

Breast cancer remains the most common cancer among women worldwide and the second most common cancer overall.

In 2022 alone, an estimated 2.3 million new cases were diagnosed, with 670,000 deaths reported. However, the report highlights significant disparities across regions.

The highest incidence rates were recorded in Australia, New Zealand, North America and Northern Europe, while the lowest rates were found in South-Central Asia and parts of Africa.

Meanwhile, the highest mortality rates were reported in Melanesia, Polynesia and Western Africa, where limited access to healthcare contributes to poorer outcomes.

The link between breast cancer survival and economic development is stark: in high-income countries, 83 percent of diagnosed women survive, whereas in low-income countries, more than half of women diagnosed with breast cancer die from it.

Urgent need for action

The WHO launched the Global Breast Cancer Initiative in 2021, aiming to reduce breast cancer mortality rates by 2.5 per cent per year, which could prevent 2.5 million deaths by 2040.

The initiative focuses on early detection, timely diagnosis and access to quality treatment.

Dr. Isabelle Soerjomataram, Deputy Head of IARC’s Cancer Surveillance Branch, emphasised the need for high-quality cancer data to drive better policies in lower-income regions.

“Continued progress in early diagnosis and improved access to treatment are essential to address the global gap in breast cancer and ensure that the goal of reducing suffering and death from breast cancer is achieved by all countries worldwide,” she said.

The path forward 

The report underscores the importance of stronger health systems, increased funding for breast cancer screening and treatment, and the adoption of cost-effective prevention policies.

With the projected rise in cases and deaths, the international community faces an urgent challenge – one that requires coordinated action to ensure millions of lives are not lost to a disease that is increasingly preventable and treatable. 

In an alert on Tuesday, UN aid coordinators OCHA said that six humanitarian workers have been killed since January – the latest victim was shot during clashes last week near a hospital in Masisi Territory about 80 kilometres west of Goma, in North Kivu.

The same clashes reportedly killed three other civilians and injured a child, according to OCHA, which said that more than 100,000 people have been forced to flee their homes due to further clashes last week in Lubero Territory, 250 kilometers north of Goma. 

Rape and other violations reported

Because of the insecurity several local health facilities have had to suspend activities. Humanitarian partners on the ground also report that there have been widespread human rights violations amid the fighting, including rape, OCHA said.

Meanwhile, local officials in South Kivu report schools are gradually re-opening in Kalehe Territory, located some 65 kilometres north of the provincial capital Bukavu.

Unexploded ordnance remains a problem in many areas affected by recent fighting, including two schools in the city of Minova, north of Bukavu, according to humanitarian partners.

The head of UN Peacekeeping Operations expressed concern over the humanitarian crisis and loss of life in the DRC during a press conference in South Sudan’s capital, Juba, on Monday.

Jean-Pierre Lacroix stressed that there is no military solution to the crisis and reiterated that while “it’s encouraging to see progress and involvement from stakeholders…the priority is a cessation of hostilities, implementation of decisions from the Luanda Process, and ensuring humanitarian access.” 

He added that the UN Mission faces limitations in M23-controlled areas but continues to protect civilians and reduce violence in other areas, safeguarding hundreds of thousands of civilians daily. 

Europe faces a ‘cradle to cane’ health crisis, warns WHO 

And in a medical update on Tuesday, UN health agency WHO warned that countries across Europe and Central Asia have a major problem with “stagnating” healthcare systems.

According to the World Health Organization (WHO), almost 76,000 children in the region die before their fifth birthday every year.

In addition, non-communicable diseases claim the lives one in six people before they’re 70.

Wide regional variations

WHO’s latest European Health Report showed that under-five mortality ranged from 1.5 to 40.4 deaths per 1,000 live births across 53 countries in the region.

The top causes of death include pre-term birth complications, birth asphyxia and congenital heart anomalies.

Despite much progress in tackling non-communicable diseases across Europe and Central Asia, conditions such as heart and lung disease, stroke and diabetes remain by far the biggest killers. 

At least 10 countries have achieved a 25 per cent reduction in premature mortality from these four non-communicable diseases. 

Nonetheless, one in six people still die before they reach their 70th birthday from cardiovascular disease, cancer, diabetes or chronic respiratory disease, WHO said.

Chad: Nearly four million could go hungry during lean season

Humanitarians in Chad are warning about the impact of the forthcoming lean season on food security, amid already dire conditions, UN Spokesperson Stéphane Dujarric said on Tuesday.

A regional assessment found that some 2.4 million people are not getting enough to eat, which is expected to rise to 3.7 million people, or 20 per cent of the population, during the lean season from June to August.

More than two million children under the age of five are malnourished, including more than half a million who are suffering from severe acute malnutrition who are at risk of dying in the coming months without the appropriate treatment. 

Additionally, nearly 300,000 pregnant and breast-feeding women are suffering from acute malnutrition.

Multiple shocks

Mr. Dujarric told journalists in New York that “this crisis is due to shocks, including natural catastrophes such as floods, which have destroyed croplands, in addition to the increasing price of basic commodities.”

Humanitarians warn that unless significant funding is received before the end of March, there will be no time to prevent a full-scale food security and nutrition crisis.

They are appealing for $1.45 billion to support operations in Chad this year but have so far received under $60 million, roughly four per cent. 

The agency is this week celebrating the 20^th anniversary of the entry into force of its Framework Convention on Tobacco Control (WHO FCTC) – one of the most widely embraced UN treaties in history.

The Convention provides a legal framework and a comprehensive package of evidence-based tobacco control measures which include large pictorial health warnings on cigarette packages, smoke free laws and increased taxes on tobacco products.

Up to 5.6 billion people are now covered by at least one tobacco control policy in line with the treaty and studies have shown a decline in global smoking rates.

‘A plague on humanity’

“Tobacco is a plague on humanity – the leading cause of preventable death and disease globally,” said WHO Director-General Tedros Adhanom Ghebreyesus. 

He noted that “since the entry into force of the WHO FCTC and the MPOWER technical package that supports it, global tobacco use prevalence has dropped by one-third.”

The Convention is the first ever public health treaty negotiated under the auspices of WHO. It came into effect on 27 February 2005 and currently there are 183 Parties covering some 90 per cent of the global population.

An event will be held on Thursday in Geneva to mark the milestone anniversary.

Bans and warnings

Thanks to the Convention, 138 countries now require large pictorial health warnings on cigarettes packets. Dozens more have implemented plain packaging rules which require a standard shape and appearance without branding, design or a logo. 

Both measures serve as powerful tools to reduce tobacco consumption and warn users about the dangers of tobacco use, WHO said.

Furthermore, over a quarter of the world’s population is now covered by policies that ban smoking indoors and in workspaces, saving millions from the dangers of second-hand smoke.

Meanwhile, over 66 countries have implemented bans on tobacco advertising, promotion and sponsorship, which include prohibitions against tobacco advertising in the media and sponsorship deals.

Confronting a ‘deadly’ industry

The treaty has also been instrumental in establishing legal defences in the face of the tobacco industry, which spends tens of billions of dollars on promotion. 

“The tobacco industry is a deadly industry behind the tobacco epidemic, now trying to position itself as part of the solution while actively derailing efforts at tobacco control which could save millions more lives,” said Dr. Adriana Blanco Marquizo, Head of the WHO FCTC Secretariat.

The treaty “equips Parties with a comprehensive set of measures to protect populations from the industry’s ever-evolving tactics – designed to profit at the cost of people’s lives and the health of our planet,” she added, urging countries “to remain ever watchful against its predatory tactics.”

The tobacco burden

Tobacco use is a major driver of noncommunicable diseases (NCDs), causing premature death and disability, WHO explained.

Tobacco-related illnesses lead to catastrophic health expenditures, particularly for the world’s poor. Smokers are also more likely to lack access to nutritious food compared to non-smokers, including in wealthier countries. 

The impacts go even further. 

Tobacco cultivation uses large areas of land that could otherwise support sustainable food production systems, while its production further depletes vital resources such as land and water that are needed to produce food. 

Additionally, trillions of discarded plastic-heavy cigarette butts pollute ecosystems every year, further harming the planet.

Undermining public health

WHO said the tobacco industry “continues to undermine public health efforts, aggressively targeting youth through marketing, lobbying against tobacco control policies, and positioning itself as part of the solution to the problem it created.” 
 
Dr. Blanco Marquizo added that although great strides have been made in tobacco control, more remains to be done as “the tobacco industry continues to kill millions of people per year and its socio-economic burdens cause strains on entire populations.” 

She urged countries to fully implement the measures under the WHO FTC, including by increasing tobacco taxes, implementing smoke free laws, enforcing comprehensive advertising and sponsorship bans, prohibiting and regulating ingredients that form tobacco products, and addressing the challenges brought by new and emerging tobacco and nicotine products. 

“Through these measures we can save the lives of millions more people globally,” she said. 

UNAIDS said that at least one status report on the impact of cuts has been received from 55 different countries up to the start of this week.

That includes 42 projects that are supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and 13 that receive some US support.

Two days after President Trump’s executive order in late January declared a 90-day pause to all foreign assistance, the Secretary of State issued an emergency waiver to resume “life-saving” humanitarian assistance, including HIV treatment.

UNAIDS reported just over a week later that there was widespread “confusion” over how the waiver was being implemented on the ground.

The 16 reports received from UNAIDS country offices around the world during the week of 17 to 21 February show that these waivers have led to the resumption of some clinical services, such as HIV treatment and prevention of vertical transmission, in many countries that are highly dependent on US funding.

Many projects ineligible

However, it’s unclear how long funding will last amid multiple reports that key US government systems and staff responsible for paying implementing partners are either offline or working at greatly reduced capacity, the UN agency said.

In addition, critical layers of national AIDS responses are ineligible for these waivers, including many HIV prevention and community-led services for key populations and adolescent girls and young women, according to the UN agency.

At the same time, data collection and analysis services have been disrupted in numerous countries, according to reports received last week, which note that the overall quantity and quality of HIV prevention, testing and treatment services has been eroded.

© UNICEF/Karin Schermbrucker

A doctor treats a toddler suffering from severe acute malnutrition and HIV at a local hospital in Katanga, DR Congo. (file)

Waiting times increase

Staff working in health facilities are facing increased workloads, and patients are experiencing increased wait times to receive lifesaving services, UNAIDS said.

Other concerns persist, from hobbled health systems to addressing gender-related priorities.

“US Government statements to UN system organizations suggest US-funded programmes focused on gender equality and transgender populations may not resume,” according to the UNAIDS situation report.

Fresh data analysis

The situation report covers more granular analysis on the global AIDS response’s heavy reliance on US foreign assistance, extracted from the datasets managed by UNAIDS.

For example, more than half of HIV medicines purchased for the Democratic Republic of Congo (DRC), Haiti, Mozambique, Tanzania and Zambia are purchased by the US.

Before the freeze, the US Government provided two thirds of international financing for HIV prevention in low and middle-income countries, according to estimates from the Global HIV Prevention Coalition.

The report also named the 20 countries that rely most heavily on funding from Washington: DRC, Haiti, Mozambique, Tanzania, Zambia, Uganda, Nigeria, Rwanda, Angola, Kenya, Ukraine, Burkina Faso, Burundi, El Salvador, Zimbabwe, Togo, Nepal, Côte d’Ivoire, Eswatini and Benin.

Services at a standstill

Civil society and community-led interventions are central to ending AIDS and to sustaining the gains into the future, according to UN agency.

People living with HIV and key populations at higher risk of infection, play a crucial role in maintaining the local services needed to stay healthy, UNAIDS said.

Yet, many critical services have ground to a halt. Here are some examples:

• Mozambique: Community workers and test counsellors supported by PEPFAR funding are not being paid. As a result, HIV testing is unavailable in most parts of the country, enrolment of new patients is on hold and efforts to support people living with HIV to adhere to their treatment have been compromised
• Tanzania: Young people working as peer educators, community health workers or lay counsellors funded by PEPFAR have been issued temporary job termination notices
• Rwanda: Community-level and facility-based HIV-prevention services targeting populations at high risk of HIV infection, including adolescent girls and young women, gay men and sex workers were not covered by waivers received from the US Government
• South Africa: US-funded facilities that support gay men, such as Engage Men’s Health, remain closed
• Ghana: All civil society organizations funded by PEPFAR have halted services to people living with HIV and key populations

Learn more about UNAIDS here.

On the ground in Côte d’Ivoire

Here is an emblematic snapshot of how the UN funding freeze has already affected this West African nation of 27 million, where Washington has supported more than half the total response to assist more than 400,000 adults and children living with AIDS.

A mother, holding her two-year-old in southwest Côte d’Ivoire, discovered she was seropositive during her pregnancy. (file)

• The stop-work order triggered a complete shutdown of services funded by the PEPFAR programme, which covers 516 health facilities in 70 per cent of the country’s health districts and 85 per cent of people living with HIV on treatment (about 265,000 people)
• More than 8,600 staff were affected, including 597 clinical workers (doctors, nurses and midwives) and 3,591 community workers
• Distribution of medicines and transport of diagnostic samples ground to halt
• US-funded services partially resumed on 12 February following receipt of waivers, but the majority of US-funded HIV-prevention services for people at high risk of infection, remain shut
• Other national health programmes and systems are affected by the freeze, including the malaria and tuberculosis control programmes and another serving mother and child health alongside the supply chain system for medicines and diagnostics

In recent months, disease surveillance has identified increases in cases and fatalities on three occasions across different areas of the country, which triggered follow-up investigations to confirm the cause and provide needed support, WHO said in a statement.

Symptoms include fever, headache, chills, sweating, stiff neck, muscle aches, multiple joint pain and body aches, a runny or bleeding from the nose, cough, vomiting and diarrhoea.

DRC currently faces multiple challenges, with a conflict raging in the east, as Congolese armed forces face off against the Rwanda-backed M23 – with the fighting involving multiple other armed groups.

Illness and death

A series of outbreaks and fatalities have been occurring in Équateur province since the beginning of 2025, the UN health agency said.

The most recent cluster occurred in the Basankusu health zone, where last week 141 additional people fell ill, with no deaths reported so far. Some 158 cases and 58 deaths were reported in the same zone earlier in February.

In January, Bolamba health zone reported 12 cases including eight deaths.

Major challenges

The remoteness of affected areas limits access to healthcare, including testing and treatment, WHO said.

Basankusu and Bolomba are around 180 kilometres apart and more than 300 kilometres from the provincial capital Mbandaka. The two localities are reachable by road or via the Congo River.

However, poor road and communication links are major challenges, said the UN healthy agency, which continues to support local authorities in reinforcing investigation and response measures, with more than 80 community health workers trained to detect and report cases and deaths.   

Further efforts are needed to reinforce testing, early case detection and reporting, said WHO, which remains on the ground supporting health workers, collaborating closely with health authorities at all levels.

Increased surveillance

The UN health agency has delivered emergency medical supplies, including testing kits, and developed detailed protocols to enhance disease investigation.

Increased disease surveillance has identified in total of 1,096 sick people and 60 deaths in Basankusu and Bolomba fitting a broad case definition of the mysterious illness.

In response to the latest cluster, a national rapid response team from Kinshasa and Équateur, including WHO health emergency experts, was deployed to Basankusu and Bolomba to investigate the situation.

The experts are stepping up disease surveillance, conducting interviews with community members to understand the background and providing treatment for diseases such as malaria, typhoid fever and meningitis, WHO reported.

Ongoing testing

Initial laboratory analysis has produced negative results for Ebola virus disease and Marburg virus disease.

Around half of the samples tested positive for malaria, which is common in the region, WHO said.

Further tests are to be carried out for meningitis. Food, water and environmental samples will also be analysed for any possible contamination.

In its 2024 Annual Report, released on Tuesday, the INCB explains that unlike plant-based drugs, these substances can be made anywhere, without the need for large-scale cultivation, making them easier and cheaper for traffickers to produce and distribute.

The rise of powerful opioids like fentanyl and nitazenes – potent enough to cause overdoses in tiny doses – has worsened the crisis, driving record-high deaths.

“The rapid expansion of the illicit synthetic drug industry represents a major global public health threat with potentially disastrous consequences for humankind,” said INCB President Jallal Toufiq.

“We need to work together to take stronger action against this deadly problem which is causing hundreds of deaths and untold harm to communities,” he continued.

Traffickers stay ahead of regulations

Criminal groups are constantly adapting to evade law enforcement.

By exploiting legal loopholes, they develop new synthetic compounds and use artificial intelligence to find alternative chemicals for drug production.

New smuggling methods – including drones and postal deliveries – make these drugs harder to detect.

As a result, seizures of synthetic substances are now outpacing those of traditional plant-based drugs like heroin and cocaine.

Patchwork response

Despite efforts to curb synthetic drugs, responses remain fragmented, allowing traffickers to stay ahead.

The INCB is calling for stronger global cooperation, including partnerships between governments, private companies and international organizations, to disrupt supply chains and prevent harm.

Medication out of reach

While synthetic drugs flood illegal markets, millions of people in low- and middle-income countries still lack access to essential pain relief medication.

The report highlights that opioid painkillers such as morphine, remain unavailable in regions like Africa, South Asia and Central America – not due to supply shortages, but because of barriers in distribution and regulation.

The INCB is urging opioid-producing nations to increase production and affordability to improve palliative care and pain management.

Regional hotspots concerns

The report identifies several regions where synthetic drug trafficking is expanding.

In Europe, the looming heroin deficit following Afghanistan’s 2022 opium ban could push more users toward synthetic alternatives while in North America, despite efforts to curb the crisis, synthetic opioid-related deaths remain at record highs.

The manufacture, trafficking and use of amphetamine-type stimulants are increasing across the Middle East and Africa, where treatment and rehabilitation services are often inadequate.

Meanwhile, in the Asia-Pacific region, methamphetamine and ketamine trafficking continues to grow, particularly in the Golden Triangle.

Call for urgent action

The INCB is urging governments to strengthen international collaboration, improve data-sharing and expand drug prevention and treatment services.

Without decisive action, the synthetic drug trade will continue to evolve, putting more lives at risk.

The health agency highlighted that essential prevention, testing and treatment services are collapsing, leaving millions at risk.

The hardest-hit regions include Africa, Southeast Asia and the Western Pacific, where national TB programmes depend heavily on international support.

“Any disruption to TB services – whether financial, political or operational – can have devastating and often fatal consequences for millions worldwide,” said Tereza Kasaeva, Director of WHO Global Programme on TB and Lung Health.

Last week, UN Secretary-General António Guterres also raised the alarm over funding cuts, noting the immediate impact on key health programmes combatting HIV/AIDS, tuberculosis, malaria and cholera.

A devastating setback

Over the past two decades, global TB programmes have saved more than 79 million lives, averting approximately 3.65 million deaths last year alone.

A significant portion of this success has been driven by US Government funding, which has provided about $200 to $250 million annually, approximately a quarter of the total international donor funding secured.  

The US has been the largest bilateral donor for programmes combatting the disease.

However, newly announced cuts for 2025 through executive orders will have devastating impacts on TB response efforts in at least 18 high-burden countries, where 89 per cent of expected US funding was allocated for patient care.

The impact will be particularly devastating in Africa, where treatment disruptions and staff layoffs could exponentially increase TB transmission rates.

Immense burden

Early reports from TB-affected countries indicate that funding constraints are already dismantling essential health services.

Among the most pressing concerns are health worker layoffs, drug shortages and supply chain breakdowns, data and surveillance systems collapse as well as disruptions to TB research and funding.

“Without immediate action, hard-won progress in the fight against TB is at risk. Our collective response must be swift, strategic and fully resourced to protect the most vulnerable and maintain momentum toward ending TB,” urged Dr. Kasaeva.

Call for urgent action

WHO reaffirmed its commitment to supporting governments and global partners in the fight against TB.

“In these challenging times, WHO remains steadfast in its commitment to supporting national governments, civil society and global partners in securing sustained funding and integrated solutions to safeguard the health and well-being of those most vulnerable to TB,” the agency said.

In a stark assessment of the current situation of the health crisis, Deputy UN High Commissioner for Human Rights Nada Al-Nashif warned that more than nine million people do not receive treatment, while 4,000 girls and young women contract the virus every week.

A staggering three-quarters of them live in sub-Saharan Africa, she noted, reminding Member States that while HIV is “entirely treatable and preventable…the world is off track in ending AIDS.”

Stigma fuelling crisis

“Stigma and discrimination are preventing concrete progress and paving the way for a resurgence of infections,” Ms. Al-Nashif said.

“Together, we have the power and the responsibility to change this. When human rights are promoted, health is protected.”

Other speakers echoed the need for human rights-based approaches to ensure universal access to treatment. They warned that discrimination and harmful laws targeting marginalized communities hinder access to prevention, testing and care.

Keep rights at the core

Florence Riako Anam of the Global Network of People Living with HIV (GNP+) quoted Nelson Mandela, saying that HIV is “more than a disease – it is a human rights issue.”

In many countries, criminalization, stigma and discrimination based on sexual orientation, gender identity, drug use as well as sex work continue to obstruct HIV response efforts, with deadly consequences.

GNP+, an NGO collecting data on stigma since 2008, has surveyed 100,000 people across 100 countries. The findings: nearly one in four respondents experienced HIV-related stigma.

Break the barriers

“To end AIDS for good, we must dismantle the human rights-related barriers that prevent certain populations from accessing the services they need and tackle the deep gender inequalities and underlying inequities that drive starkly different health outcomes,” said Vuyiseka Dubula, Head of Community, Rights and Gender at the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Ms. Dubula, who lives with HIV in South Africa, noted that while global progress has been significant – new infections down by 61 per cent and AIDS-related deaths by 73 per cent in more than 100 countries over the last two decades—there is still much work to be done.

“This is something to be proud of, but we can go even further in the next five years if we really are focused on ending HIV” Ms. Dubula said, referring to Sustainable Development Goal 3 (SDG3) on ensuring healthy lives for all.

Compassion over cruelty

Adeeba Kamarulzaman of the World Health Organization (WHO) Science Council and the Global Council on Inequality, AIDS and Pandemics echoed the need for more compassionate methods in tackling the epidemic.

She pointed to Malaysia, her home country, which once faced a devastating HIV epidemic but has since made significant progress.

In countries decriminalizing drug use, knowledge of HIV status is 15 per cent higher and HIV incidence is five per cent lower, she explained, adding that in places where sex work is decriminalized, infection rates are further reduced by 4.5 per cent.

“When we choose compassion over cruelty, when we invest in people instead of punishing them, we save lives,” Dr. Kamarulzaman said.

Persistent discrimination

Erika Castellanos, a transgender woman and Executive Director of Global Action for Trans Equality, spoke of her experience in Belize, where LGBTIQ+ people faced up to 10 years in jail before 2016. Even after the law was overturned, little has changed.

“The stigma, discrimination and institutional barriers persist in the systems that deny us dignity, in the services that exclude us and in the societies that still see us as less than human,” said Ms. Castellanos, who has lived with HIV for 20 years.

“I am here because of the hard work, sweat, blood and tears of countless people, many of whom did not survive this epidemic,” she told the Human Rights Council.

“I am alive – because of an HIV response that valued my life.”

The initiative aims to curb the spread of preventable diseases such as polio, measles and yellow fever which remain a persistent threat in hard-to-reach areas.

Speedy response

WHO delivered 79 outboard motors, two speedboats, 14 motorcycles and other essential equipment worth $750,000 to the country’s Ministry of Public Health to expand vaccination campaigns in 89 health zones in nine provinces, the agency said in a news release on Tuesday (in French).

“These boats and vehicles will allow health workers to quickly reach children and communities who have long been cut off from essential services,” said Boureima Hama Sambo, WHO Representative in the DRC.

“This will significantly reduce the number of missed vaccinations and ensure that no child is left vulnerable to diseases that we can prevent.”

This will significantly reduce the number of missed vaccinations and ensure that no child is left vulnerable to diseases that we can prevent
– Dr. Boureima Hama Sambo, WHO Representative

Fighting preventable diseases

The Congo River and its many tributaries form a vast network of isolated islands and remote settlements, particularly in provinces such as Équateur, Mongala, Tanganyika and Tshopo.

Many of these areas host large numbers of unvaccinated children, leading to repeated outbreaks of polio, measles and yellow fever, according to WHO.

In 2024, the DRC confirmed 25 cases of circulating variant poliovirus (types 1 and 2) and reported more than 102,500 suspected measles cases, resulting in over 2,200 deaths. Meningitis also remains a major concern, with 5,837 suspected cases and 465 deaths last year.

The WHO and DRC authorities have been working to address these challenges through mass immunization campaigns.

“Improving the availability of vaccines and other vital health supplies in the Expanded Programme on Immunization (EPI) branches, health zones and areas, is essential to strengthening the health system and implementing advanced and mobile vaccination strategies. Integration with other health services will make a difference, bringing significant benefits to the most vulnerable populations,” said Dr. Sambo.

Ongoing Mpox outbreak

Even as the country battles vaccine-preventable diseases, the DRC continues to face a large mpox outbreak. Between 1 January and 2 March 2025, the country recorded 2,415 confirmed cases, with 1,080 of them occurring in the last six weeks alone.

WHO has declared the mpox resurgence a public health emergency of international concern (PHEIC) and warned that the virus is circulating in at least ten provinces.

The outbreak is being fuelled by sustained human-to-human transmission, particularly in the capital, Kinshasa, where genomic sequencing indicates that one specific strain has persisted since July 2024.

Impact of violence

Complicating response efforts is the ongoing violence in the eastern DRC, which disrupted healthcare services and made it difficult to track and contain the virus. In February, the virus was detected for the first time in the south-central Lomami province, expanding its reach further.

The WHO is also monitoring new travel-related mpox cases that have emerged outside the country, including in Belgium, France, Germany, the United Kingdom and the United States.

Meanwhile, South Africa has reported its first cluster of mpox cases linked to the same strain circulating in the DRC.

“Measles is back, and it’s a wake-up call,” warned Dr. Hans Kluge, the World Health Organization (WHO) regional director for the European region.

A total of 127,350 cases were reported in the region in 2024, double the number of cases reported for 2023 and the highest number since 1997, according to analysis by WHO and the UN Children’s Fund (UNICEF).

Among the most contagious viruses affecting people, measles can damage the immune system by “erasing” its memory of how to fight infections, leaving survivors vulnerable to other diseases.

As well as hospitalisation and death caused by complications including pneumonia, encephalitis, diarrhoea and dehydration, measles can also cause long-term, debilitating health complications such as blindness.

Deaths reported

There were an estimated 107,500 measles deaths globally in 2023, mostly among unvaccinated or under vaccinated children under five, according to WHO.

“Measles remains a significant global threat,” the UN agencies said, pointing to the 359,521 cases reported for 2024 worldwide.

Current outbreaks and deaths have been reported worldwide, including in the Democratic Republic of the Congo, the United States and countries in every other region.

Based on preliminary data received as of 6 March 2025, a total of 38 deaths have been reported for WHO’s European region, which comprises 53 countries in Europe and Central Asia.

Post-COVID-19 surge

The region accounted for one third of all measles cases globally in 2024.

UN agencies pointed to a resurgence in 2018 and 2019, with 89,000 and 106,000 cases respectively, after a period of decline since 1997, with 216,000 reported cases, that reached a low of 4,440 in 2016.

Following a backsliding in immunisation coverage during the COVID-19 pandemic, cases rose significantly again in 2023 and 2024, the UN agencies said, adding that vaccination rates in many countries are yet to return to pre-pandemic levels, increasing the risk of outbreaks.

Transmission of the virus across borders and continents occurs regularly, and outbreaks of this highly infectious disease will occur wherever the virus finds pockets where vaccine levels are insufficient – particularly children, they cautioned.

Currently, children under five accounted for more than 40 per cent of reported cases in the region, and more than half of all cases required hospitalisation.

Calls for urgent government action

“Measles cases across Europe and Central Asia have soared over the past two years, pointing to gaps in immunisation coverage,” said Regina De Dominicis, UNICEF regional director for Europe and Central Asia.

In 2023 alone, 500,000 children across the region missed the first dose of the measles vaccine (MCV1) that should be given through routine immunisation services.

“To protect children from this deadly and debilitating disease, we need urgent government action including sustained investment in health care workers,” she said.

‘No health security’ without vaccines

WHO’s Dr. Kluge said “we can’t afford to lose ground” as the agency shapes its regional health strategy to tackle such serious issues.

“Without high vaccination rates, there is no health security,” Dr. Kluge said.

“Every country must step up efforts to reach under-vaccinated communities. The measles virus never rests and neither can we.”

Indeed, vaccination is the best line of defence against the virus, the UN agencies insisted.

Outbreak hot spots

The latest analysis found that Romania reported the highest number of cases – 30,692 – in the region for 2024, followed by 28,147 in Kazakhstan.

At the same time, less than 80 per cent of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia and Romania were vaccinated with MCV1 in 2023.

In both Bosnia and Herzegovina and Montenegro, the coverage rate for MCV1 has remained below 70 per cent and 50 per cent respectively for the past five or more years.

That is far below the 95 per cent coverage rate required to retain herd immunity, the UN agencies noted.

Catch-up campaigns

UNICEF and WHO are working with governments and health partners, including the European Union and the GAVI Alliance, to prevent and respond to measles outbreaks by engaging with communities.

Efforts include training healthcare workers, strengthening vaccine programmes and disease surveillance systems and initiating measles immunisation catch-up campaigns.

The UN agencies are calling for governments with active outbreaks to urgently intensify case finding, contact tracing and conduct emergency vaccination campaigns.

Analysing root causes

“It is imperative that countries analyse the root causes of outbreaks, address weaknesses in their health systems and strategically utilise epidemiological data to identify and close coverage gaps,” the UN agencies stated.

Reaching hesitant parents and marginalised communities and tackling inequitable access to vaccines must be central to all efforts, they added.

They also warned that countries that do not have current measles outbreaks should be prepared, including through identifying and addressing gaps in immunity, building and sustaining public trust in vaccines and maintaining strong health systems.

Briefing Member States in Rome, FAO officials called for urgent action to strengthen biosecurity, surveillance and rapid-response mechanisms to curb the outbreak.

FAO Deputy Director-General Godfrey Magwenzi stressed that the crisis threatens to have “serious impacts on food security and food supply in countries, including loss of valuable nutrition, rural jobs and income, shocks to local economies, and of course increasing costs to consumers.”

With millions relying on poultry for meat and eggs, the challenge is not only to contain the virus but also to protect food production systems.

The economic impact is also being felt worldwide. For example, egg prices reached a record high in the United States during February according to the US Consumer Price Index, with farmers forced to slaughter over 166 million birds so far in total as avian flu has spread – mostly egg-laying chickens.

So far this year more than 30 million birds in the US have been killed, according to news reports.

Coordinated response needed

FAO Deputy Director-General Beth Bechdol underlined the need for a global, coordinated response, calling H5N1 a “transboundary” threat that no country can tackle alone.

To address the crisis, FAO and the World Organisation for Animal Health (WOAH) have launched a ten-year Global Strategy for the Prevention and Control of High Pathogenicity Avian Influenza.

“A chain is only as strong as its weakest link. By working together, we can reduce the impact of avian influenza and protect both animal and human health – locally and globally,” Ms. Bechdol said.

Over the past four years, H5N1 has expanded to new regions, causing massive losses in domestic birds, disrupting food supplies and pushing poultry prices higher.

At least 300 new wild bird species have been affected since 2021, posing a serious threat to biodiversity.

Collective action and innovation

FAO reaffirmed its commitment to global monitoring, data sharing and technical guidance to help countries contain the virus.

Ms. Bechdol also stressed the importance of private sector engagement, particularly in developing vaccines, diagnostics and high-quality animal health services.

The briefing also included a third call for funding proposals under the Pandemic Fund, hosted by the World Bank.

Over the past two years, FAO has co-led dozens of Pandemic Fund projects aimed at strengthening disease surveillance, early warning systems and health infrastructure to prevent future outbreaks.

Unanimously adopting resolution 2777 (2025), the 15-member council stressed the “critical importance” of a continued presence of UNAMA and other UN agencies across Afghanistan.

The council also expressed appreciation for the UN’s long-term commitment to the country and its people, reiterating its full support for UNAMA and the Special Representative of the Secretary-General who leads the mission.

Ambassadors also expressed “serious concern” over the continued presence of terrorist groups in Afghanistan, and highlighted the need to combat the production, trade and trafficking of illicit drugs and chemicals used to manufacture narcotics.

They stressed the need to improve disaster risk reduction, as disasters worsen the humanitarian and socio-economic crisis.

Cuts could shut down 80 per cent of WHO programmes

Meanwhile, the UN World Health Organization (WHO) in Afghanistan warned that funding shortages could force the closure of 80 per cent of the agency’s health services there, leaving millions without access to critical medical care.

As of 4 March, 167 health facilities in 25 provinces had to shut down due to lack of money. A further 220 facilities could close by June, affecting the most vulnerable populations – women, children, the elderly and the displaced and returnees.

“These closures are not just numbers on a report, they represent mothers unable to give birth safely, children missing lifesaving vaccinations, entire communities left without protection from deadly disease outbreaks,” said Edwin Ceniza Salvador, WHO’s top official in Afghanistan.

“The consequences will be measured in lives lost,” he warned.

Dire health crisis

Even before the funding cuts, Afghanistan had been battling multiple health emergencies, including outbreaks of measles, malaria, dengue, polio and Crimean-Congo haemorrhagic fever.

Over 16,000 suspected measles cases, including 111 deaths, were reported in January and February 2025. Children are most at risk of illness and death, given “critically low” vaccination rates – only 51 per cent for first dose and 37 per cent for the second.

While some donors continue to support Afghanistan’s health sector, funding has been significantly reduced as development aid priorities have shifted in recent months.

Resources for broader humanitarian efforts in the country remain uncertain. With the first quarter coming to an end, the UN-coordinated $2.4 billion Afghanistan Humanitarian Needs and Response Plan for 2025 is only about 13 per cent funded.

“This is not just about funding,” said Dr. Salvador.

Resource requirements for health programmes under the Afghanistan Humanitarian Needs and Response Plan 2025

“It is a humanitarian emergency that threatens to undo years of progress in strengthening Afghanistan’s health system … every day that passes without our collective support brings more suffering, more preventable deaths and lasting damage to the country’s health care infrastructure.”

UNAMA in Afghanistan

Established in 2002, UNAMA is a political mission which facilitates dialogue between political leaders in Afghanistan, regional stakeholders and the international community, to promote inclusive governance and conflict prevention.

The deputy chief of the mission is also in charge of coordinating the UN’s extensive aid operation in cooperation with the de facto Taliban authorities since they returned to power in 2021.

It is also mandated by the Security Council to monitor and report on the human rights situation, with a focus on women’s rights, minorities and vulnerable groups.

UNAMA also supports regional cooperation, encouraging engagement between Afghanistan and neighbouring countries on issues related to security, stability and economic development.

The attack on one of the last operational hospitals in the area further deepened the ongoing humanitarian crisis sparked by the civil war between rival militaries, the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), which started in April 2023.

Among the stolen supplies were 2,200 cartons of ready-to-use therapeutic food – a crucial treatment for children suffering from severe acute malnutrition, a life-threatening condition characterized by severe weight loss and muscle wasting.

Also stolen were iron and folic acid supplements for pregnant and lactating women, as well as midwife kits and primary healthcare supplies meant for mothers, newborns and children.

Attack on their survival

“Stealing life-saving supplies meant for malnourished children is outrageous and a direct attack on their survival,” said Catherine Russell, Executive Director of UNICEF.

“These unconscionable acts against vulnerable children must end. All parties must adhere to international humanitarian law, protect civilians, and ensure safe and unhindered humanitarian access to those in need.”

UNICEF had successfully delivered these supplies on 20 December last year, marking the first humanitarian shipment to Jabal Awlia in over 18 months. However, the looting, combined with escalating violence that has forced aid operations to suspend, is pushing the region’s most vulnerable closer to disaster.

Children pushed closer to catastrophe

The hospital is situated in Jabal Awlia, one of 17 localities at risk of famine.

The region has been struggling with severe shortages of food, medicine and other essentials. Fighting has blocked commercial and humanitarian supplies for more than three months, leaving thousands of civilians trapped amid intensified fighting.

More than 4,000 people have been forced to flee, further deepening the crisis.

Unprecedented humanitarian crisis

Beyond Jabal Awlia, the humanitarian disaster extends across Sudan, where millions are facing life-threatening conditions.

More than 24.6 million people – over half the population – are facing acute food insecurity, and the collapse of health services, the closure of schools and record levels of displacement have created an unprecedented crisis.

In the face of rising challenges, UNICEF called on all actors to urgently ensure unimpeded humanitarian access to deliver aid, the protection of hospitals and civilian infrastructure, as well as security guarantees for aid workers to ensure life-saving assistance can reach those in need.

“We will see a…real surge in this disease – [we] will see it come back, and we see people dying the way we saw them in the 90s and in 2000s,” said UNAIDS Executive Director Winnie Byanyima who noted a “tenfold increase” from the 600,000 AIDS-related deaths recorded globally in 2023.

“We also expect an additional 8.7 million new infections. At the last count, there were 1.3 million new infections globally [in] 2023”.

Speaking in Geneva, Ms. Byanyima noted that the funding freeze announced by the White House on 20 January was due to end next month, after a 90-day review.

“We have not heard of other governments pledging to fill the gap,” she told journalists.

Already, drop-in centres where HIV patients can pick up the anti-retroviral medicines they need are not reopening, “for fear that this might not be consistent with the new guidelines”, she maintained.

“This sudden withdrawal of US funding has led [to the closure] of many clinics, laying off of thousands of health workers. These are nurses, doctors, lab technicians, pharmacy workers…it’s a lot.”

Focus on Africa

Focusing on Africa – where the eastern and southern regions bear 53 per cent of the global HIV burden – Ms. Byanyima warned that closing drop-in centers for girls and young women without notice would be disastrous. She emphasized that more than 60 per cent of new infections on the continent are among girls and young women.

Speaking to UN News earlier this month, Susan Kasedde, head of the UNAIDS office in the Democratic Republic of the Congo (DRC), highlighted major uncertainties regarding the extent and scope of cuts to PEPFAR-led programmes. This initiative, launched over two decades ago by former US President George W. Bush to prevent and contain HIV infections, is estimated to have saved around 26 million lives.

There are currently around 520,000 people living with HIV in the DRC, including 300,000 women and 50,000 children. The epidemic continues to grow, as the number of new infections is almost double the number of deaths linked to the disease.

PEPFAR’s expected contribution for the 2025 fiscal year was due to be $105 million, and it aims to provide treatment to half of the population living with HIV in the DRC – some 209,000 people.

“This means that we currently have 440,000 people living with HIV who are on treatment. Thanks to this treatment, they are alive”, said Ms. Kasedde.

Global impact of cuts

Several other UN agencies that are heavily reliant on US funding have also warned that the cut in support – in addition to chronic under-investment in humanitarian work globally – is already having a serious impact on the communities they serve.

On Friday, the UN refugee agency, UNHCR, said that thousands have been left without lifesaving aid in the war-torn eastern DRC.

The UN International Organization for Migration (IOM) also announced that funding cuts have severe repercussions for vulnerable migrant communities, exacerbating humanitarian crises and undermining essential support systems for displaced populations.

Together with IOM, the UN Children’s Fund (UNICEF) warned last Friday that that the liquidity crunch has jeopardized lifesaving work, including progress in reducing child mortality, which has fallen by 60 per cent since 1990.

“It is reasonable for the United States to want to reduce its funding – over time. But the sudden withdrawal of lifesaving support is having a devastating impact across countries, particularly Africa, but even in Asia and Latin America,” said UNAIDS’ Ms. Byanyima.

“We urge for a reconsideration and an urgent restoration of services – life-saving services.”

Presidential appeal

In a direct appeal to President Donald Trump, the UNAIDS chief highlighted that, just as President Bush had introduced the groundbreaking PEPFAR initiative, the new White House incumbent could also be part of the “prevention revolution.” She pointed to a twice-yearly injectable drug that has shown great promise in preventing new HIV infections.

According to UNAIDS, approximately 40 million people globally live with HIV, based on 2023 data. Of this number, some 1.3 million became newly infected with HIV in the same year and 630,000 people died from AIDS-related illnesses.